Medical Malpractice

At the beginning of Governor Rendell's administration, claims payments were at an all time high and Pennsylvania was facing a medical malpractice affordability crisis. The administration acted quickly and built on the reforms passed in 2002 by the General Assembly to address the concerns of the physician community and the public. The actions taken by the courts, the legislature and the administration are having an impact.

As the Governor has worked on this problem, he has always tried to craft solutions that would assure Pennsylvanians continued access to quality health care. The evidence shows that Pennsylvania has been successful in implementing reforms that are controlling medical malpractice costs and making malpractice insurance more available and affordable for health care providers.

For example, the court's requirement that a certificate be attached to each lawsuit filed certifying that a board certified expert has reviewed the case and believes the evidence shows that care was below normal standards, has been a key to fewer cases being filed. The legislature's passage of the Trauma Center Stabilization Act provided state funds for a service that was severely impacted by the cost of malpractice insurance. And his administration's change to the reimbursement for physicians and nurse midwives who deliver babies for women on Medical Assistance helped obstetricians with the increased cost of their insurance. These are just a few examples of the many actions Governor Rendell has taken that are making a difference.

The following examples are proof of the improvements in the medical malpractice situation:

Availability of health care services for consumers - The number of physicians paying the state-operated, mandatory Mcare surcharge has remained fairly constant over the past few years at about 35,000, meaning that consumers still have access to health care services in Pennsylvania.

Affordability of the primary layer ($500,000 worth of coverage) of medical liability insurance for physicians - In 2007, the state's two largest medical malpractice insurers – PMSLIC and Medical Protective – kept their rates flat for the second year in a row. In 2008, PMSLIC reduced base premiums by an average of 11 percent average reduction as compared to 2007 and Medical Protective reduced rates by 6 percent. This provides a sharp contrast to 2002, when PMSLIC increased its rates an average of 40 percent and Med Pro 45 percent. In 2003, PMSLIC increased rates another 54 percent and Med Pro an additional 16 percent.

Affordability of the secondary, or Mcare layer of insurance - Each year, the Insurance Department sets the level of the next year's Mcare surcharge. The surcharge is a percentage of the amount that each physician pays for his or her primary layer of coverage. For 2008, the Mcare surcharge was 20 percent – or approximately one-third of the 61 percent surcharge in 2000 and in 2001.

Availability of med mal insurance for physicians – There is renewed interest in underwriting in the Pennsylvania market. The med mal situation fostered a host of risk retention groups – physicians that banned together to cover their own liability costs instead of going through an insurance company. Since the beginning of Governor Rendell's administration, 28 new medical malpractice insurance entities have been licensed, giving doctors further choice of insurance providers.  Also, the number of doctors obtaining coverage from the Joint Underwriting Association (JUA), which is the malpractice insurer of last resort in Pennsylvania, has dropped to its lowest level since 2001 and is projected to continue to decrease. That's another indicator that doctors are able to find malpractice coverage in the private market.

Claims payouts from the primary layer of insurance - According to statistics from the Pennsylvania Supreme Court, the number of med mal cases filed in 2003-2006 dropped 37 percent statewide as compared to 2000-2002. In addition, the venue law has had a tremendous effect of moving more than half the cases out of Philadelphia and into their proper counties.

Claims payouts from the secondary, or Mcare Fund, layer of insurance - For the fourth straight year, the amount and number of claims paid by Mcare will decrease. In 2007, Mcare paid approximately $191 million in claims, half of what was paid when Governor Rendell first took office in 2003.

Other reforms - Mediation, which the Governor recommended in his medical malpractice reform plan, is becoming the rule rather than the exception - a change that can only impact the costs in a positive way. The courts have significantly improved data gathering so that those who continue to work on this problem can intelligently address the issues. The courts have also improved the speed of legal resolutions.

In addition, Governor Rendell's innovative Mcare abatement has continued to keep many physicians practicing in Pennsylvania while the reforms have had a chance to take effect. The Governor's goal with this program, which abated the Mcare premiums of high-risk specialists by 100 percent and all other physicians by 50 percent, was to control the cost of premiums so that physicians stayed in Pennsylvania to practice medicine. By the end of 2007, we have abated nearly $1 billion in premiums for Pennsylvania physicians. This abatement can mean a reduction of $36,000 a year in what specialists must pay to be insured. No other state in the union has a program like this.

When you look at all these statistics and programs collectively, most people agree that we've turned the corner on the medical malpractice problem.

Governor Rendell's commitment remains to making sure we have a strong health care community in Pennsylvania - our citizens deserve nothing less.