Panel hears 1st testimony on malpractice insurance

ORLANDO -- Doctors and lawyers squared off Monday before a governor-appointed task force that will recommend ways to halt skyrocketing malpractice insurance rates.

The meeting of the Select Task Force on Healthcare Professional Liability Insurance marked the first battle of what is expected to be a contentious fight pitting doctors and insurance companies against lawyers and consumer groups during the legislative session next year.

If the state government doesn't take some action, high insurance premiums "could begin to affect access to care and the health care of our citizens," Health Secretary John Agwunobi told the task force. Already, doctors say, the rates are causing some of their colleagues to flee the state.

During daylong testimony involving almost 40 witnesses, each side blamed the other for the rising premiums.

Doctors and insurance companies blamed lawsuit-happy lawyers for forcing insurance companies to raise rates, saying caps are needed on the amount of pain-and-suffering damages that juries can award patients.

Lawyers and consumer advocates blamed insurance companies for bad management, saying insurance reforms are needed.

Both sides agreed that it's not the first time Florida's 44,500 doctors are experiencing skyrocketing insurance premiums. They experienced similar crises in the mid-1970s and the mid-1980s.

But unlike in past years, doctors are unable to pass the increased cost of insurance onto patients because their fixed revenue is derived from managed care programs, Medicare and Medicaid, Robert E. White, chief operating officer of First Professionals Insurance Company Inc., said in written testimony.

Florida needs to follow the lead set by California 27 years ago to limit pain-and-suffering damages to $250,000, a change that would provide predictability to the liability insurance market, said Dr. Robert E. Cline, president of the Florida Medical Association.

"Specialists in California pay half of what specialists in Dade County pay," he said.

Cline added that doctors in obstetrics and emergency room care are leaving Florida in large numbers.

The association said its physicians have been hit with insurance premium increases of 25 percent to 400 percent.

It would like limits on expert witnesses who testify at malpractice trials, immunity against lawsuits for emergency room doctors and changes in the standard of proof for medical malpractice from a "preponderance of evidence" to "clear and convincing" evidence, Cline said.

But lawyers and consumer advocates argued that the increase in malpractice insurance rates is the result of the cyclical nature of the insurance industry and that the same "crisis" is occurring in all segments of the insurance industry.

So placing caps on damages will do nothing to lower insurance rates, they said.

During the 1990s, insurance companies kept rates artificially low as they tried to undercut rivals while profits soared from investments, said Joanne Doroshow, executive director of the Center for Justice and Democracy, a consumer advocacy group in New York.

Insurance rates went up when the economy started performing poorly and interest rates weakened, Doroshow said.

She advocates insurance reforms such as charging rates based on doctors' experience rather than their specialty areas and imposing stiffer sanctions against bad doctors.

"We're sympathetic with doctors," Doroshow said. "The solution to this has nothing to do with restricting patients' rights."

The task force must submit a report by Jan. 31. Two more public meetings are scheduled to be held before that deadline.

The task force is made up of John Hitt, president of the University of Central Florida; Marshall Criser Jr., former president of the University of Florida; Richard Beard, a trustee of the University of South Florida; Fred Gainous, president of Florida A&M University; and Donna Shalala, former president of the University of Miami and former U.S. secretary of Health and Human Services.

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