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Monday, February 10, 2003Sharon Forsch knows that a sharp rise in the cost of medical malpractice insurance last year hit doctors hard in their pocketbooks. The retired preschool teacher just doesn't think that is any reason for doctors to dig deeper into her pocketbook. Forsch, 59, is refusing to pay a $30 surcharge that she says Beachwood OB GYN Inc. in Lyndhurst added to her bill to help pay for costly malpractice insurance. Her health insurance, like most, does not cover the add-on fee. As doctors struggle to buy increasingly expensive malpractice coverage, a few are trying this revenue-enhancing tactic. So far, local and national medical societies have taken no position on whether it is ethical. But the head of a medical consumer rights group called the surcharges "extortion and fraud" that patients have no obligation to pay. The patient in question has an HMO. When we contract with HMO’s we agree to accept a certain amount per month from the insurance company to provide care, plus the patient’s co-pay for each visit. This surcharge, also often called an “administrative fee” is growing more popular as overhead becomes more and more burdensome, but it would seem to violate the terms of an HMO contract. (And those surcharges aren't necessarily just to cover malpractice premiums. They're also to cover the added administrative burden of dealing with insurance companies.) Consumer groups, predictably, aren’t happy about it, either: No managed-care company is going to cover surcharges for malpractice insurance, said Charles Inlander, president of the People's Medical Society, a consumer-rights group in Pennsylvania. And he said consumers should not be left to pay. Ah, but there’s the rub. If our healthcare system were truly a free-market and not the corporate-socialist system that it is, doctors would increase their fees as their overhead increased, and the high cost of malpractice insurance premiums would be passed on to the patients. In our system, though, we can’t increase the fees. The insurance companies and the government (via Medicare) determine how much we are paid for our efforts. And their reimbursements have been diminishing as overhead costs have continued to increase due to malpractice insurance and to administrative overhead devoted to extracting payments from those same insurance companies and government programs. That’s why doctors in so many states have been driven from practice. They have no other recourse. The Plain Dealer isn't convinced that doctors can't cover their overhead, though: But last September - one day after doctors told a special state legislative committee hearing in Cleveland that the high cost of malpractice insurance was forcing some out of business - Steven Klein signed a lease for a new Mercedes. The model he selected had a base sticker price of about $50,000. He drives home each evening to a $740,000 house in Moreland Hills. Yet Forsch said an office assistant told her the doctors "just can't afford to practice without that fee." One factor perhaps adding to the cost of Beachwood OB GYN's insurance is that Klein and the three other doctors whom state records list as shareholders are named in malpractice lawsuits pending in Cuyahoga County Common Pleas Court. I don’t know about Dr. Klein’s spending habits. For all we know, his wife could be an heiress (or a successful trial attorney), but I do know that Cuyahoga County has one of the worse reputations for aggressive malpractice lawyers. Given that we’re talking about obstetricians, a group that’s particularly singled out by trial lawyers, it’s no reflection on the doctors that each of them has a suit pending. posted by Sydney on 2/10/2003 07:46:00 AM 0 comments 0 Comments: |
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