Cheney's Medical Malpractice Deception and Distortions

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Wed, 6 Oct 2004 17:05:49 -0400

" Congress Watchdog " <CONGRESSWATCHDOG

 

[CWATCHDOGCIVJUS] Cheney's Medical Malpractice Deception and

Distortions

 

 

 

NEWS RELEASE

For Immediate Release: Oct. 6, 2004

 

 

Cheney's Claims in V.P. Debate and New Bush-Cheney Medical Malpractice

Ad Continue Campaign of Deception and Distortion

 

Government Data and Studies Show Bush-Cheney Claims About Insurance

Rates and Access to Doctors Have No Foundation

 

 

 

WASHINGTON, D.C. - Statements made by Vice President Dick Cheney in his

debate with Sen. John Edwards last night as well as the new Bush-Cheney

TV ad alleging that there's a " crisis in women's access to healthcare "

caused by Democrats blocking " legal reform to stop the frivolous

lawsuits " is an exercise in deception and distortion according to a

Public Citizen analysis of Cheney's statements and the ad.

" We recognize that some doctors in some states have suffered from large

premium increases over the past two years, " said Joan Claybrook,

president of Public Citizen. " But those rate hikes were caused by a

sour

economy that resulted in investment losses or lower than expected

earnings from stocks and bonds - the principal way insurance companies

make money. It had nothing to do with lawsuits and the legal system.

Limiting patients' legal rights, as President Bush and Vice President

Cheney seek to do, will have no affect on insurance rates and will

only harm the most severely injured victims of medical malpractice a

second time. "

Debate Fact Check

1) Cheney overstates Wyoming doctors' premiums by a factor of six.

Cheney stated: " [in Wyoming] rates for a general practitioner have

gone from $40,000 a year to $100,000 a year for an insurance policy. "

The Facts: In 2004, the insurance rate for the state's leading

underwriter (Doctors Company) for family general practice was $15,322

(no obstetrics, no surgery), according to a non-partisan report from

the Wyoming Legislative Service Office.

2) Cheney's disappearing doctor figure is contradicted by hard numbers

Cheney stated: " We've lost one out of 11 OB/GYN practitioners in the

country. "

The Facts: Cheney apparently relied on a survey commissioned by the

American College of Obstetricians and Gynecologists (ACOG) in which 9

percent of respondents said they had ceased practice. But every year

thousands of obstetricians stop delivering babies as they get older.

The ACOG survey did not attempt to determine whether malpractice rates

were a statistically significant factor affecting OB/GYNs' decisions.

In fact, the number of board-certified OB/GYNs in the United States

grew by 18.1 percent from 1999 to 2004, according to the American Board

of Medical Specialties. Meanwhile, the population of women of

child-bearing age (15 to 44) increased only 2.9 percent from 1999 to

2003, according to the U.S. Census Bureau.

There are other studies that undercut the validity of Cheney's

assertion:

* A University of California-San Francisco (UCSF) study of New York

doctors found that the main reason doctors cease providing obstetrics

care is advancing age. UCSF researchers studied the effect of liability

premiums on doctors' behavior, the only such study trying to show such

causation that we know of. The study, of New York state physicians

during the mid-1980s insurance crisis, found no association between

malpractice premiums and doctors' decisions to quit. The study did

find

that the decrease in doctors practicing obstetrics was associated with

the length of time since receiving a medical license in New York. This

relationship " very likely represents the phenomenon of physicians

retiring from practice or curtailing obstetrics as they age. "

* Obstetricians frequently cut back their practice as they advance in

years. As doctors become more financially secure, and as the

child-bearing years of their patient population pass, many

obstetricians

give up the demands of delivering babies in favor of concentrating on

the gynecological needs of their patients. For example, in 2000, 18.7

percent of Georgia's OB/GYNs were between 40 and 44 years old, but only

11.1 percent of OB/GYNs were 50-54 years old - a decrease of about 40

percent.

* A North Carolina survey found that the main reasons doctors

decreased their obstetrics patients were unrelated to fear of lawsuits.

The authors note that while some providers whose obstetrical patient

volume had decreased cited fear of lawsuits as a factor, " …[T]his was

not the overwhelming reason for stopping or planning to stop

deliveries.

The strain and inconvenience of the practice and problems with burnout

also were issues. "

3) Cheney's New Mexico anecdote is revealing: caps on damages don't

lower doctors' insurance premiums.

Cheney stated: " I was in New Mexico the other day and met with a group

of OB/GYN docs.

And they were deeply concerned because they were fearful that there'd

be another increase in malpractice insurance rates as a result of

what they believe are frivolous lawsuits and that that would put them

out of business. And one doctor indicated that her rates have gone up

so

much that she's now to the point where she is screening patients. She

won't take high-risk patients anymore because of the danger that that

will generate a lawsuit, and a lawsuit will put her out of business. "

The Facts: Cheney is correct that rates have risen in New Mexico, where

there already is a cap on non-economic damages. But this only proves

that his " solution " to a temporary spike in rates - a cap on

non-economic damages - does not lower doctors' premiums. According to

Medical Liability Monitor, rates for OB/GYNs went up in New Mexico by

52

percent in 2003, but that was more than in either of its neighboring

states, Arizona and Texas, which did not have caps in 2003. In fact,

the

New Mexico insurance company (Mutual Insurance Company of Arizona),

which increased its rates 52 percent in 2003, increased its rates 11 to

14 percent in Arizona that year.

Bush-Cheney '04 Ad Fact Check

1) There is a crisis in health care, especially access to OB/GYNs,

caused by frivolous lawsuits:

* There is no factual basis for this assertion. In fact, as the

figures above indicate, there has been a dramatic increase in the

number

of OB/GYNs in the United States since 1999 - prior to Bush

administration and AMA claims of a medical malpractice " crisis " - while

the number of women of child-bearing age has barely increased.

* This claim has been driven by anecdotes from doctors, especially

OB/GYNs, the American Medical Association and its state medical

associations. But analysis of their claims has not held up to close

scrutiny. In 2003, the U.S. Government Accountability Office (GAO)

performed a detailed examination of five of the AMA's " crisis " states

to

determine whether evidence supported the claim that rising malpractice

premiums affected consumers' access to health care. The GAO made

numerous findings showing the claims lacked a foundation. Two of them

relating to OB/GYNs were:

* Pennsylvania: " In Pennsylvania, despite reports of physician

departures, the number of physicians per capita in the state has

increased slightly during the past six years. The Pennsylvania Medical

Society reported that between 2002 and 2003, 24 OB/GYNs left the state

due to malpractice concerns; however, the state's population of women

age 18 to 40 fell by 18,000 during the same time period. "

* Nevada: " In Nevada, 34 OB/GYNs reported leaving, closing practices,

or retiring due to malpractice concerns; however, confirmatory surveys

conducted by the Nevada State Board of Medical Examiners found nearly

one-third of these reports were inaccurate. … Random calls [GAO] made

to

30 OB/GYN practices in Clark County found that 28 were accepting new

patients. … Similarly, of the 11 surgeons reported to have moved or

discontinued practicing, the board found four were still practicing. "

2) John Kerry and the liberals in Congress blocked medical malpractice

reform.

Public Citizen does not take positions on candidates running for

election. However, we have fought long and hard in Congress to

oppose Bush's initiatives to limit consumer access to our civil courts

and believe his ad mischaracterizes what has happened on medical

malpractice legislation in the U.S. Senate this Congress:

* The Senate voted on three malpractice bills. Senator Kerry did not

vote to " block " any of these bills. In each case, Majority Leader Frist

was required to get 60 votes for the bill to proceed to the floor. And

in each case, the Republicans were unable to muster even 50 votes from

their 51-seat majority to bring the bill up for debate.

* On the first controversial vote, held July 9, 2003, Frist mustered

only 49 votes. Republican Sens. Richard Shelby (Ala.) and Lindsay

Graham (S.C.) voted no. On the second vote, February 24, 2004, Frist

garnered only 48 votes; Republican Sen. Crapo (Idaho) joined Shelby

and Graham in voting no, and Republican Sen. Robert Bennett (R-Utah)

failed to vote yes. On the 3rd vote, April 7, 2004, Frist garnered 49

votes, with Crapo, Shelby and Graham again voting no.

* Had Senator Kerry voted " yes " in any of these roll calls, the bill

still would have failed to reach the floor. Moreover, had the bill

reached the floor, it would not have had sufficient Republican votes

topass.

In addition to the three Republican senators who voted no on

motions to proceed, other Republican senators, including Orrin Hatch

(Utah) and Jeff Sessions (Ala.) have publicly stated reservations about

the strict $250,000 cap contained in all three malpractice bills that

were considered, and Sen. Arlen Specter (R-Pa.) is also believed to

be opposed to the cap.

###

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based in Washington, D.C. For more information, please visit

www.citizen.org.

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