Don’t Shoot the Malpractice Insurance!

These days, there are two whipping boys for everyone’s angst over the high costs of health care insurance. The first is the supposed high cost of Malpractice Insurance, and the other is illegal aliens. (Ask some people, and what they’d describe suggests there are illegals crawling out of the pores and woodwork all over the country, that most of Mexico sneaks over the border to get treatment in Michigan!) Meanwhile, as the economy worsens, doctors are not immune to the financial crunch. But at least a handful of them are singing a very different tune than the armchair critics out there. They still wish malpractice was lower, but their fingers are pointed at the medical insurance providers themselves, and the government as well. They say that both of these are the culprits, because they take forever to pay, regularly insist on renegotiating fees after the visit has already occurred and the services have been rendered, and that some just flat out don’t pay at all.

Surgeon Gunnar Thors explains ““There is always difficulty in collecting medical bills — Not so much from patients, but from insurance companies. Increasingly, they are being more reticent in paying what they owe… we are (sic portrayed as) the bad guys for wanting to get paid.”

Last November, Family Medicine Specialists, with four offices and 33 employees nearly went out of business specifically because the state wasn’t paying them. The Illinois Department of Healthcare and Family Services owed them almost $300,000. Several employees, physicians included, went without pay until the state finally paid up.

The practitioners do understand that times are tough. Many of them regularly make payment arrangements with their patients. Some will discount for cash at the time the services are rendered. In some states, that’s the only discount they’re allowed to give self-pay patients. This seems all the more at odds when one realizes how often the insurance companies unilaterally decide they’re not paying the usual and customary fees. Joseph Fojtik, a general internist at Mercy Clinic in Cary, IL, reports that insurance companies have lowered the amount they reimburse doctors for performing many medical procedures — at a time when money is tight and expenses are up.

Times are tough all over. In many cases, though, the real issue for the healthcare provider isn’t the cost of malpractice insurance (which actually went down overall within this past year,) or the imaginary scapegoat glut of illegal aliens supposedly somehow getting all of their services for free. It’s the patients’ medical coverage provider and our very own government who seem to be having the biggest negative impact upon healthcare providers’ practices.

There’s plenty of blame to go around, but let’s bear in mind that professional malpractice costs are based upon the costs, upon how much is paid out by the insurance company. These are things that we ALL have some control over. Unwarranted suits constitute about 75 percent of the cases that take doctors away from patient care. Even if the doctor doesn’t settle and is not found to be at fault, the legal defense bill itself will raise rates (which is why some insurance companies are eager to settle out of court, but that could have huge potential damage on the doctor’s practice and rates.) The real answer, then, is for everyone to stop thinking that malpractice insurance is their personal lottery ticket. One thing’s for certain. It’s just not fair to be laying the blame on the Malpractice providers.

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