March 2003 • Volume 9 • Number 3 |
About one-third of all states are in a liability coverage crisis, estimates the AAFP Division of Government Relations. And as the crisis squeezes family physicians, constituent chapters are taking action.
Tort reform is a legislative priority for 33 chapters -- some in crisis and some acting to prevent a crisis. The AAFP is assisting them with information, for example, on the benefits of the Medical Injury Compensation Reform Act California passed in 1976.
Speak out!It's easy to send your U.S. representative good arguments for cosponsoring an AAFP-endorsed tort reform bill. The legislation was passed last year by the House, was not considered by the Senate, and now has been reintroduced in the House. The bill is known by its acronym, the HEALTH Act -- the Help Efficient, Accessible, Low-Cost, Timely Health Care Act, H.R. 5. The more cosponsors the bill gains, the more likely its passage. Go to Speak Out: AAFP Legislative Action Center at http://capitol.aafp.org/. Under "Action Alert!" open "HR 5 addresses professional liability insurance reforms." Proceed as directed to e-mail a message asking your representative to cosponsor the HEALTH Act. |
The AAFP is also championing legislation that passed the U.S. House of Representatives last year and was reintroduced last month. The Help Efficient, Accessible, Low-Cost, Timely Health Care Act would mandate reforms in all states' professional liability systems (see box below).
"It is time to act nationally on the threat to patient access to care posed by liability premium increases," said AAFP President James Martin, M.D., of San Antonio in a Feb. 6 statement on behalf of the HEALTH Act.
However, success on the federal front is by no means assured, even though President Bush has endorsed medical liability reform. Last year, the Senate failed to consider the HEALTH Act.
AAFP chapters are enlisting their members not only in federal lobbying but also in brass-knuckle local politics.
In Ohio, the legislature passed sweeping tort reform in 1996, only to have the law thrown off the books three years later by the state's Supreme Court. The Ohio AFP and other groups worked successfully last fall to help two Supreme Court justices sympathetic to tort reform win election.
Ohio AFP Executive Vice President Ann Spicer said the OAFP invited the candidates to speak at the chapter's annual meeting, repeatedly talked about the race in newsletters, and posted material on the chapter's Web site for doctors to download and give to patients. When the justices were elected, Spicer said, one put in her acceptance speech that "medicine had made the difference.''
"We like to say that we awakened a sleeping giant as far as the house of medicine goes," Spicer said. "I think that physicians in Ohio feel really empowered. ... I think they were amazed at the success they had."
In Texas, the Texas AFP featured the liability crisis on the cover of its magazine, Texas Family Physician; surveyed members; made medical liability reform its No. 1 legislative priority; and joined the Texas Alliance for Patient Access, which is pushing for reform.
Tom Banning, Texas AFP director of legislative and public affairs, said the issues center on the affordability and availability of insurance policies. "I think we had 18 or 19 liability carriers two years ago. We now have four in the state," Banning said. "You've got a system where you're either driving the insurance carriers out of the state or they're increasing their premiums to levels that are simply unsustainable for the physician."
The Georgia AFP has been encouraged by the recent appointment of FP Donald Thomas, M.D., of Dalton as chair of the state Senate Health and Human Services Committee. Thomas, a Republican, supports what in Georgia is being called civil justice reform.
"It's huge,'' Georgia AFP Executive Director Fay Fulton said of Thomas' appointment. "Legislators will cross party lines to discuss medical issues with the doctors who are elected officials.''
In Florida last month, Florida chapter EVP Tad Fisher was putting together an information kit for doctors. It included a "10 minutes a week'' initiative, encouraging doctors to spend that time sending an e-mail, making a phone call or talking to a patient about the crisis.
Fisher said FPs were particularly hard hit because of the capitation of their fees and managed care. "There's nowhere for a physician in this day and age to spread the cost," he said. "So you're looking down the barrel of 'Do I stay open? Do I fire my staff? Do I eliminate services that are risky? Do I eliminate patients who are considered risky?'''
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Copyright © 2003 by
American Academy of Family Physicians.