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Medical Malpractice Insurers: Time to End Their License to Gouge

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In 1945, Congress gave the massively powerful insurance industry an astonishing gift. It bestowed on them the freedom to do what would be illegal in every other industry (save, strangely, Major League Baseball) -- fix-prices, collude and practice anti-competitive behavior. Now there's a movement afoot to repeal this extraordinary law, called the McCarran-Ferguson Act, which Senate Majority Leader Harry Reid (D-NV) testified recently, "has been damaging to the American economy."

All this begs an important question, though -- did no one notice before? Was this extraordinary privilege, granted over 60 years ago, buried in an obscure volume of the federal code that we are just now discovering? Well, no. Actually, consumer advocates have been noticing it for a long time. Clearly, it's taken the movement to reform health care to finally put it on people's radar. But the lack of notice until now hasn't been for lack of trying.

Laws to repeal this anti-trust exemption have been introduced in every Congress for many years. The industry has fought back every time and nothing was ever really accomplished -- until now. Now that affordable health insurance has become the driving force behind repeal of this law, it's getting somewhere. Bills exist in both Houses of Congress and are beginning to be reported out of committee faster than you can say "price-fix."

But the McCarran-Ferguson Act covers a few different sectors of the insurance industry, and health is just one of them. Another significant sector is property/casualty. That's the sector that covers all liability insurance -- your auto insurance, homeowners policies, and commercial lines, as well. The insurance that doctors purchase to cover medical malpractice is part of this property/casualty sector.

For years now, doctors have been screaming about their medical malpractice insurance rates. But organized medicine and insurance executives always blame everyone else for charging doctors' exorbitant rates. They especially like to point the finger at judges, juries, and injured patients, blaming them for insurers' decisions to raise rates even though claims and payouts have dropped like a rock over the last several years. That doesn't seem to matter. They still tell lawmakers that the only way to bring rates under control is to strip away patients' rights to go to court.

We are hearing about that now, as the push for so-called "tort reform" has become part of the health care discussion. Sick and injured patients, after all, are the perfect insurance industry scapegoats. Even President Obama is talking about it, directing HHS to set up a panel to explore "tort reform" ideas, which met for the first time on October 26. But consumer advocates have always known that limiting the legal rights of patients is no answer, and that the insurance industry itself is responsible for the price-gouging of doctors. The anti-trust exemption, which leads to skyrocketing rates and profiteering within the property/casualty insurance sector, allows this to happen.

It's fascinating to watch the insurance industry try to justify 60 years of anti-competitive behavior. The medical malpractice insurers are doing their best, that's for sure. They want medical malpractice "removed from the bill," according to insurance lobbyist Larry Smarr, president of the Physician Insurers Association of America, who testified that "market conduct abuses" never happen in the medical liability industry, and that repealing the most anti-competitive law in the nation would, in his words, "undermine competition."

Whatever their tactic and latest form of utterly absurd double speak, it's crucial that when Congress does repeal the McCarran-Ferguson Act, the medical malpractice industry is not left out. The Consumer Federation of America predicts that repealing this law for medical malpractice insurers could result in a 20 percent insurance savings for doctors.

Let's finally see what happens once the industry is prevented from colluding and price-fixing, once insurer-supported "rate bureaus" that tell insurers what rates to charge are outlawed, and when the pressure to take away the right of injured patients is diminished. Maybe, finally, people will understand that it's not only unfair, but also ineffective, to try to reform insurance abuses on the backs of malpractice victims. When it comes to real health care reform, that seems like a good place to start.

 
 
 
 
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11:32 AM on 10/28/2009
Unfortunately for your readers , you place med mal insurers with the healthcare insurers. Although they both fall into McCarron- ferguson. The med mal companies cant manipulate the system like HC. They dont protect their feifdoms as BCBS does. There is plenty of competition amongst professional liability carriers, that is why the premiums keep dropping- 5 years in a row in Florida. Different with Healthcare with fake competition.

There is plenty of competition to sell professional liability insurance via domestic and foreign carriers. In Florida, there are more than 20 companies here, and maybe a half dozen HC carriers. Most states will allow any viable carrier to provide coverage for doctors. It is good for the people.

There isnt the money to be made with PL carriers compared to HC companies, the US healthcares, Aetnas and Humanas . The similarities couldnt be more different. Let us see what happens when there is true competition with HC companies, and how rates are affected. It is the HC lobby that is the largest in the country, not the med mal lobby. It is the $2.5 trillion up for grabs, and the 35% overhead that the lobbists are trying to protect- Just translate what Sen lieberman is saying" I was elected by the people to represent the insurance companies." Or Sen. Max Baucus , that wrote the 1st draft of the reform bill. Did that draft sound like it benefitted us or them?

Jim O'Hare VP MED mal claims PIC FL
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Joanne Doroshow
Executive Director, Center for Justice & Democracy
09:38 AM on 10/29/2009
Insurance is a cyclical business. We are in a soft insurance market now. Rates have stabilized for all lines of insurance, coming off a brutal hard market period when rates around the country suddenly shot up for reasons having nothing to do with lawsuits or claims. During hard market periods, when rates start to rise like this, med mal insurers base prices on what rating bureaus (ISO or Insurance Services Office) tell them to charge, allowing industry-wide collusion. For all other industries, this kind of activity is illegal and executives can go to jail for engaging in it.
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littleblackcat
04:38 PM on 10/27/2009
Where do we all sign up on a gargantuan petition to eliminate this goody that has been enjoyed by the insurance companies all these years?
One good thing that may come out of all this is that the average person might get the picture that if you don't want some yahoo writing the rules for you, you had better pay attention to what is going on in politics, local and national. Speak up or someone else will do your talking for you, or will tell you eventually what you may or may not say.
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Fireslayer
11:59 AM on 10/27/2009
As a retired (or "recovering") trial lawyer who has successfully sued and defended doctors I acknowledge I am largely a traitor to the second oldest profession.

Medical malpractice for mere negligence should be eliminated or replaced by a workers comp system but only for public health based professionals and caregivers.

There should be two health care systems and 2 tracks for the legal aspects., One being a robust public option whereby most compensatory damages in a malpractice lawsuit related to remedial treatments are already built into the system. A commission of professional peers can determine liability and one of patient peers can determine economic and pain related losses.

The other is the otherwise mythic free enterprise approach. I oppose insurance reform or regulation in the event of a robust public option. Let the greedy bastards in the insurance industry function as is their wont. Then see where people seek coverage. For those dogmatic doctors who prey on the ignorant or specialize in diseases of the rich, well let 'em sue the bastards. Freedom is not free, I believe the right wing ideologues are fond of saying.

My motivations for not supporting Medicare for all and currently liking opt-out public option are based in pure meaness. Republicans and those with the poor taste to live in a Red state should pay 30% plus for their health coverage and be subject to arbitrary cancellation etc..

Republicans should have their end of life discussions with insurance adjusters and not doctors.
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littleblackcat
04:33 PM on 10/27/2009
Tongue-in-cheek, I presume?
11:53 AM on 10/27/2009
Agreed! But we could also reduce errors in the first place by creating a simple public-private open-source HIT process to answer the Brookings Institute (http://www.brookings.edu/reports/2009/0901_btc.aspx) and IT naysayers. By using the finest physicians, scientists and evidence based-medicine from around the world to come up with “Best Medical Practices” interactive-electronic-medical-workbooks using:
XML (http://en.wikipedia.org/wiki/XML) ,
XML schema (http://en.wikipedia.org/wiki/XML_schema) ,
XForms (http://en.wikipedia.org/wiki/Xforms),
Dita (http://en.wikipedia.org/wiki/Darwin_Information_Typing_Architecture) and
web-services (http://en.wikipedia.org/wiki/Web_service)
(savings Director Orszag's 700b, no medical errors) which are IETM Class V compliant documents (http://en.wikipedia.org/wiki/IETM) that when filled out are checked for accuracy and completeness in real-time and saved to a third-party (local telecom, savings malpractice 100b). The workbooks are created, maintained and continuously updated (always learning) by the regional Health Information Technology Research Centers, CDC, NIH, FDA and HHS in conjunction with the Healthcare Industry to provide an effectivity rating for the different treatments, the ability to produce a prognosis and cost of treatment in real-time. Senator Sanders 400b in administration costs would be greatly reduced because the forms are already filled out and there's nothing to deny. DOD for their interactive-electronic-training-manuals are already using these technologies the CBO can score the savings.