Thursday, August 14, 2003
By Michael Peltier

TALLAHASSEE — After months of political wrangling, Southwest Florida lawmakers said a sweeping measure adopted Wednesday to stabilize the medical malpractice insurance market is a significant step forward — if not the final one.

The House passed the bill 87-26 after the Senate earlier voted 32-4 for the measure.
Following hours of debate in both the chambers Wednesday, local lawmakers joined their colleagues in sending to Gov. Jeb Bush the reform package they hope will stem skyrocketing insurance premiums.

That said, they agree there is likely much more to do.

"The bill you have in front of you today is a compromise package, a balanced package that is a good starting point to make sure that we continue to do what you need to do," Rep. Carole Green, R-Fort Myers, told members in debate. "What we need to do is to make sure we have quality health care available.

"It is a starting point in the right direction so that we can go home to our constituents and say, yes, we do share your concern about access to care," Green said.

The compromise plan caps damages for pain and suffering and other noneconomic penalties at $500,000 per physician and calls for an immediate freeze on skyrocketing insurance rates that physicians say are forcing many to limit their practices or go out of business.

The bill also creates liability caps for health-care centers and emergency rooms. Victims would be able to collect up to $2.5 million in noneconomic damages for the most egregious cases.

"In (homeland) security, we had to balance the issues of our civil liberties versus our need for security," said Rep. Dudley Goodlette, R-Naples, and a key House negotiator. "In this issue, we're balancing the access to quality health care in this state with the access to the courts."

Rep. Mike Davis, R-Naples, was among those who said that lawmakers have taken a significant first step in dealing with the issue. But, like many of his colleagues, Davis said he expects to return to modify the program as the effects of legislation become known.
" I've heard a lot of talk between my colleagues today that they are going to vote for it today, as I am going to, with the thought in mind that we are going to get some more cracks at this thing," Davis said.

In the Senate, Sen. Dave Aronberg, D-Greenacres, was among a handful of Democrats to vote in favor of the bill.

While saying it may not provide the immediate relief called for by physicians, Aronberg, whose cross-state district includes south Lee County, said it would bolster long-term stability in the insurance market.

"We've had three special sessions and the people at home are growing tired of our gridlock on this issue," Aronberg said. "We needed to pass a bill. When a compromise was reached, though the compromise was far from perfect, we needed to get something done."

That said, Sen. Burt Saunders, R-Naples, echoed others in saying that the legislation should allow insurance companies more accurately to predict their losses. That should result in lower rates for doctors. If it doesn't, further action may be necessary, he said.
" Clearly, this is a crisis that has to come to an end," Saunders said. "If this doesn't do it, we'll be right back here to try to figure out how to do it. It will be much more drastic."

But people on both sides of the debate have already criticized the measure.

The doctors who the bill was intended to help have said they don't support it and insurance companies say it likely won't lower rates.

Sandy Mortham, chief executive officer of the Florida Medical Association, said doctors were disappointed because they wanted a $250,000 hard cap with no variations.

"There are a lot of different parameters that open that cap up," Mortham said.

However, she did praise one part of the bill — a $150,000 cap on noneconomic damages for claims against emergency rooms.

Malpractice victims are also unhappy, saying the bill unfairly limits how much they can collect. Limits on damages make it less likely lawyers will take expensive cases, meaning access to justice is denied, they say.

Neal Roth, a malpractice attorney and one of the trial bar's chief lobbyists working against caps, said he was most disappointed that a decision was reached without data on the number of frivolous lawsuits in the state, whether any emergency rooms have closed because of high rates and other issues.

"When it got done wasn't as important to us as much as all the data being collected ... so we could get to the truth behind all the issues," Roth said.
Even lawmakers who supported the bill didn't sound completely satisfied.

"Is this the bill that I would like personally to have?" asked Allan Bense, a Panama City Republican and a key negotiator on the issue. "No."

Democrats, meanwhile, criticized the bill because it doesn't include a provision forcing insurance companies to automatically reduce premiums. Instead, it freezes rates until January.

"Folks, this is the major crisis, this is the issue — it's the amount of insurance premiums that doctors are paying," said Sen. Skip Campbell, D-Fort Lauderdale, in arguing for a rate rollback.

But Sen. Tom Lee said the rate freeze will help doctors.

"Don't anyone in this chamber think that a rate freeze is something to sneeze at," said Lee, R-Brandon. "Rates have been going up in this state over the last three years at double digit rates — 25 percent or above. A rate freeze is significant. That is a substantial accomplishment for this Legislature."

Rep. Dan Gelber, D-Miami Beach, argued that the legislation froze rates for only a few months.

"We really shouldn't call it a freeze," he said. "Maybe a chill, maybe a breeze, but not a freeze."

The House rejected an amendment filed by Gelber that would have rolled back doctors' insurance rates 30 percent in two years.

Florida is just one battlefield in a nationwide war over how much should be paid for doctors' mistakes.

In Washington, the U.S. Senate killed legislation that would have limited the ability of malpractice victims to win some types of damages to $250,000 — a ceiling sought by President Bush.

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