Liability and Health Reform Update

11/8/11 - ELECTION TODAY - Judicial Choices MATTER

2011-11-08T05:20:00.000-08:00

11/7/11 - ELECTION DAY TODAY
Judicial Choices MATTER - Support Eakin, Stabile, Covey

((Editor's comments in blue italics. Please scroll to the end for more information, disclaimer, etc.))

1. Commentary
2. Politics PA
Judicial Candidates Spar over Campaign Contributions
http://www.politicspa.com/judicial-candidates-spar-over-campaign-contributions/29156/
3. PAMPAC E-NEWS
PAMPAC supports statewide judicial candidates....
4. PA GOP - Judge for Sale
http://www.pagop.org/2011/10/pa-gop-judge-for-sale-democrat-david-wecht-owned-by-philadelphia-trial-lawyers/
5. #Rx: The PAMPAC Prescription for a Fair Judiciary:
American Med News
Texas Tort reform advocates dispute critical report
http://www.ama-assn.org/amednews/2011/10/31/prsc1031.htm
6. Fierce Healthcare.com
New payment models promote undertreatment, malpractice risks
http://www.fiercehealthcare.com/story/new-payment-models-promote-undertreatment-malpractice-risks/2011-08-05
7. PennLive.com
Pennsylvania dentists may soon be required to purchase malpractice insurance
http://www.pennlive.com/midstate/index.ssf/2011/08/pennsylvania_dentists_may_soon.html

Commentary

Odd-number year elections aren't quite as "sexy" as the even number years - you won't get to choose a president, or a member of Congress, or even a member of the General Assembly tomorrow.

What you WILL get to choose are a wide range of local offices - which impact you DIRECTLY at the most fundamental levels - right in your own backyard.

And, possibly even more important, you'll get to choose JUDGES at the local and state levels.

Keeping in mind that fair judges at many levels impact the practice of medicine (and everything else, of course), judicial elections MATTER to medical professionals.

At the state level, I'd like to ask everyone to support three statewide candidates, who have been interviewed and vetted and are all supported by PAMPAC, the political arm of the PA Medical Society, for their comprehension of the issues that face the practice of medicine and their ability to be fair and impartial. Further, I've met and spoken at length with all three of these outstanding candidates and find them to be supportive of doctors and patients, intelligent, and extremely well qualified.

Those candidates are PA Supreme Court Justice Mike Eakin (this is a retention vote, so all you need to do is vote "yes"), Superior Court Candidate Vic Stabile, and Commonwealth Court Candidate Anne Covey.

You might think fairness and impartiality is a given with judicial candidates, but it isn't always the case - especially when those candidates are owned and operated by the Philadelphia trial lawyers, who just ponied up $300,000 to ensure that its choice for PA Superior Court beats OUR choice for Superior Court, Vic Stabile. Several articles about the trial lawyers' huge last-minute contribution to THEIR candidate follow.

Is $300,000 the going rate for a statewide judge these days, or is the leadership of the trial lawyers' PAC just feeling generous? Campaign finance reports indicate Stabile has raised a total of $198,000 - while his opponent, with the recent infusion of cash provided by the Philly trial lawyers, has raised $512,000. That infusion has made it possible for their guy to buy more TV and radio time.

Cash on hand shouldn't determine the winner of a judicial election, but it's hard to compete with a $300,000 bribe - I mean contribution! - from the group which has opposed every measure that would make Pennsylvania more physician-friendly.

If YOU would like to help Vic Stabile defeat the trial lawyers' candidate, it's not too late to make a contribution. If you're a PAMED member, you can contribute to PAMPAC's support of the PA judicial candidates online: www.pampac.org (log in required).

If you're not a member, you can still contribute by mailing your personal voluntary contribution to: PAMPAC - P.O. Box 8820 - Harrisburg, PA 17105-8820, or by calling PAMPAC at 800-228-7823.

Or, you can go directly to Vic Stabile's campaign website - but cannot contribute online. I'll bet they'd be happy to take contributions over the phone, though: http://www.stabileforjudge.com/.

I've attached a "prescription" form which you can pass out at the polls or in your offices, hospital or anywhere you like as a PDF.

On a more local level, a good friend to medicine is running for a seat on the bench in Lehigh County - if you live in Lehigh County, I'd like to ask you to vote for Doug Reichley for the Lehigh County Court of Common Pleas.

Doug Reichley has supported medical liability reform in PA since he first ran for the state legislature, and has been a consistent and powerful voice for reducing lawsuit abuse in PA. I have no doubt that Doug's years of experience as both an assistant district attorney and a state legislator will make him an outstanding judge. To learn more about Doug, check out his website: http://reichleyforjudge.com/.

Doug's opponent, who isn't even eligible to serve a full term as Lehigh County Judge due to PA's mandatory judicial retirement rules, has recently mounted a sleazy smear campaign against Doug, which is based on inaccuracies and a couple of bald faced lies. You can read the TRUTH here: http://reichleyforjudge.com/?category_name=refuting-opponents-incorrect-statements.

I don't have to tell you to GET OUT AND VOTE, right?

OK, just in case - GET OUT AND VOTE TODAY! And please remind your friends and family to do the same!

Best,
DBR

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http://www.politicspa.com/judicial-candidates-spar-over-campaign-contributions/29156/
Judicial Candidates Spar over Campaign Contributions
By Sari Heidenreich, Contributing Writer

Encouraging Pennsylvanians to get out and vote for Republican Commonwealth and Superior Court candidates next week, Lt. Gov. Jim Cawley highlighted the importance of these offices Tuesday saying the courts will likely ultimately decided policies surrounding the Marcellus Shale industry and education reform as well as redistricting.
“The decisions that are going to be made seven days from now are so vitally important to the quality of life for the people of this Commonwealth. It does matter who your local township supervisor is, it does matter who your mayor and council are,” Cawley said, “and let me tell you, it very much matters who puts on a black robe and sits on a bench.”

Commonwealth Court candidate Anne Covey and Superior Court candidate Vic Stabile also attended the press conference hosted by the Republican Party of Pennsylvania. State party chairman, Rob Gleason said they anticipate only 25 percent of Pennsylvanians will vote in Tuesday’s statewide and municipal election.

The most recent campaign finance reports, released last Thursday, show that Stabile has raised $198,000 so far, according to the Associated Press. His opponent, Allegheny County Judge David Wecht has raised $512,000.

Democratic Commonwealth Court candidate Kathryn Boockvar has raised $352,000 while opponent Anne Covey had received nearly $343,000 according to the AP.

Stabile received $25,000 from the Philadelphia Trial Lawyers Association’s PAC Committee for a Better Tomorrow, according to the Associated Press. However, the group donated $300,000 his opponent, Allegheny County Judge David Wecht.

Stabile said, “I was very upset last week to see that my opponent received $300,000 from the Philadelphia Trial Lawyers Association [Committee For a Better Tomorrow]. That is the amount of money that most appellate candidates can hope to raise in these races, and they provided that to him in a single check. Obviously that has me at a disadvantage in terms of media … It does make it a noncompetitive race in many regards.”

The Committee for a Better Tomorrow actually donated the money to Wecht on two different occasions: $50,000 in September and $250,000 in October.

Wecht said he wanted to stay away from negative campaigning of partisan bickering but said, “I’m sure that my opponent [Stabile] would take contributions if he could get them.”

Wecht said the group’s contribution would not affect his ability to rule on cases if elected to the post, saying he would have “no idea which lawyer gave what” to the PAC “so there would be no possibility” he could consider the contributions of individual lawyers.

Earlier in the campaign, Wecht unsuccessfully lobbied Stabile to sign a pledge denouncing financial or advertising support from third party interest groups and 527s.

Stabile said he does not take issue with the fact that the trial lawyer’s PAC contributed to the race but the fact that they donated a disproportionate amount.

But Mark Nicastre, spokesman for the Pennsylvania Democratic Party, said Stabile’s complaint is hypocritical.

“Republicans have been steady advocates for unlimited campaign contributions, secret campaign contributions and corporate contributions through shady organizations. They are only complaining now because there deep pocketed donors haven’t come through this year,” Nicastre said.

Mike Dineen, Wecht’s campaign manager, confirmed that the Committee for a Better Tomorrow’s $300,000 donation is the largest is the largest contribution they have received but noted that in previous judicial elections state parties had contributed similar amounts.

Recently, Wecht’s campaign has expanded its television ad buy, originally just in the Pittsburgh area, to the Altona/Johnstown and Wilkes-Barre/Scranton media markets.

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PAMPAC supports statewide judicial candidates who are fair minded and understand our issues—two keys to positively impact your practice.

In the 2011 statewide judicial elections, PAMPAC supports Anne Covey for Commonwealth Court and Victor Stabile for Superior Court in the contested races. Both candidates demonstrate a depth of knowledge and appreciation about the issues that impact our profession. Both had PAMPAC support in their primary elections.

Victor Stabile is the PAMPAC supported candidate for Superior Court. He is a Cumberland County attorney in private practice that has defended physician clients.

Anne Covey is the PAMPAC supported candidate for Commonwealth Court. She is an attorney in private practice in Bucks County with strong experience in state litigation.

PAMPAC also supports the retention election of Supreme Court Justice Michael Eakin, first elected with strong statewide physician support in 2001. Justice Eakin has continued to demonstrate from the bench that he is a pro-physician jurist.

The Nov. 8 statewide judicial elections offer an opportunity to elect candidates to the bench whom we believe are best for medicine.

Don't sit this election out. Vote November 8.

PAMPAC is the political arm of the Pennsylvania Medical Society. Membership in PAMPAC is voluntary and serves as the united voice of physicians in the political arena. PAMPAC contributes to candidates for state and, through AMPAC, federal office who support the priorities of the Pennsylvania Medical Society membership. The organization is headquartered in Harrisburg, Pennsylvania and is directed by a board of members from the Pennsylvania Medical Society and the Pennsylvania Medical Society Alliance. PAMPAC eNEWS is prepared to keep readers informed about political and educational advocacy initiatives affecting Pennsylvania physicians. To learn more about PAMPAC log on to www.pamedsoc.org/pampac

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PA GOP: Judge For Sale – Democrat David Wecht Owned By Philadelphia Trial Lawyers
http://www.pagop.org/2011/10/pa-gop-judge-for-sale-democrat-david-wecht-owned-by-philadelphia-trial-lawyers/
October 31st, 2011
PA GOP: Judge For Sale – Democrat David Wecht Owned By Philadelphia Trial Lawyers

Wecht accepts $300,000 last-minute cash infusion from Philadelphia trial lawyers

HARRISBURG, PA – Republican Party of Pennsylvania Chairman Rob Gleason released statement regarding David Wecht’s willingness to be bought with a $300,000 donation from the Committee for a Better Tomorrow PAC, a special interest group bankrolled by the Philadelphia Trial Lawyers Association:

“By taking $300,000 from Philadelphia trial lawyers, David Wecht has allowed a special interest group to bankroll his campaign as he attempts to buy his way onto Pennsylvania’s Superior Court. Based on his own previous comments, Wecht should recuse himself from any case that includes a trial attorney who has donated to the Better Tomorrow PAC.

“This is a clear example of justice for sale. Could you imagine appearing in David Wecht’s courtroom with a Philadelphia trial lawyer on the opposing side? Do you think you could get a fair trial? I don’t think so, and I think the majority of Pennsylvanians would agree.

“The plot thickens because during a judicial forum on October 14th, Wecht made a public pledge to not accept any contributions from any special interest groups during the course of his campaign. What’s worse: the fact that he broke his own pledge and accepted $300,000 from a special interest group, or the fact that he’s trying to buy his way onto Pennsylvania’s Superior Court?

“In addition, this issue has already been taken up by the U.S. Supreme Court, where Justice Kennedy in writing the majority opinion stated that there is a ‘serious risk of actual bias’ if a judge does not recuse himself in a case where one or more parties have had a significant influence on that judge’s election. In this case, $300,000 would certainly qualify as a very significant influence and would significantly compromise David Wecht’s ability to adjudicate fairly.

“Since David Wecht likes pledges so much, I would challenge him to pledge today that he will recuse himself from any case that involves a Philadelphia trial lawyer who has contributed to the Committee for a Better Tomorrow PAC. To maintain the integrity of Pennsylvania’s judiciary, we are sounding the alarm on David Wecht. Voters should get to the polls on November 8th and to tell David Wecht that justice is not for sale, and support Vic Stabile,” Gleason said.

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#Rx: The PAMPAC Prescription for a Fair Judiciary:

The Pennsylvania Medical PAC, PAMPAC, supports these judicial candidates for election on November 8. A fair and balanced judiciary is essential for Pennsylvania and the patients whom we serve.

Supreme Court:
Retention of Justice Michael Eakin

Superior Court:
Election of Vic Stabile

Commonwealth Court:
Election of Anne Covey

Do Not Substitute!

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Texas tort reform advocates dispute critical report
A study says health care costs have risen since a damages cap and other measures were enacted. The state's physicians call the report misleading.
By Alicia Gallegos, amednews staff. Posted Oct 31, 2011.

http://www.ama-assn.org/amednews/2011/10/31/prsc1031.htm

Doctors and other advocates of Texas tort reforms are speaking out against an October report that says the measures have worsened health care in the state.

The report, issued by consumer advocacy group Public Citizen, claims that the rate of new doctors in Texas has fallen since the state's $250,000 noneconomic damages cap was enacted in 2003. Medicare spending has grown since the reforms, and health insurance costs are higher than the national average, the report said.

((It's important to recall that Public Citizen is funded largely by trial lawyer money....))

"Despite the sales campaign to promote Texas as an exhibit of the merits of limiting doctors' liability for mistakes, the real world data tell the opposite story," said Taylor Lincoln, research director of Public Citizen's Congress Watch division. "Health care in Texas has become more expensive and less accessible since the state's malpractice caps took effect."

The Texas Medical Assn. called the report misleading.

"First of all, we never promised the tort reform bill would lower the cost of medical care. We said it would increase access to medical care," said TMA President C. Bruce Malone, MD. "The hospitals are saving hundreds of millions a year in medical liability costs that can be applied directly to patient care."

The number of physicians in Texas has outpaced population growth by 84% since tort reforms were enacted.
Dr. Malone rebutted the report finding that the number of new doctors practicing in the state has decreased. The report based its figures on the rate of new physicians per capita. It claims that in the seven years before the cap took effect, the per capita number of doctors grew by 9.3% compared with an increase of 4.2% after the reforms.

The number of primary care physicians rose by 11.8% in the seven years leading to reforms but has remained flat since, the report said.

But comparing the rate of doctors against population growth is not an adequate assessment, Dr. Malone said. Texas has seen a rapid rise in residents in the last few years, he said.

Each year, about 4,000 doctors apply for a license in Texas, he said. In the past four years, license applications for physicians have increased 83% compared with the four years before tort reform, according to data from the TMA and the Texas Medical Board.

"We're keeping up with our huge population growth. The tort reform has allowed us to keep doctors' offices open that we might not have been able to do with the increasing liability" before reform, he said.

Data contradict report
Texas Gov. Rick Perry, who signed the reforms into law, released data contradicting the Public Citizen report.

Since the reforms were enacted, 23,520 doctors have been licensed in Texas, and physician growth has outpaced population growth by 84%, according to the governor's office. In El Paso, physician growth has outpaced population growth by 177%, while in Houston the figure is 124%.

Medical liability premiums in Texas have declined by nearly 30% since state tort reforms were enacted.
The governor cited a national report from the Commonwealth Fund that found Texas' premiums for employer-sponsored coverage for individuals are lower than those in 34 states. The Commonwealth Fund is a private foundation that advocates better health care access and quality.

The cost of medical liability insurance has declined by nearly 30% since reforms were enacted, according to Perry's office.

"In Texas, comprehensive medical liability reform has improved access to medical care, particularly in underserved areas, restored balance to the Texas judicial system, keeping doctors in the exam room instead of the courtroom, and has removed a large threat to job creation and economic growth that had been created by excessive litigation," said Allison Castle, a spokeswoman for Perry.

Patients have benefited dramatically from reform measures, said Jon Opelt, executive director of the Texas Alliance for Patient Access, a coalition of medical professionals who advocate improved access to care through lawsuit reforms. An increase in Texas doctors has led to 6.4 million more patient visits than would have occurred if reforms were not enacted, he said. Texas Alliance arrived at that figure by measuring the accelerated growth rate of physicians and factoring in the average number of patients seen annually by doctors, he said.

"What you have is more care available to more patients closer to home," he said.

Data from the governor's office show that since reforms, 23 rural counties have added at least one emergency physician and 18 counties have added their first emergency doctor. Fifteen rural counties have added either a cardiologist or cardiovascular surgeon, including 11 counties that added their first heart specialist.

In addition, the number of pediatric specialists and geriatricians has doubled in the past five years after showing no growth in two years preceding reforms, data show.

"I would venture to say there's not a state in the country that [has] seen the turnaround that we have seen," Opelt said.

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New payment models promote undertreatment, malpractice risks
http://www.fiercehealthcare.com/story/new-payment-models-promote-undertreatment-malpractice-risks/2011-08-05
August 5, 2011 — 9:38am ET By Alicia Caramenico

((I believe this is what they call a "Catch 22."))

New coordinated care models, like accountable care organizations (ACOs), are being touted as ways to eliminate unnecessary tests and procedures and improve care. While these new arrangements may reduce costs, they also may increase malpractice risks for doctors, according to Medpage Today.

These new payment models are putting pressure on doctors to undertreat patients, note authors Lee J. Johnson and Dr. Frank J. Weinstock. By doing less costly tests and procedures, doctors can be sued for failure to diagnose or treat properly.

The increased the emphasis on cost reduction and pay-for-performance initiatives is driving doctors to avoid various tests and procedures for ACO patients. But despite the financial incentives to decrease care, doctors are still liable for their patients' care, note the authors.

The malpractice risks associated with undertreatment shed light on a May survey from the American College of Emergency Physicians, which found that more than 50 percent of roughly 1,800 ER doctors said the main reason they order the number of tests they do is fear of being sued.

During a time when nationwide healthcare costs continue to rise, there are ways doctors can avoid malpractice suits and unnecessary overtreatment. For example, doctors can implement informed refusal, giving patients a real option to refuse a proposed treatment. "If the doctor is completely honest about the chances of success and the side effects/risks involved, the patient may forego the treatment of his own accord. Costs will have been cut and the physician would not have increased his liability exposure," the authors write.

For more:
- read the Medpage article

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Pennsylvania dentists may soon be required to purchase malpractice insurance

http://www.pennlive.com/midstate/index.ssf/2011/08/pennsylvania_dentists_may_soon.html
Published: Monday, August 01, 2011, 7:11 PM Updated: Monday, August 01, 2011, 8:13 PM
BY JOHN MANGANARO, For The Patriot-News

Most dentists in Pennsylvania carry malpractice insurance, but currently, they aren’t required to do so.

That may change in the near future.

Sen. Pat Vance, R-Cumberland County, has sponsored a bill requiring dentists to purchase malpractice insurance. The state Senate unanimously approved the bill in June, and it is now in the state House of Representatives. The Legislature is in recess for the summer.

Vance introduced the bill after hearing reports of patient abuse in Reading, Berks County, and other areas of the state. Dentists who didn’t buy insurance could lose their license under the bill.

“Most responsible and group dentists already carry this kind of insurance anyway,” Vance said. “But unfortunately, the rogue dentists we really need to have this kind of coverage, to protect the consumer, are the ones who don’t.”

Dentists would be required to purchase liability insurance of $3 million annually. That amount of malpractice coverage would cost the average Pennsylvania dentist about $2,400 annually, according to Gil Davis, CEO of Pennsylvania Dental Association Insurance Services.

That average is driven up by rates in the southeastern part of the state. The average in Delaware and Montgomery counties is about $2,700. Philadelphia’s rate is closer to $4,500.

Local dentist Dr. Michael Verber called the bill “a good example of good government.”

“I already have that amount of coverage, and most dentists in the state do as well,” Verber said. “With this measure, the government will be able to increase the quality of health care without dramatically increasing the burden on doctors or patients.”

Dr. Craig Mathias, a Harrisburg orthodontist, said new malpractice insurance requirements would be “another unnecessary expense.”

“As an orthodontist, I’ve got a different level of liability, so we do already carry an adequate amount of insurance in my office,” Mathias said. “I’ve got about half of that right now.”

Mathias said picking up the rest “wouldn’t be a nail in the coffin. More like a tack to have to sit on.”

Davis said the average malpractice claim against dentists is only about $20,000. Davis didn’t have a number of claims typically filed in a year, but said there “is not a significant number.”

Dr. Dennis Charlton, president of the Pennsylvania Dental Association and a dentist in Mercer County, said his organization supports the legislation.

“Nearly all dentists in the commonwealth already have this level of malpractice insurance and this law will bring our malpractice requirements to the same level as other professionals in the state,” Charlton said.

Ronald Ruman, press secretary for the Department of State, said the agency “supports the general concept to require dentists to carry professional liability insurance.” The state department oversees the licensing of dentists.

Ruman added that, because some details of the measure are likely to be debated and changed in the House, the department “will wait to see the final version before taking a position on the legislation in its final form.”

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((From a good friend and crusader for doctors and patients - please consider participating in this webinar if you'd like to learn more about the Sorry Works! model of reducing medical liability abuse.))

Donna,

On November 15th, I'm doing a webinar on my Sorry Works! Talk....same talk as I've given to countless hospitals, insurers, and associations, except by webinar. Cheap but very efffective way to get message out. Here is the registration link: http://www.sorryworks.net/pdf/November-2011-Flyer.pdf.

I hope your folks can join us!

Sincerely,

- Doug

Doug Wojcieszak, Founder
Sorry Works!
PO Box 531
Glen Carbon, IL 62034

Website: http://www.sorryworks.net/

June 3, 2011
Doug Wojcieszak, Founder & Spokesperson
Contact phone/e-mail address: 618-559-8168; doug@sorryworks.net

FIVE-STAR: DOCTORS SHOWING COMPASSION
A good friend sent a recent PIAA newsletter with a news article on how doctors struggle with compassion - see directly below:

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Doctors Often Struggle to Show Compassion While Dealing With Patients
Upon learning from his doctor that he had less than six months to live, Mike Venata said he wanted to reach across and slap the doctor. He said it wasn't the news that made him angry; it was the way it was delivered. The specialist had pulled out a piece of paper with his test results on it and said, "Well this isn't very good. This is terminal." He didn't talk to Mr. Venata, he talked to the piece of paper. "I have a guy sitting there reading a piece of paper telling me I am going to die and then walking out the door. That was not well executed," said Venata. To him the doctor's heartless presentation was as painful as the news. In research conducted at five medical schools, researchers studied two sets of faculty members on their skills at being compassionate as evaluated by their medical students and residents. One faculty group underwent a two- year program that combined experiential learning of skills such as role modeling along with reflective exploration of values through writing narratives and other activities. The other group had no intervention. The compassion-trained group was rated significantly more compassionate or humanist with their patients, demonstrating that compassionate can be taught. Another study of medical students showed that empathy scores declined among students at the end of the third year, when they had begun regular exposure to patients during clinical rotations-exactly when they need more empathy. In an editorial for the Washington Post, Manoj Jain, MD said, "The art of medicine is not just choosing the right medicine, but gauging the needs and providing reassurance and comfort to the patient." He said he believes that healthcare providers are genuinely compassionate and that is often what has steered them toward medicine in the first place. However, with the uncertainties in healthcare, increased workload and limited time, for many the joy in the work is lost, and this comes across in doctor-patient interactions. (Washington Post, 5/16)

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You know, only half (or less) of medicine deals with biology, chemistry, math, etc....the other half is all about relationships, emotions, communication, etc...yet medical schools have traditionally focused on the science. It's a shame, but we have a lot of great technical people who have trouble emotionally connecting with the customers! This is article is exhibit A.

In our Five-Star courses, this is what we teach --- and the docs actually eat it up! Docs know they are often lacking in this area, but many don't know how to make it happen, especially in their pressure- packed, overbooked professional lives. So, we teach them simple things that don't consume time or cost money....the importance of hello, using someone's name, sitting down and looking a person in the eye, avoiding the temptation to interrupt and actually listen, body language, and so on. It's actually a small investment that a) can provide nice dividends for referrals and reimbursements and b_) avoid big headaches and losses, including litigation. There's so many little things docs can do that mean the world to patients and families.

This compassion stuff is big part of it. Taking a few minutes to talk through a difficult situation, appropriate contact such a holding a patient's hand or gently touching a shoulder, appropriately relating ("You know I lost my own mother a year ago..."), even crying with them, etc. I know this is foreign to some docs because you're taught to heal and save lives and admitting defeat is not part of your DNA, but, we all die some day. Patients and families know this....and we also know despite your best efforts you can't fix every problem, cure every disease, etc. So, sometimes showing us you care is enough....but you have to do it! And to do it, you need to be trained.

Below is a great story of a Cincinnati hospital that developed a compassion training program after a family complained about how they were notified about their daughter's death during surgery. See below.

To learn more about Five-Star training from the Sorry Works!-Stevens & Lee Team, give us a call at 618-559-8168 or e-mail doug@sorryworks.net.

Sincerely,

- Doug

Doug Wojcieszak, Founder
Sorry Works!
PO Box 531
Glen Carbon, IL 62034

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This LIABILITY & HEALTH REFORM UPDATE is a free service which I provide, as a volunteer, to help supply medical liability and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform, and quality health care advocates. No one pays me to do this.

I am not employed by any physician or health care reform advocacy or liability reform organization, political party, or candidate, although I volunteer for several. I am an advocate for quality health care, physicians and patients, a breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not, nor will I ever claim to be, unbiased (I am....biased, I mean), unlike many in the mainstream media.

Most information in this newsletter is copied and pasted from other sources, and will always provide a link to the original source. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized, and appear in blue.
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9/22/11 - Become a better advocate, tort reforms work, more

2011-09-22T07:32:00.000-07:00

9/22/11 - Liability and Health Reform Update
Become a better advocate, tort reform works, more

((Editor's comments in blue italics. Please scroll to the end for more information, disclaimer, etc.))

CONTENTS:

1. Commentary
2. PAMPAC Campaign and Grassroots Advocacy Seminar
3. From Modern Physician
Harkin: Congress likely will tackle 'doc fix' in omnibus bill
http://www.modernphysician.com/article/20110920/MODERNPHYSICIAN/110929996/harkin-congress-likely-will-tackle-doc-fix-in-omnibus-bill
4. From Modern Physician
MedPAC proposes cuts to save $233 billion
http://www.modernphysician.com/article/20110921/MODERNPHYSICIAN/309219963?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMZmJYZjhBRWxYek9UYktwUGZUamg5b1g4WFFERmhzbHhwTHN6Yk9XcUU9?trk=mp_newsletter_FULL
5. From Allentown Morning Call
New law brings fairness to malpractice suits
http://www.mcall.com/opinion/yourview/mc-tort-reform-anderson--yv-20110913,0,403690.story
6. From Modern Medicine
Malpractice reform helps bottom line even if you don't get sued
http://www.modernmedicine.com/modernmedicine/Modern+Medicine+News/Malpractice-reform-helps-bottom-line-even-if-you-d/ArticleStandard/Article/detail/738812?contextCategoryId=40169
7. From the Legal Intelligencer
Delco Jury Awards $3.8 Mil. to Woman Who Died From Sepsis
http://www.law.com/jsp/pa/PubArticlePA.jsp?id=1202512430265&src=EMC-Email&et=editorial&bu=The%20Legal%20Intelligencer&pt=TLI%20PM%20Legal%20Alert&cn=TLI%20_PM20110825&kw=Delco%20Jury%20Awards%20%243.8%20Mil.%20to%20Woman%20Who%20Died%20From%20Sepsis&slreturn=1&hbxlogin=1
8. From Legal Watchdog
The True Cost of Lawsuit Abuse
http://www.legalwatchdog.org/abuse_cost.asp
9. From The Patriot News
Pennsylvania dentists may soon be required to purchase malpractice insurance
http://www.pennlive.com/midstate/index.ssf/2011/08/pennsylvania_dentists_may_soon.html
10. From Insurance Journal
http://www.insurancejournal.com/news/southcentral/2011/08/25/212358.htm
Texas Medical Liability Trust to Reduce Rates, Pay 18.5% Dividend
11. From Legal Watchdog
Gov. Perry Calls for Expanded Lawsuit Reform in Texas
http://www.legalwatchdog.org/
12. From American Medical News
Most doctors face lawsuits, but few lose them
Less than 2% of those sued make payments to plaintiffs, a study shows. Neurosurgeons are sued more often than any other specialists.
http://www.ama-assn.org/amednews/2011/08/29/prsa0829.htm
13. From Washington Examiner
Days numbered for trial lawyers getting outrageous paydays
http://washingtonexaminer.com/opinion/columnists/2011/08/days-numbered-trial-lawyers-getting-outrageous-paydays
14. From Roll Call
Gingrey: Lawsuits Handcuffing Health Care
Awards from Liability Suits Shouldn't Be Used as Investments for Hedge Funds
http://www.rollcall.com/features/Health-Care-2011_Policy-Briefing/policy_briefings/-204316-1.html
15. From NCPA
Health Reform and Medical Malpractice Reform
http://www.aei.org/docLib/2011-04-Hyman-Sage.pdf
16. From Forbes
Malpractice Suits Plunge In Wake of Mississippi Tort Reforms
http://blogs.forbes.com/danielfisher/2011/07/28/malpractice-suits-plunge-in-wake-of-mississippi-tort-reforms/
17. Everything You Wanted to Know About "ObamaCare" (but didn't know who to ask)
http://www.ustream.tv/channel/health-care-reform---desales

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1. Commentary

NO one is a better advocate for quality health care than a physician.

Let me say it again - NO ONE, not a lobbyist, a lawyer, an executive director, an adorable child, or a cute puppy can affect a legislator's opinion or vote in the same way a physician can.

So....why do physicians sit back and let people that everyone knows get paid to advocate for them do all the work?

Sure, the professionals know what to say and how to say it. They've studied your issues, and they're wonderful - to an extent.

But physicians don't need to be told what to say about the issues that affect their ability to provide quality medical care - physicians LIVE it, and legislators know that. So a heartfelt story from a physician (or a physician's spouse!) about rising malpractice premiums making it impossible to hire more staff, or about government interference making it difficult to treat a patient's INDIVIDUAL needs, is far more effective than anything a paid lobbyist can say.

Don't get me wrong, we NEED our lobbyists to maintain a consistent presence and keep the groups that represent physicians in the forefront of legislators' minds, but for the REAL heavy lifting, doctors and other members of the "family of medicine" need to get involved - up close and personally involved.

Some of the people who are the BEST at helping physicians and their families maximize their inherent ability to impact legislative and political outcomes are joining forces this Saturday in Harrisburg to provide a unique training program for physicians and their family members. PAMPAC's Larry Light (whose quiet brilliance is scary sometimes) and AMPAC's Jim Wilson (who ran the outstanding AMPAC Campaign School I attended several years ago) will share their experience, insight, and techniques for successful advocacy.

This is a members-only benefit and I'm happy to say that I'll be there to soak up more of their collective wisdom. So if you're registered, make sure to be there - and if you're not and you'd like to be, it might not be too late (although I don't know that for sure.....)

I hope to see many of you there!

DBR

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2. PAMPAC Campaign and Grassroots Seminar

((This seminar is available only to PAMPAC and AMPAC members.))

PAMPAC and AMPAC would like to invite you to a Regional Campaign and Grassroots Seminar on September 24, 2011 from 8:30 a.m.-3 p.m. The Seminar will be held at the PMS headquarters at 777 East Park Drive, Harrisburg, PA.

Increase your political effectiveness with sessions on:

Effective Advocacy Communication
Make an Impact on a Local Political Campaign
Running for Public Office – A Primer
Polish Your Political Skills
Please see the attached agenda for more information. This seminar is free to all current PAMPAC and AMPAC members. Continental breakfast and lunch will be provided.

Ask for the discounted PA Medical Society rate at-

Best Western Premier-800 East Park Dr. (717) 561-2800, (use code 3449)
Hampton Inn Harrisburg East-4230 Union Deposit Road- (717) 545-9595

To confirm your registration or for more information, please contact PAMPAC at pampac@pamedsoc.org or 717-558-7821.

If you are already registered for the session, you need do nothing else, and we look forward to seeing you in a few weeks!

Sincerely,
Jim Wilson. PhD

Manager, Political Education Programs

jim.wilson@ama-assn.org

PAMPAC POLITICAL SEMINAR
September 24, 2011
PA Medical Society Building
777 East Park Drive, Harrisburg, PA

8:30 AM Continental Breakfast

9:00 AM Effective Advocacy Communication
Meeting, Talking & Writing to Your Legislator
Message, Structure & Strategy
Stephanie Vance, Advocacy Associates

10:30 AM Break

10:45 Make an Impact on a Local Political Campaign
Fundraising, Get Out the Vote, Using your White
Coat & Office Effectively, Getting Your
Colleagues Involved
Vance & Jim Wilson, AMPAC

12:15 Lunch

12:45 Running for Public Office – A Primer
Should I Consider Running, How to get started,
State vs Federal
Larry Light, PAMPAC

1:45 PM Polish Your Political Skills
Role Play and Interactive
Jim Wilson

2:45 Closing Comments Jim Wilson

**********

3. From Modern Physician
Harkin: Congress likely will tackle 'doc fix' in omnibus bill
http://www.modernphysician.com/article/20110920/MODERNPHYSICIAN/110929996/harkin-congress-likely-will-tackle-doc-fix-in-omnibus-bill
By Rich Daly

Posted: September 20, 2011 - 6:15 pm ET

((Just what we need.....another massive bill no one will have time to read....does this make four or FIVE planned reductions of physician reimbursement floating around out there....? I've lost count.))

Congress will not prevent the looming 29.4% cut in Medicare payments to physicians until it approves a last-minute omnibus funding bill, according to a senior Senate Democrat.

Sen. Tom Harkin (D-Iowa), chairman of the powerful Senate Appropriations Committee's Labor, Health and Human Services, Education and Related Agencies Subcommittee, told reporters Tuesday that a measure to prevent the scheduled cut to provider reimbursements from taking effect in January is one of several high-profile provisions he expects Congress to include in a catch-all spending bill it will pass in the final days of the year.

Physician groups have pushed for Congress to pass a "permanent fix" to the current sustainable growth-rate payment formula. Congress has delayed such action because of the estimated $344 billion, 10-year cost of switching to another system for setting payments, according to federal actuaries.

Another measure Harkin expects the omnibus to include is funding for the federal version of state health exchanges. Insurance exchanges in each state were authorized by the 2010 healthcare law to launch in 2014, with the federal government establishing exchanges in states that opted not to establish an exchange. However, published reports have asserted that the federal exchanges were unfunded by the law, and HHS officials have not clearly affirmed or denied those reports.

Harkin, who is the senior Senate Democrat overseeing healthcare funding, made it clear that the exchanges still require congressional appropriations.

"If the states won't do it, we go in and do it," Harkin said about the federal versions of state insurance exchanges.

**********

4. From Modern Physician
MedPAC proposes cuts to save $233 billion
http://www.modernphysician.com/article/20110921/MODERNPHYSICIAN/309219963?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMZmJYZjhBRWxYek9UYktwUGZUamg5b1g4WFFERmhzbHhwTHN6Yk9XcUU9?trk=mp_newsletter_FULL

By Rich Daly

Posted: September 21, 2011 - 1:00 pm ET

Congress could fund $233 billion of the 10-year cost of overhauling the Medicare physician payment program through a series of cuts to the seniors' health program, according to draft recommendations (PDF) posted online by the staff of the Medicare Payment Advisory Commission

The proposed Medicare cuts, on which the panel has not yet voted, came in addition to Medicare-only savings that could fund a "doc fix" that MedPAC discussed last week. Those ideas included a freeze on the reimbursement rate for primary-care services and cutting payments to specialists by 5.9% each year for three years.

Such steps aim to avoid a 29.4% cut in Medicare payments to providers that is scheduled to take effect in January under the current sustainable growth-rate formula.

The suggested cuts posted Tuesday by MedPAC staff included $75 billion in estimated 10-year savings from requiring drugmakers to provide Medicaid-type rebates for dual-eligible beneficiaries. Other savings include $23 billion from rebasing skilled-nursing facilities and $14 billion from both limiting the hospital update to 1% in 2012 and implementing documentation and coding improvements.

**********

5. From Allentown Morning Call
New law brings fairness to malpractice suits
http://www.mcall.com/opinion/yourview/mc-tort-reform-anderson--yv-20110913,0,403690.story
September 13, 2011

Earlier this summer, Gov. Corbett signed the Fair Share Act into law, bringing joint and several liability reform to Pennsylvania. Hallelujah!

I want to publicly extend the appreciation of all the men and women at St. Luke's Hospital & Health Network to Gov. Corbett and members of Pennsylvania's Senate and House who supported this landmark legislation. I have been a long-standing and vocal critic of Pennsylvania's contentious medical malpractice climate, and the passage of the Fair Share Act represents a significant step in a long journey toward substantive legal reform.

The Fair Share Act brings a degree of fairness to our legal system. It maintains a person's right to collect damages in a civil lawsuit while ensuring each defendant's level of financial responsibility is assessed in a fair and equitable manner, as determined by a judge or jury.

Previously, Pennsylvania law held every defendant found even 1 percent liable in a civil suit responsible for the entire verdict if other defendants could not pay their share. Under the Fair Share Act, percentage of fault equates to percentage of financial liability — basic common sense.

In signing the Fair Share Act, Gov. Corbett emphasized the legislation is "critical to improving the state's legal climate which has a direct impact on our economic climate." He noted the bill affects "the cost of goods and services, the cost of health care, and will encourage companies to move here, start here, grow here and stay here." I wholeheartedly agree.

Pennsylvania's economy — and that of our nation and many other countries across the world — continue to teeter on the brink of crisis.

The Fair Share Act levels the playing field for those involved in a civil lawsuit, including health care providers. It will further help to attract business and industry to Pennsylvania, creating jobs and providing health care benefits to more people.

It will help reduce exorbitant legal and malpractice insurance costs paid by Pennsylvania health care providers resulting from frivolous lawsuits filed by plaintiffs and their lawyers seeking to "win the lottery" in a litigious climate where degree of liability had no bearing on degree of financial responsibility in a civil lawsuit.

There is still more reform needed to bring additional fairness, common sense and accountability into our legal system. Requirements for medical experts writing the required certificate of merit as well as financial limits to pain and suffering awards must be enacted.

The Fair Share Act demonstrates the tremendous good that comes when our elected officials choose leadership over politics and fulfill their responsibility to facilitate positive change on behalf of all Pennsylvanians. St. Luke's thanks them for their efforts in enacting the Fair Share Act and urges them to continue to act and heal Pennsylvania's legal system.

Richard A. Anderson is president and CEO of St. Luke's Hospital & Health Network.
Copyright © 2011, The Morning Call

((Fair Share was a good first step - there are many more steps to take, and physician and family of medicine advocacy will be VITAL to the success of other measures. We can't "rest" simply we have a governor who supports medical liability reform.))

**********

6. From Modern Medicine
Malpractice reform helps bottom line even if you don't get sued
http://www.modernmedicine.com/modernmedicine/Modern+Medicine+News/Malpractice-reform-helps-bottom-line-even-if-you-d/ArticleStandard/Article/detail/738812?contextCategoryId=40169

Publish date: Sep 7, 2011
By: Brenda L. Mooney

Does medical liability reform help the bottom lines of physicians who never get sued? Texas’ experience suggests that the answer is yes.

The board of governors of Texas Medical Liability Trust (TMLT), a physician-owned malpractice insurer, announced that it will reduce rates for the ninth consecutive year. For 2012, the average rate decrease will be 6.9%, varying by the specialty and location of the practice. In addition, the trust is paying out an 18.5% dividend for renewing policyholders, effective January 1, 2012. Combined, the rate reduction and dividend save TMLT policyholders nearly $35.8 million in 2012 premiums, according to the trust.

Insurance rates started on a downward trend when medical liability reform was passed in Texas in 2003, and with the 2012 cuts, physicians have saved $745.5 million in decreased premiums since that time, TMLT said. With the latest rate announcement, policyholders have seen their rates drop 56.7% since liability reform went into effect. ((Tort reform doesn't reduce premiums, though, just ask your friendly neighborhood trial lawyers' association....))

This is the seventh time TMLT has declared a policyholder dividend, which will represent about a $25.4 million benefit to the group’s policyholders in 2012.

"Physicians work within an environment of decreasing reimbursements and increasing operating costs. We are hopeful that these reductions and dividends will help physicians as they help patients," said Charles R. (Chip) Ott Jr., TMLT president and chief executive officer.

On its Web site, the Texas Medical Association (TMA) points out that all major physician liability carriers in Texas have cut their rates since the passage of the reforms, most by double-digits and by an average of 27%. That has meant $879 million in cumulative liability cost savings since January 2004, according to the association.

In addition, lawsuit filings in most Texas counties have dropped by half, TMA said.

Texas also has adopted a constitutional amendment to thwart challenges from trial lawyers, now operating under an organization called the American Association for Justice (AAJ). On its Web site opposing tort reform, AAJ argues that “Medical negligence lawsuits serve an important role in promoting public health and patient safety.” ((Actually, there's no quantifiable evidence of that.))

**********

7. From the Legal Intelligencer
Delco Jury Awards $3.8 Mil. to Woman Who Died From Sepsis
http://www.law.com/jsp/pa/PubArticlePA.jsp?id=1202512430265&src=EMC-Email&et=editorial&bu=The%20Legal%20Intelligencer&pt=TLI%20PM%20Legal%20Alert&cn=TLI%20_PM20110825&kw=Delco%20Jury%20Awards%20%243.8%20Mil.%20to%20Woman%20Who%20Died%20From%20Sepsis&slreturn=1&hbxlogin=1
Gina Passarella
August 25, 2011

A Delaware County jury has awarded $3.8 million to the estate of a 52-year-old woman who died of sepsis at Riddle Memorial Hospital 14 hours after going to the emergency room with severe constipation.

The medical malpractice award is said to be one of the highest, if not the highest, in the county in several years, and it is one of less than a handful of cases that have gone in the plaintiff’s favor in five years.

According to Raynes McCarty attorney Roy DeCaro (pictured above), who represented Janice D. Heffner's husband, William, the court told him there were 75 medical malpractice cases that went to jury verdicts between 2006 and 2010 in Delaware County and 70 of them were defense verdicts. A call to the Delaware County court administrator to confirm these statistics was not immediately returned.

DeCaro said one judge told him the verdict was a good thing for the county because defendants are reluctant to even entertain settlements in the counties where defense verdicts are so prevalent.

"I think it's important that in a county, given the right case, the jurors will give fair value," DeCaro said. "But unfortunately it's the exception to the rule. But when you get verdicts like this, then the defense insurance companies have to pay attention and perhaps they will evaluate these cases in a fairer way than they are." ((That's an outrageous claim - perhaps he could offer some statistics to back it up? There's hard evidence that fewer malpractice cases are filed in Pennsylvania since the tort reforms of 2003 and the subsequent Supreme Court rule changes, but there is NO evidence available which indicates that there are fewer or lower settlements, since the PA Supreme Court doesn't track those.))

The 12-member jury in Heffner v. Riddle Memorial Hospital found 10-2 that Riddle Memorial Hospital house physician Dr. John A. Kotyo and attending physician Dr. Lawrence P. Wean were negligent in their care of Janice Heffner and that that negligence caused her death. The jury found Wean 40 percent negligent and found Kotyo 60 percent.

DeCaro said Kotyo was a direct employee of the hospital and put on a defense along with the hospital. While Wean put on his own defense, he was considered an agent of the hospital, placing Riddle Memorial on the hook for the $3.8 million. The jury awarded $3 million in Wrongful Death Act damages and $806,785 in Survival Act damages. DeCaro has filed for delay damages of $137,409.

DeCaro said plaintiffs often win the battle and lose the war when juries think they are teaching doctors a lesson by finding them negligent but then not finding that negligence was a cause of the plaintiff's harm. So he said he spent a lot of time in his closing talking about factual cause as it relates to increased risk. Showing that the conduct increased the risk of harm, which is required in Pennsylvania, is sometimes a hard concept for juries to understand, he said. ((I don't think that's hard to understand at all - if alleged negligence caused no HARM, then for what should a defendant be compensated?))

James C. Stroud of Rawle & Henderson represented Riddle Memorial and Kotyo. He said he was obviously disappointed in the verdict. He said he thought the case went really well for his client and he was surprised at the finding of liability. He was even more surprised, he said, at the size of the verdict for wrongful death, given Heffner had three adult children. Stroud said the verdict would have been high in Philadelphia, let alone Delaware County. He said his clients are considering their options for post-trial motions.

**********

8. From Legal Watchdog
The True Cost of Lawsuit Abuse
http://www.legalwatchdog.org/abuse_cost.asp

Austin, Texas -The U.S. legal system imposes on the nation a staggering cost of more than $865 billion annually through lawsuit abuse, according to recent study by the Pacific Research Institute (PRI) of San Francisco, Calif.

The cost of lawsuit abuse is 27 times more than the federal government spends on homeland security, 30 times what the National Institutes of Health dedicates to finding cures for deadly diseases, and 13 times the amount the U.S. Department of Education spends to help educate America's children. ((I like these comparisons - they kind of remind me of the trial lawyers' "American doctors kill as many people as three jumbo jets crashing each day" rhetoric.))

The authors of "Jackpot Justice: The True cost of America's Tort System" calculated that the nation's tort system imposes a yearly "tort tax" of $9,827 for a family of four and raises health care spending in the United States by $124 billion.

Lost Jobs and Lost Retirement Saving More than 51,000 U.S. jobs have been lost due to asbestos-related bankruptcies alone. Employees at these bankrupted companies have lost $559 million in pension benefits.

Loss of Shareholder Wealth Lawsuits against American corporations generate an annual loss of $684 billion in shareholder value. Who are American shareholders? Not only Bill Gates and Warren Buffet, but 50 percent of all United States shareholders are ordinary individuals.

**********

9. From The Patriot News
Pennsylvania dentists may soon be required to purchase malpractice insurance
http://www.pennlive.com/midstate/index.ssf/2011/08/pennsylvania_dentists_may_soon.html
Published: Monday, August 01, 2011, 7:11 PM Updated: Monday, August 01, 2011, 8:13 PM
BY JOHN MANGANARO, For The Patriot-News

Most dentists in Pennsylvania carry malpractice insurance, but currently, they aren’t required to do so.

That may change in the near future.

Sen. Pat Vance, R-Cumberland County, has sponsored a bill requiring dentists to purchase malpractice insurance. The state Senate unanimously approved the bill in June, and it is now in the state House of Representatives. The Legislature is in recess for the summer.

Vance introduced the bill after hearing reports of patient abuse in Reading, Berks County, and other areas of the state. Dentists who didn’t buy insurance could lose their license under the bill.

“Most responsible and group dentists already carry this kind of insurance anyway,” Vance said. “But unfortunately, the rogue dentists we really need to have this kind of coverage, to protect the consumer, are the ones who don’t.”

Dentists would be required to purchase liability insurance of $3 million annually. That amount of malpractice coverage would cost the average Pennsylvania dentist about $2,400 annually, according to Gil Davis, CEO of Pennsylvania Dental Association Insurance Services. ((Well, at least until the personal injury lawyers start to mine the new source of income....))

That average is driven up by rates in the southeastern part of the state. The average in Delaware and Montgomery counties is about $2,700. Philadelphia’s rate is closer to $4,500.

Local dentist Dr. Michael Verber called the bill “a good example of good government.”

“I already have that amount of coverage, and most dentists in the state do as well,” Verber said. “With this measure, the government will be able to increase the quality of health care without dramatically increasing the burden on doctors or patients.”

Dr. Craig Mathias, a Harrisburg orthodontist, said new malpractice insurance requirements would be “another unnecessary expense.”

“As an orthodontist, I’ve got a different level of liability, so we do already carry an adequate amount of insurance in my office,” Mathias said. “I’ve got about half of that right now.”

Mathias said picking up the rest “wouldn’t be a nail in the coffin. More like a tack to have to sit on.”

Davis said the average malpractice claim against dentists is only about $20,000. Davis didn’t have a number of claims typically filed in a year, but said there “is not a significant number.”

Dr. Dennis Charlton, president of the Pennsylvania Dental Association and a dentist in Mercer County, said his organization supports the legislation.

“Nearly all dentists in the commonwealth already have this level of malpractice insurance and this law will bring our malpractice requirements to the same level as other professionals in the state,” Charlton said.

Ronald Ruman, press secretary for the Department of State, said the agency “supports the general concept to require dentists to carry professional liability insurance.” The state department oversees the licensing of dentists.

Ruman added that, because some details of the measure are likely to be debated and changed in the House, the department “will wait to see the final version before taking a position on the legislation in its final form.”

**********

10. From Insurance Journal
Texas Medical Liability Trust to Reduce Rates, Pay 18.5% Dividend
http://www.insurancejournal.com/news/southcentral/2011/08/25/212358.htm
August 25, 2011

Texas Medical Liability Trust announced a rate reduction for TMLT policyholders and an 18.5 percent dividend for renewing policyholders, effective Jan.1, 2012.

The average rate decrease will be 6.9 percent, but will vary by specialty and the geographic location of medical practice. The combined rate reduction and dividend will save TMLT policyholders nearly $35.8 million in 2012 premium

TMLT has reduced rates for Texas physicians for nine consecutive years since the passage of medical liability reform by the Texas legislature in 2003, the company said. The 2012 rate reduction saves TMLT policyholders about $10.4 million.

This is the seventh time TMLT has declared a policyholder dividend. This will amount to approximately $25.4 million in 2012 premium savings for TMLT physicians.

Since the passage of medical liability reform, TMLT insured physicians will have saved $745.5 million in decreased premiums, once this latest round of rate cuts and dividends is implemented.

In 2011, TMLT policyholders saw their premiums reduced 54.4 percent from 2003 rates. In 2012, this percentage is projected to increase to 56.7percent.

Source: TMLT

**********

11. From Legal Watchdog
Gov. Perry Calls for Expanded Lawsuit Reform in Texas
http://www.legalwatchdog.org/

AUSTIN – Gov. Rick Perry today urged lawmakers to maintain the principles that have helped Texas' economy lead the nation, and to build upon previous improvements to the state's legal system by further expanding lawsuit reform. The governor gave the keynote address at the Texas Public Policy Foundation's (TPPF) 9th Annual Policy Orientation for the Texas Legislature.

"As the ripple effects of the recession began to reach Texas, our sound policies helped us rebound quicker than other states and are now helping us lead the way to recovery," Gov. Perry said. "We must work together this session to strengthen the basic economic building blocks that have drawn new employers and jobs to our state to ensure Texas remains the best state to do business and raise a family."

Balancing the budget while strengthening Texas' job-friendly climate¬ – based on low taxes, predictable regulations, a fair legal system and world-class workforce – is a top priority for the governor and vital to the future of the state.

To keep Texas' legal system accountable, transparent and efficient, and maintain Texas' competitive economic position, the governor noted the need to expand lawsuit reform in Texas by:

Creating an early dismissal option for frivolous lawsuits ((That's an excellent idea. The longer these cases linger, the more they cost.))

Ensuring victims of frivolous lawsuits do not bear the financial burden of defending themselves through the creation of a "loser pays" system

Ensuring new laws cannot create causes of action unless expressly established by the Legislature
Setting up expedited trials and limited discovery for lawsuits with claims between $10,000 and $100,000

Gov. Perry also reiterated his call for legislators to use available state revenue and thoroughly review all agencies and programs in order to balance the budget without raising taxes. To ensure state agencies continue to use taxpayer dollars prudently, the governor, lieutenant governor and House speaker have already directed state agencies to identify savings of 5 percent in the 2010-2011 biennium, an additional 2.5 percent for the 2011 fiscal year, and 10 percent for the 2012-2013 biennium.

**********

12. From American Medical News
Most doctors face lawsuits, but few lose them
Less than 2% of those sued make payments to plaintiffs, a study shows. Neurosurgeons are sued more often than any other specialists.
http://www.ama-assn.org/amednews/2011/08/29/prsa0829.htm
By Alicia Gallegos, amednews staff. Posted Aug. 29, 2011.

Most physicians will be sued at least once during their career, but the majority of cases will end in their favor.

The frequency of medical liability claims varies by specialty, with neurosurgeons sued more often than other physicians, said a study in the Aug. 18 issue of The New England Journal of Medicine.

Researchers estimated that by age 65, 75% of physicians in low-risk specialties will have experienced a lawsuit, compared with 99% of physicians in high-risk specialties.

"The purpose of this study was to really try to understand what are the individual malpractice risks that physicians in each specialty face," said lead study author Anupam B. Jena, MD, an internist in the Dept. of Medicine at Massachusetts General Hospital and a clinical fellow at Harvard Medical School in Boston. "Naturally, physicians in each specialty believe they are getting sued more often than average."

Dr. Jena and his colleagues analyzed claims data on about 41,000 physicians between 1991 and 2005 from an unidentified national medical liability insurer. The study found that each year, an average 7.4% of physicians experienced a medical liability claim. But among those doctors, only 1.6% made payments to plaintiffs.

Among neurosurgeons, each year 19.1% were sued. About one in five thoracic-cardiovascular surgeons faced a claim, followed by 15.3% of general surgeons. Only 2.6% of psychiatrists were sued in a given year, the least of all specialties.

About 8% of internists and 5.2% of family physicians faced lawsuits.

Physicians sued more often do not necessarily pay higher awards to plaintiffs, the study found. Dermatologists paid an average award or settlement of $117,832, the least of any specialty. Pediatricians paid the most, an average of $520,923 per payment.

Study supports previous research

The findings are not surprising, said Brian Atchinson, president of the Physician Insurers Assn. of America.

"This study validates what PIAA has reported for decades -- that the vast majority of claims and suits brought against health care providers have no merit," Atchinson said in an email. "Our figures show that 70% of the claims and suits brought against doctors do not result in payments to patients. Furthermore, for claims resolved at verdict, the defense prevails 80% of the time. Despite these facts, as a result of our flawed and inefficient medical liability system, health care providers continue to be subjected to unnecessary stress and time away from caring for patients, as the study noted."

An average of 7.4% of U.S. physicians are sued each year.

An analysis by PIAA found that the average cost of resolving a medical liability case in 2009 was $324,969, a rise of 13.9% from 2000.

The NEJM study results on frequency of lawsuits are similar to those of an American Medical Association survey released in 2010. The survey found more than 60% of physicians were sued by age 55.

The NEJM and AMA studies "paint a bleak picture of physicians' experiences with medical liability claims and bolsters the case for national and state level reform to rein in a broken legal system that invites abuse and excessive litigation," said AMA President Peter W. Carmel, MD. "Even though the vast majority of claims are dropped or decided in favor of physicians, the understandable fear of meritless lawsuits can profoundly influence which medical specialty physicians choose, where they practice and when they retire. This litigious climate hurts patients' access to health care at a time when we are also facing a shortage of physicians and other health professionals."

Authors of the NEJM study hope the piece will motivate physicians and others to discuss and implement more creative strategies to combat meritless claims, said co-study author Amitabh Chandra, a professor of public policy at Harvard Kennedy School. Traditional tort reforms such as damages caps are merely "patching portholes in the Titanic," he said.

Researchers said there were other costs the NEJM study did not capture, including the toll on physicians' emotions and reputation during a lawsuit.

"Although most cases get resolved in favor of doctors, it's a long, torturous legal process," Chandra said. "It's very slow, and the doctor is sitting there, sweating the whole time."

Lawsuits by specialty

A study shows how often physicians by specialty are sued annually and how many end up making payments to plaintiffs who have sued them.

Percentage of physicians sued
Specialty Sued Making plaintiff payment
Neurosurgery 19.1% 3.1%
Thoracic-cardiovascular surgery 18.9% 3.8%
General surgery 15.3% 4.2%
Orthopedic surgery 14.2% 3.9%
Plastic surgery 12.7% 2.8%
Gastroenterology 11.6% 1.3%
Obstetrics-gynecology 11.0% 2.9%
Urology 10.5% 2.5%
Pulmonary medicine 9.3% 0.9%
Oncology 9.1% 1.9%
Cardiology 8.6% 1.0%
Gynecology 8.3% 3.2%
Neurology 7.8% 1.4%
Internal medicine 7.7% 1.3%
Emergency medicine 7.6 1.4%
Anesthesiology 7.3% 1.6%
Diagnostic radiology 7.2% 1.6%
Ophthalmology 6.7% 1.2%
Nephrology 6.0% 0.4%
Pathology 5.6% 1.3%
Dermatology 5.4% 1.2%
Family general practice 5.2% 1.0%
Pediatrics 3.1% 0.5%
Psychiatry 2.6% 0.5%
Other specialties 4.0% 0.7%
All physicians 7.4% 1.6%

Source: "Malpractice Risk According to Physician Specialty," The New England Journal of Medicine, Aug. 18 (www.ncbi.nlm.nih.gov/pubmed/21848463)

Weblink
"Malpractice Risk According to Physician Specialty," The New England Journal of Medicine, Aug. 18 (www.ncbi.nlm.nih.gov/pubmed/21848463)

"Medical Liability Claim Frequency: A 2007-2008 Snapshot of Physicians," AMA Policy Research Perspectives, August 2010 (www.ama-assn.org/ama1/pub/upload/mm/363/prp-201001-claim-freq.pdf)

Copyright 2011 American Medical Association. All rights reserved.

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13. From Washington Examiner
Days numbered for trial lawyers getting outrageous paydays
http://washingtonexaminer.com/opinion/columnists/2011/08/days-numbered-trial-lawyers-getting-outrageous-paydays
By: David Freddoso Online Opinion Editor
08/23/11 8:05 PM

Here's a tip for you: Listening to really, really loud sounds over long periods of time can damage your hearing.

Perhaps you already knew that. But a few years back, a group of clever trial lawyers decided they could make some serious money by arguing in court that you are too stupid to know it yourself.

They filed 26 consumer fraud lawsuits in multiple states against Motorola and other manufacturers of Bluetooth headsets. They alleged that consumers were not warned sufficiently about the dangers, and that they "would not have purchased their Bluetooth headsets but for defendants' false advertising."

That led to a single class-action case in federal court, in which the plaintiffs sought refunds, restitution and punitive damages. And attorneys' fees, of course.

The case was pretty light on the merits -- in fact, Apple recently got a similar nuisance case thrown out of court over its iPod product line. But millions of people had purchased Bluetooth headsets, and so the potential for liability was high.

And these kinds of nuisance cases often cost a lot of money to defend. Most deep-pocketed defendants would rather spend a million dollars making a case like this one go away than spend millions more in litigation.

For the lawyers, this case was simple: File a lawsuit, then get a settlement agreement -- which they did. Under its terms, a hearing loss charity was to get $100,000. The lawyers were to get $800,000. And those who cranked up the volume full blast until they lost their hearing? They would basically get nothing. ((Look at that again - the lawyers were to get $800,000.))

But this week, the U.S. Ninth Circuit Court of Appeals put a damper on the business model of legal extortion by trial lawyers filing frivolous lawsuits. It sent this particular class-action settlement back to the lower court for reconsideration. It was the court's first failure to rubber-stamp such a class-action settlement in eight years.

Ted Frank of the Center for Class Action Fairness had filed the objection to the settlement. "We have been saying all along that this is an abuse of the class-action process," Frank told me. He said that the case could be a milestone in his fight to prevent such abuses.

"A defendant is willing to throw a million dollars at a case to make it go away, because it's often more expensive to defend it," Frank said. "And the attorneys are OK with settling for that million dollars, if they get the million dollars. But if most of the money has to go to their clients, they won't bring the crummy cases in the first place. They'll only bring meritorious cases."

Frank has become the proverbial fly in the trial lawyers' ointment, objecting again and again to bogus nuisance settlements that make up the bread and butter for some. In January, his objection helped convince a court to throw out a settlement between Classmates.com (the online social site with the annoying popup ads) and some users who felt they had been duped into signing up.

In that case -- whose merits appear much stronger than the Bluetooth case -- the lawyers had negotiated $117,000 for the aggrieved class, and a million-plus-dollar fee for themselves.

Frank's organization, a nonprofit 501(c)(3), is currently fighting settlements that are overly generous to trial lawyers in cases against Kellogg, Volkswagen and Toys "R" Us, among others.

He has also filed an objection to a settlement in an antitrust case against Sirius XM radio, which provided nothing -- zero -- for the plaintiffs, and $13 million (or 100 percent of the monetary settlement) for the attorneys.

The message for certain trial lawyers is that their days of self-serving deals and sponging off deep-pocketed defendants are numbered.

((Ted Frank is one of my heroes.....!))

David Freddoso is The Examiner's online opinion editor. He can be reached at dfreddoso@washingtonexaminer.com.

**********

14. From Roll Call
Gingrey: Lawsuits Handcuffing Health Care
Awards from Liability Suits Shouldn't Be Used as Investments for Hedge Funds
http://www.rollcall.com/features/Health-Care-2011_Policy-Briefing/policy_briefings/-204316-1.html
By Rep. Phil Gingrey
Special to Roll Call
March 25, 2011, 10:23 a.m.

It is a well-known fact that a strong doctor-patient relationship is an important part of an effective health care system.

What is less known, however, is that this relationship is in serious peril because of increasing attempts by some trial attorneys and Wall Street to exploit medical malpractice cases in search of large profits.

In the past few years, hedge funds and investment firms have begun capitalizing on medical lawsuits in order to reap rewards that are actually intended for injured patients. Furthermore, many of these suits aren’t even based on legitimate claims and oftentimes it is the patient’s own attorney who is responsible for facilitating these deals.

This is an alarming and costly problem. The New York Times reported that in this year alone, the financing of these types of frivolous suits will cost nearly $1 billion, adding a large amount of wasteful spending to our already ailing health care system. Health care liability awards should not be used as an investment vehicle for law firms and hedge funds, but should be used to make the patient whole.

When the well-being of patients is no longer the first priority, the need for tort reform becomes more important than ever. Support for meaningful medical malpractice liability reform can be traced back 30 years, to when then-Gov. Jerry Brown (D) of California implemented tort reform laws to address this very problem. The results were significant. The state saw an improvement in the care of patients and their safety, more accessibility to care, growth in the industry and lower costs.

The need for reform is still being echoed today, but on a national level. Most recently, we heard President Barack Obama during his State of the Union address talk about the need to look at alternate ways to lower the cost of health care, including medical liability reform. What may have been traditionally thought of as a political issue is now clearly an initiative with widespread bipartisan support.

This support gives us the ability to answer the call for reform by implementing meaningful liability solutions on a much larger scale. To do so, I introduced H.R. 5, the Help Efficient, Accessible, Low-cost, Timely Healthcare Act, along with my co-sponsors, House Judiciary Chairman Lamar Smith (R-Texas) and Rep. David Scott (D-Ga.). Our bill parallels the successful reforms in California and would ensure that injured patients can be made whole while creating substantial savings for our health care system.

And the savings that these reforms would bring about are quite significant. Meaningful medical liability reform has the potential to dramatically reduce the cost of health care by as much as $200 billion annually. Currently, this money is being lost to the practice of defensive medicine, frivolous lawsuits and excessive fees instead of being used to compensate injured patients. In a time when each and every dollar that we spend counts, these savings could make a huge difference in the quality of health care provided.

This cost ultimately increases insurance rates and creates a less desirable environment for physicians to practice medicine. In fact, the rising cost of medical malpractice insurance has been the main reason cited by medical students for deciding not to practice, which is a contributing factor to our national physician shortage.

Lack of reform not only increases the costs of health care significantly, but it directly strains the doctor-patient relationship. When medical liability cases becomes less about the quality of care and more about outside parties earning dividends on patient injury awards, the need for reform is clear. After all, it should be easier to see your doctor than to sue your doctor.

Maintaining the status quo in our health care system is no longer acceptable. Big, expensive and intrusive bills are not the kinds of solutions the American people want. But by supporting reforms such as the HEALTH Act, we can enact cost-cutting and meaningful measures that truly turn our focus back to the care and protection of patients nationwide.

Rep. Phil Gingrey (R-Ga.) is a member of the House Energy and Commerce Committee and its Subcommittee on Health. He co-chairs the GOP Doctors Caucus.

**********

15. From NCPA
Health Reform and Medical Malpractice Reform
http://www.aei.org/docLib/2011-04-Hyman-Sage.pdf

The final version of the Patient Protection and Affordable Care Act (PPACA) included only two minor provisions related to medical malpractice. Section 6801 encourages states "to develop and test alternatives to the civil litigation system," say David A. Hyman, University of Illinois, and William M. Sage, University of Texas at Austin.

Section 10607 authorizes $50 million over a five-year period to support demonstration grants to states for the "development, implementation, and evaluation of alternatives to current tort litigation for resolving disputes over injuries allegedly caused by health care providers or health care organizations."

To qualify for the new funding, a state must demonstrate that its proposal:

Makes the medical liability system more reliable and efficient.
Encourages the disclosure of health care errors and enhances patient safety.
Improves access to liability insurance.
Fully informs patients about the differences in the alternative and current tort litigation.
Provides patients the ability to opt out of or voluntarily withdraw from participating in the alternative at any time.
Does not conflict with state law and will not limit or curtail a patient's existing legal rights.

Why did the PPACA not emphasize malpractice reform as a more important component of health care reform? Should the PPACA have done more to change the rules of malpractice liability? What kinds of changes might make sense? The PPACA's omission of malpractice reform was a missed opportunity to secure the support of physicians for payment reform and delivery-system transformation. The real issue is what we want our health care system and our malpractice system to do when working together.

Modifications to both should be undertaken with that question in mind, say Hyman and Sage.

((Dr. Sage is fair-minded and intelligent, as he demonstrated during Pennsylvania's medical liability crisis.))

Source: David A. Hyman and William M. Sage, "Do Health Reform and Malpractice Reform Fit Together?" The American Enterprise Institute, April 1, 2011.

For text:

http://www.aei.org/docLib/2011-04-Hyman-Sage.pdf

For more on Health Issues:

http://www.ncpa.org/sub/dpd/index.php?Article_Category=16

**********

16. From Forbes
Malpractice Suits Plunge In Wake of Mississippi Tort Reforms
http://blogs.forbes.com/danielfisher/2011/07/28/malpractice-suits-plunge-in-wake-of-mississippi-tort-reforms/
Jul. 28 2011 - 2:01 pm
By DANIEL FISHER

A new study of medical malpractice litigation in Mississippi suggests caps on pain and suffering awards and other reforms had a dramatic impact on lawsuits against doctors in that state.
The study in the current issue of Obstetrics & Gynecology is by Mark Behrens of Shook, Hardy & Bacon, the defense firm of choice for tobacco companies and manufacturers with serious toxic liability issues. No matter. Behren simply looks at the number of lawsuits filed against doctors insured by the Medical Assurance Co. of Mississippi, the state’s largest med-mal insurer, and comes up with convincing evidence that once the legislature made it harder to sue and win big bucks, lawyers responded by filing fewer suits.

The charts make for interesting viewing. In the years before Mississippi began seriously discussing med-mal tort reform lawsuits against MACM-insured physicians rose at a steady rate of about 8.5% a year to around 250. They jumped to 355 in 2001 and then surged to 630 in 2002, after legislators passed a law capping non-economic damages at $500,000 for suits filed after Jan. 1, 2003. Who knew doctors could commit more malpractice simply because the legislature changed the rules? (The MACM said by the end of 2006 that it was “disposing of most of those claims with little or no expense,” casting doubt on quality of that last-minute lawyering.) ((I LOVE that this reporter pointed out the surge in claims JUST PRIOR to reforms going into effect - we had the same thing happen here in PA in 2002, and the numbers generated by the get-in-under-the-old-rules surge of filings has been used to make it look like the reforms had far more effect than they did ever since.))

The once-friendly legislators punished trial lawyers the following year by eliminating any increases in the cap on pain and suffering, outlawing forum shopping by forcing plaintiffs to sue in the county where they were allegedly injured, and other tweaks that made it harder to drag tangential players into lawsuits. Lawsuits fell to 132 in 2003, their lowest level since 1989, and since have averaged about 150 a year, compared with 207 a year in the decade before 2002.

The steady increase in lawsuits before tort reform exceeded the rise in MACM physician rolls, which was about 3.5% a year. The number of insured jumped 14% after reform passed to 2,500 and has since increased to 2,721. So, as Behrens points out, the reduction in lawsuits filed can’t have anything to do with the number of physicians practicing. If tort reform doesn’t explain the lower number of suits, why else are more doctors drawing fewer claims of malpractice? Medicine didn’t suddenly get safer in Mississippi in 2003. ((Which only goes to prove that the number of lawsuits filed has far more to do with money than it does with safety.))

Behrens also talks about declining med-mal insurance rates, although as Tom Baker of the University of Pennsylvania has demonstrated convincingly, med-mal rates tend to rise and fall to their own rhythm. Still, the numbers are impressive. Premiums rose more than 10% each year between 2000 and 2004, with a 45% increase in 2003. Since 2006 they’ve fallen 5% to 20% a year.

The Mississippi experience offers a few important lessons. First, despite what some lawyers (and state Supreme Courts) say, the legislature does have the power to dictate the terms of civil litigation. The argument that medical malpractice litigation makes medicine safer is an idea in search of supporting evidence. ((YES!)) And lawyers, like all business people, respond to economic incentives. The sudden spike in apparent malpractice followed by a major decrease says everything about economics and very little about how many people were actually injured by malpractice. ((Again, YES!))

**********

17. Everything You Wanted to Know About "ObamaCare"
(but didn't know who to ask)
http://www.ustream.tv/channel/health-care-reform---desales

Video of Lehigh Valley COALITION for Health Care Reform's Constitution Day Educational Workshop - Everything You Wanted to Know About "ObamaCare" (but didn't know who to ask) at DeSales University on Sept. 17th.

Part 1
http://www.ustream.tv/recorded/17332009 - 1:59.25
Introduction - PPACA Nuts and Bolts, Implementation Timeline - Donna Baver Rovito - PA Rep. Stephen Bloom - Dr. Elena Farrell (D4PC) - Dr. Nick Pandelides (D4PC) - Samuel Denisco (PA Chamber) - Rep. John Shadegg - Dr. Richard Armstrong (D4PC)

Part 2
http://www.ustream.tv/recorded/17334048 - 6:27
Dr. Richard Armstrong (D4PC) (cont) -

Part 3
http://www.ustream.tv/recorded/17334228 - 1:01.17
Terrence O'Connor (HB 42) - William Taylor Reil (Nullification) - John Morningstar (Health Care Compacts) - John Brinson (Individual Reforms needed) - Dr. Alieta Eck (AAPS Pres-Elect)

Part 4
http://www.ustream.tv/recorded/17335319 - :58.37
Panel Discussion - Closing

For more information about the Coalition, go to www.meetup.com/lehigh-valley-coalition-for-health-care-reform

**********

This LIABILITY & HEALTH REFORM UPDATE is a free service which I provide, as a volunteer, to help supply medical liability and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform, and quality health care advocates. No one pays me to do this.

I am not employed by any physician or health care reform advocacy or liability reform organization, political party, or candidate, although I volunteer for several. I am an advocate for quality health care, physicians and patients, a breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not, nor will I ever claim to be, unbiased (I am....biased, I mean), unlike many in the mainstream media.

Most information in this newsletter is copied and pasted from other sources, and will always provide a link to the original source. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized, and appear in blue.

This Update is emailed to health professionals, physician and patient advocates, grassroots activists, and others interested in ensuring access to quality medical care.

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PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL OR PATIENT YOU KNOW SO WE CAN GET THIS INFORMATION TO MORE OF THE PEOPLE WHO NEED IT.

Donna Baver Rovito, Editor, Liability and Health Reform Update

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Lehigh Valley COALITION for Health Care Reform: www.meetup.com/lehigh-valley-coalition-for-health-care-reform Email: LVCoalition4HCR@aol.com

6/24/11 - Fair Share Act Passes PA Senate - Now Back to the House

2011-06-24T18:22:00.000-07:00

6/24/11 - Liability and Health Reform Update
Fair Share Act Passes PA Senate
Now back to the House

((Editor's comments in blue italics. Please scroll to the end for more information, disclaimer, etc.))

~~~~~~~~~~~~~~

Editor's Comments:

MANY THANKS to everyone who called, wrote and emailed members of the PA Senate to support the Fair Share Act! Your advocacy made all the difference in the world!

Please watch for more comments further down in this newsletter....

And thanks again for all your help!

DBR

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Bill to limit lawsuit liability passes state Senate
GOP leaders expect it to move quickly through House to Corbett.
http://www.mcall.com/news/local/pa-xgr--lawsuit-liability-20110621,0,7756316.story
by Mark Llevy

HARRISBURG — A top priority of Gov. Tom Corbett moved an important step closer to becoming law Tuesday as the state Senate passed a bill limiting the liability of defendants in some civil court cases for negligence after passionate debate that pitted the interests of business owners, hospitals and insurers against lawyers who represent victims.
Senators in the Republican-controlled chamber voted 32-18 to send the bill to the House, which handily passed a nearly identical bill in April and where leaders of the GOP majority expect to move it quickly to Corbett's desk. All but one Republican voted for it, and all but three Democrats opposed it.
The vote came after 90 minutes of floor debate Monday and Tuesday over what impact the bill would have on the state's economy and what would happen to people who are wronged and seek justice through the courts.
Current law holds all guilty defendants potentially liable for 100 percent of damages if their co-defendants cannot pay for the negligence resulting in death or injury to a person or property.
But supporters of the bill say the law hurts Pennsylvania's business climate because it allows a victim's lawyers to drag a deep-pocketed company with little connection to the negligent act into the case because of its ability to pay. Opponents of the bill, however, say changing the law will hurt victims of negligent acts and their families who seek justice in the courts after they are maimed and unable to work, or killed.
"This is a bill that's been identified by every business organization that I'm aware of in the state as a No. 1 priority to help them create jobs in this commonwealth," said Senate Appropriations Committee Chairman Jake Corman, R-Centre. "This is a bill that the health care organizations have been strongly supportive of to help them keep their viability in their communities."
Democrats accused Republicans of driving a larger agenda to take away rights.
"It hurts people," said Sen. Larry Farnese, D-Philadelphia. "It doesn't create an economic boom. It doesn't create jobs. It puts people in a position where they can be hurt, where their quality of life can be destroyed and where government does nothing to make their lives better."
On Monday, senators voted 28-22 to approve a Corman-sponsored amendment to an underlying bill written by Senate Judiciary Committee Chairman Stewart Greenleaf, R-Montgomery, who, like trial lawyers and labor unions, opposed the bill that came over from the House.
Under the bill, defendants found to be less than 60 percent at fault wouldn't have to pay more than their share of the damages, except for awards in circumstances including intentional misrepresentation, an intentional act, an environmental crime or a liquor law violation.
Corman's amendment eliminated two additional exceptions for cases where children are involved and where the victim lost wages because of injury or death.
Hospitals, insurers and business groups lobbied against Greenleaf's bill and said it carried too many exceptions to fix the inherent unfairness in the law.
"If you think the civil justice system is a welfare program where everybody gets everything they're asking for, then vote against this bill," said Sen. Jeffrey Piccola, R-Dauphin. "But that's not what civil justice is all about. Civil justice is about fairness, this bill is about fairness."
Senate Minority Leader Jay Costa, D-Allegheny, then called out Piccola for apparently flipping his arm during Costa's response — "we're not going to flip our arm to the people of Pennsylvania who are going to be harmed by this legislation," Costa said — and Greenleaf warned that Medicaid claims will rise, but insurers won't lower premiums if the bill becomes law.
"This will be a welfare state if you pass this legislation," Greenleaf said.
A similar bill has passed a GOP-controlled Legislature twice before in Pennsylvania. After it became law in 2002, House Democratic leaders sued and state appellate courts overturned it on grounds that the bill it was written into violated the Pennsylvania Constitution's requirement that bills confine themselves to a single subject.
The Legislature later passed a replacement bill, but it was vetoed in 2006 by then-Gov. Ed Rendell, a Democrat.

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Details for RCS# 182
Monday Jun. 20, 2011
Senate Bill 1131 PN 1322
A3169 CORMAN AMENDMENT NO. A-3169
http://www.legis.state.pa.us/cfdocs/legis/RC/Public/rc_view_action2.cfm?sess_yr=2011&sess_ind=0&rc_body=S&rc_nbr=182

Summary
YEAS
28
NAYS
22
LVE
0
N/V
0
TOTAL
50

Y ALLOWAY
Y ARGALL
Y BAKER
N BLAKE
N BOSCOLA
N BREWSTER
Y BROWNE
Y BRUBAKER
Y CORMAN
N COSTA
Y DINNIMAN
Y EARLL
Y EICHELBERGER
Y ERICKSON
N FARNESE
N FERLO
Y FOLMER
N FONTANA
Y GORDNER
N GREENLEAF
N HUGHES
N KASUNIC
N KITCHEN
N LEACH
Y MCILHINNEY
Y MENSCH
N ORIE
Y PICCOLA
Y PILEGGI
Y PIPPY
Y RAFFERTY
Y ROBBINS
Y SCARNATI
N SCHWANK
Y SMUCKER
N SOLOBAY
N STACK
N TARTAGLIONE
Y TOMLINSON
Y VANCE
Y VOGEL
Y WARD
N WASHINGTON
Y WAUGH
Y WHITE DONALD
Y WHITE MARY JO
N WILLIAMS
N WOZNIAK
N YAW
N YUDICHAK

Details for RCS# 190
Tuesday Jun. 21, 2011
Senate Bill 1131 PN 1389
FINAL PASSAGE
http://www.legis.state.pa.us/cfdocs/legis/RC/Public/rc_view_action2.cfm?sess_yr=2011&sess_ind=0&rc_body=S&rc_nbr=190
Summary
YEAS
32
NAYS
18
LVE
0
N/V
0

TOTAL 50

Y ALLOWAY
Y ARGALL
Y BAKER
N BLAKE
Y BOSCOLA
N BREWSTER
Y BROWNE
Y BRUBAKER
Y CORMAN
N COSTA
Y DINNIMAN
Y EARLL
Y EICHELBERGER
Y ERICKSON
N FARNESE
N FERLO
Y FOLMER
N FONTANA
Y GORDNER
N GREENLEAF
N HUGHES
N KASUNIC
N KITCHEN
N LEACH
Y MCILHINNEY
Y MENSCH
Y ORIE
Y PICCOLA
Y PILEGGI
Y PIPPY
Y RAFFERTY
Y ROBBINS
Y SCARNATI
Y SCHWANK
Y SMUCKER
N SOLOBAY
N STACK
N TARTAGLIONE
Y TOMLINSON
Y VANCE
Y VOGEL
Y WARD
N WASHINGTON
Y WAUGH
Y WHITE DONALD
Y WHITE MARY JO
N WILLIAMS
N WOZNIAK
Y YAW
N YUDICHAK

~~~~~~~~~~~~~~

From the PA Medical Society Website:

Bill to Modify Pennsylvania’s Joint and Several Liability Law Now in the House
http://www.pamedsoc.org/HomePageNews/Joint-and-Several.html

A much needed liability reform bill is another step closer to becoming law. After passing the Senate by a vote of 32-18, Senate Bill 1131, which would modify Pennsylvania’s joint and several liability law, was approved by the House Judiciary Committee and now goes to the House floor for its consideration. As amended by Sen. Jake Corman (Centre, Juniata, Mifflin, Perry, and Union) and passed by the Senate, SB 1131 is now identical to House Bill 1 and Senate Bill 2, which will no longer be considered. Pennsylvania is one of only a handful of states that has complete joint and several liability. Under the current law, if one defendant is without assets or has insufficient funds to pay their share, the other defendant(s) can be held responsible for 100 percent of the jury’s award. If this legislation is passed, each responsible defendant would only have to pay their share as long as the jury finds them less than 60 percent at fault. If a defendant is found more than 60 percent at fault, they can be made to pay 100 percent of the damages, if the other defendant(s) are without sufficient funds. Some exceptions for full joint and several liability would still exist, including intentional misrepresentation, hazardous tort(s), hazardous substances released or threatened to be released, and liquor code violations. This is not the first time around for this legislation. In 2002, a very similar bill was signed into law, but was thrown out by the state Supreme Court on a procedural technicality. In 2006, Gov. Ed Rendell vetoed yet another bill after previously indicating he would sign it if it passed.PAMED has been a long-time advocate for medical liability reforms, and has been successful in getting a number of reforms passed in Pennsylvania, including Act 13 of 2002. Currently, PAMED also supports a bill to allow physician apologies (HB 495) and a bill to strengthen the certificate of merit requirements.

~~~~~~~~~~~~~~

The Legal Intelligencer
With Senate Votes, Joint and Several Liability on Track to Be Transformed
http://www.law.com/jsp/pa/PubArticlePA.jsp?id=1202498110403&src=EMC-Email&et=editorial&bu=The%20Legal%20Intelligencer&pt=TLI%20AM%20Legal%20Alert&cn=TLI_am20110622&kw=With%20Senate%20Votes%2C%20Joint%20and%20Several
Amaris Elliott-Engel
June 22, 2011

As state Sen. Jake Corman fought back a proposal to temper changes to Pennsylvania's joint and several liability doctrine, he said the original proposal to limit the circumstances under which a defendant has to pay for another defendant's part of a judgment was the result of a compromise struck back in 2002.
The state Senate voted Monday 28-22 and Tuesday 32-18 to amend Senate Bill 1131 to strip it of exceptions that would have maintained the application of joint and several liability to economic damages and cases involving the interests of minors.
With the amendment, Senate Bill 1131's language mirrors the language of a bill passed by the House of Representatives, backed by Gov. Tom Corbett, but bottled up in the Senate Judiciary Committee. The proposal would require defendants that are apportioned responsibility for causing a plaintiff's injuries at 60 percent or less to only pay the portion for which they were found liable.
The 60 percent proposal is the same as one that became law in 2002 before being struck down by the state Supreme Court on procedural grounds and was passed by the General Assembly in 2006, only to be vetoed by then-Gov. Edward G. Rendell, a Democrat.
Corman, a Centre County Republican, said that the exemptions backed by state Sen. Stewart Greenleaf, R-Montgomery, the majority chair of the Senate Judiciary Committee, were well meaning but would dramatically reduce the impact of what Republicans in Harrisburg are trying to accomplish with changing the state's tort law.
"We don't compensate one by taking from another who was not found by a jury to have that level of responsibility," Corman said. He also pointed out that about 40 states have changed the doctrine of joint and several liability in some form.
Pennsylvania's doctrine of joint and several liability is likely to be revised because the House of Representatives already has passed parallel legislation to modify the doctrine and Corbett said in his budget address that he would sign legislation abrogating the doctrine of joint and several liability, arguing legal liability scares jobs away and leaves minor players stuck paying the full price of lawsuits.
While the language is the same in the amended SB 1131 and House Bill 1, the same bill has to pass both chambers of the General Assembly. In April, the state House of Representatives approved HB 1, known as the "Fair Share Act," on a 112-88 vote.
Erik Arneson, communications and policy director for Sen. Majority Leader Dominic Pileggi, R-Delaware, said in an e-mail the most likely option would be for the House to take up SB 1131 after it reached final passage in the Senate.
Defense attorney Craig Murphey, president of the Pennsylvania Defense Institute and a partner with MacDonald Illig in Erie, said unlike other states, this proposal would not completely eliminate the concept of joint and several liability.
"We believe that this will create a more even playing field for plaintiffs and defendants," Murphey said. "We think the 60 percent threshold is a reasonable compromise and it eliminates the real harm" to defendants compelled to pay more than their proportion of a judgment because a co-defendant could not afford to pay the award.
Fewer defendants could be brought into lawsuits under the proposed regime because there will be less likelihood of having to pay the entire judgment, so there may be less motivation "to bring in a co-defendant who may only have a tangential involvement in an incident," Murphey said.
Plaintiffs attorney Mark W. Tanner, co-managing partner of Feldman Shepherd Wohlgelernter Tanner Weinstock & Dodig in Philadelphia, said in an e-mail that legislators "elected to shift the burden of providing fair compensation to victims away from wrongdoers, and have placed it squarely on the shoulders of the taxpayers. At the end of the day, that is who will bear ultimate responsibility for the socioeconomic survival of victims and their families who may now be unable, by virtue of this legislation, to collect the fair compensation from the parties responsible for causing them harm."
Tanner predicted that the bill may cause defendants to bring in more co-defendants because primary tortfeasors will face less exposure if there are more co-defendants.
Greenleaf said on the floor of the Senate Monday that he agreed it was important to revise joint and several liability, but he said the 60 percent threshold was abandoning a state policy that favors injured victims.
Now all of a sudden, "instead of protecting victims we're protecting defendants," Greenleaf said.
Greenleaf bottled up HB 1's companion, SB 2, in committee and crafted alternatives to the proposal because he argued joint and several liability still provides important protection in the tort system to injured victims.
The proposal already preserves joint and several liability in cases of intentional misrepresentation, an intentional tort, release of a hazardous substance or a dram shop action.
State Sen. Daylin Leach, D-Montgomery, asked why an innocent victim should bear the risk in an imperfect world when a defendant who has done wrong can't pay damages.
State Sen. Jay Costa, D-Allegheny, and Greenleaf argued that states that have limited the doctrine of joint and several liability have worse unemployment rates than Pennsylvania, while Sen. Donald White, R-Indiana, said that Pennsylvania ranks at the bottom in the country's job growth. Reforming joint and several liability could increase the number of jobs in the state because businesses may feel more likely to engage in a job-creating enterprise, White said.
Corman said that representatives of Pennsylvania businesses and the health care industry said changing joint and several liability was their top legislative priority. •

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((Excellent piece, only four pages, good analysis of what works and what doesn't work....))

The State of Medical Liability Reform
July 2011 Bulletin of the American College of Surgeons
http://www.facs.org/fellows_info/bulletin/2011/pollack0711.pdf

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Mississippi Clarion Ledger
Torts: Remember bad, ol' days?
3:53 PM, Jun. 16, 2011
http://www.clarionledger.com/article/20110619/OPINION01/106190309/Torts-Remember-bad-ol-days-?odyssey=mod%7Cnewswell%7Ctext%7COpinion%7Cp

Mississippi's tort reform efforts were being widely criticized over the past week, as the state Supreme Court addresses the issue.
The court is trying to determine if the state's $1 million cap on non-economic damages is constitutional. The 5th U.S. Circuit Court of Appeals made the request in the case of a Mississippi woman who sued Sears, Roebuck and Co. after she was involved in a collision with one of its vans in Neshoba County.
As per the state's cap, a federal judge reduced a federal jury's award from $4 million, of which $2.2 million was for non-economic damages. The appeals court asked the state court to review the case.
That has prompted renewed debate about the "fairness" of Mississippi tort reforms. Some folks must have short memories.
Some may not remember that less than a decade ago, the state faced a crisis in the availability and affordability of insurance. Doctors were retiring early, leaving the state and limiting high-risk services. Hospitals couldn't retain doctors or recruit new ones with rising insurance rates.
The Clarion-Ledger's 2002 series "Fighting Lawyers, Fleeing Doctors: Seeking A Cure" and "Hitting the Jackpot in Mississippi Courtrooms" elucidated the issues.
Under former Democratic Gov. Ronnie Musgrove, the 2002 Legislature capped non-economic "or pain and suffering" damages in medical malpractice lawsuits and other reforms. It was a historic moment for the state. But insurers and businesses complained that tort reform was only half done, both in civil justice (business) and medical malpractice reforms.
Some groups labeled Mississippi a "judicial hellhole" for frivolous lawsuits and multi-million dollar verdicts.
Republican Gov. Haley Barbour campaigned on the issue, saying he would finish the reform job.
So, in 2004, under Barbour, the Legislature passed a comprehensive package of business tort reforms and expanded on medical issues from 2002.
Since Mississippi adopted tort reforms, the state has lost its reputation as a place where "jackpot justice" ruled.
Other states have caps, too, so the state Supreme Court action is being closely watched.
The essential element should be remembered that it is not the amount of the cap that's key, but that a cap is set. Insurance companies must have a standard to determine risk, some basis for potential losses.
Caps on non-economic damages do just that.

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From the Institute for Legal Reform
The Lone Star Model:
Lawsuit Reform Has Helped Fuel Texas' Job Creation Machine

While the most of the nation continues to struggle to recover from the economic downturn, one state has led the way in creating jobs: Texas.In fact, according to Dallas Federal Reserve President Richard Fisher:

Since the recovery began, 38 percent of all the jobs created in America have been created in the State of Texas.And, according to Fisher, lawsuit reform has been an integral part of Texas' amazing jobs recovery.During the past decade, Texas Governor Rick Perry has signed into law three major pieces of lawsuit reform legislation -- the most recent coming this spring.These reforms are helping making the Lone Star State a less-threatening place to do business, and they are helping to fuel the state's job creation machine.Click below to watch the clip of Richard Fisher explaining the impact of lawsuit reform on CNBC's Squawk Box:

The Institute for Legal Reform is an advocacy group working to end lawsuit abuse. ILR is a national campaign of the U.S. Chamber of Commerce, with the critical mission of making America's legal system simpler, faster, and fairer for everyone.

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June 20, 2011

Rep. Fleming Tells the Truth on Medicare
To view this youtube video please click the video below:

http://www.youtube.com/larep04#p/u/4/Nd7HJoweTic

For the latest videos from Washington, D.C. Please Click Here
Sincerely, JOHN FLEMING, M.D.Member of Congress

Dr. John Fleming is Chairman of the Natural Resources Subcommittee on Fisheries, Wildlife, Oceans and Insular Affairs and is a member of the House Armed Services Committee. He is a physician and small business owner and represents the 4th Congressional District of Louisiana.

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((This is a marvelous montage of the members of the Doctors' Caucus talking about Medicare reform!))

The Medicare Truth - GOP Doctors Caucus
From: larep04 Jun 17, 2011
http://www.youtube.com/larep04#p/u/5/BWQTPjYWQB0

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From the Editor:

Important qualifier here - while I disagree with the AMA's position on the PPACA and will work in any way possible to see the new health care law repealed, defunded, declared unconstitutional or any combination of the three, I find the vast majority of the work which has been done in the past - and continues to be done today - by the AMA and the AMA Alliance, to which I PROUDLY belong, to be of GREAT VALUE to America's health and welfare.

Another important qualifier - unless otherwise stated, NOTHING I SAY IN THIS NEWSLETTER IS THE OFFICIAL OR UNOFFICIAL POSITION OF THE AMA ALLIANCE, WHICH IS A NON-POLITICAL CHARITABLE ORGANIZATION which engages in legislative, but NEVER political advocacy. My opinions are MY opinions, and shouldn't reflect on the AMA Alliance or the PA Medical Society Alliance in any way.

As in the AMA, there are Alliance members on BOTH sides of the political divide over the PPACA. But that doesn't stop us from working together to help improve the health of America's communities through health awareness projects, medical and nursing school scholarships, support of medical families and health projects, and much, much more, and that important work needs to continue, regardless of whether we agree on a single policy point or not. There WAS no dissent at the AMA Alliance meeting in Chicago, at which I proudly represented the Pennsylvania Medical Society Alliance, for which I will become president in October. In fact, the amazing group of volunteers representing their state and county Alliances may be the most productive and forward-thinking group of people I've ever known, and we don't intend to let policy disagreements interrupt the important work we do to improve America's health.

I don't want anyone to assume that I want to see the AMA diminished by what I consider to be a poor policy choice about the PPACA. In fact, my advice to the physicians with whom I correspond regularly and in this newsletter has always been that if doctors don't LIKE AMA policy, they should get involved and CHANGE AMA policy. I still firmly believe that - the AMA is just like Congress in that respect - its members shape the policies it adopts.

I respect the efforts being made by those within the AMA to change policy, even if they weren't successful this time, as I respect and admire the efforts being made by those who've chosen another path and support OTHER organizations which represent physicians.

The bottom line for me has always been this - doctors need to be involved in policy, legislation, and politics, no matter HOW MUCH they might hate the necessity. If they're not, someone ELSE will decide how doctors should practice medicine, what kind of health care Americans will be able to access, and who will be responsible for making decisions about that care. Right NOW, a whole lot of people who didn't go to medical school are making decisions that ONLY DOCTORS should be making, and America's doctors are at least partially responsible for the position they find themselves in right now.

For far too long, America's doctors have been SO focused on providing quality health care to their patients that they've forgotten to take care of their own profession. They've been content to pay dues to some organization - or worse, pay dues to NO organizations - to represent their interests. But the only person who can be relied upon to look out for one's interests all the time is oneself - and the majority of doctors in America have defaulted the protection of their right to practice medicine in the way they were trained to other people for FAR TOO LONG.

It may already be too late to preserve medicine as an independent profession dedicated to quality care and the doctor-patient relationship. Already, there are bureaucrats writing thousands of pages of regulation that will put themselves in between doctors and patients. And if doctors don't speak up and get involved RIGHT NOW, it will be too late.

So here's your challenge - if you're mad at the AMA, JOIN IT and take it back. If you're not sure where your state medical society stands, FIND OUT. MANY of them openly oppose the PPACA and others don't support it even if they haven't taken a public position. Join your COUNTY medical society - there's nowhere you can impact policy more than at the local level.

Find out where your specialty society stands and JOIN IT at the state and national level. Explore the many other groups which are advocating for repeal of the PPACA, like the American Association of Physicians and Surgeons or AAPS, Docs4PatientCare, the Coalition to Protect Patients' Rights, the Benjamin Rush Society, Take Back the Profession, the Coalition of State Medical and National Specialty Societies, the Citizens Council for Health Freedom, the Lucidicus Project - you can google and find any of these, and there are more, probably lots more.

Join more than one. HELL, JOIN THEM ALL - and then DO SOMETHING instead of waiting for a lobbyist or a staff member to do it for you. Yeah, I know you don't have the time. You need to MAKE THE TIME. Unless you've GIVEN UP on being able to provide the best quality care for your patients - then, just sit back and let it all happen.

Legislators at all levels of government need to hear from America's doctors and medical families more now than ever before. Doctors and the people who support them must stand together to protect not only the profession, but America's quality of health care. Dissonance among health care professionals WEAKENS their ability to stand up to the challenges facing the profession.

Physicians and physicians' groups which oppose the PPACA and support repeal of the PPACA need to find ways to network and work together to achieve that goal. More doctors need to run for Congress in 2012 - or for their state legislatures. More doctors need to get onto legislators' advisory boards, or get involved in campaigns for people who support their goals.

I'll do whatever I can to make what YOU have to do easier - and so will all the groups I listed and others I probably don't even know about. But YOU must take the initiative to reach out and partner with other physicians who feel the way you do. Bitching in the doctors' lounge or on a blog or on Facebook may make you feel better for a little while, but it doesn't make a real difference. Only GETTING INVOLVED can make the difference that needs to be made.

And ONLY YOU can do that for yourself and your profession.

Need direction? Just ask - I'm here to help. And, as always, it is my honor to fight alongside of America's dedicated doctors....

DBR

From Modern Physician

READER POLL: Is the AMA right on the individual mandate? http://www.modernphysician.com/article/20110624/MODERNPHYSICIAN/306249952/1207?trk=mp_newsletter

Do you agree with the AMA's decision to continue its support for the so-called individual mandate?

TAKE OUR POLL » — Modern Physician

((The NO votes were winning when I last checked....but not by much.))

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Chicago Examiner
Former AMA chief predicts demise of ObamaCare
http://www.examiner.com/conservative-in-chicago/former-ama-chief-predicts-demise-of-obamacareJune 23, 2011 10:35 am CT
Keith Liscio

In an exclusive interview, former American Medical Association President Donald Palmisano predicted that whether by court action or the legislative process, President Obama’s signature healthcare reform law would be overturned. Dr. Palmisano spoke to your Chicago Conservative Examiner while he was in Chicago for the AMA’s annual conference this week and is the spokesman for the Coalition to Protect Patients’ Rights.
First and foremost, Palmisano (who is an attorney as well as a doctor) believes that the law will not survive scrutiny in the Supreme Court. He bases this opinion on an analysis of the expected swing vote on the Court, Justice Anthony Kennedy.
According to Palmisano, Kennedy has generally been reluctant to extend the Commerce Clause of the Constitution unnecessarily. In this case, the Obama administration is hoping that the court will essentially give it permission to regulate a person’s right not to buy health insurance by imposing a fine. Palmisano believes that this will be viewed by the court as regulating “inactivity” and will not stand, saying, “If the government can regulate that, they can force you to do anything.”
Regardless of the eventual legal outcome of the measure, however, he believes that public dissatisfaction with the law may cause the election of enough Republicans in the Senate in 2012 to overturn it legislatively. The Republican-controlled House of Representatives has already voted to defund implementation of the law.
As to the AMA Convention, Palmisano was disappointed that the organization voted to reaffirm its position that individuals be responsible for purchasing health insurance. This position has been widely seen as tacit support for the individual mandate in the President’s healthcare law.
Perhaps more importantly, however, the organization voted to oppose the law’s Independent Payment Advisory Board and the AMA will now actively work to overturn it. IPAB is a new unelected and unaccountable 15- member group appointed by the President and empowered to make recommendations without Congressional approval to cut spending in Medicare if spending growth exceeds certain levels. Palmisano, CPPR and now the AMA believe that sweeping changes to the nation’s healthcare policy should have Congressional approval.
Although he is strenuously opposed to the law, Palmisano refuses to call it “ObamaCare,” considering that term “a pejorative.” At the same time, he feels like the official name of the act, the Patient Protection and Affordable Care Act is something of a misnomer, claiming, “It doesn’t protect patients and isn’t making care more affordable.”
Asked if his position was influenced by partisan considerations, Palmisano said, “I’m a scientist. I believe in applying the scientific method and making decisions based on experimentation and proof. By that standard, [ObamaCare] is a disaster.”
The Coalition to Protect Patients’ Rights is made up of thousands of health care professionals who are dedicated to improving the quality and availability of healthcare for all Americans. The organization believes that President Obama’s healthcare reform has reduced the quality and accessibility of American health care.

Donald Palmisano, MD, JD, FACS, is a clinical professor of surgery and clinical professor of medical jurisprudence at Tulane University School of Medicine and an adjunct professor at The Tulane University School of Public Health and Tropical Medicine in the department of Health Systems Management. He is the author of the book On Leadership – Essential Principles for Success.

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The Washington Times
PALMISANO: Nailing Obamacare’s rationing board
Republicans and Democrats join forces to stop a Medicare killer
By Dr. Donald J. Palmisano
http://www.washingtontimes.com/news/2011/jun/20/nailing-obamacares-rationing-board/
6:50 p.m., Monday, June 20, 2011

With Medicare’s trustees predicting the Medicare program will go bankrupt in 2024 - five years earlier than was projected before the passage of the Patient Protection and Affordable Care Act - even Americans who strongly supported Obamacare have little choice but to acknowledge that Medicare must be reformed - and soon. While lawmakers continue to argue about the best way to protect this vital program for the seniors it serves and those who it has yet to serve, there is a growing bipartisan consensus that the Independent Payment Advisory Board (IPAB) is one provision of the new health law that will do more to undermine the program than save it.
Recently, Rep. Allyson Schwartz, Pennsylvania Democrat, became the seventh Democrat to sign on as a co-sponsor to a Republican bill that calls for the repeal of the board. In announcing her decision, she referred to the IPAB as a “flawed policy that will risk beneficiary access to care.”
This new effort to repeal IPAB is gaining momentum and could eventually bring together most House Republicans and many of the 72 House Democrats who fought to prevent the the board from being included in the new law in the first place. In addition, many of the groups that supported Obamacare like the American Medical Association, American Heart Association and AARP are now expressing opposition to IPAB and joining those that opposed it, including the organization for which I am a spokesperson, the Coalition to Protect Patients’ Rights.
Unfortunately, most people in the country, including seniors relying on Medicare, have no idea what IPAB is or how it will affect their lives if it ever becomes operational. More concerning, President Obama decided to make the board the centerpiece of his efforts to reduce the deficit by calling for it to be strengthened - not eliminated. Starting in 2015, the IPAB will give 15 unelected bureaucrats unprecedented power to slash billions of dollars from Medicare when spending exceeds targeted growth rates. The cuts made by the board will come on top of the $500 billion that was transferred from Medicare to a new entitlement program as a result of the new health care law. Democrats and Republicans have found little common ground in recent years, but there has been widespread agreement that the IPAB could exacerbate the shortage of doctors who see Medicare patients and ultimately, contribute to a reduced quality of care for our most vulnerable.
At a time when all Americans are tiring of partisan politics from both political parties, we must take advantage of the few issues on which both sides can agree. Our lawmakers must now show they are still able to put their short-term political squabbles aside for the common good of America’s patients by repealing IPAB and uniting for a constructive debate on ways to save our nation’s valued Medicare program.

Dr. Donald J. Palmisano is the former president of American Medical Association and spokesperson for the Coalition to Protect Patients’ Rights.

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Dr. Donald Palmisano - Past President of the American Medical Association (AMA) 2003-2004 - joins Don and Roma - 6/21/2011

http://www.wlsam.com/FlashPlayer/default.asp?SPID=17424&ID=2218663
Download this show
Listen

Don and Roma talk with Dr. Donald Palmisano, Past President of the American Medical Association 2003-2004.
Find out more about what Dr. Palmisano is writing and talking aboutwww.intrepidresources.com
Find out about Dr. Palmisano's book, "On Leadership: Essential Principles for Business, Political and Personal Success"www.OnLeadership.US

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((Dr. Palmisano is a clarion voice for the kind of health care reform America REALLY needs - not to mention one of my personal heroes. Anyone who aspires to be a success at anything should read his book, On Leadership, Essential Principles for Business, Political and Personal Success. It was a pleasure to see Dr. P and his wife Robin at the AMA meeting in Chicago earlier this week. As always, Dr. Palmisano was standing up for what he believes is right and fighting for America's health. It is an honor to know this outstanding leader. A more detailed review of On Leadership will follow in a subsequent edition of this newsletter.))

Find out about Dr. Palmisano's book, "On Leadership: Essential Principles for Business, Political and Personal Success"www.OnLeadership.US

Or buy it on Amazon: http://www.amazon.com/Leadership-Essential-Principles-Success-ebook/dp/B001IKKDVM/ref=kinw_dp_ke?ie=UTF8&m=AG56TWVU5XWC2

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This LIABILITY & HEALTH REFORM UPDATE is a free service which I provide, as a volunteer, to help supply medical liability reform and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform and quality health care advocates. NO ONE pays me to do this. I am not employed by any physician or health care reform advocacy or liability reform organization, political party or candidate, although I volunteer for several. I am an advocate for quality health care, physicians, and patients , a breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not, nor will I ever claim to be, unbiased (I am....biased, I mean), unlike many in the mainstream media. Most information in this newsletter is copied and pasted from other sources, and will always be identified with links. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized and appear in blue.
This Update is emailed to health professionals, physician and patient advocates, and others interested in ensuring access to quality medical care.
Join our Google Group or Facebook Page or email LiabilityNEWS@aol.com and put "subscribe" in the subject line to ensure you get all issues ASAP. It also appears on the following BLOG (when I remember to post it): http://liabilityandhealthnewsupdate.blogspot.com.

If you'd prefer not to receive these periodic updates about health care issues in America, please hit "Reply" and put "Unsub health group" in the subject line and I'll remove your email address immediately.

PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL OR PATIENT YOU KNOW SO WE CAN GET THIS INFORMATION TO MORE OF THE PEOPLE WHO NEED IT.

Donna Baver Rovito, Editor, Liability and Health Reform Update
ROVSPA@aol.com
DonnaRovito@gmail.com
LiabilityNEWS@aol.com

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6/18/11 - ACTION ALERT - Fair Share AMENDMENT Vote Wednesday

2011-06-18T16:00:00.000-07:00

6/18/11 - Liability and Health Reform Update
ACTION ALERT - Fair Share AMENDMENT Vote Wednesday

((Editor's comments in blue italics. Please scroll to the end for more information, disclaimer, etc.))

Editor's Commentary - PLEASE CALL YOUR STATE SENATOR

Pennsylvania's doctors, hospitals and businesses support the Fair Share Act - the ORIGINAL Fair Share Act, passed by the PA House and then bottled up in the Senate.

On Wednesday, the only measure that could make it our of Sen. Stuart Greenleaf's Judiciary Committee will reach the Senate floor - but before it passes, it needs MAJOR work. So we're asking you to contact your state senator and ask him or her to vote YES on the Corman Amendment to Sen. Greenleaf's SB1131.

Without the Corman Amendment, SB1131 isn't worth passing - so you need to ask your senators to vote Yes on the Corman amendment BEFORE they vote on SB1311. After the CORMAN AMENDMENT passes and is attached to SB1311, THEN we'd like them to vote Yes on it.

Following is important information to help you get engaged in the fight - WE NEED YOUR CALLS AND EMAILS BEFORE WEDNESDAY'S VOTE.

How to contact your Pennsylvania State Senators (alphabetically):

http://www.legis.state.pa.us/cfdocs/legis/home/member_information/senators_alpha.cfm

If you don't know who represents you, use this easy tool to find out:

http://www.legis.state.pa.us/cfdocs/legis/home/findyourlegislator/#address

Do it right now, before you forget.

Thank you!

DBR

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From our friends at Cold Spark Media and Citizens to Protect PA Jobs:

Hello everyone,We need your help to score a major victory for tort reform in Pennsylvania.

The PA Senate is going to vote on SB 1131 on joint and several - but this is not the bill which will help Pennsylvania businesses like HB1, which passed the house with a huge margin, would have. This is a significantly watered-down version and needs to be amended on the Senate Floor in order to make it effective.

Senator Corman is offering an amendment to SB1131 that reforms the failed Joint and Several liability system in Pennsylvania. This is the Fair Share Act that we've been fighting for over the last many months. Your help so far has been crucial but this is not the time to let up. Please call your Senator and ask him or her to vote for CORMAN AMENDMENT to SB1131. Tell them to stand on the side of small business, hospitals, doctors, and manufacturers, and not on the side of the trial lawyers.Find your senator here:

http://coldsparkmedia.us2.list-manage2.com/track/click?u=e2bb6bcf79685949aeb096c74&id=5c0733b45b&e=7af57e8c87 .

We believe that Senators Erickson, Mary Jo White, and Gene Yaw are on the fence. Please encourage them to stand up for job creation in Pennsylvania by supporting the CORMAN AMENDMENT

Sincerely,Citizens to Protect PA Jobs

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The Legal IntelligencerTort Reform Compromise Gains in State Senate
http://www.law.com/jsp/pa/PubArticlePA.jsp?id=1202497538582&src=EMC-Email&et=editorial&bu=The%20Legal%20Intelligencer&pt=TLI%20AM%20Legal%20Alert&cn=TLI_AM20110616&kw=Tort%20Reform%20Compromise%20Gains%20in%20State%20Senate&slreturn=1&hbxlogin=1
Amaris Elliott-Engel - June 16, 2011

A proposal to abolish the common-law doctrine of joint and several liability has become law once in the last decade before being struck down by the state Supreme Court on procedural grounds. The same proposal was passed by the General Assembly in 2006, only to be vetoed by a Democratic governor.

But in 2011, the measure isn't getting past a state Senate committee chairman in its original form, despite the fact that Republicans control the governor's mansion and both houses of the state legislature.

Instead, state Sen. Stewart Greenleaf, R-Montgomery, the majority chairman of the Senate Judiciary Committee, crafted alternatives to a proposal that has been popular with lawmakers in the past and would require defendants that are apportioned responsibility for causing a plaintiff's injuries at 60 percent or less to only pay the portion for which they were found liable.

Greenleaf's latest alternative to House Bill 1/Senate Bill 2 was introduced Monday and was approved by the Judiciary Committee 13-1 Tuesday. The bill also was sponsored by State Sen. Jake Corman, R-Centre, who was one of the sponsors of SB2.

Senate Bill 1131, the latest Senate alternative to HB1/SB2, would still apply joint and several liability to economic damages and in cases "where a minor has a beneficial interest."

State Sen. Dominic Pileggi, R-Delaware, the Senate Republican Majority Leader, plans for the Senate to vote on the issue of joint and several liability this month, perhaps as early as next week, spokesman Erik Arneson said in an e-mail, but amendments are almost certain to be offered.
Greenleaf said that he amended SB2 because joint and several lability needs to be reformed, but still provides an important function in Pennsylvania law: ensuring that injured victims are substantially compensated for their injuries.

"Joint and several liability has always had the philosophy that we should protect the victims of wrongdoing and make sure, best as we can, that they're fully compensated and not throw them onto the taxpayer."

Greenleaf argued that SB2 would cause victims, subject to physical injuries and who cannot get fully compensated, to rely on the governmental programs of Medicaid or Medicare for their care.
Employers who cannot get compensated for workers' compensation claims from judgments also will be adversely affected, and doctor defendants in medical malpractice cases will no longer be able to turn to hospital co-defendants to supplement their share of defense verdicts, Greenleaf said.

Even though the stars might have seemed aligned for changes to Pennsylvania's tort law because Republicans control the General Assembly and the executive branch, the Pennsylvania Republican Party is not a monolith on issues that have support among Republican voters, including tort reform, school choice and whether to tax natural gas drillers, said Christopher Borick, director of the Muhlenberg College Institute of Public Opinion.

"What happens sometimes in the small body of the Senate, it only takes a few key members who have differences on the matter to really hold it up and in this case craft a version that is less intense relative to the House version," Borick said.

James Redmond, senior vice president for legislative services for The Hospital and Healthsystem Association of Pennsylvania, said that proponents of changing Pennsylvania's tort law hope that SB1131 can be amended so it ends up looking more like SB2.

The association opposes SB1131, not only because of the proposed exception of ending joint and several liability for noneconomic damages, but because making an exception for minors who have a beneficial interest in tort cases "could be interpreted as including most cases," Redmond said.
Greenleaf deserves credit for trying to bring the proponents and opponents of changing the doctrine of joint and several liability together, but the health care provider community, business community and insurance community view SB2/HB1 as non-negotiable, Redmond said.

Redmond said he believes that the majority of the Senate is supportive of SB2, but that version of tort reform is opposed by Greenleaf and will not get out of the Judiciary Committee.

Mark E. Phenicie, legislative counsel for the trial lawyer group Pennsylvania Association of Justice, said that one reason that SB2/HB1 may be less popular in the Senate than in the past is that there are 20 new senators and a totally new Senate leadership since the 60 percent standard was last passed by legislators.

Phenicie said that SB1 is a compromise between SB2 and Senate Bill 500, a prior bill introduced by Greenleaf which would abolish joint liability for any defendant whose percentage share of liability is less than the percentage share attributed to the plaintiff. The bill would bar a plaintiff from recovering damages from the defendant in excess of the defendant's percentage share.

"We think that [compromise] eminently fair," Phenicie said. "Most of the angst on tort reform has mostly come to non-economic damages. While they're very real they're hard to quantify."

Redmond said SB1131 is only being called a compromise by the state's trial lawyers.

Proponents of the Greenleaf's proposal fear that Gov. Tom Corbett will find it unacceptable, Phenicie said.

Corbett's press office did not respond to a request for comment Wednesday.

A spokesman for Republican House Majority Leader Mike Turzai, R-Allegheny, said there is nothing to comment on regarding alternatives to HB1 until the full Senate acts.

In April, the state House of Representatives approved HB1, the "Fair Share Act," on a 112-88 vote
During his budget address in March, Corbett said that he would sign legislation abrogating the doctrine of joint and several liability, arguing legal liability scares jobs away and leaves minor players stuck paying the full price of lawsuits. •

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http://www.pittsburghlive.com/x/pittsburghtrib/opinion/s_741555.html
Torts' tough track
By Brad Bumsted, TRIBUNE-REVIEW

Sunday, June 12, 2011

How much clout does a committee chairman have? Quite a lot, is the answer. But in the end, not more than a majority of his or her caucus or the will of the House or Senate.

It's an issue now because Senate Judiciary Chairman Stewart Greenleaf will not allow the "Fair Share Act" to emerge from his committee for a Senate vote. It has been passed by the House and it's a top priority of Gov. Tom Corbett.

It's issue No. 1 for the business community but Greenleaf thinks it shortchanges victims.

The bill would prevent minor parties in lawsuits from having to pay full damages when those most responsible can't pay. Supporters say it prevents targeting "deep pocket" defendants who bear a small share of the responsibility for causing damages. It's based on the concept of "comparative responsibility."

Ultimately, Greenleaf knows he can't block it if a majority of Senate Republican Caucus members demand action. But he is trying to hold out for some modifications.

It's likely there's a majority. And a member of leadership, Senate Appropriations Chairman Jake Corman, R-Centre County, has his own bill, which is like the House bill. It's also parked in the Judiciary Committee.

The bill has been passed twice before by the General Assembly but never became law. So supporters see no need to compromise on a weaker version. The legislation was overturned by the courts and later vetoed by then-Gov. Ed Rendell, a Democrat.

It pits trial lawyers against the business and insurance communities.

Greenleaf wants to make sure victims have a fair shot and ultimately taxpayers and ratepayers aren't left holding the bag.

But supporters say taking this step is critical for reducing Pennsylvania's reputation as a haven for plaintiffs' lawyers and to improve the overall climate for business. It's the first step in "tort reform" and Corbett and House Majority Leader Mike Turzai, R-Bradford Woods, will have more to follow.
What Greenleaf is doing is no different from what numerous committee chairmen have done in the past. When Rep. Bill DeWeese, D-Greene, was House Judiciary chairman in the 1980s, he used to bottle up bills restricting abortion.

Last session, former House Appropriations Chairman Dwight Evans, D-Philadelphia, refused for the longest time to release the so-called Castle Doctrine bill. That bill expands the concept of self-defense by allowing people to shoot an assailant outside their home without retreat when their lives are in danger. Currently they can do that in their homes. But the majority of the House wanted action on the bill. Many Democrats supported it.

A "discharge resolution" was filed and then-Democrat House leaders saw the handwriting on the wall. Evans released it. It was approved by both chambers, then vetoed by Rendell.

It should soon end up on Corbett's desk. Like several other bills, it's stuck in a no-man's land with a House-passed and Senate-passed version. It's all about who gets the credit -- which legislator becomes the final sponsor.

Greenleaf says it's the business community that won't compromise. He said he offered "compromise after compromise." Businesses leaders say: Why should we if we have the votes?

Erik Arneson, a spokesman for Senate Majority Leader Dominic Pileggi, R-Delaware County, said there will be a vote this month. On what version, it remains to be seen.

As for the clout of committee chairmen, it's like most other arenas, including the private sector -- there are limits on a boss's power.

~~~~~~~~~~~~~~~~~~

Members of the PA Senate JUDICIARY Committee

Officers

Greenleaf, Stewart J. , Chair
19 East Wing
(717) 787-6599
sgreenleaf@pasen.gov
Senate District 12 Bucks (part) and Montgomery (part) Counties

White, Mary Jo, Vice Chair
169 Capitol Building
(717) 787-9684 mwhite@pasen.gov
Senate District 21 Butler (part), Clarion, Erie (part), Forest, Venango and Warren (part) Counties

Leach, Daylin , Minority Chair
184 Main Capitol
(717) 787-5544
http://www.senatorleach.com
Senate District 17 Delaware (part) and Montgomery (part) Counties

Scarnati, Joseph B., III, ex-officio
292 Capitol Building
(717) 787-7084
jscarnati@pasen.gov
Senate District 25 Cameron, Clearfield (part), Elk, Jefferson, Mckean, Potter, Tioga and Warren (part) Counties

Majority

Alloway, Richard L., II
187 Main Capitol
(717) 787-4651
alloway@pasen.gov
Senate District 33 Adams, Franklin and York (part) Counties

Earll, Jane M.
177 Capitol Building
(717) 787-8927 jearll@pasen.gov
Senate District 49 Erie (part) County

Gordner, John R.
351 Main Capitol
(717) 787-8928 jgordner@pasen.gov
Senate District 27 Columbia, Dauphin (part), Luzerne (part), Montour, Northumberland and Snyder Counties

Orie, Jane Clare
362 Main Capitol
(717) 787-6538
jorie@pasen.gov
Senate District 40 Allegheny (part) and Butler (part) Counties

Piccola, Jeffrey E.
173 Capitol Building (717) 787-6801
jpiccola@pasen.gov
Senate District 15 Dauphin (part) and York (part) Counties

Rafferty, John C., Jr.
20 East Wing (717) 787-1398
jrafferty@pasen.gov
Senate District 44 Berks (part), Chester (part) and Montgomery (part) Counties

Minority

Boscola, Lisa M.
458 Capitol Building
(717) 787-4236 boscola@pasenate.com
Senate District 18 Lehigh (part), Monroe (part) and Northampton (part) Counties

Farnese, Jr., Lawrence M.
543 Main Capitol (717) 787-5662 http://www.senatorfarnese.com
Senate District 1 Philadelphia (part) County

Hughes, Vincent J.
545 Capitol Building
(717) 787-7112
hughes@pasenate.com
Senate District 7 Montgomery (part) and Philadelphia (part) Counties

Stack, Michael J.
543 Main Capitol (717) 787-9608 stack@pasenate.com
Senate District 5 Philadelphia (part) County

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Pittsburgh TRIBUNE-REVIEW
Corbett pushes limits on who would pay damage awards from lawsuits
http://www.pittsburghlive.com/x/pittsburghtrib/news/state/s_740798.html

By Brad Bumsted

Tuesday, June 7, 2011

HARRISBURG — Republican Gov. Tom Corbett wants the General Assembly to place limits on who would have to pay damage awards in civil suits before lawmakers recess for the summer, a spokesman said on Monday.

Specifically, Corbett is asking the House and Senate to approve legislation that would apportion liability based on one's degree of actual responsibility — for those parties deemed less than 60 percent responsible, said Kevin Harley, the governor's press secretary.

Currently, an award can be collected from any liable defendant. Supporters of the legislation say a company 10 percent responsible for an accident now can be required to pay 100 percent of damages if others can't pay.

The governor sees it as a major step to making Pennsylvania more business-friendly, Harley said.
A House-passed bill, and an identical Senate bill, are pending in the Senate Judiciary Committee. Chairman Stewart Greenleaf, R-Montgomery County, met with supporters and opponents yesterday from the legal, insurance and business communities in an effort to find middle ground.
Greenleaf said he proposed several compromises rejected by business leaders.

"They said they want the Legislature to decide," he said.

Greenleaf said he will continue to seek compromise on modified versions of the legislation Corbett is seeking.

Asked if he would release the House bill or a similar Senate bill from his committee, Greenleaf said, "No. Those bills are terribly unfair." ((Says Sen. Greenleaf.....))

While House leaders call the legislation the Fair Share Act. Mark Phenicie, legislative counsel for the Pennsylvania Trial Lawyers Association, which opposes the legislation, calls it the Corporate Irresponsibility Act.

"There's nothing fair about that bill," Phenicie said. ((Oh, and the guy the trial lawyers pay to make sure they keep making lots of money in PA....he says it's unfair, too.))

Gene Barr, vice president for government and public affairs for the Pennsylvania Chamber of Business and Industry, argued that "broad-based legal reform is very important in making Pennsylvania a more competitive state in terms of attracting business.

"We are one of a handful of states that has not reformed civil liability for businesses, and that's a big reason why we are viewed by CEOs as among the costliest states to do business."

Legal reform and property tax reform are on Corbett's list of "wants" from the Legislature along with a no-tax-hike budget, Harley said..

Under a law enacted five years ago, school boards are required to submit proposed property tax increases to voters if the increases exceed a so-called "education index," slightly higher than the inflation rate. But there are 10 exceptions to seeking voter approval, and they have prevented most tax increases from going to a referendum.

In five years, only 14 such referendums have appeared on the ballot. Pennsylvania has 500 school districts.

Corbett in his March budget address called for eliminating all exceptions.

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From Defense of Medicine Blog
High Quality Care Does Not Reduce Litigation Exposure
by Jonathan B. Stepanian, Esq.
http://www.defenseofmedicine.com/2011/05/high-quality-care-does-not-reduce-litigation-exposure/#more-563

Providing high quality care is not strongly associated with a reduction in litigation exposure according to a recent study published in the New England Journal of Medicine. The results of this study, while frustrating to some, reaffirm our belief that litigation has more to do with the process of care rather than the quality of care; I have written about this point in the past.

The New England Journal authors sought to assess “whether high-quality health care institutions are less likely to be sued for negligence than their low-performing counterparts.” Although this premise may seem logical, its validity has been questioned by many studies.

In this recent study, the authors compared 1465 nursing homes in terms of quality indicators and demands for compensation for injury. The authors chose nursing homes because quality data on those facilities is widely available and standardized. Hospital data is less available and standard. Additionally, the incidence of malpractice claims against institutions is not widely available. For this study, the authors were able to look to five of the largest nursing home chains in the United States to obtain information related to the incidence of claims against their facilities.

To define which nursing homes provided “high quality care,” the study authors selected 10 specific quality indicators to compare across facilities, such as the incidence of falls or fractures, the development of pressure ulcers, and staffing. They questioned whether those facilities with better quality indicators faced a lower incidence of malpractice claims.

Some will find their results frustrating. Although the authors found an inverse relationship between nursing home performance and litigation risk for several of the measured quality indicators, the associations were weak. The authors observed

[T]he levels of litigation were only fractionally lower for the best-performing nursing homes than for their worst-performing counterparts.

Intuitively, we like to think that increases in quality of care will lead to lower risk of litigation.

However, this recent New England Journal study does not demonstrate that this is necessarily true. Although quality care is certainly important, health care providers need to remember that the process of providing care is equally important. Refining that process of care may help to lower the risk of negligence litigation.

About the author - Jon is a partner at the McQuaide Blasko law firm whose practice is specialized in litigation, complex medical professional liability defense, health care, and providing legal counsel on numerous issues associated with day-to-day hospital operations. He has successfully tried several cases to verdict as first-chair trial counsel before juries in both state and federal court. Jon has also represented clients in appellate litigation, mediation, and in connection with administrative agency investigations. Contact Jon by email.

~~~~~~~~~~~~~~~~~~

((And at the federal level, kudos to Reps. Dent and Paulson for this latest entry in the medical liability reform saga...))
Press Releases - June 16, 2011
Dent and Paulsen Introduce Medical Liability Reform Bill
http://dent.house.gov/index.cfm?p=PressReleases&ContentRecord_id=6ba7c5a6-72f1-4bfb-8463-18569408470b

WASHINGTON, D.C. -- U.S. Reps. Charlie Dent (PA-15) and Erik Paulsen (MN-3) today introduced legislation (H.R. 2205) to decrease the cost of health care and improve protections for patients through comprehensive medical liability reform.

“The 2010 health care law missed a critical opportunity to enact meaningful medical liability reforms,” said Rep. Dent. “Our medical justice system is a major cost driver for health care spending and it impacts the ability of patients to receive high quality care. We expect doctors to make decisions based solely on what is best for their patients, not on what is best to defend against frivolous lawsuits. Across the United States, the lack of comprehensive reform has affected where qualified doctors practice, what fields of medicine they pursue, and the services they provide. As Congress continues to discuss ways to reform and strengthen our health care system, advancing the common-sense policies included in H.R. 2205 will help reduce health care spending and ensure access to quality care.”

“The reality is medical liability does contribute to increased healthcare costs. Healthcare professionals practice defensive medicine for fear of frivolous lawsuits and end up ordering billions of dollars in extra tests and treatments,” said Rep. Paulsen. “The current environment not only increases the cost of care for patients, but also discourages highly skilled and dedicated physicians from providing important services. Three out of four emergency rooms have reported shortages of specialists, and many orthopedic surgeons have chosen to retire early or scale back their surgical duties, because of liability concerns. These reforms are needed to protect patients, reduce healthcare costs, and ensure that this nation continues to produce the world’s greatest healthcare professionals.”

The practice of defensive medicine – when doctors order tests and treatments in order to protect themselves against frivolous lawsuits – is estimated to cost as much as $200 billion annually.

Congressional Budget Office (CBO) analyses indicate comprehensive medical liability reform would save the government $54 billion over the next decade and cut national health care spending by 0.5 percent per year.

H.R. 2205 will help end the costly practice of defensive medicine by encouraging states to adopt effective alternative medical liability laws that reduce the number of health care lawsuits initiated, reduce the average amount of time taken to resolve lawsuits and reduce the cost of malpractice insurance. The legislation will also enact nationwide reforms to stabilize compensation for injured patients, hold parties responsible for their degree of fault, ensure that meritorious claims are swiftly resolved, encourage compliance with accepted clinical practice guidelines, and guarantee that medical care is available to those who need it the most by providing protections to safety-net providers.

Charles W. Dent (R-PA-15) Erik Paulsen (R-3-MN)
1009 Longworth House Office Building 127 Cannon HOB
Washington, DC 20515 Washington, D.C., 20515
Telephone: 202-226-0778 Telephone: 202-225-2871
FAX: 202-226-0778 FAX: 202-225-6351
http://dent.house.gov http://paulsen.house.gov

~~~~~~~~~~~~~~~~~~

From MedInnovation
http://medinnovationblog.blogspot.com/2011/06/health-reform-and-great-unmentionable.html
Monday, June 6, 2011
Health Reform and the Great Unmentionable : Lack of Patient Compliance as One Cause of Poor Outcomes

The typical attempt to solve a social ill focuses on giving people information, or it tries to motivate people through fear. But these strategies tend to fail…The more important and deeply rooted the behavior, the less impact information has the more people close their minds to messages that scare them.

Tina Rosenberg, Join the Club: How Peer Pressure Can Transform the World, W.W. Norton and Company, 2011June 6, 2011 - U.S. health system critics and health reform zealots often close their minds to a major cause of poor outcomes – lack of patient compliance. Instead , they attribute poor outcomes to lack of universal coverage, socioeconomic distress, or the profit-seeking medical industrial complex. To say bad outcomes stems from bad behavior to cultural and peer conformity is unmentionable and therefore unspeakable because patients are sacred. Criticism of patients as a source of bad results is off-limits. It is viewed as bad politics. These are potential voters you are criticizing. Health professionals and the capitalistic system in which they practice, not patients or population factors, are said to be responsible for the bad health of the nation, even though abundant evidence exists that other things – life style, poverty, income differences, inferior education, lack of family cohesion, violence in the streets and homes, clean water, adequate energy sources, culture, and simply following the crowd – are more responsible (1, 2).The “Social Cure”In her new book, Join the Club, How Peer Pressure Can Transform the Word (3), Tina Rosenberg, a Pulitzer-prize winning author , does us a favor by reminding us that patient behavior, dictated by the culture in which they live and their desire for social acceptance by peers, plays just as great a role as most other factors combined . Rosenberg reminds us, again and again, that the “social cure” – people responding positively to peer pressure and new social norms – may be more important than health reform itself. No amount of information she asserts, or warnings from government expert or from doctors “can budge us when we refuse to be budged…We often lie to others about our bad behavior, but the more interesting and powerful excuses come when we lie to ourselves.” People do not like to be lectured to about their health. They prefer to listen to their own inner demons, no matter what the consequences, To them, it is short-term gratification, not long-term consequences, that count.Patient Non-ComplianceIn the paragraph that follows, she gives these examples of what she is talking about.“Take, for example, patient adherence – failure to carry out a doctor’s orders. Poor patient adherence is a serious problem; dozens of studies have shown this. Only a fourth of the people on blood-pressure drugs in one study took their pills correctly. Only 13 percent of diabetes patients taking certain drugs complied with their regimens for a year. Three-quarter of patients in a study did not keep follow-up appointments and 50 percent of patients with chronic illnesses dropped out of a treatment within a year.”Failure of Alternative ApproachesAlternative approaches have been tried to help patients comply – counseling, group therapy of patients with common diseases, patient information brochures, electronic beeping pillboxes, automated –reminder phone calls, DOTS (Directly Observed Treatment, Short-Course) by loved ones, a nurse, or a community worker) – may work temporarily but in the long-term none of these approaches can get people to take their pills more than half the time.Innovative "social Cure" ProgramsThe point of Rosenberg’s book is this. People do not respond to what authorities or doctors tell them to do, but to what their peers approve of or what they do. Creating innovative peer groups to respond to health problems, whether these groups be similar to alcoholics anonymous, to maverick organizations persuading teenagers it is manipulative tobacco companies not adult do-gooders that are trying to get them to stop smoking, peers telling gays and HIV-positive individuals that condom use is a good thing – creates positive social change and the “social cures.” These programs , she says, are what we ought to be concentrating upon.Summing UpIn summary, the health of society may depend more on social and peer conformity than its national health system. People will do what they want to do and what they think pleases their peers rather than following the advice or warnings of harm from health experts or doctors.References1. L. Sagan, The Health of Nations: The Cause of Sickness and Well-Being, Basic Books, 1987.2. D. Satcher, and R. Pamies, Multicultural Medicine and Health Differences, MacGraw Hill, 2006.3. T. Rosenberg, Join the Club: How Peer Pressure Can Transform the World, W, W. Norton and Company, 2011.
Posted by Richard L. Reece, MD at 6:30 AM

~~~~~~~~~~~~~~~~~~

Some Programs OK’d By Health Law Lacking Funding
By Phil Galewitz
KHN Staff Writer
Jun 09, 2011
http://www.kaiserhealthnews.org/Stories/2011/June/09/unfunded-appropriations-health-law.aspx

((The administration promised medical liability reform as a carrot to get the AMA to endorse the PPACA and threw $25 million at states for "demonstration projects." Then, this year, they promised more....but, not surprisingly, the money just isn't there....))

While the health care law has survived Republican efforts to repeal it, some of its individual initiatives are in limbo or limping along because of funding problems. The law authorized the new efforts but didn’t provide appropriations for them. That has to occur separately – and given current deficit woes, as well as wrangling between Democrats and Republicans, the programs might never get off the ground, some experts say. “Since the law was passed, the budgetary picture in Congress has changed dramatically," said Bruce Vladeck, former Medicare administrator in the Clinton administration and now a New York health care consultant. "So stuff (Obama administration officials) were interested in doing when health reform passed, they now have a realistic sense that …they are never going to get an appropriation to do it.”

One of the higher-profile initiatives that has not received any funding is a $50 million program to help states test alternatives to resolve medical malpractice disputes.

The American Medical Association, which backed the health law, is upset. “Congress should fully fund medical liability demonstration and pilot programs in the health reform law,” said Dr. Cecil Wilson, president of the AMA. “Everyone pays for the increasingly irrational medical liability system in this country.” ((That's what happens when you accept promises from politicians....))

A separate program that is providing $25 million in grants to test malpractice reforms to improve patient safety hasn’t been affected. The White House approved those grants six months before the health care law was enacted.

Other initiatives in the health law slated for this year that haven't started or been fully funded include:
--A $24 million program to help test regional systems for delivering emergency care. The effort would help hospitals work together to assure adequate physician staffing in the ERs. No money has been proposed.

--A program to have health clinics run by nurse practitioners. The program has received $15 million instead of the $50 million called for in the law.

--A project to monitor for-profit nursing home chains and a program to increase use of information technology such as electronic health records in nursing homes. No money has been proposed.

Although these programs were authorized under the health law, funding was not mandated.
Administration officials say, given the budget squeeze, they’ve had to set priorities on funding.

“While recognizing the importance of restraining federal spending, the administration has proposed funding for some activities authorized by the Affordable Care Act, such as nurse-managed health centers and many workforce programs,” said Jessica Santillo, a spokeswoman for the Health and Human Services Department.

Some lobbying groups aren’t satisfied. For example, emergency room physicians worry they may lost an opportunity to improve care. “We’ve been very disappointed at the lack of federal funding to implement the regionalized systems of emergency care pilot projects that were created under the Affordable Care Act,” said Dr. Sandra Schneider, president of the American College of Emergency Physicians. She said numerous studies have proven that “regionalized, coordinated and accountable emergency care systems would not only improve patient outcomes, but do so at less cost.”

Another program from the law that has not been funded is a $60 million program to test alternative dental providers such as hygienists or dental aides who would extract teeth and fill cavities in rural areas where dentists are scarce. The program, which is supposed to start by March 2012 was strongly supported by the Battle Creek, Mich.-based W.K. Kellogg Foundation which has been funding a similar program in Alaska. The federal money would be awarded to colleges, community health centers and Indian health clinics.

“We were excited to see the inclusion of the oral health provision in the bill,” said Alice Warner, program officer at the Kellogg Foundation. “We thought it was forward thinking.”

The American Dental Association, which opposes the idea of letting anyone but trained dentists extract teeth and fill cavities, applauded the lack of funding in Obama’s 2012 budget request. “We didn’t want this concept to get a foot in the door,” said an ADA spokesman.
pgalewitz@kff.org

~~~~~~~~~~~~~~~~~~

From the Washington Examiner
http://washingtonexaminer.com/opinion/2011/06/texas-makes-losers-pay-bringing-frivolous-lawsuits
Texas makes losers pay for bringing frivolous lawsuits
By: Examiner Editorial 06/04/11 8:05 PM

((Sigh......TEXAS......))

It's no wonder that Texas Gov. Rick Perry has recently been the focus of speculation about whether he might run for president in 2012. Texas has been on an economic roll since 2001, creating far more new jobs than any other state in the nation even as its population swelled to 25 million. Love him or hate him, Perry is in his fourth term in Austin and thus deserves a big chunk of the credit for many of the good things happening in the Lone Star State. Texas also has implemented some of the most significant state-level reforms in the country aimed at reducing or eliminating lawsuit abuse.

The latest of these is a "loser-pays" provision requiring plaintiffs to pay the winners' legal costs in civil suits seeking punitive damages. The provision is included in the 2011 Omnibus Tort Reform Act Perry signed May 30. In addition to the loser-pays provision, the new law:

• Allows a trial judge to send a question of law directly to the appellate court without requiring all parties to agree if a ruling by a court of appeals could decide the case.
• Allows plaintiffs seeking less than $100,000 in damages to request an expedited civil action.
• Allows a trial court to dismiss a frivolous lawsuit immediately if there is no basis in law or fact for the lawsuit.

((Along with the caps on non-economic damages passed in 2003, it's no wonder there's a backlog of thousands of doctors seeking licenses to practice medicine in Texas.))

Because such litigation is controlled at the state level, the United States is unique among the industrialized nations in not having a national loser-pays law. That fact is likely among the key reasons why the American media so frequently report new examples of people suing for the most outrageous of reasons. Take, for example, Mark S. Gold, a Miami traffic court lawyer who got drunk at a local strip club last November, then woke up the next morning with a tab of nearly $19,000. He promptly sued the strip club's corporate owner, claiming he should not be held responsible for the huge bill because the bar "continuously served plaintiff alcoholic beverages to the extent that he was rendered intoxicated, partially or temporarily unconscious, and further to the extent that he had a complete loss of judgment, rational thought, or ability to enter into lawful contracts or agreements."

Odds are Gold will walk away with most, if not all, of his bar tab forgiven since the defendants know they could lose big-time if he convinces a jury to award him punitive damages. As things now stand, plaintiffs like Gold have nothing to lose and everything to gain by clogging the courts with frivolous litigation. How many such suits would be filed if losing plaintiffs everywhere knew that they would have to pay the defendants' legal fees? The absence of loser-pays provisions in the vast majority of states helps explain why class-action plaintiff litigation cost more than $248 billion last year, according to the Towers Watson (formerly Towers Perrin) 2010 Update on U.S. Tort Cost Trends. That's $808 for every man, woman and child in the country. It also makes the U.S. legal system twice as expensive, measured as a percentage of gross domestic product, as those of other industrialized nations, according to the Institute for Legal Reform

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This LIABILITY & HEALTH REFORM UPDATE is a free service which I provide, as a volunteer, to help supply medical liability reform and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform and quality health care advocates. NO ONE pays me to do this.

I am not employed by any physician or health care reform advocacy or liability reform organization, political party or candidate, although I volunteer for several. I am an advocate for quality health care, physicians, and patients , a breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not, nor will I ever claim to be, unbiased (I am....biased, I mean), unlike many in the mainstream media.

Most information in this newsletter is copied and pasted from other sources, and will always be identified with links. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized and appear in blue.

This Update is emailed to health professionals, physician and patient advocates, and others interested in ensuring access to quality medical care.

Join our Google Group or Facebook Page or email LiabilityNEWS@aol.com and put "subscribe" in the subject line to ensure you get all issues ASAP.

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PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL OR PATIENT YOU KNOW SO WE CAN GET THIS INFORMATION TO MORE OF THE PEOPLE WHO NEED IT.

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ROVSPA@aol.com
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LiabilityNEWS@aol.com

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5/18/11 - ACTION ALERT - Fair Share Hearing Thursday at Phila Bar Assn

2011-05-18T11:22:00.002-07:00

5/18/11 - Liability and Health Reform Update
ACTION ALERT
IMPORTANT HEARING ON FAIR SHARE ACT AT PHILA BAR ASSN TOMORROW

Senator Stuart Greenleaf, chair of the Senate Judiciary Committee, is holding a public hearing on the Fair Share Act tomorrow in decidedly NON-neutral territory - the Philadelphia Bar Association offices on Market Street.

Business leaders, doctors, lawyers who support liability reform (and there are MANY of you out there) and other who support the Fair Share Act (HB1 or SB2 - NOT Senate Bill 500) are welcome to attend this PUBLIC hearing.

Those giving testimony in support of the Fair Share Act tomorrow will include leaders from the PA Chamber of Commerce, the NFIB, the Insurance Federation and the Hospital and Health Services Association of PA.

Thursday, May 19, 2011

When: 12:00 PM

What: JUDICIARY (public hearing to receive testimony on the issue of joint and several liability including Senate Bills No. 2 and 500)

Where: Philadelphia Bar Assn.
1101 Market St.
11th Floor
Philadelphia, PA

Our friends at the Chamber and the PA Manufacturers Association, as well as our allies at Cold Spark Media, are looking for business people who would be willing to speak to the media about how passing joint and several liability reform would benefit Pennsylvania business and health care.

If you're able to attend, or are willing to speak with the media, please contact Lindsey at Cold Spark Media: lindsey@coldsparkmedia.com

Thank you!

Donna Baver Rovito
Editor, Liability and Health Reform Update
ROVSPA@aol.com

Some additional information on HB 1 and SB 2 follows:

From DefenseofMedicine.com
((Just discovered this wonderful site - but I'll be back to it often!))

Joint and Several Liability Update
http://www.defenseofmedicine.com/2011/04/joint-and-several-liability-update/

The Pennsylvania Legislature is poised to alter the joint and several liability rules in the Commonwealth but there are now multiple versions, including a watered-down proposal, vying for passage.

There are three bills before the Legislature that propose changes to joint and several liability: House Bill 1, Senate Bill 2, and Senate Bill 500. HB 1 and SB 2 do not differ significantly and constitute an attempt to reenact the “Fair Share Act” that previously passed both houses of the Pennsylvania legislature in 2002, was signed into law by then-Governor Mark Schweiker, but was subsequently declared unconstitutional by the Pennsylvania Supreme Court in DeWeese v. Cortes.
Under HB 1 and SB 2, no defendant would be required to pay more than their proportionate share of the verdict. Therefore, if one defendant is found 50% negligent and another defendant found 50% negligent, each defendant is responsible for paying only 50% of the verdict.

SB 500, introduced by Senator Stewart Greenleaf, is markedly different however. The bill would eliminate joint liability only if the plaintiff’s percentage share of negligent conduct exceeds the share of negligence attributable to the defendant. This represents significantly less of a reform than HB 1 or SB 2.

For instance, under SB 500, if a plaintiff is not found to have been negligent and two defendants are found to both be 50% responsible for the plaintiff’s injuries, the plaintiff may continue to recover the full verdict amount from either of the defendants. The plaintiff may continue to recover the entire award from one defendant regardless of the fact that the defendant was found only 50% responsible.

The only time that SB 500 would operate as a reform to the joint and several liability rules would be if the plaintiff is found to have negligently contributed to their own injuries. Therefore, for example, if a plaintiff is found 25% responsible, one defendant found 15% responsible, and another defendant found 60% responsible, the plaintiff may only recover 15% of the award from the defendant found 15% responsible.

The real world application of SB 500 is likely limited, particularly in medical professional liability cases. If health care providers seek meaningful reform, their best options continue to be HB 1 or SB 2. Unfortunately, they may be at odds with the Pennsylvania Bar Association, which may be headed toward supporting SB 500.

Read more: http://www.defenseofmedicine.com/2011/04/joint-and-several-liability-update/#ixzz1MYgd3jgx

About the author
Jon is a partner at the McQuaide Blasko law firm whose practice is specialized in litigation, complex medical professional liability defense, health care, and providing legal counsel on numerous issues associated with day-to-day hospital operations. He has successfully tried several cases to verdict as first-chair trial counsel before juries in both state and federal court. Jon has also represented clients in appellate litigation, mediation, and in connection with administrative agency investigations. Contact Jon by email.

~~~~~~~~~~~~~

From The Daily Item:

May 12, 2011
Pa is one of few states with a joint liability bill
http://dailyitem.com/0100_news/x1693506665/Pa-is-one-of-few-states-with-a-joint-liability-bill
By Evamarie Socha

Thu May 12, 2011, 08:17 PM EDT

LEWISBURG — Liability reform can rein in health-care costs, and having fewer uninsured patients makes better financial sense for Pennsylvania’s hospitals, a health-care legislative expert told a gathering of Evangelical Community Hospital’s Business Partners Thursday.

Tim Ohrum, director of legislative services for the Hospital and Healthsystems Association of Pennsylvania, said that the Corbett administration and legislators are starting to understand better how these two issues affect health-care costs in the Keystone State.

In discussing medical liability reform, Ohrum said Pennsylvania is one of a few states without a joint liability bill. What this means is that regardless of how much liability a health-care provider has in a civil lawsuit, if the other parties can’t or won’t pay their share, the provider may end up covering all of it.

“The hospital is seen as having deep pockets,” Ohrum said, a position that puts it at risk for bankruptcy.

He cited the case of Tyrone Hospital, near Altoona, which covered all liability in an OB/Gyn lawsuit though only being responsible for 20 percent. The hospital was forced to file bankruptcy in September 2006 but emerged from it in August 2010.

Ohrum thanked state Rep. Fred Keller of the 85th legislative district for the House’s recent approval of a “fair-share” bill that limits liability of multiple defendants in a civil lawsuit and protects those less than 60 percent at fault from paying more than their share of damages.

Regarding the uninsured, Ohrum said it’s essential to restore Medicaid funding in Pennsylvania, which faces an increase in essential services needs at the same time it sees lower revenue, largely as a result of end of federal stimulus monies.

Figuring out “the glide path off federal stimulus money” is one big issue, Ohrum said, “how to elevate the medical assistance payments at a time when the states are short of money.”

Gov. Tom Corbett’s proposed budget, released March 8, includes a 3 percent decrease in health-care funding and cuts hospital funding, both state and federal, by $333 million. Hospitals contributed $246 million to the state budget over three years; the budget makes for them to sustain $333 million above that. Also, the budget cuts hospital payments by 7 percent, making for an even larger sacrifice on the part of hospitals.

“Folks think of welfare as someone who refuses to get a job,” Ohrum said, but the elderly, the disabled and children — all who are least able to work — are the most frequent recipients of such benefits.

“It’s grandma and grandpa; they’re not going to go out and get a job,” he said. Neither will people with disabilities or children below age 18. “This is who this safety net was built for,” he said.

Also, before the recession, about 30 percent of Pennsylvanians were receiving Medicaid. That number grew to 48 percent after the recession began, he said.

Norm Rich of Evangelical’s board of directors told the group the “Evangelical & You” program is just above $10 million. The fundraising campaign is generating support for the Surgical and Cardiovascular Expansion Project (SCEP), endowments and the Evangelical Care Fund.

~~~~~~~~~~~~~

From the PA Medical Society's website:
PAMED Supports Repeal of Complete Joint and Several Liability
http://www.pamedsoc.org/HomePageNews/Joint-and-Several.html

House Bill 1 and Senate Bill 2 would modify Pennsylvania’s joint and several liability law. By a vote of 112-88, the House passed HB 1 on April 11, 2011, sending the bill to the Senate for consideration.

A hearing was also held in the Senate Judiciary Committee on April 11 on SB 2, a similar bill sponsored by Sen. Jake Corman (R-Centre).

Pennsylvania is one of only a handful of states that has complete joint and several liability. Under the current law, if one defendant is without assets or has insufficient funds to pay their share, the other defendant(s) can be held responsible for 100 percent of the jury’s award.

If either HB 1 or SB 2 is passed, each responsible defendant would only have to pay their share as long as the jury finds them less than 60 percent at fault. If a defendant is found more than 60 percent at fault, they can be made to pay 100 percent of the damages, if the other defendant(s) are without sufficient funds.

Under HB 1, some exceptions for full joint and several liability would still exist, including:

Intentional misrepresentation
Hazardous tort(s)
Hazardous substances released or threatened to be released
Liquor code violations

This is not the first time around for this legislation. In 2002, a very similar bill was signed into law, but was thrown out by the state Supreme Court on a procedural technicality. In 2006, Gov. Ed Rendell vetoed yet another bill after previously indicating he would sign it if it passed.

PAMED has been a long-time advocate for medical liability reforms, and has been successful in getting a number of reforms passed in Pennsylvania, including Act 13 of 2002. Currently, PAMED also supports a bill to allow physician apologies (HB 495) and a bill to strengthen the certificate of merit requirements.

~~~~~~~~~~~~~

From Care for PA website - affiliated with the Hospital Assn. of PA

((This is a couple of weeks old, but is a good rundown on the Fair Share Act))

The ‘Fair Share Act’ is common sense legal reform that is in place in 40 other states and must be passed in Pennsylvania to ensure a strong health care and business environment for its residents.

Important Legal Reform Closer to Law; 'Fair Share Act' Must Now Pass Senate

http://www.careforpa.org/issues/medical-liability/important-legal-reform-closer-to-law-fair-share-act-must-now-pass-senate/

With the help of the CareforPA community who emailed state House of Representative members earlier this month, important legal reforms are one step closer to becoming law. House Bill 1 (also known as “The Fair Share Act”) was passed by the House and is now in the state Senate Judiciary Committee for consideration, along with its companion bill, Senate Bill 2.

It’s critical that House Bill 1 or Senate Bill 2 is passed by the Senate and goes to the Governor for signature in order to help address the high legal costs paid by Pennsylvania health care providers. Currently, those high legal costs increase health care costs for all Pennsylvanians, limit access to medical care for Pennsylvanians, hurt statewide job growth, and keep hospitals from finding physicians who want to work in our state. You can read more about Pennsylvania’s medical liability crisis by clicking the “Related Articles” link on the right side of this page.

Next Steps for Legal Reform

Both House Bill 1 and Senate Bill 2 are in the state Senate Judiciary Committee, which is chaired by Senator Stewart Greenleaf who favors trial lawyers and opposes both bills. Sen. Greenleaf has introduced his own bill, Senate Bill 500, as an alternative. Sen. Greenleaf’s bill, however, only would apply in very rare instances, essentially keeping the current broken legal system in place. Pennsylvania’s hospital community opposes Senate Bill 500.

Sen. Greenleaf must bring either House Bill 1 or Senate Bill 2 up for a vote in the committee, and the committee must pass the bill by a majority vote in order for the bill to move to the full Senate for consideration.

Pennsylvania’s Fair Share Act has the support of more than 40 organizations representing hospitals, medical professionals, businesses, and local governments. It’s a common sense legal reform that is in place in 40 other states and must be passed in Pennsylvania to ensure a strong health care and business environment for its residents.

You Can Help

If you have not done so already, please take a moment to email your Senate member and urge them to support House Bill 1 or Senate Bill 2. As Senate members hear from Pennsylvanians like you, they will put pressure on Sen. Greenleaf to put House Bill 1 or Senate Bill 2 up for a vote.

By using CareforPA’s email system, you can make a big difference in less than a minute. After you send your email, use the links at the bottom of this page to pass the information on to your family and friends.

~~~~~~~~~~~~~

((If YOUR state senator is a member of this committee, please contact him or her IMMEDIATELY and ask him or her to support HB 1 or SB 2 - NOT Senate Bill 500. And if your state senator is NOT a member of the Judiciary Committee, please ask him or her to contact colleagues who ARE on the Judiciary Committee to support HB1 or SB2))

Members of the PA Senate JUDICIARY Committee

Officers

Greenleaf, Stewart J. , Chair
19 East Wing
(717) 787-6599
sgreenleaf@pasen.gov
Senate District 12
Bucks (part) and Montgomery (part) Counties

White, Mary Jo, Vice Chair
169 Capitol Building
(717) 787-9684
mwhite@pasen.gov
Senate District 21
Butler (part), Clarion, Erie (part),
Forest, Venango and Warren (part) Counties

Leach, Daylin , Minority Chair
184 Main Capitol
(717) 787-5544
http://www.senatorleach.com
Senate District 17
Delaware (part) and Montgomery (part) Counties

Scarnati, Joseph B., III, ex-officio
292 Capitol Building
(717) 787-7084
jscarnati@pasen.gov
Senate District 25
Cameron, Clearfield (part), Elk,
Jefferson, Mckean, Potter,
Tioga and Warren (part) Counties

Majority

Alloway, Richard L., II
187 Main Capitol
(717) 787-4651
alloway@pasen.gov
Senate District 33
Adams, Franklin and York (part) Counties

Earll, Jane M.
177 Capitol Building
(717) 787-8927
jearll@pasen.gov
Senate District 49
Erie (part) County

Gordner, John R.
351 Main Capitol
(717) 787-8928
jgordner@pasen.gov
Senate District 27
Columbia, Dauphin (part), Luzerne (part),
Montour, Northumberland and Snyder Counties

Orie, Jane Clare
362 Main Capitol
(717) 787-6538
jorie@pasen.gov
Senate District 40
Allegheny (part) and Butler (part) Counties

Piccola, Jeffrey E.
173 Capitol Building
(717) 787-6801
jpiccola@pasen.gov
Senate District 15
Dauphin (part) and York (part) Counties

Rafferty, John C., Jr.
20 East Wing
(717) 787-1398
jrafferty@pasen.gov
Senate District 44
Berks (part), Chester (part) and Montgomery (part) Counties

Minority

Boscola, Lisa M.
458 Capitol Building
(717) 787-4236
boscola@pasenate.com
Senate District 18
Lehigh (part), Monroe (part) and Northampton (part) Counties

Farnese, Jr., Lawrence M.
543 Main Capitol
(717) 787-5662
http://www.senatorfarnese.com
Senate District 1
Philadelphia (part) County

Hughes, Vincent J.
545 Capitol Building
(717) 787-7112
hughes@pasenate.com
Senate District 7
Montgomery (part) and Philadelphia (part) Counties

Stack, Michael J.
543 Main Capitol
(717) 787-9608
stack@pasenate.com
Senate District 5
Philadelphia (part) County

4/19/11 - Liability&HealthNews ALERT - Fair Share Act in Judiciary Committee - Need help NOW

2011-04-19T10:32:00.000-07:00

4/19/11 - Liability&Health News ALERT
Fair Share Act in Senate Judiciary Committee:
Need help NOW!

by Donna Baver Rovito

Editor, Liability and Health News Update

((Donna's in-article comments in double parentheses and blue italics. Please scroll to the end for more information, disclaimer, etc.))

~~~~~~~~~~~~~

((This alert courtesy of a fellow supporter of medical liability reform in the Lehigh Valley, Mary Barket. Thanks for the heads-up, Mary!))

ACTION ALERT!

Senate Bill 2 (the Fair Share Act) is now going through the PA Senate Judiciary Committee after passing in the House. This is important tort reform (see below).

We need to let Sen. Lisa Boscola, a member of the Judiciary Committee, know that we need her vote! Call her today at 717-787-4236 or 610-868-8667 and let her know that we need this bill to come to the PA Senate floor!

((If you live in Lisa Boscola's district, please contact her - if not, see the Commentary below to see if your Senator is a member of the Judiciary Committee....DBR))

Nothing would provide a greater “stimulus” to Pennsylvania’s lagging economy than a fair, predictable and even-handed legal system. Current Pennsylvania law allows a defendant who is just marginally responsible for injury or harm to be made to pay 100 percent of the damages.

We need meaningful reform – the Fair Share Act – to limit awards against defendants who are judged to have been only partially liable in a lawsuit. The Fair Share Act would create a proportional liability system in which defendants found to be less than 60 percent responsible for an injury or damage to pay only their proportionate share of the award.

~~~~~~~~~~~~~

Donna's COMMENTARY

In fact, we need physicians, members of medical families, and other supporters of liability reform and quality health care throughout PA to make calls to their Senators who sit on the Judiciary Committee.

It might seem that the Republican majority will support this measure, which was passed twice by the PA legislature, but given the strong ties of some members of the Judiciary committee with the trial bar, it's something we DEFINITELY shouldn't take for granted.

If you live in the district of ANY of the following members of the Judiciary Committee, please contact their offices ASAP and tell them YOU support the Fair Share Act and that you'd appreciate his or her vote to move it out of Committee so the full Senate can vote on it and express the will of the people in PA on this issue.

At this point, with the vote taking place shortly, unless you KNOW your Senator well enough that he or she would open your email right away rather than waiting for it to be processed through his or her office, it would be best to CALL. We've included phone numbers for your convenience.

Your message should be short and sweet - "Please ask Sen. ___________ to vote YES on moving the Fair Share Act out of the Judiciary Committee for a full Senate vote."

If you don't know who your state senator is, go here to find out: http://www.pasen.gov/cfdocs/legis/home/findyourlegislator/#zip

Doctors - please write letters to your local newspapers about the importance of this bill to Pennsylvania medicine! If you'd like help with that, please email me!

Thank you!

DBR

~~~~~~~~~~~~~

Members of the PA Senate JUDICIARY Committee

Officers

Greenleaf, Stewart J. , Chair
(717) 787-6599
sgreenleaf@pasen.gov

White, Mary Jo, Vice Chair
(717) 787-9684
mwhite@pasen.gov

Leach, Daylin , Minority Chair
(717) 787-5544
http://www.senatorleach.com

Scarnati, Joseph B., III, ex-officio
(717) 787-7084
jscarnati@pasen.gov

Majority

Alloway, Richard L., II
(717) 787-4651
alloway@pasen.gov

Earll, Jane M.
(717) 787-8927
jearll@pasen.gov

Gordner, John R.
(717) 787-8928
jgordner@pasen.gov

Orie, Jane Clare
(717) 787-6538
jorie@pasen.gov

Piccola, Jeffrey E.
(717) 787-6801
jpiccola@pasen.gov

Rafferty, John C., Jr.
(717) 787-1398
jrafferty@pasen.gov

Minority

Boscola, Lisa M.
(717) 787-4236
boscola@pasenate.com

Farnese, Jr., Lawrence M.
(717) 787-5662
http://www.senatorfarnese.com

Hughes, Vincent J.
(717) 787-7112
hughes@pasenate.com

Stack, Michael J.
(717) 787-9608
stack@pasenate.com

~~~~~~~~~~~~~

From the PA Medical Society Website
PAMED Supports Repeal of Complete Joint and Several Liability
http://www.pamedsoc.org/MainMenuCategories/Government/NewsfromHarrisburg/Joint-and-Several.html

House Bill 1 and Senate Bill 2 would modify Pennsylvania’s joint and several liability law. By a vote of 112-88, the House passed HB 1 on April 11, 2011, sending the bill to the Senate for consideration.

A hearing was also held in the Senate Judiciary Committee on April 11 on SB 2, a similar bill sponsored by Sen. Jake Corman (R-Centre).

Pennsylvania is one of only a handful of states that has complete joint and several liability. Under the current law, if one defendant is without assets or has insufficient funds to pay their share, the other defendant(s) can be held responsible for 100 percent of the jury’s award.

If either HB 1 or SB 2 is passed, each responsible defendant would only have to pay their share as long as the jury finds them less than 60 percent at fault. If a defendant is found more than 60 percent at fault, they can be made to pay 100 percent of the damages, if the other defendant(s) are without sufficient funds.

If either HB 1 or SB 2 is passed, each responsible defendant would only have to pay their share as long as the jury finds them less than 60 percent at fault. If a defendant is found more than 60 percent at fault, they can be made to pay 100 percent of the damages, if the other defendant(s) are without sufficient funds.

Under HB 1, some exceptions for full joint and several liability would still exist, including:

Intentional misrepresentation
Hazardous tort(s)
Hazardous substances released or threatened to be released
Liquor code violations

This is not the first time around for this legislation. In 2002, a very similar bill was signed into law, but was thrown out by the state Supreme Court on a procedural technicality. In 2006, Gov. Ed Rendell vetoed yet another bill after previously indicating he would sign it if it passed.

PAMED has been a long-time advocate for medical liability reforms, and has been successful in getting a number of reforms passed in Pennsylvania, including Act 13 of 2002. Currently, PAMED also supports a bill to allow physician apologies (HB 495) and a bill to strengthen the certificate of merit requirements.

~~~~~~~~~~~~~

From the Philadelphia Inquirer
Posted on Tue, Apr. 19, 2011
http://www.philly.com/philly/business/20110419_Pennsylvania_trial_lawyers__business_groups_square_off_over_lawsuit_reform.html
Pennsylvania trial lawyers, business groups square off over lawsuit reform
By Chris Mondics Inquirer Staff Writer

Trial lawyer Gerald McHugh Jr. likes to explain the battle over lawsuit reform now playing out in Harrisburg by using the story of a childhood rock-throwing incident that ended with his neighbor's smashed window.
The woman who owned the house knew McHugh's parents and called to complain. At dinner that evening in the McHugh family's West Philadelphia home, his parents read him the riot act: He would pay for the window, even though he had not thrown the rock that broke it. He and his friends could sort out who actually was responsible and how costs might be shared.

"My parents resolved that case quickly and surely," McHugh said. "I had participated, it was wrong, and therefore I was paying for a new window."

((Right....we should base all legal precedent on little boys breaking windows and one incident of parental responsibility. Does Atty. McHugh think the state of PA should be everyone's daddy?))

McHugh, a lawyer with the Philadelphia trial and appellate firm of Raynes McCarty, said the anecdote showed in the simplest of terms why the Pennsylvania Senate should vote down a proposal that would end the long-standing practice of requiring some defendants to pay full civil-damages awards, even though they might have minimal responsibility.

McHugh has become a leading spokesman for Pennsylvania trial lawyers, who believe the changes would serve businesses, physicians, hospitals, and other institutions at the expense of aggrieved customers.

This so-called doctrine of "joint-and-several liability" traditionally has undergirded civil litigation in state courts throughout the country. It has been defended by trial lawyers and other proponents who say it improves the odds for accident victims to gain fair compensation.

((It has also been repealed in all but a handful of states, including PA. As usual, PA is lagging behind....))

If one defendant does not have enough money or is judgment proof, it stands to reason that an accident victim should seek compensation from another defendant, even though that defendant may have only minimal responsibility, trial lawyers contend. ((Plus, they want to make sure their 40% contingent fees are based on the HIGHEST possible amount of money....ooops, did I say that out loud?))

McHugh's personal story of the childhood rock-throwing incident sounds folksy, but it rings hollow to businesses, physicians, and many health-care institutions that say the current legal doctrine is a green light for trial lawyers and plaintiffs to seek out the deepest pockets.

The businesses have been pushing legislation, passed by the state House of Representatives on April 11, that would end the practice for any defendant found to have less than 60 percent responsibility. The bill, which has been praised by Gov. Corbett, a Republican, now is in the Senate, which is expected to deal with the issue before lawmakers leave for summer recess.

"The long-standing legal rule of 'joint and several' has been grossly distorted by greed and, in many cases, has become nothing more than a search by personal-injury lawyers for defendants whose only real reason for being named in a lawsuit is their ability to pay," said Gene Barr, vice president of the Pennsylvania Chamber of Business and Industry." ((Mr. Barr is absolutely correct - this is why every doctor in the hospital the day an incident occurs is likely to be named in a lawsuit whether they had anything to do with it or not.))

Under the bill passed by the House, sponsored by State Rep. Curt Schroder (R., Chester), a defendant who is less than 60 percent responsible would have to pay only a proportional share of a damage award. Exceptions include cases in which the defendant intended to cause harm, engaged in intentional misrepresentation, or engaged in activity that resulted in the release of hazardous substances.

While Corbett earlier this week praised the House for passing the bill, called the Fair Share Act, it faces stiff opposition from the state's politically powerful trial lawyers and many Democrats who see the measure as a favor to big businesses, physicians, and hospitals at the expense of accident victims. ((And not all of that opposition will be from Democrats. In the case of trial lawyers, it often seems that profession trumps political party.))

"The effect, if it becomes law, is that injured victims will not be able to recover the full damages awarded to them in a court of law if they are victims of sexual assault, rogue judges, greedy gas drillers who damage the environment, and other wrongdoers," said Bill Patton, spokesman for Rep. Frank Dermody (D., Allegheny), the House Democratic leader.

But with both chambers of the legislature and the governor's office controlled by Republicans, who traditionally favor lawsuit restrictions, opponents of the bill face difficult odds. According to legislative sources, one approach they are considering is suggesting some modified version of "joint-and-several" liability, where defendants with the greatest ability to pay would still face paying a disproportionate amount, but not so much as before.

The battle playing out in Harrisburg is a mirror image of legislative confrontations and judicial elections that have been fought over lawsuit reform nationwide. Business groups have been aggressive in supporting judicial candidates who take a more restrictive approach to litigation, and have pushed bills in state capitals making it harder to sue. Dozens of states have eliminated joint-and-several liability and instituted other curbs on lawsuits.

In Pennsylvania, and nationally, business groups say excessive litigation costs are a drag on the economy, diverting precious resources from business development and job creation.

The Pennsylvania Chamber of Business and Industry points to a 2008 study by consultant Towers Perrin that concludes the U.S. tort system cost $252 billion in 2007, or $835 per person.

The study's authors qualified their work, noting they had made no effort to quantify potential benefits from lawsuits, such as the added incentive for manufacturers to make safer products rather than confront litigation.

Business and their lawyers do not see it that way, of course. Mitch Goldman, a lawyer at Duane Morris L.L.P. who specializes in health care, said a hospital client of his faces potential ruin because of the joint-and-several rule.

The hospital, which he declined to identify, is embroiled in litigation over a medical-malpractice case - in which, he said, it had only minimal involvement. But, he said, if the hospital went to trial and lost, it would be stuck with a huge bill. As a result, it probably will settle.

"The hospital in almost every one of these cases will be the deepest pocket," he said.

~~~~~~~~~~~~~

This LIABILITY & HEALTH NEWS UPDATE "newsletter" is a free service which I provide, as a volunteer, to help supply medical liability reform and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform and quality health care advocates. NO ONE pays me to do this.

I am not employed by any physician or health care reform advocacy or liability reform organization, political party or candidate, although I volunteer for several. I am a quality health care, physician, and patient advocate, breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not nor will I ever claim to be unbiased (I am....biased, I mean), unlike many in the mainstream media.

Most information in this newsletter is copied and pasted from other sources, and will always be identified with links. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized and appear in blue.

This Update is emailed to health professionals, physician and patient advocates, and others interested in ensuring access to quality medical care.

Join our Google Group or Facebook Page or email LiabilityNEWS@aol.com and put "subscribe" in the subject line to ensure you get all issues ASAP. It also appears on the following BLOG (when I remember to post it): http://liabilityandhealthnewsupdate.blogspot.com.

If you'd prefer not to receive these periodic updates about health care issues in America, please hit "Reply" and put "Unsub health group" in the subject line and I'll remove your email address immediately.

PLEASE FORWARD THIS IMPORTANT INFORMATION TO EVERY HEALTH CARE PROFESSIONAL OR PATIENT YOU KNOW, AND SEND ME MORE EMAIL ADDRESSES OR DIRECT OTHERS WHO HAVE INTEREST TO ONE OF THE ADDRESSES BELOW SO WE CAN GET THIS INFORMATION TO MORE OF THE PEOPLE WHO NEED IT.

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4/1/11 - Liability&HealthNewsUpdate - Tort reform in PA, "Happy" belated birthday, PPACA?

2011-04-01T11:10:00.000-07:00

4/1/11 - Liability&Health News Update Tort Reform in PA, "Happy" belated birthday, PPACA? ((Donna's in-article comments in blue italics. Please scroll to the end for more information, disclaimer, etc.)) Commentary: OK, I've recently changed my mind on a lot of important things: We don't need liability reform in PA. Or anywhere else, for that matter. The lawyers have been right all along - if there weren't mistakes, there wouldn't BE any malpractice lawsuits. There's no such thing as defensive medicine. The government, not doctors, is far more qualified to dictate America's health care. Everyone should be forced to pay for everyone else's health care (or car, or house, or iPhone). Legislators shouldn't have to READ those pesky laws they pass. We should give the PPACA a CHANCE instead of trying to repeal it. Hey, it might work. What's the fuss about border security? EVERYONE should be allowed to enjoy America's largesse. The Constitution is old and outdated and we should ignore it. Our taxes are too low - they pay lots more in Europe and look how great everything is there. People should just stop whining about their rights and do what the government tells them to do. The people who run our government are SO much smarter than the average citizen. Gasoline is too cheap - I'd love to pay $10 a gallon. (scroll down......) ((APRIL FOOL!)) ~~~~~~~~~~~~~ ((Dr. Marilyn Heine is a dynamo and will be an outstanding president of the PA Medical Society.....here are her comments from Monday's Capitol press conference on medical liability reform in PA.)) Pennsylvania State Capitol News Conference, Media Center Remarks of Marilyn Heine, MD President-Elect, Pennsylvania Medical Society On March 28, 2011 Good Morning. Thank you for the opportunity to share with you a few reasons it is imperative to reform our legal system to ensure continued access to high quality medical care for all Pennsylvanians. We’ve all seen the barrage of personal injury lawyers’ ads on billboards, television, and telephone book covers asking, “Have you been injured?” and “Did you have a ‘less than perfect’ outcome?” They offer to make someone rich simply by suing. Through constant repetition of these types of advertisements, personal injury lawyers have skillfully changed the way Americans view personal responsibility. They have convinced many that when something doesn’t go the way they’d like, that “they’ve been injured” and someone else is to blame. Everyone in this room has examples of how lawsuit abuse negatively impacts each of our types of work. For physicians, personal injury lawyers are strangling patient care. The motive of a personal injury lawyer is the “contingency fee,” and it is taking its toll on physicians and our patients. Young physicians who graduate from Pennsylvania’s medical training programs often leave to practice elsewhere. Physicians in private practice in Pennsylvania find it nearly impossible to recruit new associates. The cost of medical liability insurance is higher here than in much of the country. Furthermore, despite what our opponents say about Pennsylvania’s medical liability climate, lawsuit abuse continues to erode the clinical practice of medicine. As I stand here this morning, physicians across Pennsylvania are ordering medically unnecessary MRIs, CAT scans, PET scans, biopsies, and other tests for one simple reason…the fear of litigation. This drives up the cost of health care for all of us. The overwhelming majority of claims brought against physicians are dropped, dismissed, withdrawn, or found in favor of the physician. Yet, these claims are costly to defend. And time spent on defense is time that a physician could have been caring for other patients. Personal injury lawyers have a huge error rate. Their error rate is crippling patient care by increasing costs and decreasing access. Broad based liability reform in Pennsylvania is good for all Pennsylvanians from patients, physicians and hospitals, to employers and civic organizations, to the girl scouts and our little league teams. The benefit of broad legal reforms will be felt by all of us because each of us has been the victim of Pennsylvania’s out-of-control legal system. Everything we buy has a higher price tag due to lawsuit abuse. Some call this a “tort tax.” The only ones who won’t benefit from fixing a broken legal system are those who created the need for reform in the first place…personal injury lawyers. I respectfully ask our legislature to do the right thing. For the better health of all Pennsylvanians, restore common sense to our legal system. Thank you. The patient-doctor relationship has been the priority of the Pennsylvania Medical Society since its founding in 1848. Today, the physician members continue to focus on better health for all Pennsylvanians. To learn more about the Pennsylvania Medical Society, visit its web site at www.pamedsoc.org or its patient website at www.myfamilywellness.org. The Institute for Good Medicine at the Pennsylvania Medical Society can be found www.goodmedicine.org. The Pennsylvania Medical Society is a proud sponsor of the PAMED Better Health Network, www.BetterHealthPA.org. The PAMED Better Health Network™. Where innovators meet innovators. Find out more at www.BetterHealthPa.org ~~~~~~~~~~~~~ From the Pittsburgh Post-Gazette Sorry is OK: Doctors and nurses should be allowed to say so Tuesday, March 29, 2011 ((For more information about this concept, visit our good friend Doug Wojesiak's site Sorry Works! at www.sorryworks.net)) Those who deliver superior health care recognize that patients are not a number on a chart but human beings with feelings. And in a human enterprise in which not all treatments work and mistakes are sometimes made, doctors and nurses should not be discouraged from being empathetic even in adverse situations. Unfortunately, in a litigious culture, people have to watch what they say -- and that's especially true in a health care setting, where costs have been driven up by the threat of lawsuits. In short, if kindly health care providers express sorrow after a treatment that didn't work, they could be sorrier still if sued. Fortunately, state legislation aims to rectify that affront to common sense. House Bill 495 says that any benevolent gesture or statement by a health care provider "that conveys a sense of apology, condolence, explanation, compassion or commiseration emanating from humane impulses" shall be inadmissible in a liability action. Is this a real problem? There's no question, according to Scot Chadwick, vice president of governmental affairs for the Pennsylvania Medical Association, which supports the bill. He says the doctors and others are eager to talk to family members if a procedure doesn't work out but are inhibited from doing so in a toxic legal environment. HB 495, which passed the House 171-27 this month and is now in the Senate Judiciary Committee, is part of several tort reform measures being pushed by a coalition of more than 50 business, health care, local government and insurance groups. On Monday in Harrisburg the coalition released the results of a poll that showed broad public support for various components of tort reform. On the so-called apology legislation, 84 percent of the 800 registered voters surveyed were in favor. This is hardly surprising. Families and friends of patients don't want an unresponsive health care provider. They want answers and they want doctors and nurses to share in their pain if the news is not good. Long before modern lawsuits, an ancient wisdom observed that a "soft answer turns away wrath." This bill allows for that kindly, humane answer. First published on March 29, 2011 at 12:00 am ~~~~~~~~~~~~~ ((From one of our liability reform allies - this group is looking for doctors who are willing to speak at events, write letters to editors and legislators, etc - basically, they're looking for health care professionals to help them make NOISE on PA medicine's behalf - please contact either me or Lindsey Shaw if you can help in this effort.)) Good morning! My name is Lindsey Shaw, and I am helping Citizens to Protect PA Jobs, a Pennsylvania based pro-business advocacy group organize grassroots support for broad based liability reform. We are pushing for true legal reform here in PA, but we really need your help to do it! We are in need of people that would be willing to write letters to the editor, make calls/send e-mails/send letters to their legislators and show up at different events such as town hall meetings. You can find out more about the issue at hand at the following website under "Lawsuit Abuse Reform:" http://www.protectpajobs.com/issues/. If you or someone else you know is interested in participating in our cause, please e-mail me back with your/their name, phone number and e-mail address. We are looking for the doctors to write letters to the editor, make calls / send emails / send letters to their legislators and show up at different events. Thank you, and I look forward to hearing back from you soon! Sincerely,Lindsey N. Shaw(717)-433-0379Lindsey@coldsparkmedia.com ~~~~~~~~~~~~~ From the Pittsburgh Post-Gazette: Corbett opposes Medicaid expansion under health care law Wednesday, March 23, 2011 By Laura Olson http://www.post-gazette.com/pg/11082/1134106-100.stm HARRISBURG -- Gov. Tom Corbett says the Medicaid expansion under the year-old federal health care law is unaffordable to Pennsylvania, and he is repeating a request for speedy consideration of lawsuits challenging the constitutionality of that law. ((It's unaffordable to EVERY state - please stand strong on this, Gov. Corbett.)) Mr. Corbett testified this morning at a U.S. House committee field hearing here, along with his insurance and welfare department secretaries, on the state's fiscal and administrative challenges in beginning to implement the health care law's provisions. In his previous role as state attorney general, Mr. Corbett joined in a multistate lawsuit challenging the federal law. That suit and several other similar cases are working their way through the court system, while states are left to begin enacting portions of the law. Enacting the required changes will add another 750,000 Pennsylvanians to the state Medicaid rolls, Mr. Corbett said. That would mean one in four state residents would be receiving Medicaid benefits, at a cost he described as unsustainable. The state already spends 30 percent of its operating budget on Medicaid, he said. "That means that before we spend one penny on schools, on roads, police, firemen, infrastructure, we will only have 70 cents of our state dollar left," Mr. Corbett said. "With the commonwealth facing a tremendous budget shortfall in the billions this year, we simply cannot afford the expansion of Medicaid." Outside the hearing room, several Pittsburgh-area residents joined in a rally supporting the health care law. They said they're counting on the insurance exchanges that will start under that law in 2014 to help them gain coverage. Cal Schuchman, a Reserve resident who until recently worked as a security guard, said he was on the state's adultBasic program for more than three years. That coverage ended this month, and he's unable to afford the more expensive Fair Care insurance that the state made available to adultBasic recipients. Without health insurance, the 61-year-old said he'll continue exercising and eating a balanced diet, which he sees as his only options to stay healthy until the insurance exchanges are created. "There shouldn't be any juggling act here finding funding -- this is a necessity," said Mr. Schuchman. Laura Olson: 717-787-4254 or lolson@post-gazette.com First published on March 23, 2011 at 12:50 pm ~~~~~~~~~~~~~ ((Few people "get" the whole "health care is a right" issue better than Dr. Paul Hsieh.)) From The Objective Standard Health Care and the Separation of Charity and Statehttp://www.theobjectivestandard.com/issues/2011-spring/health-care-charity-state.asp This article is from TOS Vol. 6, No. 1. The full contents of the issue are listed here. Paul Hsieh If someone in America needs medical care but cannot afford it, should he rely on charity or should others be forced to pay for it? President Obama and his political allies say that Americans should be forced to pay for it. Forcing some Americans to pay medical bills for other Americans, says Obama, is a “moral imperative”1 and “the right thing to do.”2 Throughout the health-care debate of 2010–11, Obama repeatedly referred to government-run health care as “a core ethical and moral obligation,” arguing that, “No one should die because they cannot afford health care, and no one should go broke because they get sick.”3 In speeches, he repeatedly cited the story of Natoma Canfield, an Ohio cancer patient without health insurance, as a justification for his health-care legislation.4 Many of Obama’s supporters on the political left made similar moral claims. Vanderbilt University professor Bruce Barry wrote in the New York Times that, “Health insurance in a civilized society is a collective moral obligation.”5 T. R. Reid, former foreign correspondent for the Washington Post, called universal health care a “moral imperative.”6 Ezra Klein, another writer for the Washington Post, agreed that it is an “ethical obligation.”7 But all such claims are wrong—morally wrong. There is no “right” to health care. Rights are not entitlements to goods or services produced by others; rather, they are prerogatives to freedom of action, such as the right to free speech, the right to contract, or the right to use one’s property. Any attempt to enforce a so-called “right” to health care necessarily violates the actual rights of those who are forced to provide or pay for that care. If a patient needs a $50,000 operation but cannot afford it, he has the right to ask his friends, family, neighbors, or strangers for monetary assistance—and they have the right to offer it (or not). But the patient has no right to take people’s money without their permission; to do so would be to violate their rights. His hardship, genuine as it may be, does not justify theft. Nor would the immoral nature of the act be changed by his taking $100 each from five hundred neighbors; that would merely spread the crime to a larger number of victims. Nor would the essence of the act change by his using the government as his agent to commit such theft on an even wider scale. The only moral way for this patient to receive the assistance he needs is for others to offer it voluntarily. Morally, he must rely on charity. Fortunately for him, there is no shortage of people willing to offer charity, nor is there a shortage of reasons why one might self-interestedly wish to do so. . . . To read the rest of this article, select one of the following options:Subscriber Login Subscribe Renew Purchase a PDF of this articl ~~~~~~~~~~~~~ BRIEFS ((These are quick summaries and links to articles which might interest you. Many of these come from the "Today's Daily Dose" newsletter which is now administered by the Independent Women's Forum - The Daily Dose is a joint project with the Independent Women's Forum (501(c)(3)) and the Independent Women's Voice (501(c)(4)). This is part of the SavingOurHealthCare.org http://www.savingourhealthcare.org initiative which is sponsored by several physician advocacy organizations as well, including the American Association of Physicians and Surgeons - AAPS - and Docs4PatientCare. You can sign up free to get the whole version of Today's Daily Dose in your email box. Really, it's all you need to read to keep up with all the news and information about health care reform.)) WHY OBAMACARE IS WRONG FOR AMERICA And second, you’ve probably already heard about Why Obamacare Is Wrong for America, the new book by Grace-Marie Turner, Jim Capretta, Tom Miller, and Bob Moffit, with an introduction by Rep. Paul Ryan. I encourage you to watch the webcast of the book launch at their site, and refer interested friends to the book as a substitute for having to wade through a sea of PDFs and background. It distills in an excellent way the chief arguments against this law, and provides a strong overall view on the nature of America’s health care crisis. Check it out! SOURCE: Why ObamaCare Is Wrong for America Latest Polling Rasmussen Reports March 28, 2011 58 percent of voters favor repealing ObamaCare ObamaCare Is Billion-Dollar Cash Cow for AARP, GOP Report Says, Pressing for Probe Henry J. Reske - Newsmax The powerful seniors lobby AARP stands to make more than a billion dollars over the next 10 years from the sale of supplemental Medicare policies under ObamaCare, a House GOP report reveals. The report from Reps. Wally Herger, R-Calif., and Dave Reichert, R-Wash., alleges the Affordable Care Act will result in great demand for the Medigap policies that have the AARP stamp of approval, The Washington Post reported. Uncovered: New $2 Billion Bailout in ObamaCare Washington Examiner Investigators for the House Energy and Commerce Committee have discovered that a little-known provision in the national health care law has allowed the federal government to pay nearly $2 billion to unions, state public employee systems, and big corporations to subsidize health coverage costs for early retirees. At the current rate of payment, the $5 billion appropriated for the program could be exhausted well before it is set to expire. Lawmakers Unveil Legislation Which Removes Automatic Funding for Health Care Legislation Pat Summers - Fox News Georgia Republican Congressman Jack Kingston and Texas Republican Congressman Louie Gohmert held a press conference to introduce new legislation designed to remove up to the $105.5 billion in automatic funding that they insist was buried in President Obama's health care legislation. ObamaCare Implementation: What Rivkin Said, and Why Michael F. Cannon - Cato @ Liberty A couple of people have asked me about a comment David Rivkin made at Cato's recent conference on the first anniversary of ObamaCare. Rivkin is representing the 26 states suing to overturn ObamaCare in Florida v. HHS, the case in which a federal judge declared ObamaCare unconstitutional and void. In his most recent ruling in that case, Judge Roger Vinson allowed the Obama administration to keep implementing and enforcing the law, in part because the fact that most of the plaintiff states are also implementing the law "undercut" their request that he stop the Obama administration from doing so. ObamaCare Cost in One Chart Joseph Lawler - The American Spectator The Congressional Budget Office produced this clear graph on the budgetary effects of ObamaCare. The left-hand scale is billions of dollars. "Net Changes in Other Revenues" means, generally, tax increases. "Net Changes in Other Spending" is mostly cuts to Medicare. This chart represents the absolute best-case scenario that Democrats could present to the CBO for scoring. In all likelihood, the Medicare cuts (the medium-blue lines) will not materialize. Where’s My Waiver? Caroline May - The Daily Caller Conservative groups are encouraging individual Americans to request health care reform waivers from the Obama administration. Wednesday, Let Freedom Ring, a conservative public policy organization, in coordination with groups such as Americans for Tax Reform, Heritage Action, and others launched the website WheresMYWaiver.com to allow individuals to easily submit waiver requests to the Department of Health and Human Services. “With union workers comprising over 45% of waiver beneficiaries, it is quite ironic that the very same folks that fought for ObamaCare are now seeking to be exempt from it. National Restaurant Association Member Tells Congress of Real Impact of New Health Care Law on Business Restaurant News A Michigan restaurateur and National Restaurant Association member today gave the Subcommittee on Health of the House Energy & Commerce Committee a look at what it takes to run a restaurant business in the United States—and a daunting prognosis for what the new health care law could mean for businesses like his. On behalf of the National Restaurant Association, Larry Schuler described for Congress how the law will significantly impact his employees and how he runs his business, and urged early action to make fundamental changes to the Patient Protection and Affordable Care Act (PPACA) of 2010. In Campaign Against Health-Care Law, Republicans Take on AARP Dan Eggen - Washington Post House Republicans, who are continuing their efforts to chip away at President Obama’s health-care law, have now set their sights on a powerful group that strongly supported the legislation: the AARP seniors lobby. Two GOP members of the House Ways and Means Committee released a report Wednesday alleging that the nation’s largest seniors group stands to gain financially from the Affordable Care Act, because the law could result in greater demand for supplemental Medicare policies that carry the AARP stamp of approval. Obama Administration Delaying Some Rules for Appealing Health Insurance Denials Susan Jaffe - Los Angeles Times The Obama administration is delaying until next January its enforcement of some new rules designed to protect patients who appeal insurers' decisions to deny or reduce health care benefits. In the meantime, the Labor Department said in a posting on its website that it will revise the requirements to deal with objections raised by insurers. These rules were mandated by the health care law, and federal officials had earlier said they would start enforcing them in July. Why States Are Shying Away From ObamaCare’s Health Insurance Exchanges Peter Suderman - Reason Should states refuse to implement the health care overhaul? As I pointed out last week, some of them already are, and now opposition to the law appears to be scoring wins in even more states. A story in Politico this afternoon notes that Tea Party activists opposing the law seem to be “finding surprising success...blocking the law’s implementation.” Those victories are occurring at the state level, where a number of governors are both politically sympathetic and justifiably worried about the burdens the law places on their states. At first glance, the law seems like a trap for those who both oppose the law and favor federalism: ObamaCare calls on states to set up exchanges; in any state that does not sufficiently comply by 2013, the federal government will simply swoop in and set up an exchange on its own. Pelosi: Health-Care Defunding Provision Will Not Be Signed into Law ((But....didn't she also say that Americans would LIKE the PPACA once they found out what was in it?)) Felicia Sonmez - Washington Post's 2 Chambers House Minority Leader Nancy Pelosi (D-Calif.) said Wednesday that any longer-term government funding bill that eventually gets signed into law by President Obama will not include any policy riders aimed at defunding the national health-care law. “Let’s put it this way: the health-care rider is not one that will be in any bill that will be sent to the president and that the president will sign. ... This bill will not be repealed,” Pelosi said at an event touting Democrats’ health-care and student loan laws. CQ Healthbeat: CMS Actuary: Medicare Cuts In Health Care Law Unrealistic ((No kidding.....we've been saying that all along....)) The cuts in Medicare spending growth that pay for the health care overhaul "may not be viable indefinitely," Rick Foster, the chief actuary of the Medicare and Medicaid programs, told House lawmakers on Wednesday. Republicans on the House Energy and Commerce Subcommittee on Health scheduled Wednesday's hearing as a way to contrast Foster's skepticism about whether the health care law (PL 111-148, PL 111-152) will ultimately reduce the federal deficit, after the Congressional Budget Office (CBO) projected in February that repealing the law would add $210 billion to the deficit from 2012-2021. The cuts in the law are so deep that medical providers "eventually would become unable or unwilling to provide services to Medicare beneficiaries," Foster testified (Adams, 3/30) Weekly Standard: Cash For Doctors Revisited http://www.weeklystandard.com/articles/cash-doctors-revisited_555536.html[ Dr. Brian Forrest's] practice, Access Healthcare outside Raleigh, doesn't accept insurance. Instead, Forrest takes payment from patients on the spot, and he lists prices in his waiting room in an effort to be transparent, "like a Jiffy Lube." At the time, he said he figured his approach would become more popular as people opted to circumvent the hassles and cost of regulations from government and insurance companies. Now, nearly a year later, Forrest says he's more sure than ever that his business model makes sense. He's planning to franchise his practice, with six similar doctors' offices scheduled to open in North and South Carolina this summer, and plans to open others as far north as Baltimore and as far west as Indiana (Tony Mecia, 4/4). The New England Journal of Medicine: Hospitals' Race to Employ Physicians -- The Logic Behind A Money-Losing Proposition http://healthpolicyandreform.nejm.org/?p=14045&query=TOC ((It's not about cost - it's about control.)) If the fee-for-service system persists, large physician networks will provide hospitals with greater pricing power when they are contracting with health plans. This scenario favors greater hiring of specialists. Conversely, if payment systems move toward population health management and risk-based reimbursement, then large outpatient networks will allow a system to shift patients away from higher-cost hospital-based care and recapture lost revenues as shared savings or capitation surpluses. This scenario favors greater hiring of PCPs. A major concern in either scenario is the potential for hospitals to convert greater market power into higher prices and less competition (Dr. Robert Kocher and Nikhil R. Sahni, 3/30). Louisiana is Ninth State to Seek Waiver from ObamaCare’s Medical Loss Rules David Hogberg – Investor’s Business Daily IBD has just gotten word that Louisiana will become the ninth state to request a waiver from ObamaCare’s medical-loss-ratio regulations. An MLR is the share of health premiums spent on medical costs. Under ObamaCare, insurers in the individual and small group market must have an 80% MLR, which means that 80% of premiums are spent on medical care, leaving 20% for things like salaries, advertising, fraud prevention and profits. The Rise of the Anti-ObamaCare Compacts David Weigel – Slate Back in December, I attended part of the American Legislative Exchange Council’s annual meeting and heard about a bold, new-ish idea that could let states slip out of the Affordable Care Act’s mandates. Several states — Arizona, Virginia, etc — have already passed Health Care Freedom laws that prohibit the states from complying in the health care mandate. According to Nick Dranias of the Goldwater Institute, that opens the door for states to form compacts that would supersede federal regulation. On Health Care, Stop, and Then Start Over! Carter Wood – National Association od Manufacturers’ Shop Floor Leaders of the Start Over! Coalition, including the National Association of Manufacturers, wrote Sen. Kay Bailey Hutchison (R-TX) to express support for her amendment (S.Amdt.197) to the pending small business bill, S. 493, that would suspend further implementation of the Patient Protection and Affordable Care Act. Rep. Larry Bucshon Supports Amicus Brief against ObamaCare ((Let's hear it for the physician members of the GOP Doctors' Caucus! They need the support of their physician and other health care professional colleagues all over the country - let them hear from you today!)) The State Column Congressman Larry Bucshon (IN-08) joined Congressman Paul Broun (GA-10) and fellow members of the 112th Congress in supporting an amicus brief filed by the American Center for Law and Justice in support of the Commonwealth of Virginia in the 4th Circuit of the U.S. Court of Appeals. The amicus brief focuses on why the individual mandate in the Affordable Care Act is unconstitutional and therefore the entire law must be completely invalidated. 1,000+ Pages of Health-Care Rules? David Nather and J. Lester Feder – Politico Health care lobbyists and advocates are bracing for six pages of the health care reform law to explode into more than 1,000 pages of federal regulations when the Department of Health and Human Services releases its long-delayed accountable care organization rules this week. “What, you expected less than a thousand pages for legislation that only took a page and half?” a staffer with one of the current proto-ACOs asked. ((Actually, they just released 429 pages of ACO stuff.....based on six pages in the 2,700 page bill....can anyone do the math here? How many pages of regulations should we expect? And where are the environmental activists screaming about all the trees they're going to kill?)) The Real Cost of Health Care Andrew Freeman and Dr. Paul Keckley – The Hill’s Congress Blog A year ago President Obama signed health care reform into law. Political debate continues, even as the business of implementing reform marches on. Both elements need reliable and complete information if the best choices are to be made for America. But official health care figures are incomplete. A number of important health-related costs are currently not captured by official statistics. Putting these into the picture not only offers a richer sense of the challenges facing US consumers, but also has important implications for the US economy. ((And if you add in the cost of the mandates on citizens, businesses and states, the REAL cost of the PPACA is somewhere in the neighborhood of SEVEN TRILLION DOLLARS. That's a pretty exclusive neighborhood.)) Evan Bayh Now Unsure If ObamaCare Reduces Health Costs Real Clear Politics “The real issue that was not addressed, Laura, that you’ve raised now, and I think appropriately, is the cost, the cost to both the government and to your listeners. We need to take steps now to get the costs of health care under control. That was not dealt with really in an aggressive way in this legislation. I think it now needs to be,” Sen. Evan Bayh (D-Indiana) told Laura Ingraham. ((Ummmm...wasn't cost control one of the POINTS, Senator?)) One Year of ObamaCare Nathan Deal – Savannah Morning News March 23 marked the one-year anniversary of the president signing ObamaCare into law. The majority of the major provisions aren’t set to go into effect until 2014, but the harmful effects are already starting to surface. If something is not done soon to stop ObamaCare from full implementation, its negative impact will be even more destructive across the board. No one is above the law, and we must follow federal law even when we disagree. As a constitutionalist and a conservative, I believe firmly in the rule of law. As such, Georgia will prepare for implementation of this federal law even as we continue to fight against ObamaCare all the way to the Supreme Court. Currently, our case is before the 11th Circuit Court of Appeals after our great victory in a federal district court in Florida. Canadian Medical Association Calls on Governments to Fix Ailing Health System Karen Kleiss – Edmonton Journal/ Vancouver Sun The Canadian Medical Association says governments need to stop playing “whack-a-mole” with problems in the health-care system and embark on a wholesale transformation to address the ongoing, national crisis. Association president Dr. Jeff Turnbull on Tuesday called on federal election candidates to share their visions for the future of health care, while Canadians contribute their ideas at CMA-sponsored town halls across the country, including one in Edmonton Tuesday night. A Primer on Health-Care ‘Exchanges’ Julie Appleby – Washington Post It seems like a simple idea: Create new marketplaces, called “exchanges,” where consumers can comparison shop for health insurance — sort of like shopping online for a hotel room or airline ticket. But, like almost everything else connected with the health-care overhaul law, state-based insurance exchanges are embroiled in politics. Some Republican governors are threatening to refuse to set up exchanges unless they get more flexibility over Medicaid, the state-federal health program for the poor. Others say they don’t want to implement any part of the federal health-care law. ObamaCare’s Campaign of Misinformation Merrill Matthews – Forbes ((And yet, in spite of ALL the taxpayer dollars spent on "selling" the PPACA to the masses, 58% of Americans want it repealed....my suggestion, Madame Secretary, would be for you to hire a new advertising agency....what, are you using the same agency that produces those creepy Burger King commercials or something?)) Health and Human Services Secretary Kathleen Sebelius appeared on National Public Radio’s Diane Rehm Show last week as part of a concerted effort to promote the one-year anniversary of President Obama’s health care legislation. She claimed that the opposition has been delivering “lots of misinformation” about the legislation. Below I provide some quotes from her appearance, along with a summary of the law. I’ll let you decide who is disseminating the misinformation. Media Matters and Reality on ObamaCare ((Actually, the terms "Media Matters" and "Reality" are mutually exclusive....)) Derek Hunter – Daily Caller Forget comedy clubs, if you really want a laugh these days you simply have to venture over to the Media Matters website. The extent to which the organization is willing to contort reality to keep fellow “progressives” in line is nothing short of an expert yoga class. Given their recent “declaration of war” against Fox News for perceived bias, and the questionable legality of it given the group’s “charity” tax status, this is as surprising as the sun rising in the east each morning. There is no length to which Media Matters’ employees will not go to defend anything Democrats do; it’s what they’re paid to do. So it came as little surprise that on the one-year anniversary of ObamaCare’s passage, Media Matters was there to defend the unpopular law. ObamaCare’s Birthday No Cause To Celebrate Rep. Tom Price – The Weekly ((Once again, let's hear it for the Doctors' Caucus! Visit them at http://doctorscaucus.gingrey.house.gov/)) Last Wednesday marked one year since President Obama signed ObamaCare into law. Contrary to what its supporters have said since the time of its passage, the law remains a profoundly destructive impediment to quality health care in America and its implementation – if allowed to proceed – will disrupt the patient-doctor relationship and limit choices for care. In the past year, two federal judges have ruled the individual mandate unconstitutional, the estimated cost of ObamaCare has risen, and the promise that Americans could keep the coverage they have has been proven false. The Ulterior Motive Behind Rising ObamaCare Premiums Sally Pipes – Forbes Last week, proponents of ObamaCare celebrated the one-year anniversary of the passage of the landmark health care law with several hundred events across the country. They have little reason to cheer, according to a sobering new study. In the report, former Congressional Budget Office Director Douglas Holtz-Eakin calculates that health reform’s tax on insurers, which takes effect in 2014, will raise family premiums by $5,000 over the decade–all by itself. ((Ummmmm....but wasn't the bill supposed to "bend the cost curve" DOWNWARD?)) Not-So-Happy Birthday for ObamaCare Ronald E. Bachman – The Gwinnett Gazette The Patient Protection and Affordable Care Act (PPACA) commonly referred to as ObamaCare was signed into law on March 23, 2010. One year later, the law remains unpopular with the public and a core fiscal concern for many voters, while many are learning just how intrusive are the government mandates. Supporters believed that once passed, the law would gain in popularity. It has not. This law of the land may not be for long. In January this year, Senior U.S. District Court Judge Roger Vinson ruled the individual mandate in the new law to be unconstitutional. NYC Hopes to Join Legions Freed from Health Care Rules Michelle Malkin – Dayton Daily News New York Democratic Rep. Anthony Weiner toasted the one-year anniversary of ObamaCare last week — and accidentally spilled his champagne glass all over the disastrous, one-size-fits-all mandate. Ostensibly one of the federal health care law’s staunchest defenders, Weiner exposed its ultimate folly by pushing for a special cost-saving regulatory exemption for New York City. If it’s good for the city Weiner wants to be mayor of, why not for each and every individual American and American business that wants to be free of ObamaCare’s shackles? On ObamaCare’s Anniversary, Voters Favor Repeal 58%-36% Avik Roy – Forbes Since the Patient Protection and Affordable Care Act was signed into law one year ago, Scott Rasmussen has been conducting a weekly tracking poll, asking likely voters whether or not they favor or oppose repealing the law. (Many other polls that are less reliable do not assess whether respondents are likely to vote, a key factor in the accuracy of any given survey.) Rasmussen’s latest survey shows that likely voters favor repeal by a wide margin: 58 percent to 36 percent. Even more telling, among those expressing a strong opinion, 46 percent strongly favor repeal, as compared to 27 percent who strongly oppose. Obamacare's First Anniversary. Let's Hope There Aren't Too Many More. Paul Howard, National Review Online, March 24, 2011 This week marks the first anniversary of the passage of the Patient Protection and Affordable Care Act, aka "Obamacare." The Obama administration and its allies will be hawking the law's achievements, while its critics (present company included) will be touting its myriad problems, unintended consequences, and budget-shattering costs. For policymakers who want to move the country in the direction of a more market-oriented health-care system, the key to "repealing and replacing" Obamacare will be to define a narrative that links health care to the nation's broader economic woes, and to avoid the trap of pigeonholing the Obamacare debate as a debate just about health care. It's really a debate about the future of the American economy, and that's a debate that should resonate with moderates, conservatives, and independents. . . Obamacare: One year later Dr. David Gratzer and Dr. Jason Fodeman, Washington Times, March 23, 2011 This week marks the one-year anniversary of Obamacare, and there has been no shortage of Washington rhetoric on the goals of the legislation for the occasion: Bending the cost curve. Reducing health insurance premiums. Expanding the number of insured Americans. But as we mark this anniversary, it's important to note the other agenda that has been missed in the debates of the past two years: reining in our doctors. Look carefully at the legislation signed into law by President Obama last March, and you'll discover a not-so-subtle campaign to dramatically reshape the doctor-patient relationship. From compensation to autonomy, Obamacare represents something of a war on doctors. . . Health Care’s Hidden Costs: $363 Billion Parija Kavilanz – CNN Money http://money.cnn.com/2011/03/23/news/economy/health_care_hidden_costs/A year after the passing of health reform, a new industry report revealed that consumers may be paying billions of dollars more in out-of-pocket health care expenses than was previously thought. These “hidden” costs of health care — like taking time off to care for elderly parents — add up to $363 billion, according to a report from the Deloitte Center for Health Solutions, a research group. That amounts to $1,355 per consumer, on top of the $8,000 the government says people spend on doctor fees and hospital care. ObamaCare Unlikely to Gain Popularity… During Tax Season Hadley Heath – Independent Women’s Forum http://www.iwf.org/inkwell/show/24554.htmlTime is ticking away… Only a few weeks left to file your taxes! I almost laughed when I read this headline from The Hill: Administration hopes tax time will boost support for healthcare reform. “Health care reform” meaning the one-year-old law that includes at least 20 different tax hikes? Oh yes, that’s bound to be popular around tax time. But the article from The Hill focuses specifically on small business taxes. The administration is hoping that small businesses (that is, fewer than 25 employees) will apply for the small business tax credit in ObamaCare. Boehner, McConnell Push Assault on Health Care Law Michael D. Shear – New York Times’ The Caucus http://thecaucus.blogs.nytimes.com/2011/03/23/boehner-mcconnell-push-assault-on-health-care-law/?partner=rss&emc=rss A year after President Obama signed his health care law into effect, the two leading Republicans in Congress are making it clear that they do not intend to let up in their assault on the historic measure. In a joint opinion article to be published in the Cincinnati Enquirer Wednesday morning, House Speaker John Boehner and Senator Mitch McConnell of Kentucky, the Republican leader, promise to continue pursuing “full repeal” of the law. “The fog of controversy has now cleared, but contrary to the confident predictions of some, the contents of this law are even worse than anyone expected,” the pair write. “And that’s saying something.” Public Wants ObamaCare Repealed, and I Can Do It Rep. Steve King – DesMoines Register http://www.desmoinesregister.com/article/20110323/OPINION01/103230342/0/MOMS/?odyssey=nav%7Chead On March 23, 2010, President Obama defied the wishes of the American people and signed ObamaCare into law. At the time, supporters of the unconstitutional law claimed that Americans would warm up to ObamaCare as they began to realize what was in it. This claim was unlikely then, and recent polling indicates that it is completely without merit now. A Glimpse of a Future with ObamaCare Sally C. Pipes - Washington Post The one-year anniversary of the Affordable Care Act this week brings new reason to consider a major health-care announcement by Massachusetts Gov. Deval Patrick. Almost five years into his state’s Romneycare plan, it turns out that spending is out of control, threatening public-sector budgets and private-sector wealth generation. The solution to this government-created mess, Patrick told the Greater Boston Chamber of Commerce last month, is more government control — or health-care reform Part II, as some are calling it. Americans in the other 49 states should pay attention. Massachusetts is the blueprint for ObamaCare, and Patrick is among those who want his state’s plan to serve as a national model. Senate Democrats Eye Health-Law Strategy David Nather - Politico It may be uphill for Democrats to hold the Senate in 2012, but they’re eyeing an opportunity on the health care law: They believe the Republican candidates might be forced to push so hard for repeal that they lose swing voters. That may be a surprising take, given that the law is still unpopular with much of the public. With 23 Democratic seats and only 10 Republican seats up for reelection, it could take a hard sell for those candidates to turn the public around. 11th Circuit Accelerates Timetable for ObamaCare Constitutional Appeal Avik Roy - Forbes I got busy with other things, and haven’t had a chance to comment on important developments with the ObamaCare constitutional challenges. So here’s my take. As readers will know, in January, Judge Roger Vinson of the U.S. District Court for the Northern District of Florida overturned PPACA in its entirety. The White House refused to abide by the ruling, instead asking Vinson to “clarify” it. Vinson responded vigorously, demanding that the White House seek an expedited appeal of his ruling by March 10. $5B Hollywood Handout Bankrupting ObamaCare Chris Gonsalves - Newsmax A $5 billion handout to states, big corporations, and Hollywood unions to subsidize health insurance for early retirees is threatening to bankrupt a major part of the year-old healthcare reform law, according to staffers of the House Energy and Commerce Committee. A small percentage of the organizations singed up for the plan has already drained more than $500 million from the program’s coffers. Breaking Health Care Research: Pursuing a Different Path in Health Reform Margot Crouch - The Foundry After one year, ObamaCare remains just as unpopular as ever. The fight for repeal has gained ground in both Congress and the states. But repeal is only the first step in setting a new agenda on health care. In her recently released paper, Heritage expert Nina Owcharenko explains the four steps necessary to creating lasting reform that is truly market-based and patient-centered: “Unlike ObamaCare, Congress should pursue an approach to health care reform that preserves the doctor–patient relationship and cutting-edge innovation while controlling costs and expanding access to private health coverage.” ~~~~~~~~~~~~~ From the NCPA's health care blog: Is Medicaid Real Insurance? ((Quick, easy answer - NO.)) http://healthblog.ncpa.org/is-medicaid-real-insurance/?utm_source=newsletter&utm_medium=email&utm_campaign=HA#more-18618 Filed in Health Alerts on March 30, 2011 with 9 comments As governors across the land pepper the federal government with requests to scale back Medicaid — many people are losing sight of the fact that health care reform (what some call ObamaCare) requires a huge expansion of Medicaid. In fact, in just three years the nation is expected to start insuring about 32 million uninsured people. About half will enroll in Medicaid directly; and if the Massachusetts precedent is followed, most of the remainder will be in heavily subsidized private plans that pay little more than Medicaid rates. That raises an important question: How good is Medicaid? Will the people who enroll in it and in private plans that function like Medicaid get more care, or better care, than they would have gotten without health reform? The answer to that question is not obvious. In fact it’s probably fair to say that we are about to spend close to $1 trillion over the next 10 years insuring the uninsured and we really don’t know what we expect to accomplish by spending all that money. The 32 million newly insured may not get more health care. They may even get less care. And even if they do get more, odds are that low-income families as a group will get less care than if there had never been a health reform bill in the first place. The reason: the same bill that insures 32 million new people also will force middle- and upper-middle-income families to have more generous coverage than they now have. As these more generously insured people attempt to acquire more medical services they will almost certainly outbid people paying Medicaid rates for doctor services and hospital beds. To make matters worse, the health reform bill (following the Massachusetts precedent) did nothing to increase the supply side of the market to meet the increased demand. Both anecdotal and scholarly reports from Massachusetts are consistent with this prediction. The wait to see a family doctor in Boston is now longer than in any other US city. More people are going to emergency rooms for their care in the state than before Massachusetts enacted its health reform. A Boston cab driver went through a list of twenty doctors (a list Medicaid gave her!) before she found a doctor who would see her. A preliminary report on the state as a whole found that nearly a quarter of adults who were in fair or poor health reported being unable to see a doctor because of cost during the implementation of the reforms. Further, state residents earning less than $25,000 per year were much less likely than higher earners to receive screening for cardiovascular disease and cancer. That brings us back to the initial question: Is Medicaid real insurance? Or is there little practical difference between being on Medicaid and being uninsured? It would appear at the margin that there’s not much difference. Currently there are roughly 10 million people in the U.S. who are eligible for Medicaid and S-CHIP but have not bothered to enroll. That implies that for about one in every six eligibles, Medicaid insurance is not worth the effort it takes to fill out the enrollment papers! Consider the case of Dallas emergency rooms. At Parkland Memorial Hospital both uninsured and Medicaid patients enter the same emergency room door and see the same doctors. The hospital rooms are the same, the beds are the same and the care is the same. As a result, patients have no reason to fill out the lengthy forms and answer the intrusive questions that Medicaid enrollment so often requires. At Children’s Medical Center, next door to Parkland, a similar exercise takes place. Medicaid, S-CHIP and uninsured children all enter the same emergency room door; they all see the same doctors and receive the same care. Interestingly, at both institutions, paid staffers make a heroic effort to enroll people in public programs — (going patient by patient, family by family) right there in the emergency room. Yet they apparently fail more than half the time! After patients are admitted, staffers go from room to room, continuing with this bureaucratic exercise. But even among those in hospital beds, the failure-to-enroll rate is significant. Clearly, Medicaid enrollment is important to hospital administrators. It determines how they get paid. Enrollment may also be important to different sets of taxpayers. It means federal taxpayers pay more and Dallas County taxpayers pay less. But aside from the administrative, accounting and financial issues, is there any social reason we should care? Economics teaches that people reveal their preferences through their actions. If people act as though they are indifferent between being uninsured and being on Medicaid, we may infer they are equally well off in both states of the world from their own point of view. If someone drops a $20 bill on the floor in Parkland’s emergency room, how long do you think it would stay there? Probably not very long. If someone drops a Medicaid enrollment form on the floor, how long do you think it would stay there? Probably until the next janitor comes along with a broom. Health economists tend to think Medicaid insurance is really valuable – worth a lot more, say, than $20. Many patients, through their actions, communicate that they disagree. Against this conclusion, there are two counter arguments worth considering. First, some claim that transactions costs (administrative difficulties) are the real reason why so many eligibles don’t enroll. At Parkland and Children’s Hospital those costs are close to zero, however. Second, there is the argument from paternalism: that people will be better off if we push them into Medicaid, whether they prefer it or not. But even on that score, the evidence is weak. A very comprehensive RAND study, found that the type of insurance people have — or whether they are insured at all — does not affect the quality of care they receive. With respect to cancer care, it is unclear that Medicaid matters very much. Health blogger Avik Roy summarizes other studies that find that Medicaid patients do no better and sometimes worse than the uninsured. Additional evidence is supplied by Scott Gottlieb. If you’re trying to get a primary care appointment, it appears your chances are better if you say you are uninsured. Health economist Austin Frakt takes issue with these studies, claiming that Medicaid and non-Medicaid populations are fundamentally different, even after adjusting for race, income and other socio-economic factors. That claim seems improbable — at least at the margin — however, in light of the heavy ping-pong migration of people in and out of Medicaid eligibility. Frakt points to some studies finding that Medicaid makes a positive difference over being uninsured. But the results would probably have been just as good or better if we spent the money giving free care to vulnerable populations. Moreover, even with their Medicaid cards, enrollees turn to emergency rooms for their care twice as often as the privately insured and the uninsured. Austin and I have had a further volley (at his blog and mine) after a version of this Alert appeared at Kaiser Health News last Friday. Here’s my bottom line: after we get through spending our $1 trillion under ObamaCare, there is no convincing reason to believe that the bottom half of the income distribution will have more care, better care, or better access to care than they have today. ~~~~~~~~~~~~~ From the AMA March 23, 2011 AMA Report Finds Physicians Support nearly 170,000 jobs and $44.7 billion in Economic Activity in Pennsylvania Study provides state-level snapshot of the economic impact of office-based physicians studied (Harrisburg, Pa.) A new report released by the American Medical Association (AMA) and the Pennsylvania Medical Society (PAMED) shows that office-based physicians play a vital role in Pennsylvania’s economy by supporting jobs, purchasing goods and services and generating tax revenue. In 2009, office-based physicians in the Keystone state contributed $44.7 billion in economic activity and supported nearly 170,000 jobs. According to the Pennsylvania Medical Society (PAMED), the AMA report further proves the vital role of our state’s physicians in helping local communities with economic recovery. “Our focus is always the better health of Pennsylvania patients, and in the past, other studies like those by the Institute for Good Medicine at PAMED have shown the millions of dollars our members provide in charitable care,” said Ralph Schmeltz, MD, president of PAMED. “Now, this new AMA study provides yet another example of the benefits to communities of robust physician practices, specifically jobs and business opportunities for others.” AMA President Cecil B. Wilson, MD, agreed. “Although physicians are primarily focused on providing excellent patient care, physician offices and the jobs and revenue they produce are significant contributors to state economies,” said Dr. Wilson. “This study illustrates that office-based physicians contribute to both the health of their patients and also to the economic health of their local communities.” The study found that, in comparison to other industries, office-based physicians almost always contribute more to state economies than each of the following: education, legal, nursing home, and home health. The findings show the economic impact of office-based physicians as measured through sales revenue, jobs, wages and benefits and tax revenue. The report provides information on the economic impact of office-based physicians in all 50 states and the District of Columbia. In Pennsylvania, office based physicians supported $28.3 billion in wages and benefits. To view the Pennsylvania report, please visit www.pamedsoc.org/economicimpact. For the full national report, visit www.ama-assn.org/go/eis. The Pennsylvania Medical Society has been focused on the better health of patients since it was first founded in the 1800s. Today, the organization continues to stress the importance of the patient-doctor relationship. To learn more about PAMED visit www.pamedsoc.org or our patient website at www.myfamilywellness.org. The American Medical Association helps doctors help patients by uniting physicians nationwide to work on the most important professional, public health and health policy issues. The nation’s largest physician organization plays a leading role in shaping the future of medicine. For more information on the AMA, please visit www.ama-assn.org. ~~~~~~~~~~~~~ From the Heritage Foundation Doctors Give the Practice of Medicine under Obamacare a Grim Prognosis http://blog.heritage.org/2011/03/23/doctors-give-the-practice-of-medicine-under-obamacare-a-grim-prognosis/?utm_source=Newsletter&utm_medium=Email&utm_campaign=Morning%2BBell Posted March 23rd, 2011 at 6:00pm in Health Care with 2 comments Print This Post On Monday, The Heritage Foundation hosted a panel of current and future physicians to discuss the impact of Obamacare on their profession. Their remarks highlighted the importance of the doctor-patient relationship as the heart of the practice of medicine and detailed direct threats as a result of the new health law. Representative Michael Burgess, M.D., (R-TX) explained that part of being a physician is fighting for the best interests of each individual patient. Under Obamacare, this will be harder to do, as government inserts itself further into the provision of care. One example is the creation of accountable care organizations (ACOs) in Medicare. Representative Burgess pointed out that under ACOs, doctors would not be held accountable to patients, but rather to the hospital or health plan in charge. Based on his experience as an OB/GYN, Representative Burgess argued that it will be more difficult for doctors to stand up for patients’ needs to insurers or the government if they work directly for the latter. Dr. Martha Boone, a urologist from Atlanta, further argued that currently, if an insurer denies coverage for a certain treatment, she can call the medical director (a fellow physician) and explain her rationale. In the case of coverage provided by the government, such as Medicare and Medicaid, that’s not an option—the answer is always no. Greater government influence in medical decision-making will come at the expense of patients’ own desires. Physicians’ concerns go beyond the expansion of bureaucratic power into patient care. Jeet Guram, a first-year medical student at Harvard Medical School, pointed to the new law’s expansion of Medicaid, a flawed program, to cover an additional 18 million Americans. Since Medicaid pays physicians significantly lower rates than private insurance or Medicare, it is difficult for doctors to accept Medicaid patients without risking insolvency. As more Americans enter the system, barriers to access for Medicaid beneficiaries will become even more pronounced. Of further concern to Guram is Obamacare’s “misalignment of priorities” when it comes to medical innovation. The new law increases government control over cost and utilization of services, which could distort demand. Further discouraging innovators are the law’s new taxes on pharmaceutical and medical device manufacturers. As Representative Burgess said, investors “don’t hazard big things for small rewards.” Medicine is on the cusp of exciting new territory, but discouraging future innovation could change that. The sentiments expressed by the panel echo those of the medical profession at large. According to a recent survey sponsored by Pfizer, 59 percent of physicians cited the interference of non-medical entities in medical decisions as a negative development in the health care system. And 50 percent held an unfavorable view of Obamacare, compared to 24 percent who saw it as favorable. Threats to the doctor-patient relationship existed before the passage of Obamacare. However, rather than empowering doctors and patients, the new law will result in further erosion as a result of government intrusion in health care. ~~~~~~~~~~~~~ From John Goodman's Health Care Blog at the NCPA Does the GOP Have a Health Plan? by John Goodman ((Of course it does. Always did. Claims that the Republicans HAD no plan were lies.)) Filed in Health Alerts on March 28, 2011 with 32 comments ((Goodman has an amazing ability to make the complex comprehensible. Other than myself, he may well be the only person in America who really understood John McCain's health care plan - and HE was able to explain it so people would understand it, while, me, well, not so much....)) The Republicans have no plan to insure the uninsured. How do I know that? A New York Times editorial told me. So did Ezra Klein, writing in The Washington Post. Matt Miller, also writing in the Post, went further. “I’m willing to repeal ObamaCare,” he wrote, provided the Republicans can “cover the same number of uninsured” and “do it at a lower cost.” So why don’t the Republicans have a plan? That’s easy. “They’re against reform because it would cover the uninsured — and that’s something they just don’t want to do,” wrote Paul Krugman in The New York Times. The Times’ own editorial said the same thing. ((And I hear they want to dirty up our air and water, too - oh, and make Grandma eat dog food!)) All this has caused me to suffer a bout of severe depression. But, wait a minute. Wasn’t health care the biggest issue in the last presidential election? And…how memory fades…didn’t the Obama campaign spend millions of dollars…promoting his own plan?…no, that’s not right… Ah, now I remember. The Obama campaign spent tens of millions of dollars on TV commercials attacking the John McCain health plan! It spent more money than has ever been spent for or against any policy proposal in the history of American politics. The McCain plan, for all those suffering from collective amnesia, proposed to replace all existing health care tax and spending subsidies with a universal health grant, structured like a refundable tax credit. The Patients’ Choice Act version of the idea is sponsored by Tom Coburn (R-OK) and Paul Ryan (R-WI). It promises $2,300 (individual) or $5,700 (family) to everyone who isn’t enrolled in a government health plan. So what was candidate Obama’s problem with that? Did he object that the plan wasn’t generous enough? Too few regulations? No, none of that. The Obama TV ads focused like a laser on raw self-interest. McCain’s health plan, the ads said, will cause your withholding taxes to go up (without mentioning the offsetting credit that would cause them to go down). Think about that. The Obama campaign spent all that money attacking the most comprehensive and progressive proposal for universal care proposed by any serious presidential candidate in modern times on the grounds that somebody’s tax bill might — just might — go up! I’ll skip over the question of how you can spend that much money on TV ads and not come to the attention of The New York Times or any of the opinion writers mentioned above, to address a point that can easily get lost with all the demagoguery swirling around. Under the McCain/Coburn/Ryan approach, the first $5,700 a family spends on health insurance is courtesy of Uncle Sam. To have the kind of coverage a typical large corporation has, employees and employers would have to kick in about $6,300 more (with unsubsidized money). Not everyone may choose, or be able, to do that. Some might add $3,300 of their own money and buy a $9,000 plan. Some might settle for whatever catastrophic coverage $5,700 will buy. But everybody — and I mean everybody who doesn’t turn down a free lunch — would have protection against large medical bills. Let’s contrast that approach with what happens under the new health reform legislation. Recently, Health and Human Services Secretary Kathleen Sebelius gave 30,000 McDonald’s workers a temporary waiver from the new regulations so they can keep their limited-benefit, “mini-med” plans — which would otherwise be wiped out by ObamaCare regulations. If McDonald’s lowered these employees’ wages by $5,700 and bought them $5,700 worth of health insurance, the only subsidy available today is the one embedded in the tax law — the ability to pay premiums with dollars that escape the payroll tax. (These employees earn too little to pay income taxes.) That’s worth about $872 — less than one-sixth of what the Republicans were offering. The new health reform law will make things even worse. Because mini-med plans won’t be compliant in 2014 with ObamaCare’s mandated benefit package, McDonald’s will have to pay a $2,000 fine for each employee. In short, to get the kind of plan McCain/Coburn/Ryan would give them for free, McDonald’s workers would have to pay almost all of the cost out of their own pockets (remembering that employer payments are dollar-for-dollar substitutes for wages) and pay a net fine to the government to boot! To be fully compliant with the new law, McDonald’s and its employees will have to spend an estimated $12,500 on family health insurance in 2014. In this case the federal tax subsidy rises to $1,913. But that implies that $15-an-hour employees will have to give up more than one-third of their take home pay! This is what backers of ObamaCare call “insuring the uninsured.” Technically, employers and employees have another option. They could drop employer-provided insurance, pay a $2,000 per person fine and let low-income employees join Medicaid or enroll in heavily subsidized plans in newly created health insurance exchanges. But if every employer did this, the cost to the federal government would far exceed the revenues ObamaCare raises. This way of insuring the uninsured is not paid for under the new law. For all the hoopla, the health reform law enacted last year has no practical way to insure millions of uninsured and underinsured families. By contrast, the Republicans actually had a plan. It’s a better plan than ObamaCare. More universal. More progressive. More rational. And it was funded. But they would be foolish to trot this plan out again and start talking about it — subjecting themselves to more relentless and dishonest demagoguery — unless the Democrats are willing to renegotiate the entire health reform package. One party cannot reform major institutions on its own. Not Social Security. Not health care. Not Medicare. Invariably, the party that tries to go it alone loses seats in the next election. ~~~~~~~~~~~~~ From the Allentown Morning Call Dent, Toomey slam medical device tax Republican lawmakers meet with industry reps, who say levy would be devastating. By Colby Itkowitz, CALL WASHINGTON BUREAU March 23, 2011 A 90-year-old local manufacturer that fits war veterans with prosthetics could close if a new federal tax on medical device manufacturers is enforced. "Basically, if the tax goes through we will turn out the lights, lock the doors and go home and not be able to service patients anymore," said Chris Field, chief financial officer of BOAS Surgical, which manufactures pedorthic, orthotic and prosthetic devices and has a branch in Allentown. To help offset the cost of reforms, last year's health care law includes an excise tax of 2.3 percent on sales of most medical devices beginning in 2013. It is expected to raise $20 billion over 10 years. Advocates for the tax said businesses would benefit from millions of new government-insured customers and should help pay for the reforms. Field says his small business, which employs 45 people, would be crushed by the tax. Large corporations like B. Braun Medical Inc. in Bethlehem say the tax would stunt growth. Bruce Heugel, chief financial officer at B. Braun, said the tax would cost his business $24 million. He said an Ernst & Young survey shows the medical device industry makes a profit of 3.4 percent on sales. A tax of 2.3 percent would consume more than 65 percent of the industry's profits, Heugel said. Big device makers have lobbied forcefully against the new tax. B. Braun does not employ its own lobbyist, but is a member of the Medical Device Manufacturers Association, a trade organization representing device makers in Washington, D.C. The group spent $360,000 in 2010 on lobbying, mostly against the tax. Jan Wald, a medical device analyst at Morgan Keegan, said the tax will not devastate the industry but will crimp innovation. "It's not going to kill it, but it is going to potentially damage it and I think the issue there is, the device industry has maintained itself and been able to grow at a nice rate primarily because of the ability to innovate," Wald said in a phone interview. "To the extent that there is less research and development …I think that's the danger." Republican lawmakers U.S. Rep. Charlie Dent and U.S. Sen. Pat Toomey held a joint event at B. Braun on Wednesday, the one-year anniversary of the health care law, to decry the tax. Afterward Dent spent an hour speaking with industry representatives about the tax's impact. Other local companies that would be affected by the tax, OraSure Technologies and Olympus America, did not participate. "Only in Washington could people say we are going to lower health care costs by adding to the cost of all the things we have in hospitals and doctors' offices," Dent said. Dent received $12,850 in individual contributions from B. Braun in 2010, according to OpenSecrets.org. ((You know, it would be really NICE if the media checked up on this kind of information for EVERYONE....like, I'd like to know where Bob Casey's campaign contributions came from - which unions, or special interest groups in favor of government health care contributed to HIS campaign....or which trial lawyers, since he opposed liability reform. But most of the media never bother to check THAT information. Only for those greedy Republicans, because we all KNOW they can be "bought," right? NEVER the other side....)) Some lawmakers in Congress, including Dent, have offered legislation to repeal the tax. Toomey said he expects the Senate to vote, but likely not pass, a repeal attempt. It's unclear where U.S. Sen. Bob Casey, D-Pa. stands on the tax. Spokesman Larry Smar said his boss believes there "are a number of ways in which the law can be changed" and wants to continue examining and debating the issues. ((Nice way to dodge. SO I just did a little of my own checking on Sen. Casey's contributions - seems that almost $4 million of his career campaign contributions have come from lawyers and law firms - FIVE TIMES the amount he received from his second largest group of contributors, retired people who gave him $800,000, while 27% of his PAC contributions - about 9% of his total - were from unions. Guess that explains a little....assuming that politicians ONLY vote to favor their donors.)) The tax was championed by U.S. Sen. Max Baucus, D-Mont., who wrote the Senate version of the health care bill. He said hospitals, insurance companies, the pharmaceutical industry and medical device makers would benefit under it. ((Ummmm...paying a NEW tax benefits them....how?)) Toomey said start-ups in the state are too small to be profitable and will not survive the additional levy. "We've got a tax that on every level I can think of is going to harm an incredibly important industry in Pennsylvania," he said. Robert Loiterman, president and CEO of GrantAdler Corporation, a small start-up in Allentown that makes implants for vascular access, said the tax would make it difficult to keep his business going because he needs a positive cash flow to qualify for working capital. "This tax is not so much a tax on my profit; my company is just starting revenue … it's in addition to my losses while I ramp my sales to hopefully get to break even," Loiterman said. Most medical device companies are small. Brendan Benner, spokesman for the industry's trade association, said 80 percent have fewer than 50 employees. "These are by no means giant corporation entities that can easily absorb this tax," he said. colby.itkowitz@mcall.com 202-824-8216 Copyright © 2011, The Morning Call ~~~~~~~~~~~~~ ((GOOD FOR ST. LUKE's! If more doctors and hospitals countersued for meritless cases - note I didn't say "frivolous" which has an entirely different legal definition and is deliberately difficult to prove - then there would be fewer of them. When doctors and hospitals "win" 90% of court verdicts - costing countless hours that could otherwise be devoted to health care and well over $100,000 per case - that means lawyers are pursuing at least a COUPLE of cases that probably shouldn't have made it past the first steps. While no one who's been through the trauma of a court case WANTS to go back to court to countersue, this is a non-legislative way to provide negative reinforcement to the legions of personal injury lawyers who are willing to take the chance of a big payout. I know of two groups which assist doctors and hospitals in such endeavors - Doctors' Advocate, www.doctorsadvocate.org, based in PA, and Medical Justice, www.medicaljustice.com, based in Florida. There are probably others.)) St. Luke's countersues in Cullen cases Hospital claims plaintiffs filed abusive claims in the deaths of two patients. http://www.mcall.com/news/local/bethlehem/mc-bethlehem-stlukes-cullen-countersu20110328,0,6946756.story STORY ARCHIVES: Charles Cullen Case St. Luke's Hospital and Health Network has countersued prominent local personal injury lawyers and their clients, charging that the original plaintiffs filed abusive lawsuits when they alleged the hospital was responsible for two additional deaths at the hands of serial-killer nurse Charles Cullen.With the lawsuits, which name attorney Martin Cohen and his firm, Cohen & Feeley, attorney John R. Vivian of Easton and Dr. John Shane of Allentown, the hospital is seeking to recover attorney fees and costs and collect punitive damages over the filing of the earlier complaints, which were dismissed in Lehigh County Court. The dismissals were upheld on appeal. Also named as defendants are Harry H. Miller of Saylorsburg; Robert Hall Jr. of Northampton and Leslie Hall of Mount Bethel, who were executors of the estates of relatives who died at St. Luke's-Fountain Hill while Cullen worked there. Over the course of the two cases, both filed in 2004, St. Luke's amassed a total of $564,111 in legal fees and costs, the lawsuits say.In a statement, the hospital said it is seeking "a full public accounting" of the initial complaints against it. "At St. Luke's, we believe it is our responsibility to respond to frivolous lawsuits which represent an inappropriate and unconscionable attempt to divert precious health care resources for personal financial gain," said St. Luke's President and CEO Richard A. Anderson. "We believe the actions of these individuals and their attorneys are reprehensible and should not go unaddressed." Mark K. Altemose, a lawyer at Cohen & Feeley, which has offices in South Whitehall and Bethlehem townships, said no one there could comment since they had not seen the complaints. "Our firm at all times acted appropriately within the bounds of the law," he said. Shane denied allegations in the complaints, filed Friday, that he "blatantly ignored" a lack of evidence that Cullen was involved in the deaths of Regina C. Miller and Marilyn Hall. Shane, who also had not seen the lawsuits, said he offered "an honest opinion based on a thorough review of the case. "Harry Miller said he pursued the case because he had been told his late wife, Marilyn, was going to recover while she was at St. Luke's. That doctor, whose name Miller could not remember, gave Miller "a glowing description of how I was going to take my wife home in five days," he said, adding he believes Cullen killed his wife. Leslie Hall declined to comment. Robert Hall and Vivian could not be reached for comment.Cullen, who worked as a nurse in health care facilities in the Lehigh Valley and New Jersey, pleaded guilty to killing 29 patients — 22 in New Jersey and seven in Pennsylvania — and is serving a life sentence in a New Jersey prison. Formerly of Bethlehem, Cullen worked at Warren Hospital, Liberty Nursing and Rehabilitation Center and Sacred Heart Hospital in Allentown, Lehigh Valley Hospital-Cedar Crest, Easton Hospital and St. Luke's-Fountain Hill, among other places between 1993 and his arrest in 2003. According to the complaints, after Cullen had been arrested for killings in New Jersey, he told investigators of the patients at St. Luke's he had killed. Regina Miller and Marilyn Hall were not among them, they said. When they were admitted, both Marilyn Hall and Regina Miller suffered from "end-stage" heart complications, the lawsuits said.In the Hall case, the St. Luke's complaint says Cohen & Feeley investigated the case and determined it was "not viable," but took the case over from Vivian four years later anyway. While he had the cases, Vivian had Shane sign certificates of merit, documents that were required for the filing of the case against the hospital, the St. Luke's suits say.St. Luke's alleges in its complaints that Shane and Vivian "had an outstanding and pre-existing arrangement by which Dr. Shane would sign his name to any written statement provided by Vivian… regardless of the merits of the claims." Cohen & Feeley took over the cases from Vivian. The cases eventually were dismissed in county court. State Superior Court affirmed the decisions last June. The St. Luke's suits claim that the defendants wrongfully used the court system against the hospital, despite a lack of evidence Cullen was involved in the cases. They said St. Luke's spent $228,116 defending itself in the Miller case and $335,995 in the Hall case. St. Luke's also claims that Shane signed a certificate of merit fraudulently stating the evidence suggested Cullen was involved in the patients' deaths. The suits also claim Vivian had Shane sign certificates without regard to the facts of the case or by adopting language prepared by Vivian. tim.darragh@mcall.com ~~~~~~~~~~~~~ This LIABILITY & HEALTH NEWS UPDATE "newsletter" is a free service which I provide, as a volunteer, to help supply medical liability reform and health care reform news and information, legislative updates, and political insight to physicians, patients, liability reform and quality health care advocates. NO ONE pays me to do this. I am not employed by any physician or health care reform advocacy or liability reform organization, political party or candidate, although I volunteer for several. I am a quality health care, physician, and patient advocate, breast cancer survivor, physician's spouse, journalist, political noisemaker, mom, and freelance writer. I am not nor will I ever claim to be unbiased (I am....biased, I mean), unlike many in the mainstream media, who are biased by won't admit it. Most information in this newsletter is copied and pasted from other sources, and will always be identified with links. Opinions and clarifications are my own, and do not reflect the official position of any physician or patient advocacy organization, tort reform, or health care reform group unless stated as such. My opinions are placed in double parentheses (("my opinion")), italicized and appear in blue. 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