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Senate's plan is too flawed to fix medical crisis

Re: Endless Summer, July 2.

Your editorial criticizing Gov. Jeb Bush for calling lawmakers back to Tallahassee to adopt meaningful medical liability reforms and concluding that the Senate passed a "fair and thoughtful bill" was wrong and warrants a response.

The governor understands this worsening crisis is eroding the availability of health care services for our citizens and that the solution lies in a comprehensive set of reforms. The governor was correct in proposing a reform package based on the 60 recommendations of the task force of university leaders. Now it is time for the Senate to adopt this holistic approach to improving patient safety, enhancing physician discipline, stabilizing the insurance market and enacting much-needed legal reforms.

We respect the Senate's attempts to craft its own solution, but its proposal is fraught with problems and simply won't solve this crisis. In short, the Senate plan doesn't contain costs, doesn't assure the availability of high-risk care, doesn't stabilize the insurance market, and doesn't restore fairness to the broken legal system.

The Senate's proposed "cap" of $6-million on noneconomic damages is no cap at all _ it's too high to contain costs and keep doctors from leaving the state. The proposal to create a new medical screening panel adds a litigation layer and increases costs. The Senate fails to provide sovereign immunity protections for emergency rooms health care providers, who are required by law to see anyone seeking treatment.

The Senate fails to include "bad faith" reforms that are critical to immediately lowering premiums for doctors and hospitals. Florida's largest medical liability insurer pledged a 20 percent rate rollback if such reforms passed. The Senate also proposes creating a state-run insurance entity to fill the vacuum left by private insurers, who will leave the state due to this ineffective response to the crisis. A similar experiment was tried in the 1980s, and went insolvent.

Finally, the Senate fails to address important legal system reforms such as eliminating joint and several liability, which enables trial lawyers to go after "deep pockets" regardless of their fair share of fault.

Florida is veering toward a medical meltdown. The task force of university presidents gave lawmakers a reasonable blueprint for solving this crisis. Gov. Bush is right to call lawmakers back to Tallahassee until they pass measures that will truly solve this crisis. It's time for the Senate to act and to heal health care for 16-million Floridians.

Bob Asztalos, Coalition to Heal Healthcare in Florida,

Tallahassee

Recalls and recalls

Re: Endless summer.

After reading your editorial about our wonderful governor, it seems to me he just doesn't get it. The people elected him to run the state, not be its dictator. Putting a cap on malpractice is one thing, but to tell our senators that he is going to keep recalling them until he gets his way is pretty bad.

I am still upset over him vetoing the funding for the new train. I did vote against it, but the other side won out so it should be funded. Our governor needs to look at the situation another governor is in and go over that word recall. Maybe we need to start up our own call for a recall.

Robert A. Luciano, St. Petersburg

It's about what insurance industry wants

Re: Cap can address malpractice crisis, letter,

June 28.

It is obvious that the letter writer, obtained selective statistical data from the insurance industry. Data available to all Florida citizens from the Florida Department of Financial Services suggests that there has been little change in the average number of medical malpractice claims filed over the past five years or in the average payout per claim during the five-year period, despite the insurance industry's touting of multimillion-dollar awards. The Department of Financial Services could confirm that in the year 2002, when certain physicians saw their premiums suddenly increase, the number of medical malpractice claims remained stable at 1,500 and the average payout per claim, $256,464.13, was generally consistent with the five-year history.

It is scandalous that the insurance industry has manipulated well-intentioned physicians by suggesting that an arbitrary $250,000 cap on every case involving noneconomic damages _ including death, brain damage and quadriplegia _ will be the "cure-all" to control the sudden increase in medical malpractice premiums paid by the high-risk specialties of medicine.

Unfortunately, the real interest of the insurance lobby has little to do with caps but is a strategic effort to obtain legislation that would change the bad faith laws involving medical malpractice claims, which now allow private attorneys representing physicians to put pressure on their insurance companies to settle meritorious claims within the policy limits of the physician. Under the present law, if the insurance company refuses to settle a meritorious claim within the policy limits of the physician and acts in bad faith, there is a process wherein the insurance company insuring the doctor may be held responsible for a judgment rendered in excess of the physician's coverage. If the bad faith law was changed as suggested by the governor, and advanced by the House of Representatives, the effect would be more litigation because the insurance companies would have no incentive to settle just cases.

A second interest of the insurance industry is an attempt by legislation to immunize emergency room health care providers by limiting a patient's recovery against negligent emergency room providers to $100,000, both as to economic and noneconomic damages, which is the same immunity provided to the state in its hospitals and teaching facilities.

The governor's "wish list" for the insurance industry is short-sighted and wrong, not only for the victims of medical malpractice but for physicians.

The Legislature and the governor need to address this issue so that the rights of innocent malpractice victims are not impaired and, further, that physicians have assurances that the insurance industry will be regulated to guarantee that premiums will be controlled or, alternatively, that a state-supported insurance fund, as advanced by the Senate, would be created to stabilize the market and provide affordable liability insurance to physicians.

Richard A. Hirsch, Tampa

Florida's favorable tax climate

Your June 16 editorial, Worse than Alabama, criticizing Florida's tax structure, was more misinformation than fact. To date, Gov. Jeb Bush has enacted $6-billion in tax relief, including taxes paid by our seniors and savers, reducing taxes in Florida to their lowest level in 11 years. Florida is one of the few states that have not raised taxes and is recognized as a friendly tax environment.

A recent survey by Tax Foundation, named Florida one of the top 10 best business tax climates in the nation, and another survey of 280 corporate executives ranked our state one of the top three business climates in the United States. A friendly business and tax climate draws more businesses to our state, creating more jobs for Floridians.

As result of our tax policies, while other states struggle economically, Florida leads the nation in revenue growth and job creation. Our state has posted job growth for 14 straight months, at a rate faster than any of the other 10 most populous states. Our unemployment rate has been lower than the national average for the last 15 months.

The fact is that as long as government exists, so will the taxes that pay for services to our citizens. The sales tax, Florida's primary source of revenue, is a fair way to assess this burden. It does not require workers to contribute a percentage of their salaries to the state, but it does generate revenue from the goods they purchase (with the exception of food and medicine). In effect, our citizens determine their contribution, and our visitors contribute for the use of our services as well.

Florida's low tax rate is one of the key factors driving our economic vitality. By contrast, our neighbors in Alabama are still battling an ongoing economic slump, and considering a $1.3-billion tax increase. Adopting the "Alabama Plan" embraced by the St. Petersburg Times only makes sense for those who believe misery loves company.

Dr. Pamella Dana, director, Governor's Office of Tourism,

Trade and Economic Development, Tallahassee

Medicaid cuts hurt the poor

Re: Florida limits coverage for circumcisions,

July 1.

I read with interest the article about cutting Medicaid funding for circumcision. The savings noted are substantial, but the heading of this article should have noted that this is but one of several cuts that will affect Medicaid recipients.

These cuts will take away transportation services. I work in a rural county as a school social worker, and many of the families I work with do not have cars or access to them. There is limited public bus service. This cut will effectively prevent access to doctors. What typically happens when families cannot get to medical and psychiatric appointments is they wait until the situation becomes a crisis. The sore throat becomes a strep infection, and the child ends up in the emergency room via ambulance. The individual who should be taking medication to control a mental illness ends up Baker Acted by the police and taken to a crisis unit. Both are more expensive alternatives to the doctor's appointment.

Cutting money for eyeglasses, hearing aids and dentures can affect the kinds and types of jobs people get. If one can't read something because of poor eyesight one may not be able to take even the lowest paying of service jobs. Hearing is important for employment as well. Dentures are not vanity items: Employers are more likely to hire the person with teeth than without to do counter work.

These cuts chip away at both access to health care and jobs for poor people. Once again we balance a budget on the backs of the people with the least power _ all because of tax cuts for the wealthy. Seems pretty mean to me.

Cynthia Ryalls-Clephane, Brooksville

Are we so devoid of compassion?

Senior citizens who are financially poor and ill _ the majority of nursing home residents _ are about to experience yet a further decrease in their quality of life, thanks to the budget signed by Gov. Jeb Bush.

No longer will the state pay for hearing aids, dentures and glasses for seniors on Medicaid. This became effective July 1. The politicians who approved this budget do not care if the poor and the sick can eat, see or hear. It is unlikely they will be able to vote and certainly out of the question that they will donate to the politicians' re-election campaign, so why should they concern themselves with these people?

Have we reached the stage where we are so devoid of compassion? Where we have a political system that listens to the demands of the rich only?

I pray for the day when I see politicians on Medicaid and in a nursing home, but I know that is unlikely to happen. After all, they take care of themselves first and foremost.

John E. Lythgoe, Dunedin

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