Political malpractice

July 05, 2004

MALPRACTICE insurance rates are through the roof, and that has Gov. Robert L. Ehrlich Jr. steaming. It should. A proposed 41 percent rate increase by the state's largest malpractice insurer on top of last year's 28 percent increase has serious consequences. It means a lot of doctors, particularly those in high-risk specialties, can't afford to stay in business. The availability and quality of medical care will suffer. It has become a real crisis.

But for all of Mr. Ehrlich's righteous anger - he clearly likes speechifying in front of unhappy doctors - his actions are less impressive. He offered legislation last winter but lobbied sporadically and ineffectively for it. More recently, he has called for a special session of the legislature to solve the problem, but even supporters know that's empty rhetoric. Why call for a vote when the administration doesn't even have a proposal on the table?

But worst of all, Mr. Ehrlich has gone to the trouble of creating a task force to reach a consensus on malpractice reforms and didn't bother to consult legislative leaders. Nor has he given plaintiff's lawyers much voice in the effort. Naturally, the task force has already been condemned by trial attorneys and by Senate President Thomas V. Mike Miller. Why wouldn't they? The deck's been stacked against them - and anyone familiar with Annapolis knows a bill doesn't go far when Maryland's powerful Senate president is strongly opposed.

It's also curious that the governor hasn't sought advice from his most important potential ally in malpractice reform - House Speaker Michael E. Busch. Mr. Busch may be a Democrat and he may oppose the governor on slot machines, but he's experienced in health care reform and perfectly willing to take on political sacred cows.

So what gives? Incompetence no longer flies as an excuse. The governor knows this issue - and how it plays in Annapolis. His last proposal contained some good ideas to cut litigation costs. But his behavior suggests the former congressman is sticking strictly to the D.C. political playbook. He's on the side of physicians and insurers, traditional Republican campaign donors, but against the trial attorneys who tend to side with Democrats. He's making a political statement, not seeking a solution.

Medical malpractice is a difficult and complex matter. For reform to actually pass, it requires an artful compromise, a balanced approach that won't necessarily please the powerful special interests involved. For instance, litigation costs should be lowered, but what about addressing medical mistakes? Mr. Ehrlich may turn up his nose at the notion of tax-subsidized malpractice insurance premiums (and it isn't a pleasant thought) but a little of that might be the sweetener needed to get legislation on track.

A serious issue such as rising malpractice premiums deserves a more serious effort by Maryland's top elected leader. The good news is that it's only July. The next legislative session is six months away. If Mr. Ehrlich's goal is to find a cure, he needs to start acting like a doctor - instead of just currying their favor - and pursue a less-partisan course to heal a failing system.

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