Maryland's top political leaders want to convene a special session of the General Assembly in the coming weeks to address escalating medical malpractice insurance rates, but they remain divided over how much to try to accomplish.
Senate President Thomas V. Mike Miller Jr. (D-Calvert) is drafting legislation that would create a temporary state fund to effectively block the 33 percent rate increase most doctors are facing in the coming year.
"If the goal is no increases for doctors, we can do that right now," Miller said in an interview. "We should have done it in July. . . . If the goal is to push right-wing party politics, nothing is going to happen."
Longer-range reforms, he said, can be debated when the legislature returns for its regular session in January.
Miller's stance puts him at odds with Gov. Robert L. Ehrlich Jr. (R) and House Speaker Michael E. Busch (D-Anne Arundel). Both of them advocate linking passage of a state fund to more substantive changes in how injured patients are compensated in malpractice cases, as well as measures that might curb insurance costs for years to come.
A task force appointed by Ehrlich is expected to issue proposals in early November, while Busch's staff is researching reforms that have been enacted in other states, many of which experienced similar spikes in insurance premiums.
"If there's going to be some kind of fund, it's got to be coupled with significant reforms," Busch said in an interview. "I think it can be done if people of goodwill want to get it done."
Busch argued that if the legislature simply creates a fund to freeze rates, the interest groups fighting over the issue -- doctors, trial lawyers and insurance companies -- will have little incentive to craft longer-range solutions.
Miller, however, suggested that the parties are so "dug in" that compromise over most issues could be difficult. Ehrlich's task force, for example, is using as its starting point for reform a bill that the Senate killed during the last legislative session. The legislation included several new limits on payouts to patients.
"A special session needs to be limited to what can pass now," Miller said.
Medical Mutual Liability Insurance Society of Maryland, which provides coverage to more than three-quarters of the state's physicians in private practice, is raising rates by 33 percent next year, following a 28 percent increase this year. Obstetricians and others in higher-risk specialties have felt the brunt; their premiums have gone up more sharply than other physicians.
That was underscored during a meeting of Montgomery County legislators and health care providers last week.
Among those who spoke was Amy Ampey. The young physician delivers babies and cares for women's health. She would like to continue doing both but with her bill for malpractice insurance climbing to $112,000 in 2005, she worries what the future holds. Three years ago, her malpractice premium was $45,000.
On Wednesday, a partner in her Olney practice saw her last obstetrics patient after concluding that the cost equation was too risky. The decision reverberated immediately, forcing the dismissal of a nurse practitioner.