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    From physician to legislator: how one ob/gyn advocated for state-level tort reform

    Watching his state's medical care system crumble and many of his partners shutter their practices spurred one Mississippi ob/gyn to take a personal stand on tort reform. His run for elected office was successful—in more ways than one.

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    Liability insurers raise premiums, but payouts remain flat
    The news item above, from the November 2005 issue of this magazine, gives credence once again to the feeling that we are being gouged. But is that really true? Americans love conspiracy stories. Even The History Channel has a series on the subject. What conspiracy story could be better than a bunch of big, impersonal, rich insurance companies getting together to formulate a plan to gouge our hard-earned dollars from us? But the American justice system has all sorts of avenues for taking conspiring corporations to court, showing their misdeeds, and forcing them to "make whole" those they harmed, so why is the trial bar not actively going after those "evil" insurance company conspirators? Let's look at the facts versus the information put out in the media by the trial lawyer lobby, and then look at one ob/gyn's experience (mine) with engineering tort reform at the state level.

    The insurance 'numbers' game

    First, you need to know that the Center for Justice and Democracy is made up of people affiliated with Ralph Nader.1 Their spokesperson, Joanne Doroshow, said in a press release that, "today's liability insurance crisis for doctors is not caused by jury verdicts or the legal system. It is driven by the insurance industry's economic cycle that takes advantage of a weak economy to price-gouge doctors and make huge profits."2 That statement does not pass the "common sense" test. For several years, my policy was with The St. Paul Companies, but they pulled out of the market because they were losing too much money. [At one time, Mississippi had more than a dozen companies writing medical company liability insurance policies. We're now down to three:] One is the state-sponsored last resort, the second is a captive of the state medical association, and the third is a captive of the state hospital association. [All the commercial carriers left because they couldn't make a profit, yet my premiums remained high!]

    The report alleging that insurers were raking in money and paying out a pittance was written by Jay Angoff, to whom the press frequently refers as "the former Insurance Commissioner of Missouri."3 What the media fail to mention is Mr. Angoff's current job. According to the Illinois Civil Justice League, [Mr. Angoff is a lobbyist for the Illinois Trial Lawyers Association and employed by a law firm that specializes in medical malpractice litigation.4] My perception of trial lawyers is that they are hardly unbiased participants in the civil justice system.

    Both Mark Twain and Benjamin Disraeli have been quoted as saying, "There are three kinds of lies, Lies, Damned Lies, and Statistics." Mr. Angoff used statistics to support his contention that the medical malpractice insurance companies were making a lot of money from our premium dollars. Commenting on Mr. Angoff's report, James Copland of the Manhattan Institute said, "A look deeper into the numbers shows that, as usual, CJD (Center for Justice and Democracy) is 'creatively' using statistics to mislead its readers."5 Mr. Copland lists and discusses four points to debunk Mr. Angoff's report:

    • The study mismatches cash flow by linking current premium payments to current claim payments.
    • The study is seriously skewed by "survivorship bias" effects.
    • The study handpicks its time frame to generate its results.
    • The study ignores all costs insurance companies incur apart from payments to claimants to create the illusion of profitability.

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    Sid Bondurant, MD
    DR. BONDURANT is Clinical Professor of Obstetrics and Gynecology at the University of Mississippi Medical School, Jackson, MS. A State ...

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