The two leading Democrats in the Maryland General Assembly emerged from a mid-October meeting with Gov. Robert L. Ehrlich Jr. (R) in good enough spirits to make a rare joint appearance outside the governor's mansion.
Senate President Thomas V. Mike Miller Jr. (Calvert) and House Speaker Michael E. Busch (Anne Arundel) both offered sunny forecasts for a special session on medical malpractice, and then Miller slapped Busch on the back -- perhaps a little too hard.
"As soon as we fix medical malpractice, we'll move on to slots," the long-serving Senate president said with a hearty laugh.
Next week, when that long-promised special session convenes in Annapolis, advocates for malpractice reform will come armed with a valuable lesson gleaned from a slots debate that collapsed in disarray. For any deal to be sealed in Annapolis, it must first overcome a vexing obstacle: a relationship among Ehrlich, Miller and Busch that borders on dysfunctional.
"Relations between those three men have been badly damaged," said Isiah Leggett, who served the past two years as the state's Democratic Party chairman. "There is just a fundamental lack of trust. They are very cautious of one another because they have not forgotten the failures of the past."
To end successfully, the special session that Ehrlich called for next week will require accord from 188 Maryland legislators on the complex subject of medical malpractice. But the quest for a deal centers on the ability of Miller, Busch and Ehrlich to do something that -- even at this late date -- they have not done: agree on a unified plan. Although other lawmakers will be involved in efforts to forge a deal, the only negotiations that ultimately matter are those among "the big three," as Miller, Busch and Ehrlich are routinely referred to in Annapolis.
What the three agree on is the need for action: Without state intervention, doctors insured by the state's largest medical malpractice carrier will face an average 33 percent increase in rates that take effect Jan. 1. It is a big enough hit, doctors have said, that some will decide to leave the profession.
The search for common ground has been complicated for months by partisan and philosophical differences among the two Democrats and Maryland's Republican governor.
Ehrlich, who campaigned against raising taxes, has resisted Democratic efforts to impose a tax on HMOs to pay for a state fund that would reduce doctors' insurance costs. And Miller, a lawyer, has resisted several of Ehrlich's proposals to limit payouts to injured patients -- and their attorneys -- in medical malpractice cases. The governor argues that such initiatives are necessary to hold down doctors' insurance rates in the long term.
But personalities also have come into play. Ehrlich irked Miller and Busch over the summer when he launched a series of visits to hospitals designed to generate television coverage and drum up pressure for the legislature to act. "He was out touring hospitals and promising a solution for six months before Senator Miller and I got so much as a phone call," Busch said.
A lack of personal chemistry and lingering distrust between Miller and Busch also have contributed to the delays. Miller, who has presided over the Senate for nearly two decades, and Busch, who ascended to his leadership post two years ago, fought bitterly during the slots debate. Their failure to present a more united front against Ehrlich on medical malpractice has left some Democrats dismayed.
Among those who have advocated a "logical compromise" is Sen. Brian E. Frosh (D-Montgomery), who led a Senate task force on the issue. As negotiations dragged on last week, Frosh said he was at a loss to explain why Ehrlich, Miller and Busch had not brokered a deal.
"You see from afar some of the same dynamics as appeared in the slots debate," Frosh said. "But I can't tell how much of this is personal, ideological or situational."
Ehrlich said he knew from the moment he was elected in 2002 that the regular rhythms of one-party rule in Annapolis would have to change.
