Is the physician crisis real, or is Ohio a battleground?

To hear doctors tell it, the cost of malpractice insurance in Ohio has risen so sharply, the practice of medicine as we know it may cease to exist -- or will, at the very least, undergo dramatic change.
On the other hand, lawyers who represent patients in malpractice lawsuits accuse doctors of exaggerating the problem to force state legislatures and the United States Congress to pass laws that would cap monetary awards by juries for the pain and suffering inflicted by negligent practitioners.
And then there are the insurance companies. They contend that the rise in premiums is directly related to the increase in the cost of providing coverage to physicians. They argue that they're now paying out much more money to settle cases or satisfy jury awards than they did several years. The insurance companies vehemently object to the trial lawyers' contention that the premium increases are designed to make up for losses they suffered through bad stock market investments.
Caught in the middle of this heavyweight rumble are the people of Ohio, who worry about losing their family physicians through early retirement or relocation to other states where the cost of insurance is comparatively lower. They also worry about having to travel some distance to see a specialist. The uncertainty is especially hard on the elderly, who don't adapt to change easily, particularly when it comes to their health care.
Objective analysis
Given the differing positions that have been staked out by the special interest groups, it's time for a truthful, objective analysis of the issue. We believe that will be accomplished only by having an independent commission conducting hearings around the state, so doctors, lawyers, insurance representatives and members of citizens organizations can have a say.
The goal would be to be to answer the question posed in the headline of this editorial: Is the physician crisis real, or is Ohio a battleground?
Recently, The Vindicator published two front-page articles that explained what the Ohio State Medical Association believes should be done by the General Assembly to address the concerns of the doctors and detailed the opinions expressed by some of the local physicians in a survey conducted by the Mahoning County Medical Society. The bottom line: If something isn't done to control the rising cost of practicing medicine in Ohio, the Buckeye State will experience what is taking place in other states.
As we noted in an editorial in January, from Nevada to West Virginia to Pennsylvania, the insurance crisis is undermining the delivery of health care. Trauma centers in Las Vegas and Philadelphia have been closed, the shortage of qualified obstetricians has forced pregnant women in Mississippi and West Virginia to travel more than 100 miles, and surgeries in many states have been canceled because surgeons have taken leaves of absences to protest the high cost of malpractice insurance.
Though the message is getting through -- Ohio, like other states, has passed a tort-reform bill that caps awards for pain and suffering -- the problem persists.
Why an independent commission? Because what we now have in the ongoing debate is point and counterpoint. Doctors insist that reining in jury awards for noneconomic claims will result in lower premiums. But trial lawyers respond that in those states that have limits on what juries can award for pain and suffering, the cost of malpractice insurance has not decreased dramatically.
As for the insurance companies, executives should have to publicly explain how they arrive at the decision to increase premiums. Given that some specialties carry greater risk than others, do the insurance companies use a different standard for those doctors compared with family practitioners? Is a physician's record based on the number of lawsuits filed against him or her, or on the number of actual payouts the insurance company makes?
Stock transactions
As to the trial lawyers' claim that the stock market losses are the real reason for the steep increase in premiums, the companies should be required to provide details of their stock transactions to the Ohio Department of Insurance so staff can determine whether there is any merit to the claim.
Doctors, on the other hand, must be willing to open their books to the public so Ohioans can determine for themselves whether the high cost of insurance and the reduction in Medicare reimbursements are, indeed, making it impossible for many of them to continue practicing in this state. If the Ohio State Medical Association wants the General Assembly to intercede and enact legislation that provides short-term relief -- although the tort-reform bill went into effect in April, there are bound to be court challenges that could last several years -- it must be willing to come clean with what is taking place in doctors' offices.
Among the legislative initiatives the association is pushing is the creation of medical review panels to screen litigation for nonmeritorious claims. The goal of the panels would be to settle claims that have merit in lieu of trials.
Ohio's doctors are also seeking a temporary sales tax credit based on a percentage of their liability insurance premiums so as to offset sharp premium increases.
And, the association wants the Legislature to follow California's lead and enact a bill that creates a sliding scale for attorney contingency fees.
There is no doubt that Democrats and Republicans will lock horns when these initiatives are introduced in the GOP-controlled House and Senate. That's why an independent commission delving into the issue of medical malpractice insurance is so necessary. The panel would be created by the General Assembly and its members appointed by the governor and legislators from both parties.