The Perfect Storm

US News and World Report writer Mary Brophy Marcus wrote an article a few years back about the critical shortages of physicians in the United States and the escalating cost of healthcare due to the malpractice crisis, which piece she entitled Healthcare’s “Perfect Storm.” The title was, indeed, most appropriate, one that predicted an ominous future for the Americans. That bad omen came true. Today, there is a serious crisis in healthcare cost that is bankrupting Medicare and other private insurance companies and medical care providers in the United States, thanks to the mandated malpractice insurance for all physicians in America.

The same crisis could wreak havoc to our own healthcare system in the Philippines and cause us and our family immeasurable pain and suffering, if we, the people, allow our legislators to pass a law mandating all physicians in the country to buy malpractice insurance as physicians in the United States are required to have.

Since that US law was passed, malpractice lawsuits suddenly skyrocketed, malpractice lawyers mushroomed, and so with ambulance chasers and bills boards encouraging patients to sue physicians, medical staffs, clinics, and hospitals. Physicians were forced to practice defensive medicine, ordering more tests, X-rays, CT scans, MRI, etc., in order “to be extra careful” and protect themselves. Healthcare costs escalated. America has grown into a litigious society it is today. Because of large settlement awards to plaintiffs, insurance companies had to jack up malpractice premiums to a prohibitive level. Unable to cope with the financial burden, many physicians called it quits. The vicious cycle continued leading to a present healthcare crisis in the United States.

In this revealing and alarming essay, the author related how a Las Vegas OB-GYN specialist with a thriving practice, seeing 40 patients a day and delivering 20 babies a week, had to fold his obstetrics practice after 12 years because of skyrocketing malpractice premium in the United States. Although he had never been sued before, his malpractice rate jumped from $33,000 (more than 1.3 million pesos) to a more ridiculous $108,000 (almost 4.5 million pesos) a year! At an income tax (bracket) rate of almost 50 percent, this physician had to earn about $216,000 (almost 9 million pesos) a year just to be able to pay Uncle Sam the annual income tax and the malpractice premium of $108,000, with nothing left in his pocket for himself, his family, his office staff and other overhead expenses.

The example the writer illustrated above is typical and widespread across North America, where currently there is a healthcare crisis, almost to a catastrophic proportion. The run-away malpractice insurance premium rate is forcing countless physicians, especially those specialists regularly performing high-risk procedures (heart surgeons, obstetricians, neurosurgeons, orthopedic surgeons, emergency room physicians, etc.) to curtail their practices or retire prematurely, or change career, to avoid debts or bankruptcy.

“People are dying,” stated Loren Johnson, president of the American College of Emergency Physicians’ California chapter. The reason is because states are running low on vital medical specialists and services as a result of this malpractice crisis.

The Washington County Hospital in Hagerstown, Maryland, like many other hospitals, had shut down their trauma center (emergency room) because of lack of physicians and the very costly malpractice premium. Many training hospitals are concerned that the high cost of malpractice premium they have to buy for their residents might cause them to close their programs. And this will further reduce the number of practicing physicians in the country, making healthcare even lesser accessible for the people.

When both hands of the physicians are tied as a consequence of a prohibitive malpractice insurance premium, a coverage required by all hospitals in order for a physician to join the medical staff, they are essentially deprived of their individual constitutional right to practice their profession and art. And the ultimate victims who will suffer the brunt of all this are the people, the patients, especially the sickness-prone seniors and the children.

The potential profitability of filing a suit against a physician becomes a strong incentive for many patients to sue their physician at a drop of a hat. Indeed, the United States, most unfortunately, has become a very litigious society, for a fast buck!

The crisis came to a head when St. Paul Companies, the largest malpractice insurers, dropped tens of thousands of physicians, leaving them naked, without any coverage at all, and scampering for other insurers. And this came at a prohibitive price because other insurers took advantage of this situation and raised their premiums. The reason for all this was the increase of medical lawsuits and the high-priced damage awards.

In Las Vegas, for instance, like in many other metropolis, one sees a billboard almost every mile, advertising personal injury lawyers, with a “no-legal-fee-if-we-lose” incentive, practically enticing people to sue their physicians.

Can crisis this happen to the Philippines? Yes, since we, Filipinos, are very fond of copying everything and anything from the United States. As a matter of fact, it appears many of our legislators are still bent on importing the scary and potentially devastating idea of mandating malpractice insurance coverage for every physician in the Philippines.

Are these legislators misinformed, miserably blind, simply dumb, or cleverly planning to invest in, or put up, malpractice insurance companies in the Philippines? If the reason is none of the above, then why in heaven’s name would they, who have sworn to serve and protect the interest and welfare of the Filipinos, could even think of importing a harmful piece of legislation, like the mandatory malpractice insurance for physicians in our country, when the same experiment has despondently failed in the United States and has been causing a healthcare havoc, pain, and suffering among the Americans? Only our legislators, malpractice lawyers, ambulance chasers, and insurance companies will benefit from a national suicidal law such as this.

Why do we have to import mistakes, miseries and heartaches from abroad when we have more than enough of our share right here in our country, courtesy of some of our elected officials. For Filipinos in the United States who have seen “the future,” this proposed law is a sugar-coated poison that would kill our healthcare system and the medical profession, with the patients and their family as the ultimate victims.

If we must, let us import from the United States ideas and programs that will be good for our people, and not a bad piece of legislation that has already been proven deleterious by the Americans themselves, who are now trying very hard to undo and correct their errors of the past. Let us learn from this bad experiment in the United States and not bring this killer dinosaur to our shores.

Mandating our physicians to buy malpractice insurance in order “to protect the patients” is like forcing them to use a shotgun to get rid of a fly on our nation’s forehead. This in itself would be the greatest MALpractice of all.

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The author is Chairman of the Filipino United Network – USA and Loyal Alliance for Medical Missions in the Philippines (LAMP). Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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