As the state government works toward reform and Congress continues to debate possible solutions on the national level, Ohio and other crisis states are losing physicians to early retirement and relocation. A 2002 Ohio State Medical Association (OSMA) survey of Ohio physicians found that 96 percent are concerned about their ability to practice as the result of rising professional liability insurance. Physicians in high-risk specialties indicated these costs significantly impact their willingness to perform risky procedures and one in three physicians is considering early retirement. Malpractice insurance rates for physicians throughout Ohio have increased between 25 and 44 percent since 2000, depending on the area of the state and the physician’s history. Hospitals continue to experience double-digit increases in their premiums, and in many cases also are forced to absorb higher deductibles.

Ohio’s government has taken initial steps toward seeking a remedy to the medical malpractice situation, including the passage of Senate Bills 281, 120 and 179 earlier this year. Among other things, SB 281 caps non-economic damages in malpractice lawsuits at between $350,000 and $1 million depending on the severity of an injury. SB 120 links liability to actual responsibility and SB 179 modernizes peer review processes. OHA strongly advocated in favor of these tort reform bills.

Others in Ohio are also taking action to protect providers from the steadily climbing malpractice premiums. Groups of physicians throughout the state are exploring the possibility of forming their own captive insurance companies. Though such companies may stabilize rates, they also tend to be underfunded, thereby exposing both the participating doctors and their hospitals if claims exceed the new companies’ financial resources. OHA established a Sponsored Deductible Program (SDP) to help physicians finance large insurance deductible losses on their medical professional liability coverage and the OHA Board of Trustees voted in August to proceed with the creation of a new medical malpractice insurance company to help stabilize the market for Ohio physicians and hospitals. Plans are for the new company to provide insurance to physicians and hospitals that would take effect Jan. 1, 2004, offering an alternative to physicians with coverage that expires in January. OHA would provide initial capital and Ohio hospitals will be invited to buy stock to fund additional capital. The new company plans to offer insurance at rates based on actuarial forecasts and to further stabilize the market in Ohio by increasing competition and the options available to physicians.

This fall, both Ohio’s General Assembly and U.S. Congress will face a new slate of tort reform legislation in the struggle to protect health care providers and their patients’ access to care (www.ohanet.org/med-mal/legislation/default.htm). OHA is investigating the potential impact of these bills and will continue advocating on behalf of hospitals and reporting on the legislation. The Ohio Supreme Court also plays a vital role, with the power to uphold legislation that addresses the medical malpractice insurance crisis and to prevent the expansion of tort liability that characterized the court during the 1990s. As the 2004 state Supreme Court races draw closer, Friends of Ohio Hospitals, the political action committee (PAC) of OHA, will support the candidates best poised to have a positive impact on Ohio health care.

As physicians in high-risk specialties such as obstetrics move out of Ohio or choose to retire early when they cannot meet rising premiums, at-risk patients lose trusted providers and may be forced to travel further to receive care. Through programs designed to aid physicians and new legislation seeking to create a better system, Ohio is taking important steps to turn down the heat on the state’s medical malpractice situation.