Legislation would lower insurance for rural doctors

JEFFERSON CITY, Mo. -- A Southeast Missouri lawmaker is proposing legislation intended to lower medical malpractice insurance rates for rural doctors and encourage more of them to practice in the state's less populous counties.

The bill sponsored by state Rep. J.C. Kuessner, D-Eminence, aims to turn the expected impact of a separate measure to overhaul Missouri's civil litigation system into a boon for rural areas. Kuessner's bill would require insurers to calculate medical malpractice rates for doctors in third- and fourth-class counties, the state's smallest, separately from those for doctors in larger counties. Currently, rates are based on statewide malpractice liability.

The litigation bill is a priority of Republican Gov. Matt Blunt and the GOP majorities in the legislature. While it would apply to all types of lawsuits, Missouri doctors have been its most visible and vocal proponents. Many doctors claim expensive damage awards in cases involving medical error have caused their malpractice insurance rates to skyrocket, forcing some to scale back or quit their practices.

One provision of the bill, which is expected to pass, would require lawsuits to be filed in the county where an alleged injury occurred. Supporters say it would prevent cases from being steered to jurisdictions such as St. Louis and Kansas City where juries have plaintiff-friendly reputations.

Kuessner reasons that if a higher percentage of medical malpractice cases are going to be heard by more conservative rural juries, who presumably will be less generous than their urban counterparts, then rural doctors should get the benefit in the form of lower rates.

"The cheapest rates are now going to be in rural areas," Kuessner said. "That will be an incentive for doctors to come back to rural areas."

If doctors in high-demand -- and high-risk -- fields such as obstetrics knew they could pay substantially less for insurance by basing their practices in, say, Scott County rather than St. Louis city, they might be more inclined to locate in rural areas, Kuessner said.

The bill would apply to every county in Southeast Missouri expect for Cape Girar-deau, New Madrid and St. Francois.

State Rep. Terry Swinger, an optometrist and bill co-sponsor, said it makes sense for medical malpractice rates to be more reflective of claims filed in a particular area, just as is the case with car insurance.

"If we are going to quit venue shopping, we need to change how doctors' medical malpractice payments are based," said Swinger, D-Caruthersville.

The bill is HB 622.

mpowers@semissourian.com

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