Wednesday, August 06, 2003

From the subscription-only A.M. Best BestWire, on July 29:
Three weeks ago, a handful of congressmen asked the General Accounting Office to find out why medical malpractice premiums were kyrocketing. Its conclusion? There's not enough data to say for sure. The GAO made no recommendation for any executive action based on its report, which was produced at the request of 10 Democrats led by U.S. Rep. John Conyers Jr., D-Michigan. The report did say Congress "may wish to consider encouraging" the National Association of Insurance Commissioners and state insurance regulators to gather more data to better understand of the market.

Rep. John Conyers said in a prepared press release:

Rep. John Conyers, Jr. issued the following statement concerning the GAO Report on medical malpractice: "Today's report makes it clear that extreme, anti-victim tort 'reform' of the type proposed by the Republicans and President Bush will not resolve the insurance crisis but will simply serve to inflict greater harm on the victims of medical malpractice and wrongdoing by HMOs and drug companies." Among the information included in the GAO Report:
* There is no correlation between losses paid by medical malpractice insurers and limitations on non-economic damages. Minnesota, which had no caps on non-economic damages, had the smallest increase in losses paid by insurers during the period covered (1992-2002), while Florida, which has among the most severe caps on non-economic damages in the country, experienced the greatest increases in insurance losses.
* Lack of competition had an important impact on medical malpractice rates. "Because fewer insurers are offering [medical malpractice] insurance, there is less price competition." "When a large insurer leaves a state insurance market [as St. Paul did in 2002], the supply of medical malpractice insurance decreases, and the remaining insurers may not need to compete as much on the basis of price."
* Reduced investment income by the medical malpractice insurance industry also had an impact on the insurance market. "The approximately 1.6% percentage drop in the return on investments these insurers experienced from 2000 through 2002 would have resulted in an increase in premium rates of around 7.2% over the same two year period."
* The terrorist attacks of September 11 and the cyclical nature of the medical malpractice insurance business further contributed to premium spikes. "Reinsurance rates overall have increased as a result of reinsurers losses related to the terrorist attacks of September 11, 2001." "Cycles in the medical malpractice market tend to be more extreme than in other insurance markets because of the longer period of time required to resolve medical malpractice claims and factors such as changes in investment income and reduced competition."
* The GAO has no idea as to what contributes to increased insurance pay outs, and concluded that what's needed most is greater information. Possibilities leading to insurance company losses include "a sicker, older population," "a reduced quality of care," "the breakdown of the doctor-patient relationship owing, for example, to factors such as the increasing prevalence of managed care organizations," and other potential factors. "While we could not analyze such potential causes for increased losses, understanding them would be useful in developing strategies to address increasing medical malpractice premium rates." Conyers concluded, "The Republican approach of capping non-economic and punitive damages, capping attorneys fees, and insulating HMO's and drug companies from liabilities clearly misses the mark. The Democratic alternative of limiting frivolous actions, subjecting medical malpractice insurance companies to the antitrust laws, requiring that savings from legal reforms are passed on to consumers, and giving Congress greater information to assess the root causes of the insurance crisis is clearly more in tune with the GAO's findings."

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