Emerson hears local health care concerns

Skyrocketing malpractice insurance, tort reform and decreasing Medicare payments are the top health-care concerns, according to about 40 local doctors and other health care officials who attended a Wednesday morning health-care roundtable hosted by U.S. Rep. Jo Ann Emerson.

"We have to look at the big picture," said Emerson, who has hosted seven such meetings across Southeast Missouri. "We have a crisis in health care and most people agree it could hurt patients' access to health care if doctors are going elsewhere, especially in rural Missouri."

Doctors complained that malpractice insurance has doubled for some of them, despite the fact that lawsuit claims against them have either decreased or stayed the same. Another problem, Emerson said, is that while the cost of providing medical care has risen for doctors, the amount they get reimbursed for by Medicare has dropped significantly.

'We have to fight'

"Hospitals and doctors have to eat the costs they don't get back from Medicare," she said. "We have to fight this at the state and federal level."

Emerson said the House passed a tort reform bill based on legislation in California, but it was defeated in the Senate. She expects to take that fight back to the House soon, she said.

Doctors are passionate about the issue.

Stanley Sides, a blood and cancer specialist with Cape Girardeau Physician Associates, said his group's malpractice insurance increased 34 percent -- or $80,000 -- over last year. That's not as bad as some obstetricians in town, he said. He's heard that one doctor's insurance doubled to $150,000.

"So we don't even know why ours is up like that," he said. "We're very low-risk with no surgery."

Decreasing Medicare

While that is happening, his group suffered a 4.4 percent decrease in Medicare reimbursements. If that keeps happening, patients will have access to health care limited.

"My personal concern is going to be the poor, the uninsured, the people on Medicaid, those people are going to suffer," Sides said. "Doctors just won't see them or won't be able to participate in helping them."

Bill Kapp, an orthopedic surgeon, said he believes the problem with malpractice insurance is that Missouri doctors are helping subsidize losses felt in other states with higher claims.

"Our claims haven't gone up, but we're seeing a 50 to 100 percent increase, on top of a 30 percent increase last year," said Kapp, who helped organize Wednesday's event. "It's coming to a head."

Kapp said in Missouri, the cap on lawsuits is set at $500,000 for non-economic damages -- like pain and suffering -- and a punitive cap is $250,000. The problem, he said, is that litigants can sue as many doctors who were involved, regardless if the involvement is minimal.

"Someone can show up in the ER with a problem, he recognizes it and sends it to someone else and the patient can sue everybody who he came into contact with," Kapp said. "It doesn't matter if it's negligence on the patient's part, they're suing everybody."

Kapp also likes the California model, which was adopted in 1975. There are no caps on economic damages, but there is a cap on punitive and non-economic damages and there is a limit on joint liability.

"If a person is 1 percent at fault, he pays 1 percent of the bill," Kapp said. "They can't go looking for the deepest pockets in the room."

The California law also puts a time limit on liability of two years. A doctor is responsible for a child until age 19 in Missouri, and in California that is limited to eight years. That means doctors who deliver babies can only be sued if something goes wrong with a child to that age.

"Something has to happen," Kapp said.

smoyers@semissourian.com

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