In June, the Brandywine Hospital closed its trauma center, which served the southwestern suburbs of Philadelphia, and the Paoli Hospital, also near Philadelphia, closed its paramedic unit, said Andrew Wigglesworth, president of the Delaware Valley Health Care Council.
Many obstetrics units have struggled financially because of growing competition and reduced payments from the federal government and private insurers. That was true of the obstetrics unit that closed Friday at Mercy Hospital in West Philadelphia.
"We had been subsidizing the program because we had the resources," said Gavin Kerr, chief executive of the Mercy Health System. "But as the malpractice premiums increased, that dramatically shrunk the resources.
"There are other obstetrics programs in the community," Kerr added, "but you want to have a baby as close to home as you can, in as comfortable a place as you can."
Concern for the safety of mothers grows when maternity wards close. Since early last month, when the Atmore Community Hospital in southern Alabama shuttered its ward, women have had to travel 15 miles, to Brewton, Ala., for a hospital with an obstetrics department.
The roots of the crisis are complex. The insurance companies, President Bush and the American Medical Association largely fault the rising cost of awards in malpractice lawsuits. From 1995 to 2000, the average jury award jumped more than 70 percent, to $3.5 million, and a few claims since then have run to more than $40 million, according to Jury Verdict Research in Horsham, Pa.
J. Robert Hunter, the insurance director of the Consumer Federation of America, attributes the soaring premiums to insurance companies' mismanagement. The insurers acknowledge that through most of the last decade they dropped premium prices while battling for more business from doctors and hospitals, depending for profits on financial reserves and returns from booming equity and bond markets. Now, with Wall Street in a slump, the insurers say they must increase prices to survive. Hunter and other consumer advocates say the price shock is intolerable.
Bush and the AMA are campaigning for a federal law that would limit claims for pain and suffering to $250,000 in each malpractice case. The medical association is also urging state legislators to take similar action. Already this year, lawmakers in Pennsylvania and Nevada have imposed lawsuit limits, and Gov. Ronnie Musgrove of Mississippi is expected to call a special session of his state legislature to confront malpractice insurance costs.