Maryland Poll: Republicans Blame Lawyers, Democrats Blame Insurers

November 22, 2004

Republicans in Maryland are three times as likely as Democrats to blame rising health costs on malpractice lawsuits, according to a recent poll conducted for The Baltimore Sun, and Democrats are twice as likely as Republicans to blame insurance companies and HMOs.

Republicans want to limit jury awards and lawyers’ fees, while Democrats are much more likely than Republicans to support efforts to weed out incompetent doctors.

The poll found that 67 percent of Marylanders believe the malpractice system needs “major change,” while 25 percent support “minor change.” Only 6 percent say it’s fine as it is.

The issue has drawn a lot of attention in Annapolis. Republican Gov. Robert Ehrlich has offered a proposed remedy that was heavy on limits to jury awards and lawyer fees. The proposal has been criticized by Thomas V. Mike Miller, the Democratic president of the state Senate, as anti-victim.

The leaders are struggling to reach consensus on a reform package for a special session.

The poll of 725 Marylanders was conducted by Ipsos-Public Affairs.

The poll also found higher medical costs affecting Marylanders. Because of rising costs, 21 percent said they sometimes don’t get prescriptions refilled and 23 percent said they are less likely to visit a doctor.

Ehrlich, Miller and House Speaker Michael E. Busch, a Democrat, are searching for agreement on a reform package that could be passed in time to block a 33 percent rate increase for doctors due to take effect Jan. 1. Most Maryland doctors were hit by a 28 percent increase in malpractice premiums this year. Several reform measures died in this year’s legislative session.

There is disagreement on what reforms would work best. But the consensus for action appears solid among lawmakers and the public.

“There has been an increasing consensus in the last couple of weeks among legislators, doctors and others that there is a problem, and that it could impact access to care,” said Nancy Fiedler, senior vice president of the Maryland Hospital Association, which is pressing for reforms in the court system.

Doctors from across the state, especially obstetricians and hospital emergency room surgeons, have warned at hearings and meetings in Annapolis over the last year that they can’t afford the higher premiums and that many will have to limit or shut down their practices.

“What we’re trying to do is guarantee no rate increases to doctors whatsoever,” Senate President Thomas V. Mike Miller, said after a recent meeting with House Speaker Michael Busch. “We are also trying to increase the reimbursement rates for doctors who serve Medicaid patients.”

The speaker said there must be two parts to any meaningful settlement–a temporary fund to maintain premiums at 2004 levels and a long-term solution that would include higher reimbursements for doctors and limits on lawsuits.

‘Stop loss’ fund proposal
Busch and Miller have pushed for a “stop loss” fund that would solve the immediate problem by holding premiums at the 2004 level and reimbursing insurance companies if premiums aren’t enough to pay malpractice claims.

Ehrlich included the stop loss fund in the bill he offered, but the Democratic leaders were unhappy that he did not provide a funding source. They favor requiring health maintenance organizations to pay the same 2 percent tax on premiums paid by other health insurance companies and using that money for health care. Ehrlich has balked at any new fees or taxes. His bill provided that the money would come out of the regular general fund budget.

That idea drew criticism from Miller, who said money should not be taken out of the general fund. “Under no circumstances can our general funds be allocated or used to help fund lifestyles for wealthy doctors and wealthy lawyers,” Miller said.

There is broad agreement in Annapolis that doctors and hospitals are being squeezed between lower reimbursements and higher malpractice premiums. But there is no consensus on why premiums are increasing and how much, if at all, money paid to settle lawsuits is contributing to the premium increases.

Miller and some other key Senate leaders have been reluctant to restrict medical malpractice lawsuits. But Busch said creation of a stop loss fund can’t be accomplished unless the legislature also puts limits on lawsuits.

Copyright 2004 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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