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By Catherine Dolinski
From Gazette.net
November 23, 2004
ANNAPOLIS -- Doctors converged on the capital again last week to
loudly plead for relief from surging malpractice premiums. But by
the end of the week, the three men who could make that happen said
there is still no consensus on a reform plan. Prospects for a
special session on the issue remain anyone's guess.
Gov. Robert L. Ehrlich Jr. characterized his hour-plus discussion
with House Speaker Michael E. Busch and Senate President Thomas V.
Mike Miller Jr. on Nov. 18 as "very tense." While prospects for a
special session to address the malpractice issue are growing, he
said, he is still not overly optimistic.
"The tense atmosphere pertains to the fact that, in order to get a
bill like this done, there must be compromise," Ehrlich (R) said,
adding that he will submit a revised proposal to Busch and Miller
sometime next week.
The proposal will combine tort reforms and other measures intended
to stop or at least slow the recent spike in medical malpractice
insurance premiums, which many doctors say could drive them out of
business if not addressed soon.
Among the few reforms on which Ehrlich, Busch and Miller agree is
the creation of a so-called stop-loss fund, which the state would
create to subsidize large malpractice award payouts in exchange for
an agreement by insurers to freeze doctors' rates. But by all three
leaders' accounts, how to pay for the fund remains a major snag in
negotiations.
Busch and Miller have agreed that lifting the 2 percent tax
exemption on HMO premiums is the best way to pay for the fund, but
Ehrlich said he has made it clear he does not want a premium tax.
He disputed reports that he wants to use general funds to pay for
the stop-loss fund, projected to need $50 million.
"That, in fact, is not the case," the governor said, adding later
that "we do have [a funding source] and it's not the HMO tax."
"If it's not the HMO tax, then tell us what it is," said Busch
(D-Dist. 30) of Annapolis. "Is it a tobacco tax? Is it a fee of some
sort?"
Busch said that if the governor does not include a specific funding
mechanism in his proposal, "there's no sense in even talking about a
special session."
The speaker, who has already collected the petition signatures
necessary to call a special session with Miller instead of waiting
for the governor, stressed that the House is ready to go into
session at any time. "We're on board," he said.
While time is running short to call a special session before the end
of the year, time is running even shorter for doctors whose premiums
are due on Dec. 1. Premiums are increasing by 33 percent on average
for most doctors, many of whom say they are on the cusp of deciding
whether to close or downsize their practices.
On Nov. 17, a coalition of doctors called Save Our Doctors, Protect
Our Patients, lined Lawyers Mall to call for an immediate special
session and drive home their argument that the malpractice situation
will create an access to health care crisis.
"When are you guys going to get to work?" said Carol Ritter, an
obstetrician-gynecologist from Baltimore County, addressing her
remarks to legislative leaders. "We needed a special session
yesterday. We need you to get to work so that we can get back to
work."
The rally was followed a few hours later by a meeting of the Senate
commission on medical malpractice, which deliberated on a range of
patient safety provisions as well as the creation of either a
stop-loss fund or premium subsidy for doctors.
The recommendations included stronger reporting laws on bad doctors
and adverse medical outcomes, plus expanding the authority of
agencies that oversee the discipline of doctors who make medical
errors. The Senate commission will meet again Dec. 1 when it will
present its final recommendations for a bill on tort reform, patient
safety and insurance reform.
The apparent slow progress toward a special session fired up the
doctors who converged on Annapolis last week.
"There are individual doctors making decisions now," said John
Caruso, a neurosurgeon in Hagerstown. "We need a special session by
Dec. 1."
Miller (D-Dist. 27) of Chesapeake Beach said "incremental progress"
is being made toward a final bill, though he remained cautious on
the subject of a special session.
Miller said he, Busch and Ehrlich have agreed so far on a few areas
of reform, such as mandatory mediation and granting hospitals
increased authority to deal with doctors who have multiple
malpractice claims filed against them. But with the Senate
commission not yet finished with its work, Miller was reluctant to
commit to many, if any, tort reforms yet.
The three leaders also differed on when they would meet next --
which may or may not include a meeting Wednesday as well as on Dec.
1.
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