Maryland Senate President Thomas V. Mike Miller Jr. called yesterday for the General Assembly to hold a special session this fall to halt major increases in doctors' insurance rates.
Miller (D-Calvert) said in an interview that he would like to create a state fund to help private insurers pay for jury awards and settlements in medical malpractice cases once they exhaust their resources. A $50 million fund, Miller said, would allow insurers to effectively freeze at current levels the premiums they are now charging doctors.
"There really is no need for a rate increase whatsoever," Miller said. "This is a problem that is solvable immediately with very little effort."
Miller declined to say how he would pay for his proposal and said several other details remained to be worked out. But his plan, which he pledged to flesh out in coming weeks, could shake up a politically volatile debate dominated thus far by Gov. Robert L. Ehrlich Jr. (R).
The state's largest malpractice insurer, Medical Mutual Liability Insurance Society of Maryland, has asked state regulators to approve an average 41 percent increase in premiums for next year. Doctors say such rate increases are making it more difficult to practice, particularly for those in high-risk specialties, such as obstetrics.
Ehrlich has called for curbing payouts to injured patients and has set up a task force to look at other possible solutions, including limits on attorney's fees in malpractice cases. In recent weeks, he has traveled the state, seeking to enlist doctors' help in pressing legislators for reforms.
Miller argued yesterday that none of what Ehrlich has proposed would have an immediate effect on doctors' premiums, however. Most experts agree that changes in the way victims are compensated, for example, could take a few years to affect insurance rates.
"The governor continues to play right-wing Republican politics with this issue," Miller said. "It's politics. It's not relief."
In a brief interview yesterday, Ehrlich said he is "not opposed to the concept" of a state insurance fund, but added: "The devil's in the details." Ehrlich has said previously that taxpayers should not have to bear the cost.
Donald J. Hogan Jr., a policy aide coordinating the work of Ehrlich's malpractice task force, said it would be a mistake to set up a fund without also enacting broader reforms. Republicans have blamed trial lawyers for pushing malpractice payouts to unreasonable amounts.
A short-term state fund "doesn't get the job done," Hogan said. "You're just throwing money at the problem."
Ehrlich was cool to a similar pitch for a state fund made in June by representatives of three groups pitted against one another in the malpractice debate -- doctors, trial lawyers and insurance companies.
Under that plan, the state would have paid the difference between the amount raised by insurers under current premiums and their payouts for jury awards and settlements.
Advocates of such a fund have floated several possible ways to pay for it, including a surcharge on motorists with drunken-driving convictions or a premium tax on HMOs.
Miller steadfastly declined to say how he would fund his plan, allowing only that the cost would not be borne by taxpayers generally. He predicted that Ehrlich would eventually come around to the idea.
House Speaker Michael E. Busch (D-Anne Arundel) has said he is open to the idea of a temporary state insurance fund. Busch, however, has also said it could be a mistake to establish a fund without making other reforms to curb medical malpractice rates in the future. He has suggested looking at ways to better police doctors, for example.
The Maryland constitution requires Ehrlich to convene a special session if a majority of members of the House and Senate petition him asking for one. The governor can also call legislators to Annapolis for a special session on his own.
Legislators spent much of the summer talking about the possibility of a special session to legalize slot-machine gambling, but those efforts appear to have collapsed in recent weeks.
During an appearance at a Salisbury hospital this week, Ehrlich left open the possibility of a session on medical malpractice before legislators reconvene in January. Speaking to more than 100 doctors at the Peninsula Regional Medical Center, he urged greater participation in Annapolis.
"For your own good, in the short term and the long term, become more dangerous in the political process," Ehrlich urged. "You need to get with it now."
Staff writer Matthew Mosk contributed to this report.