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OpinionFebruary 6, 2003

It's a bit alarming to hear doctors say their practices -- and, therefore, access to quality health care -- are being threatened by the cost of swelling medical malpractice insurance. The health-care industry is clearly worried. Twelve states are considered to be in a crisis. And 31 others, including Missouri, have serious problems with malpractice insurance...

It's a bit alarming to hear doctors say their practices -- and, therefore, access to quality health care -- are being threatened by the cost of swelling medical malpractice insurance.

The health-care industry is clearly worried. Twelve states are considered to be in a crisis. And 31 others, including Missouri, have serious problems with malpractice insurance.

The 2002 malpractice insurance rates reported by doctors ranged from $8,000 a year for psychiatry to more than $60,000 for neurosurgery, which is considered a higher-risk specialty.

Doctors say that's too high.

High premiums are causing doctors to abandon higher-risk specialties. New physicians are reluctant to go into those specialties or avoid states with higher premiums.

By way of protest, some doctors in Florida, Mississippi and West Virginia have stopped patient services. In New Jersey, doctors have threatened to boycott non-emergency services.

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Missouri doctors are also feeling the pinch. There are instances in Cape Girardeau of doctors who used to deliver babies but have stopped because providing that particular service pushes up malpractice insurance rates. A doctor in Poplar Bluff, Mo., recently closed up shop because she could no longer afford the premiums.

More than 500 doctors and medical students swarmed on the Capitol in Jefferson City recently to urge legislators to do something to reduce personal-injury lawsuits. That is the culprit, they say, behind escalating premiums.

They showed up armed with ideas. The Missouri Medical Association is supporting two bills that would revise the laws that govern liability lawsuits. A main provision of each bill would reduce the maximum amount in punitive damages that juries could award plaintiffs in medical malpractice suits. The Missouri Legislature is said to hold this as a priority this year.

President Bush also wants to crack down on frivolous lawsuits and favors setting a $250,000 cap on awards for pain-and-suffering damages.

There's some opposition, however. Democrats, including Gov. Bob Holden, and attorneys who represent plaintiffs in tort cases, say that it's the insurance cycle and bad investments made by the insurance companies that are driving up rates.

Often lost in the argument is that all of this affects patients too. Doctors admit sometimes they may go overboard in ordering unnecessary tests out of fear of lawsuits. Those tests aren't free or even cheap.

No one denies it's a problem. Pointing fingers will not resolve the issue facing Missouri and other states. Negotiations tempered with compromises, along with legislative action, will be important in dealing with the problem and making sure there is quality health care for all.

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