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Medical malpractice reform will bring relief for rural health care crisis

Patient access to health care is seriously threatened in Washington. More and more communities are finding it difficult to recruit and retain physicians to care for local residents. The threat to Washington patients is growing to a crisis level.

There are a number of reasons for this health care crisis. While availability of health care is decreasing, the cost of health care is on the rise. According to a recent report by the Department of Health and Human Services, health care spending increased 9.3 percent in 2002, which is the largest surge in 11 years. One important reason is the rising cost of liability insurance premiums doctors must pay to stay in practice.

The situation has become so dire, that in many cases, liability insurance isn't even available for many physicians, forcing some into early retirement because they cannot obtain insurance in their specialty. In 17 Washington counties doctors aren't available to deliver babies due to a lack of malpractice insurance.

Unfortunately it's the patients who suffer. Many folks are finding themselves without a doctor when they need one. The crisis has hit home with an alarming number of physicians having been forced to close their practices throughout the 15th District. In the last few years, several physicians, from obstetricians to family practitioners and surgeons, have been forced to leave our communities. It's not because they wanted to, but instead because they had no other option. This means that when you or I need medical services, it won't be available and we may be forced to leave our area to get the medical care we need.

Rural communities like White Salmon, Goldendale and Sunnyside are particularly impacted by this situation. Recruiting and retaining doctors is already a challenge for smaller communities. In addition, a strong, vital local health care system is a major dynamic in the economic viability of rural communities. Of course, the picture isn't much brighter in larger communities like Yakima.

The reality is medicine, like any business, cannot provide services when the cost of doing so exceeds the payments received to provide the care. At a time when the federal government, through Medicare, has drastically cut payments to physicians for the medical care they provide - sometimes to less than 40¢ on the dollar, the liability insurance premiums that physicians must pay have multiplied. Insurance costs are expected to increase an average of 20 to 40 percent this year.

This combination of financial pressures is creating a problem that must be fixed. The 2004 Legislature recently convened and our top priorities must be to adopt policies to create a reasonable and fair medical malpractice system.

There are a few basic reforms to the medical malpractice system that would help bring down the cost of insurance, keep physicians in practice, and reduce the overall cost of health care.

While patients must be protected from medical negligence, a sense of logic and fairness must also apply in a doctor's, or a hospital's exposure to civil lawsuits. Nationally, our tort system is the most expensive in the industrialized world. The cost in 2001 was $205 billion, which translates into $721 for every U.S. citizen.

During the 2003 legislative session, tort reform legislation was approved by the state Senate; however, the bill was blocked by the Democrat leadership of the state House. Once again, lawmakers will be considering legislation during the 2004 legislative session that will:

• link awards to actual fault;

• cap non-economic damages (not a cap on medical bills, loss of income or other economic damages);

• change the burden of proof to make lawsuits fair and reasonable;

• limit the amount lawyers take to give patients a fair amount of reasonable awards;

• ensure suits are filed in a reasonable time frame, saving time and money;

• and make sure arbitration is an option to bring reasonable resolution sooner.

The Legislature has the opportunity to make positive changes to a system in dire need of help. To be successful however, we must come together and work with the insurance, medical and the legal communities to strengthen access to health care and halt the exodus of physicians leaving our communities.

Rep. Dan Newhouse (R-Sunnyside) represents citizens in the 15th Legislative District. He is the Assistant Ranking Republican member on the House Financial Institutions and Insurance Committee in addition to serving on the House Judiciary Committee. Dr. John Adkison is President of the Yakima County Medical Society and a member of Orthopedics Northwest in Yakima.

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