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The Hartford Courant

WASHINGTON: A walkout by West Virginia surgeons will increase pressure this year on state legislatures and Congress to try to control the rising cost of malpractice insurance, officials of medical associations said Thursday.

The West Virginia action, which canceled nearly all surgeries at four hospitals in the state’s Northern Panhandle, came after doctors in eastern Pennsylvania pulled back at the last minute from a threatened New Year’s Day strike over malpractice costs.

In Connecticut, Tim Norbeck, executive director of the Connecticut State Medical Society, said he had not heard any direct discussions about a job action by physicians. But, Norbeck added: “Certainly, the situation is heating up considerably in Connecticut.”

President Bush urged Congress in July to cap medical malpractice damages, warning that huge court awards are driving doctors out of the profession. The House narrowly approved a measure that would have achieved many of Bush’s objectives, but the Senate did not complete action.

“This is what we have said will happen — that there will be a meltdown,” said Dr. Donald Palmisano, president-elect of the American Medical Association. “We believe the states have to act and Congress has to act. It should be a two-pronged approach.”

An aide to incoming Senate Majority Leader Bill Frist, R-Tenn., said malpractice reform will be on the list of health care proposals Congress will consider this year. State officials, however, seem to be focusing their hopes for quicker action on state legislatures. As in Connecticut, West Virginia lawmakers are scheduled to convene Jan. 8.

In Pennsylvania, doctors dropped plans for a walkout after Gov.-elect Ed Rendell said he would support a $220 million malpractice bailout plan. The proposal would cut physicians’ payments to a state insurance fund by two-thirds, but the Health Insurance Association of America said Thursday it opposes the plan because it would impose a new tax on health insurance.

“American workers and their health insurers already pay for the high cost of medical liability lawsuits,” said Dr. Donald A. Young, president of the insurance association. “Where is the equity in asking them to pay again?”

Helen Matheney, a spokeswoman for the West Virginia State Medical Association, said members are “very hopeful” the state legislature will act quickly this year on a 10-point program than includes a cap on malpractice awards. State lawmakers debated but did not complete work on malpractice reforms last year.

Norbeck said he hopes Connecticut lawmakers will move this year because the prospects of congressional legislation are uncertain. Because of filibuster provisions, most controversial measures, including malpractice reform, require 60 votes in the Senate. That could be difficult to reach, Norbeck said.

Without action at the state or federal level, patients could encounter more problems finding physicians, Norbeck said. Already, 28 obstetricians have said they will not deliver babies in Connecticut, Norbeck said, adding that some are paying $120,000 to $160,000 a year for malpractice insurance.

“We’re going to hear a lot more horror stories,” Norbeck predicted.

The West Virginia action is not the first in the last 12 months. In early July, the University of Nevada Medical Center closed its trauma center for 10 days because the center’s surgeons could not afford malpractice insurance. The state legislature responded with a cap on medical malpractice awards, but doctors are still considering leaving the state, according to local news media reports.

The malpractice problem is centered in a cluster of four states — New York, New Jersey, Pennsylvania and West Virginia — but it includes states scattered across the South and West, the AMA and the American Colleges of Obstetricians and Gynecologists said in reports last summer.

Connecticut is one of four states that should be watched “for mounting problems,” the reports said. The others are Illinois, Kentucky and Missouri. Medical malpractice insurers are boosting Connecticut rates 20 percent to 49 percent on average, The Courant reported in November.

The House-passed legislation, which the AMA supported, would limit non-economic damages, such as pain and suffering, to $250,000. Punitive damages would be capped at twice the amount of economic damages awarded, or $250,000, whichever is greater.

The California-based Foundation for Taxpayer and Consumer Rights opposed the legislation, contending it would shield health maintenance organizations and doctors from legal accountability for harm they may cause patients.

Officially, West Virginia surgeons say they are taking a leave of absence rather than striking. “This is not a strike. I am not protesting anything,” Dr. Gregory Saracco, of Wheeling, told the Associated Press. “I’m taking time to look at other options.”

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