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Unprecedented Changes Afoot for Ohio Health Care

Monday, January 5, 2004 at 11:19 AM

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Governor Bob Taft could soon sign a bill that would create unprecedented changes in medical malpractice for doctors who volunteer to treat poor and uninsured patients in Ohio. Some applaud its innovation, while others criticize it for what they consider to be unfair. ideastream's Tasha Cook reports.

In a small medical office tucked away inside MetroHealth Clement Center for Family Care, Doctor Ken Frisof examines Ira, who’s worried that he may be sick.

Ken Frisof: All right, deep breath.

Doctor Frisof is a family physician who treats low-income patients at this clinic on East 79th Street in a poor and under served area of Cleveland.

He is also National Director of the Universal Health Care Action Network. His advocacy group has serious concerns about Senate Bill 86, legislation that would give doctors who volunteer to serve poor and uninsured patients greater protections from medical malpractice lawsuits. Doctor Frisof sees the bill as an affront to his advocacy work.

Ken Frisof: It offends me deeply because it legitimates a two-class system of care, which institutions like ours are trying to break out of. It tells somebody you are not like the other patients, coming into the office. You are different. I don’t really trust you so therefore before I see you, I’m going to make you sign this piece of paper saying you can’t sue me, say, I mess up.

Under Senate Bill 86, health care workers will be protected from medical malpractice lawsuits when they treat the poor in any setting.

Senator Steve Stivers, a Columbus Republican, introduced the bill as a way to expand health care for the more than one million uninsured Ohioans. The alternative, he says, would be to spend billions of tax dollars on health care for all.

Steve Stivers: Legal rights are of no consequence if you don’t have access to healthcare. Suing for healthcare you didn’t get, you can’t sue for healthcare you didn’t get. So, if you go ask someone that doesn’t have healthcare, which would you rather have: The ability to sue somebody or good healthcare, you will universally get the answer: good healthcare.

But good healthcare, experts argue, may not be what the poor and uninsured receive. According to a 1993 study published in the Journal of the American Medical Association and another study in 2000 by the Harvard School of Public Health, poor and uninsured patients are more likely to suffer from negligent care and less likely to sue for malpractice.

Doctor Helen Burstin was among the lead researchers of both studies.

Helen Burstin: They were more likely to actually suffer medical care that didn’t meet the community standard. So, you know, one argument was it was actually because of their status of-their, you know, inability to access legal care - legal representation - that actually inhibits their likelihood to sue even when actually having a significant negligent injury.

But these findings don’t sway Doctor James Tasse, who leads Cleveland’s Physician Advocacy Group, which was formed in response to skyrocketing malpractice insurance costs.

James Tasse: Until we can take away the burden and the anxiety on the part of the doctors, I mean I think you can bring up all the studies that you want, they’re not going to believe it.

The ethics behind the bill alarm Wendy Johnson, the Medical Director of the Cleveland Department of Public Health.

Wendy Johnson: I just think the premise of the legislation is questionable - to take away the rights of a certain group of the population. I just really don’t think it’s warranted in this situation.

The bill doesn’t grant blanket immunity for doctors. It makes them legally responsible, if a patient can prove the doctor committed willful and wanton misconduct.

Richard Mason is director of the Ohio Academy of Trial Lawyers. He calls the bill unconstitutional. Mason also says doctors haven’t provided enough evidence to support the bill.

Richard Mason: They can’t say we tried to treat these poor people and we just find that they’re suing too much, juries are giving away too much money so this has to be fixed. They haven’t done that so they’re just perceiving that there might be a problem and they want to solve it in advance, and to us, that just sort of indicates that the medical profession just is misguided in the ways that they’re seeking to solve their real problem of increasing medical malpractice insurance.

But Tim Maglione, spokesman for the Ohio State Medical Association, says the bill has nothing to do with medical malpractice insurance.

Tim Maglione: It promotes professional volunteerism and it also promotes access to healthcare to individuals that might not otherwise be able to get it. And the wonderful thing about free care is that it is better than no care at all.

Senate Bill 86 is a moral quandary. That’s what Doctor Burstin concludes.

Helen Burstin: On the one hand you would make the argument that because we so desperately need more providers who are willing to serve the poor, if granting them immunity from malpractice lawsuits helps them move in that direction, well, that’s a positive. But at the same time, if we also know that these patients are more likely to suffer injury, then taking away their ability to sue when they have a significant injury is also difficult.

A spokesman for Governor Taft says the governor supports Senate Bill 86. Governor Taft is expected to sign the bill this week. In Cleveland, Tasha Cook, 90.3.

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