Senate Health, Education, Labor and Pensions Committee and Senate Judiciary Committee Hold Joint Hearing on Role of Litigation in Patient Access Care

Senate Health, Education, Labor and Pensions Committee and Senate Judiciary Committee Hold Joint Hearing on Role of Litigation in Patient Access to Care

ENZI:
Thank you, Mr. Chairman. I appreciate having this hearing. I've learned a great deal today. I would ask that the statement I have be made a part of the record, and I want to bring a little different dimension to some of the discussion here.

I'm from Wyoming. That's one of the—the lowest populated state in the nation. We're one of those two square states out there in the west—couldn't exist if the square hadn't been invented. We're about 300-plus miles on the side, and we have a little over 493,000 people in the state. Our biggest city is 50,000 people. It goes downhill pretty quick from there.

So we have a little problem with the number of doctors that we have, and we're considered a pool all by ourselves. I don't
have a way to check and see how drastically that affects the insurance rates, but I know that it does.

Not only are my obstetricians leaving, but two days ago in the Washington Post, page two, there was almost a full page article about a doctor in Wheatland, Wyoming, whose insurance premiums just went up above $150,000 and he's going to quit the practice. Now, in Wheatland, he delivered all of the kids. He was interviewed at a basketball game in Douglas. That's 60 miles away. He delivered a third of the kids there.

In Casper, Wyoming, we have a doctor who's also going out of the practice there. He delivers a third of the kids in that town. That's a city just under 50,000. In Torrington, they're losing their only doctor, which means all medicine, not just obstetrics.

So we've got this huge problem. I'm willing to go with any kind of a solution. Actually, what I'd like to do at the moment, I think, is join California as part of their pool. I guess that's not an option.

We have one insurance company for doctors. I remember when we had our first child. It was a difficult delivery. It came about three months early, and, consequently, when we were having our second child, there wasn't any doctor in our town. There was only one to begin with, but he wasn't willing to take on a second child with those kinds of difficulties.

I hope when we're looking for the solutions on this, we will take into consideration those areas of the country that are extremely remote and extremely rural. Dr. Wilbourne comes from a state that's considerably more populated than Wyoming but is still down on those bottom parts of the chart.

You described some of the medical liability and patient access problems that are isolated in your part of the country. Do you think that the crisis you described is less severe in states that have enacted medical litigation reforms?

WILBOURNE:
I think it is to a great degree. There is a lot of reform that can be done. But when we see these lawsuits go forth, and there is no limit to what you might get from a jury, then there is nothing to deter someone from saying, "Let's sue 100 people this week, and maybe one of them will settle just because they don't want to spend $91,000 defending their case, and we'll get something, and I really don't even have to go to the courtroom. I don't have to try this case. I'll just get enough in this settlement and that settlement, because the insurance companies will do that."

So there's no deterrent to keep the number of suits down, so we get into this situation where more and more suits are filed, and the premiums, in my opinion, keep going up. Yes, there's a lot of different answers here today as to who thinks it's whose fault. The problem that we have is the doctors are sitting here saying, "I don't know whose fault you're going to say it is, but I can't practice medicine under these conditions. I cannot pay my malpractice insurance premium. I'm left to either go out of business or move somewhere else."

I chose a state that doesn't seem to be litigious. I jokingly said the other day that in Maine, if there's a problem, instead of suing you, they just run the snow plow past your driveway so you can't get out in the morning. But there doesn't seem to be as litigious an environment in that state. Perhaps that's why the rates are still affordable.

But I'm greatly concerned. There was just an article in yesterday's Bangor Daily, an editorial that was written by the chairman of NEH, New England Health Care Systems, that has a 10-day hospital in Camden, citing this concern, the increase in insurance that the hospital is having to pay this year for the hospital there in Camden, and that he was concerned that the problems that were in New Jersey and Pennsylvania were going to start to move northward into our state, and that perhaps our senators should look at that now before we get to a crisis in Maine.

ENZI:
Thank you, and since my time has expired, I'll be giving you a written question and a couple of others of you, particularly Mr. Montemayor, on feelings among insurance commissioners for expanding beyond their borders to have bigger pools for the liability. So I'll send that to you in writing, though, since I have run out of time.