LETTERS TO THE EDITOR

THE BALTIMORE SUN

A new approach could safeguard doctors, patients

The solution to the medical malpractice crisis lies in the model provided by the workers' compensation system.

The patchwork of "solutions" that I have seen thus far are all minor, temporary fixes that may result in lower malpractice insurance premiums, but would do nothing to correct the basic inequities in the system ("Special session puts pressure on lawmakers and governor," Dec. 27).

Caps on damage awards and lawyers' fees are similar to putting Band-Aids on a trauma patient in the emergency room. This may be quick and easy, and the patient may stop bleeding temporarily, but he will die because what he really needs is major surgery.

Before workers' compensation legislation was enacted, employees with minor injuries received no medical care or wages while they were unable to work. They were forced to sue their employer and prove negligence to receive benefits. Frequently attorneys would not take smaller cases, leaving these workers on their own.

On the other side of the ledger, there were runaway, big-dollar cases with devastating effects on some employers.

Given the obvious unfairness of this situation, workers' compensation commissions were formed to protect both employees and employers.

Under this system, all injured workers received medical care and wages according to a fee schedule without needing to sue, and the employer's liability insurance premiums dropped dramatically. Attorneys usually are not involved but can be called in when there is a dispute over coverage.

While it is not a perfect system, at this point, few people other than trial attorneys would change it.

As physicians and patients we now find ourselves in a similar position. Many patients with injuries are not compensated either because they don't want to sue their physicians or can't find an attorney to do so because their claim is too small.

Patients should not be put in this position. If an injury occurs, a patient deserves fair compensation without having to prove fault or malpractice.

On the other hand, a physician should not face the threat of a devastating lawsuit every time he or she treats a patient, or be forced to pay outrageous insurance premiums.

The medical malpractice system doesn't need to be changed. It needs to be completely scrapped and replaced with one based on the workers' compensation system.

Dr. Henry A. Spindler

Columbia

Liability isn't cause of high medical costs

The Sun's article "Medical liability target of GOP push" (Dec. 25) highlights that this issue is mainly a partisan political argument, and part of the GOP's long agenda related to deregulation, privatization, tort reform and free markets.

But high malpractice insurance premiums are not a reason for the high cost of health care; rather, they reflect the high cost of health-care technologies of the 21st century, and are a function of it.

High health-care costs are one of the reasons the medical consumer expects a satisfactory result -- and when that doesn't happen, we expect that someone must pay and pay big: the doctor, the hospital or the insurer.

But let's look at what underlies inflation and the escalation of health-care costs and not blame the crash on the speedometer.

J. Russell Tyldesley

Catonsville

Give Ehrlich credit for taking on lawyers

The Sun made some valid points in its editorial "The malpractice plan" (Dec. 24). I disagree, however, with its criticism of Gov. Robert L. Ehrlich Jr., as I believe his battle in this war has been a frustrating, uphill battle with a state Senate saturated in plaintiff attorneys' dollars.

It's funny how the lawyers never seem to give up anything, even as they hide behind the poor and injured.

But when this crisis really hits, and doctors retire, relocate or reduce their practices, our elected officials will pay the price when they come up for re-election.

Dr. Christos M. Ballas

Finksburg

Conservatives lack empathy for victims

Like so many Republican causes, the issue of medical malpractice insurance "reform" boils down to conservatives seemingly compulsive inability to put themselves in other people's shoes ("Special session puts pressure on lawmakers and governor," Dec. 27).

How many of them would think limits on malpractice damage awards were such a wonderful idea if they or one of their loved ones were permanently injured by a botched medical procedure by an incompetent doctor?

Joe Roman

Baltimore

Make insurers show need for price hikes

There is no question that the cost of medical malpractice insurance for physicians has surpassed crisis proportions ("Special session puts pressure on lawmakers and governor," Dec. 27). It is unclear, however, whether the exponential rise in the cost of malpractice insurance is the result of "runaway juries," price-gouging by the insurance carriers or the unsound investments the insurers made in the stock market boom of the late 1990s.

With the present anti-lawsuit propaganda spurred by the Bush administration and the conservative media, I question whether there really has been a growth in jury awards that would correspond to the rise in the insurance rates.

In this political climate, CEOs of an unregulated industry are free to fatten themselves at the expense of the public good.

Before we further limit compensation to victims of malpractice, the insurance companies should be required to open their books to state insurance regulators and show how much they have paid for malpractice claims and other expenses balanced against their income from premiums and investments.

Perhaps the malpractice insurer carriers are justified in raising their rates, but they should be required to show this rather than being allowed to raise rates at will.

Alan Cohen

Baltimore

How slots can solve the health-care crisis

As a retiring surgeon I have thought a lot about the medical liability crisis in Maryland -- and indeed one of the reasons for my retirement at this time is the 100-percent increase in my malpractice premium for 2005.

The causes of the crisis are complicated and multifaceted. Also, the costs of maintaining a practice of medicine continue to rise while reimbursements are strictly controlled.

Physicians need alternative sources of income to keep our practices viable.

So forget the racetracks. We need slot machines in our doctors' offices.

Patients complain of the long wait and the old magazines in our waiting rooms.

Let's make the waiting time more enjoyable, and at the same time provide income for the doctors.

Dr. John A. Singer

Baltimore

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