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The Gazette
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Miller issues warning on medical malpractice
Earlier this month, the Medical Mutual Liability Insurance Society of Maryland refused a Senate commission's request for information about the company's request to raise doctors' premiums by 41 percent. Maryland Insurance Commissioner Alfred W. Redmer denied that request, but did approve an increase of 33 percent, based on actuarial evidence. "We need to look at a balance sheet, we need some information," Miller (D-Dist. 27) of Chesapeake Beach told The Gazette on Wednesday. "Without that information, I'm not sure how we can proceed with medmal reform." Miller strongly backed the call for a subpoena from Senate Judicial Proceedings Committee Chairman Brian E. Frosh (D-Dist. 16) of Bethesda, who chairs the medical malpractice commission that first requested the data from Med Mutual. In a letter dated Oct. 16, Med Mutual CEO David Murray called the commission's request for data about case histories, financial reserves and award payouts unrealistic and even inappropriate. If the senators have questions about Med Mutual's rate filing, Murray wrote, they should ask Redmer about it. A representative from Med Mutual declined to comment for this report. Frosh called the Oct. 16 letter "the most arrogant response I've seen in my entire career in the legislature" and wrote to both Miller and House Speaker Michael E. Busch (D-Dist. 30) of Annapolis seeking a subpoena. In backing Frosh, Miller also aired some hard feelings toward the insurance industry, which stem back to the defeat of his bill during this year's legislative session to create a People's Insurance Counsel. Miller compared the insurance lobbyists who fought that bill to the representatives from Medical Mutual who are refusing the commission's request. To issue a subpoena, however, Miller said he must have the support of the Legislative Policy Committee, which is made up of House and Senate leaders. House Speaker Michael E. Busch (D-Dist. 30) of Annapolis has not yet agreed to convene the committee, and on Thursday questioned whether a subpoena even falls under the policy committee's purview. Busch said Med Mutual made a terrible error in judgment and should have cooperated more -- including sending a representative to speak with members of the Senate commission in person rather than sending a written refusal. Busch said he understood the Senate president's call for a subpoena, particularly given the difference between the rate increase that Med Mutual requested and the increase that Redmer judged to be appropriate. "Why is there a 20 percent gap?" But the speaker stopped short of joining the call for a subpoena -- at least for now, and did not commit to calling a meeting of the policy committee. "I don't ever remember anyone being subpoenaed to Annapolis," he said, adding that he worries about subpoenas becoming a regular tool of governing in an increasingly partisan climate. Busch said he hopes that Med Mutual will remedy the situation by cooperating. If not, "maybe it will come down to a subpoena." Frosh said he still believes that a subpoena is necessary, and hopes to convince Busch of the same -- soon. As for using subpoenas in the course of governing, he said it is appropriate in some cases. "That's why the state has expressly authorized us to do it." In contrast to the wrangling over subpoenas, a bipartisan coalition of other lawmakers from both chambers rolled out an expansive reform proposal on Tuesday and called on Busch, Miller, and Gov. Robert L. Ehrlich, Jr. (R) to convene a special session to address the medical malpractice crisis. "We want to keep our eye on the ball, and the ball is that the people of Maryland do not have interruptions to their medical care," House Majority Leader Kumar P. Barve said at Anne Arundel Medical Center, where he appeared with other sponsors of the bill and members of the state medical society, which has endorsed the proposal. The proposal includes some elements of the bill that Ehrlich proposed last year, such as lowering the caps on awards for pain and suffering and calculating lost wages on a post-tax basis. Other proposals include limiting plaintiff attorneys' fees; requiring insurers to justify their reserve accounts; increased funding for patient safety and enacting an "apology law" to prevent patients from using statements made by a physician after a medical error against the physician in court. Other sponsors include Sen. John C. Astle (D-Dist. 30) of Annapolis, Del. Wade A. Kach (R-Dist. 5B) of Cockeysville, Del. John P. Donoghue (D-Dist. 2C) of Hagerstown, Sen. John J. Hafer (R-Dist. 1) of Frostburg and Del. Adrienne A. Jones (D-Dist. 10) of Woodstock, The bill also will provide for a "stop-loss fund," which would be used to subsidize large malpractice payouts in exchange for an agreement from insurers to freeze doctors' insurance premiums. Priced at roughly $20 million to $50 million, the stop-loss fund is perhaps the only reform on which lawmakers, the governor and the stakeholders have all forged some degree of consensus. So far, there has been no agreement on a funding source. The legislators who spoke at Tuesday's press conference said the intent of the expansive bill was to "frame" the discussion about reform. All stressed the need for Busch, Miller and Ehrlich to act quickly. Asked about Miller's call for a subpoena, Kach said he was unfamiliar with the details of the request, but hoped it would not be an obstacle to reform. "I hope this is not being used as an excuse to stall resolving this problem; obviously everyone accepts that there is a problem out there," Kach said, adding that he also hopes that Med Mutual will adopt a more conciliatory tone. "Here's my position," said Barve (D-Dist. 17) of Gaithersburg. "I think it would be great if both the insurance companies and trial attorneys were to divulge the details of their expenses. If we're going to have an open and fair investigation, we have to look into both sides." "There are factions here that think Med Mutual is the problem," Astle said. "They want to know about the reserves, and that's going to be part of the discussion. I know Med Mutual is reluctant to provide it because they think it could put them at a competitive disadvantage." As for a subpoena, Astle said, the insurance company is an easy target for opponents to tort reform. "The only way we'll find an answer is if everyone comes to the table," he said. |
