Letters to the Editors

Frivolous suits threaten quality of our health care

Doctors are leaving the state of Florida due to the unaffordable medical malpractice insurance. Insurance rates are skyrocketing due to a civil justice crisis in Florida manifested by an abundance of frivolous lawsuits filed by unscrupulous personal injury attorneys. The problem has become so bad that the Florida Medical Association is keeping track of doctors leaving the state.

Last spring, I was profiled by your paper as one physician who is seriously considering leaving the state due to the crisis. I am a neurosurgeon who treats patients with highly complicated brain and spine disease. My insurance rates have nearly doubled despite the fact that I have never had a civil settlement or jury award against me.

I returned to my hometown, St. Petersburg, two years ago to practice medicine. I am a success story for the state's higher education system: I attended St. Petersburg Junior College and the University of South Florida as an undergraduate and medical student. By returning to Florida, I am providing care to the citizens of the state that helped educate me. I routinely provide free medical care to those with no insurance and discount service to those with Medicaid and Medicare.

I entered medicine to care for patients and I enjoy doing so. Sometimes there are bad outcomes. That is the nature of the human condition: not everyone gets better and sometimes people get worse. In very few cases does a bad outcome indicate that any error occurred. Despite this, according to national statistics, I will be sued every two years. I have a simple economic decision to make in one or two years. If I can afford insurance, I will stay. If I cannot, I will have no choice but to leave the state to work elsewhere. The state that helped educate me will no longer benefit from the dollars spent subsidizing my state tuition.

For now I choose to stay and fight. I will be fighting the industry that has eroded medical care throughout the nation: the personal injury industry built by trial attorneys. Their lawsuits have little to do with "defending the little guy" or "improving medical care." Their suits are about making money for themselves. For those lawyers who would deny it, ask them if they will take a case when there is no insurance money to go after or no deep pocket to pick.

I know that if I leave, Florida residents will have less access to care. When they need emergency brain or spine surgery, there may not be a neurosurgeon at their hospital. During the transfer to another hospital, they may suffer irreversible brain or spinal cord injury. I do not want citizens in this state to lose access to care, so for now I choose to stay and fight. I want to be on the list of physicians who defended medical care for patients and not the list of physicians forced out by the personal injury industry.
-- David McKalip, M.D., St. Petersburg

The real problem is with insurance

Re: Malpractice insurance crisis hits home, Aug. 17.

The headline should emphasize that this is an "insurance" crisis. In Florida, we have been the recipients of so-called medical malpractice reforms in the 1970s and 1980s. Then, Miami obstetricians threatened to close shop because of exorbitant medical malpractice insurance premiums.

The propaganda then, and now, is identical. "We must put a stop to the increasing number of claims and huge, runaway-jury awards, greedy plaintiffs (patients) and frivolous lawsuits." The available evidence, however, does not support these myths.

In every state where so-called medical malpractice reforms have been implemented, there has not been a corresponding reduction in medical malpractice insurance premiums. Such reforms did not obligate the insurance industry to reduce premiums.

Experienced medical malpractice attorneys do not pursue frivolous medical malpractice suits. These cases are extremely complex, challenging, time-consuming and extraordinarily expensive. In Florida, before being able to bring suit, you must have an under-oath statement by a doctor that the case has merit. The burden at trial is a rightfully heavy one, requiring that the patient prove the doctor negligent and that negligence, more likely than not, caused the patient's injuries or death. Failures in proof to the satisfaction of either the judge or the jury more often favor the health care profession.

While there have been (and currently are) laws that provide significant sanctions against patients and their attorneys should they pursue meritless and frivolous court claims, the media -- with some exceptions -- generally do not find newsworthy medical malpractice cases that result in no jury award whatsoever. The "huge" jury awards are rendered because six to 12 fine citizens have heard all the evidence and determined that the catastrophically injured patient is so entitled.

The solution? It is not medical malpractice "reform." Imposing arbitrary caps on patients' potential financial recovery operates to immunize those responsible and works a discriminatory social injustice to those patients who are the most seriously injured and inalterably disabled.

But what can or should be done? Doctors, hospitals and consumers/patients should demand Congress and state legislators immediately convene investigation into the merits of this so-called "crisis." Specifically, they should investigate whether the medical malpractice insurers are engaged in a boycott (more than 40 insurers have pulled out of Florida) or conspiratorial coercion in the face of stock market losses versus paid claims. Why? The insurance industry is exempt from antitrust laws under the McCarren-Ferguson Act. The time has come to consider removing this exemption and force the insurance industry's accountability for what appears to be predatory underwriting and profit engineering scare tactics, crippling the public health, safety and welfare.

We do not need medical malpractice reform. What we need is health care reform and insurance industry practices reform.
-- Roy L. Glass, medical malpractice attorney, St. Petersburg

Questions for the insurance industry

Recent articles in the St. Petersburg Times have focused on the twin crises we find ourselves facing: the so-called medical malpractice crisis and the crisis facing plain folks looking for reasonably priced homeowners coverage.

What have we, as ordinary citizens, done to bring about this situation? It is a fact, after all, that some doctors do injure and even kill their patients. It is also a fact that nature's winds and waters cause property damage. Why blame the weather or the lawyers?

Doctors and homeowners are willing to pay reasonable premiums for necessary protection. Neither are willing nor can they afford to pay insurance premiums that are clearly unaccountably high.

As a justification, we are told that the insurance companies are losing money under present premium rate schedules. If they are indeed losing money, the question becomes "Why?" Considering the importance of insurance, are we not entitled to know the facts? What documentary evidence exists in insurance companies' files supporting such increases? What happened to the surpluses acquired during the profitable years? What failed investment strategies contributed to the problem?

Over the years, crying "crisis" has been a very successful scheme in raising the cost of insurance. Unfortunately, it has also caused doctors to war against their own patients and the lawyers representing them. It has also caused the ordinary citizen to consider rejecting any insurance and going "bare," not in the best interest of the individual or the community.

One wonders whether cooked books and grossly overpaid executive salaries have anything to do with the problem.
-- Guy N. Perenich, Clearwater

There are too many uninsured people

Re: Health insurance woes, letter, Sept. 8.

I just finished reading this letter. My wife, through no fault of hers, is one of the 40-million uninsured that the writer mentions.

In January of this past year, the company she was with decided not to write policies in the state of Florida. She has tried unsuccessfully to obtain insurance to no avail. Some of the questions asked by insurance companies include, "Have you ever been to a doctor?" What person over 55 could say no? In my wife's case she had a doppler test for the carotid artery, and the results were negative, but when they send for the doctor's records this shows up and they deny her the insurance. One agent said, we only want to insure healthy people.

My wife has a cousin up north who has severe arthritis but had no trouble obtaining insurance without doctor's records or home interviews. Does this policy change from state to state? As we all know, there are a lot of us seniors living here and some are without insurance. I think the powers that be should investigate this practice. A country like this should never have that amount of people uninsured. When a national health plan is brought up, our leaders cry out, socialism. They are the same representatives who have full medical coverage for themselves and their families for as long as they live.

Another practice that should be outlawed is the one where you pay an administration fee from $25 to $40 plus the first month's fee. When you are notified that they don't want to insure you, they send the premium back minus the administration cost. They make some money even when they don't approve you. I think this practice should be stopped.

Is there anyone in our Florida government looking into the number of people living in this state who are uninsured?
Jack Joyce, Spring Hill

Our humanitarian Floridians

Re: This lady is my angel, Aug. 29.

The Times should have put this touching article on the front page of its main section. It is a superb example that makes one proud of our humanitarian Floridians of which Sheila Bolden-Foy is No. 1!

Her last patient in the Times article, a World War II U.S. fighter pilot, said of Mrs. Bolden-Foy: "You're the best thing that ever happened to America." I agree 100 percent. I'm sure there are many more like Mrs. Bolden-Foy in Florida that deserve public recognition in the near future.
-- Peter Hlinka, St. Petersburg

Dispensing love and joy

For years I've watched these precious aides as they toil for hospice and our beloved patients. Your story on Aug. 29 showed Sheila Bolden-Foy's radiance as she dispenses love and joy in her work. Your reporter also caught the powerful love she received from her patients. These aides are the very heart and soul of hospice. Thank you for honoring them.

Praise, too, for Dirk Shadd's stunning photos, from a hospice volunteer who learns from them at each opportunity.
-- Dorothy Lecain, Palm Harbor

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