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HEALTH INSURANCE NEWS & COMMENT: With the debate over health care reform heating up across the country, one sobering fact ought to give everyone pause; you can't have universal health care if you don't have enough doctors. Many press reports have focused on the shortage of physicians across the country, and the problem in southern Maryland is particularly acute, with doctor shortages in practically every medical discipline. Those shortages are projected to be severe by 2015 and the impact on health care in our region will be significant.

Senator Roy Dyson, the vice chairman for the Senate Committee on Education, Health & Environment Affairs, touched on this issue recently and attributed it to the burdens of student loans and low reimbursement rates from health insurance providers, including Medicare and Medicaid. While he expounded at some length on these cost factors, he neglected to mention one issue that's been a sticking point and a significant cost burden for doctors for decades - medical malpractice liability.

I'm not surprised Senator Dyson failed to bring up an issue that pits doctors against lawyers in pitched battle - it's never pretty. Lawyers believe tort reform, the solution doctors call for to deal with the medical malpractice problem, takes away the people's right to hold doctors financially accountable for their mistakes.

Doctors believe most medical malpractice suits are frivolous and the awards unjustifiably inflated, and they are forced to spend time and money on multiple tests and procedures -"defensive medicine" - to avoid possible lawsuits.

The fact is you cannot have a serious discussion about what is pricing doctors out of the market in southern Maryland without mentioning medical malpractice liability and tort reform - unless, like too many of our elected officials, you're a lawyer and really don't want to call attention to the issue because you have a personal stake in the status quo.

On average, one of every five dollars a doctor makes goes toward malpractice insurance premiums, and when you add to that the need to repay student loans, the shrinking health insurance reimbursement rates, and the expense of living in southern Maryland, particularly when it comes to housing, it's no wonder we're ground zero for a critical doctor shortage in our state.

The answer to the problem is to make the medical liability process less attractive to trial lawyers and individuals looking to become rich at a doctor's expense. Legitimate claims of medical malpractice could be addressed by risk management programs where the hospital investigates claims of malpractice and, if cause is found, offers an apology and a settlement in lieu of a court battle. Comment here

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