The House Energy and Commerce Subcommittee on Health held a July 17 hearing to discuss the impact of excessive litigation on the health care system. Subcommittee Chair Michael Bilirakis (R-FL) opened the hearing, saying, “The United States is facing a crisis that, in the end, is going to harm patients. One has to look no farther than my home state of Florida, where some obstetricians/gynecologists are paying in excess of $200,000 per year for their liability insurance.”
Rep. Anna Eshoo (D-CA) said, “I don’t think we should fall into the trap of either defending one side and vilifying the other…. I disagree with my colleagues in that the total presumption that the rising costs of malpractice premiums are solely due to patient litigation…there are a variety of factors.”
Noting the impact in his home state, Rep. Ed Whitfield (R-KY) said that one county in Kentucky went from six obstetricians to three because of the rising cost of malpractice insurance. “In a neighboring county, all four obs quit….We have doctors leaving Kentucky and going to Indiana because malpractice rates are lower because Indiana has adopted meaningful tort reform,” he said.
Criticizing the focus of the hearing, Rep. Henry Waxman (D-CA) said, “The title of the hearing assumes that this is simply because the legal system is out of control….We don’t know to what extent that business practices of insurance companies contribute to this…. We need to understand this.”
Witnesses presented the views of health care practitioners, consumer advocates, the legal profession, and the insurance industry. While all witnesses testified either in support of, or in opposition to, tort reform proposals, several witnesses framed their remarks around the impact of medical malpractice litigation on women’s health.
Dr. Lisa Hollier of the American College of Obstetricians and Gynecologists said that “when ob-gyns cannot find or afford liability insurance, they are forced to stop delivering babies, curtail surgical services, or close their doors.”
She told the subcommittee that there is a crisis in nine states—Florida, Mississippi, Nevada, New Jersey, New York, Pennsylvania, Texas, Washington, and West Virginia—where premiums for medical malpractice insurance range from $40,000 to $200,000 per year for obstetricians.
Noting that this disproportionately impacts women in underserved rural areas, Dr. Hollier said, “With the economic viability of delivering babies already marginal due to sparse population and low insurance reimbursement for pregnancy services, increases in liability insurance costs are forcing rural providers to stop delivering babies.”
Dr. Hollier called upon Congress to “act swiftly,” saying that “without legislative intervention, women’s access to health care will continue to suffer.” Emphasizing the need to provide quality health care to all women, Fran Visco of the National Breast Cancer Coalition (NBCC) said, “NBCC believes that the most effective way to reduce lawsuits is to create a fair and transparent system of accountability for health care. Once defined, a high quality health care system would be one where everyone knows the rules. Doctors would follow it. Insurance companies would embrace it. And patients would benefit from it.”