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Thursday, December 18, 2003 - Page updated at 12:00 AM

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Locke floats malpractice remedy

Seattle Times staff reporter

Gov. Gary Locke is expected to throw a $30 million budget bone to doctors, who have been nipping at legislators' heels, demanding limits on large jury awards in malpractice cases.

According to a draft circulated late yesterday, Locke's supplemental budget, to be rolled out today, calls for a $20 million increase in Medicaid payments to doctors who deliver babies, of which $10 million would be state money. It also proposes $10 million to start a "patients' compensation fund" that would cover "excess" jury awards above a certain limit, still unspecified.

Locke was expected to announce the proposals with his rollout of a $200 million supplemental increase in the state's two-year budget.

The measures are part of a medical malpractice reform proposal floated by Locke and other top state Democrats, including House Speaker Frank Chopp, Senate Democratic leader Lisa Brown and state Insurance Commissioner Mike Kreidler.

Even with the meaty funding proposals, the reform package left many doctors growling.

Gearing up for the legislative session that begins Jan. 12, doctors have insisted they will settle for nothing less than caps on "pain and suffering" portions of jury awards in malpractice cases. Many doctors, particularly those in high-risk specialties, believe limiting such awards is necessary to stop liability insurance from becoming prohibitively expensive and hard to get.

Dr. Judy Kimelman, an obstetrician-gynecologist from Seattle, said the proposals would have little effect.

"They don't resolve the issue at all," she said. "Basically, you're still going to have these huge jury awards — they'll just break the state's bank."

Kimelman noted that doctors would be expected to pay premiums to the patient-compensation fund in exchange for lower premiums in commercial insurance.

"We're going to end up paying twice," she said. "Their whole idea is that you just throw more money into the system, instead of stopping the money being leached out of the system."

Tom Curry, executive director of the Washington State Medical Association, said increased state funding for deliveries simply addresses inadequate reimbursement levels without truly reforming the system.

Democrats, while acknowledging the doctors' complaints, have been equally insistent that they will not limit jury awards to victims of medical errors.

Locke's proposal met with praise from the state's association of family doctors, who often are called upon in rural areas to deliver babies. The Washington Academy of Family Physicians "strongly supports" Locke's proposal, said Dr. Jean Marshall, president of the group.

Increasing the reimbursement rate for Medicaid (the state-federal insurance program for low-income residents) will allow doctors to continue providing obstetric care to vulnerable patients in underserved communities, she said.

The package of reforms also focuses on measures addressing patient safety.

Many of the specifics were contained in legislation proposed by Democrats last session, which ended in a stalemate on medical malpractice issues. As this session nears, and heading into an election year, doctors have threatened to campaign against legislators who oppose their reform efforts.

The proposals planned for today's announcement include programs to reduce medical errors, target doctors with numerous malpractice settlements, protect health professionals who report unprofessional conduct by doctors, and authorize hospitals to share information so each can learn from the others' mistakes without fear of fueling lawsuits.

Legislative sources said one aim was to allow big urban hospitals, with the resources to figure out how to prevent certain errors from occurring, to share with smaller hospitals without fear of litigation.

Under the proposal to be aired today, those programs would be funded through a surcharge on health-professions licensing and through a small portion of malpractice settlements and suits.

A third area of the proposal, focusing on the legal system, would require mediation or arbitration of medical malpractice cases, limit the number of expert witnesses, and decrease the number of years a minor has to file a malpractice claim. It also would allow doctors and hospitals to tell patients that an error has occurred, apologize and make an offer of remedy without fearing their actions would be used as evidence in a lawsuit.

Ree Sailors, a health-policy adviser to Locke, said the governor had hoped to announce that increased Medicaid reimbursements would cover emergency-department doctors as well as obstetricians, but technical details on payments had not yet been worked out.

Kreidler, the insurance commissioner, is also proposing regulatory changes to help provide affordable liability insurance to child-care centers, nursing homes and other organizations that care for children and vulnerable adults.

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com

Copyright © 2003 The Seattle Times Company

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