TAMPA - Florida is one of the two worst states in the nation for medical malpractice insurance costs, and last fall's reforms didn't go far enough, the president of the American Medical Association said during a visit Tuesday.
"Florida and Pennsylvania are the two states everybody's looking at for something worse to happen," said Dr. Donald Palmisano, a Louisiana surgeon who became president of the national doctors' group last June.
Something worse, in Palmisano's book, would be an incident that showed how rising malpractice insurance rates drive doctors to stop practicing medicine. What happens, he asked, if there's a school bus accident and no longer a practicing neurosurgeon in the area to treat injured children?
Palmisano discussed malpractice reform during an interview Tuesday. He also addressed the Hillsborough County Medical Association on Tuesday evening.
Palmisano is not apologetic for making malpractice reform the association's top legislative priority - ahead of, for instance, help for the nation's 43-million uninsured people. That's because soaring premiums are driving too many doctors out of practice, he said.
"It won't matter if you have insurance, it won't matter if you have prescription drug benefits, if you can't find a doctor," he said.
Not everyone agrees. Malpractice reform is "getting to be a tired old tune" for the AMA, said Debra Henley of the Academy of Florida Trial Lawyers.
Doctors need to give time for recent Florida reforms to work before pushing for more restrictions on the legal system, she said. Reforming insurance laws would be a more direct way to affect doctors' insurance rates, she said.
"In the eyes of patients injured by medical malpractice, the reforms go way too far," she said.
Florida lawmakers enacted several measures designed to lower doctors' malpractice insurance costs last year after a drawn-out, contentious debate between doctors, lawyers and politicians.
The new law limits jury awards for noneconomic damages, or those for pain and suffering, to $500,000 in most cases. In rare cases, those damages could go up to $2.5-million.
But so far, the reforms haven't lowered most doctors' insurance rates. They have lowered what Florida doctors would otherwise pay by about 8 percent, state insurance regulators said last fall.
That's because the new cap is too high, Palmisano said. A $250,000 cap - what doctors and Gov. Jeb Bush wanted - is needed, he said.
The Florida Medical Association is lobbying for more change: a constitutional amendment that would limit lawyers' share of what a jury awards to patients.
Palmisano says he doesn't want to hurt patient safety or keep patients who have genuinely been hurt from recovering damages. But he argues that lawsuits aren't the best way to improve safety.
"It's driven safety underground," he said of the high insurance rates. Doctors don't want to discuss mistakes for fear of being sued.
A better system, he said, would be one that encourages voluntary, confidential reporting of errors, similar to aviation, so that mistakes could be reviewed to look for causes and ways to prevent future errors.
