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Some M.D.s lack dose of reality

One of my cyberspace pen pals in the medical community thinks I've misdiagnosed the so-called medical malpractice-insurance crisis in the commonwealth.

In a recent column , I suggested the insurance industry ("Big Insurance") probably is squeezing doctors by jacking up the cost of medical-malpractice insurance and then blaming the increase on the jury awards paid to supposed greedy lawyers of so-called victims.

M.E.L. M.D. sent an e-mail response explaining why I was completely wrong. (I get a lot of those — on many topics. Sigh.)

Some editing was done because of space limitations. His comments are quotes. Mine are italicized within the text of his message.

"Doctors are being squeezed: Managed care and government programs freeze the fees doctors can charge, as well as increasing malpractice fees that are astronomical."

In other words, government price-fixing ("price controls") prevents you from passing on the cost of any insurance increase to the customer. You've identified the real culprit: government interference. Welcome to socialized medicine. The government's solution to increasing costs is making them illegal, thereby forcing YOU to pay for its supposed compassion. Why isn't the medical community demanding government stop its price-fixing so you could make a decent profit?

"Out of 14 new general-surgery doctors trained at (a local hospital) in the past five years, 13 have left Pennsylvania to practice in other areas."

Many professionals move for a myriad of reasons. For all you know, they may have moved to states that have laws similar to Pennsylvania. Have any doctors moved here•

"You are blaming the insurance industry for the crisis. That is the exact position the Trial Lawyers Association is taking."

Um, actually it's taking the same position I had taken.

"The insurance industry may have some responsibility in the crisis…"

May have some?! Who do you think sets rates• And if the Legislature caps jury awards, what makes you think Big Insurance will pass along any savings to you?

"… but lawyers take 40 percent of the awards in these malpractice cases, and the sky is the limit."

How else could a poor person afford the cost of a malpractice case• And attorneys get nothing if they lose.

"The 'jackpot' mentality is causing the crisis to spiral out of control. The malpractice awards have nothing to do with quality of patient care; they have everything to do with money."

You're suggesting all victims are storytellers and all doctors are saints?

"Lastly, your statement 'hold the insurance industry fully accountable for errors their clients make' is totally incorrect. Doctors may deliver perfect health care, but if there is anything less than a perfect outcome, then patients will sue."

How do you suggest we hold incompetent doctors — and their insurance companies — accountable•

"Malpractice has become the jackpot… despite the quality of the doctor's care. It's about money; it is not about quality of care for the patients."

Yes, dear M.D., it is about the money — isn't it?