by Dan Perkins

Source: NMA Release

The troubles of America's healthcare has been making headlines for over a decade, and still the problems grow.  Today, people with limited financial resources have fewer options for quality care.  Sadly, the problems are revealing themselves in black and white. Growing disparities in the health of white Americans and African Americans is, in part, a result of a healthcare system that has put dollars before health.

The financial problems of the healthcare system do not only affect patients, they also adversely affect healthcare providers, primarily doctors and nurses.  It is situation that has drawn the attention of the National Medical Association (NMA), the nation’s oldest and largest medical association, representing the interests of more than 25,000 African-American physicians and their patients.

Last August, members of the NMA elected Winston Price, MD as the organization's 105th president.  Price, a New York licensed physician, is the chief medical consultant for VCASTI International, a medical information systems and technology company, which he founded. He is also an assistant professor of clinical pediatrics at SUNY Health Science in Brooklyn, New York.

In his inaugural address to convention delegates, Price outlined three key priorities of his administration: addressing the impact of health disparities, implementing programs and initiatives designed to eradicate disparities, and strengthening the infrastructure of the NMA.

On June 14, 2005, Price directed his concerns, and those of the NMA, to Congress when he spoke before the Committee on Small Business.

In his speech, Price noted that Illinois, which is the Committee Chairman’s home state, and New York, which is the Ranking Member’s home state, have both been designated red states by the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG).  Price noted that the color designation was not symbolic of party preference - red symbolizing Republicans - but rather recognition of the fact that “the Land of Lincoln and the Empire State, as well as 18 other states in the union, are in the throes of a medical liability crisis.”

Price continued, “Both states have a significant minority population, and in both states’ minority physicians in private practice are either limiting the scope of their practices, closing up shop altogether, or moving to ‘greener pastures.’ Price noted that by greener pastures, he meant states where a physician can afford to practice with malpractice insurance.  “We must also add that there are at least 20 other states approaching ‘crisis’ status, and the picture is getting bleaker,” he warned.

Price personalized the crisis by citing the circumstances of three NMA members.  He began by pointing to the nationally-profiled case of Rev. Ronald V. Myers, Sr., MD, who was forced this year to close his medical clinics in the Mississippi Delta after two decades because his medical insurer dropped him for refusing to give the insurer carte blanche access to his patients’ records.  When Myers attempted to obtain coverage from a risk management pool, he was quoted a policy that cost almost $200,000 for the 5 clinics, as opposed to the $6,000 total fee he paid prior to the cancellation by his insurer.

Price explained that Myers had never had a malpractice lawsuit filed against him. Following the cancellation of Myers’ medical coverage meant, approximately 3,000 of his former patients, most of whom are African-American, were left without adequate medical care. Price told the Committee that Myers’ former patients represent the poorest, neediest and most vulnerable people in America.

Underscoring the fact that Myers’ case was not an isolated incident, Price then told the Committee about Dr. McCune, who is also a Mississippi physician.  “(McCune) had bought a malpractice policy to cover him in a primary care practice, and the policy was supposed to cover him throughout the state of Mississippi,” said Price to the Committee members.  “After the policy was ‘signed, sealed and delivered,’ the carrier apparently had a change of heart, and decided they would only cover him at one hospital though he has practice privileges at numerous hospitals." Price explained that McCune has taken legal action against the insurer and his case goes to trial this summer.  Price said McCune asked him to tell the members of the Committee that malpractice insurance carriers “have so much power in the marketplace that the doctors feel as though they are under siege.”

The third and final case presented by Price involved Dr. Joseph Harris, who lives in Reno, Nevada, and serves a rural population in northwest Nevada and northeastern California.  Price told the Committee, “The obstetricians in that section of the United States are struggling to find coverage as well, and many are moving away or closing up shop.  Dr. Harris’ main concern is that this problem crosses geographic as well as racial lines and certain specialties such as OB/GYNs are especially vulnerable.”  Price echoed Harris' warning that if the problem is not addressed expeditiously, more Americans will be forced to drive hundreds of miles just to obtain quality healthcare and critical services.

Price told the Committee that not all state insurance commissioners are alike, and that the time has come for “a more substantive national dialogue about their role and influence.”  Speaking on behalf of the NMA, Price urged the committee to look into insurance terms and concepts pertaining to: collateral source rule, contingency fees, periodic payments, provision of qualified expert witnesses, and clarification of informed consent.

He further urged the Committee to develop recommendations to the Congress that would achieve the following four conditions:

• Limit unquantifiable non-economic damages, such as pain and suffering, to reasonable levels (He asked the Committee to consider a possible cap of $250,000.),

• Respect states’ rights by allowing states that have already enacted damages caps, to keep those caps in place and have the flexibility to change them, allocate damages fairly, in proportion to a party’s degree of fault and considering other payments already made,

• Limiting the number of years a plaintiff has to file a health care liability action to ensure that claims are brought before evidence is destroyed, while witnesses are available and memories are fresh, and

• Re-examine the processes by which malpractice insurance premiums are set by insurance commissions at the state level.

Price acknowledging that there was no “silver bullet” to the nation’s medical insurance crises, but he urged the Committee to begin to address the problems by taking action on his recommendations.  He insisted that the current state of affairs is “unacceptable” and he urged the Committee to work towards effective solutions, and to then advocate for their adoption by Congress.

THE END