SB 67-CLAIMS AGAINST HEALTH CARE PROVIDERS  9:06:02 AM CHAIR SEEKINS announced SB 67 to be up for consideration. MR. WARD MURDES, attorney, divided his testimony into three concepts: responsibility, trust, and value. Whenever a bill lowers a person's responsibility it invites the same social aspects. No one can prove the insurance companies will lower premiums in response to the bill. SB 67 would punish people who are severely harmed. 9:10:35 AM The state should trust the juries and the judges to apply the law. The insurance company attorneys consistently demand a jury trial because juries are notoriously cheap. The $250,000 cap would negatively affect the most horribly injured. There is currently no indication that the insurance companies would decrease their rates as a result of SB 67. Doctors should be held accountable for every dollar of damage they cause. He opposed SB 67 in total. 9:13:38 AM SENATOR THERRIAULT asked Mr. Murdes to talk about the current system, which has a $400,000 cap, and the workability of getting around the cap. MR. MURDES said in 17 years of medical malpractice work he has never had a verdict for personal injury non-economic damages exceeding $250,000. Alaskan jurors overall simply don't award big money. Getting around the cap is a non-issue. SENATOR THERRIAULT said the next case might receive the big money judgment. MR. MURDES asserted that Alaskan jurors are not inclined to award damages against doctors. He urged the committee to do some research into the perceived crisis and he volunteered his time to do an analysis for the committee. 9:17:27 AM SENATOR THERRIAULT asked Mr. Murdes his suggestion on allowing an upper limit. MR. MURDES said the jury addresses the compensatory damage limit. Gross negligence is not defined very well in Alaska law. Sometimes doctors don't do what they are paid to do and they should be held accountable. 9:19:20 AM MS. MARGARET LUEY testified in opposition to SB 67. Her husband experienced permanent damage due to medical negligence. At the time he was 49 and in excellent health. He was intellectually gifted and a valued employee of British Petroleum as a computer scientist and lead auditor. He enjoyed fishing, canoeing, camping, hiking, gardening, and woodwork. Now there is not a day that passes that Richard does not struggle. It is a labor for him to communicate and express ideas. He is now stared at and treated as mentally defective. Non-economic losses and pain and suffering are terms that are cavalierly tossed around. Richard suffers from a loss of self-esteem and a loss of his education due to a brain injury. 9:23:24 AM When his injury occurred they had just purchased a dream home and a new car. In an instant that all vanished. Today they face a mountain of debt. The legal battle for accountability was a steep uphill fight for five years and they never did get a day in court. Every attorney stopped helping them due to the extraordinarily high cost of expert medical testimony estimated to be $150,000. Doctors are reluctant to testify against each other and juries tend to presume all doctors are truthful. 9:25:51 AM This belief requires a higher level of evidence to prove a doctor has been careless. She urged the committee to quash the bill. 9:27:41 AM MR. RICHARD LUEY testified against SB 67. 9:28:53 AM MR. BRIAN SLOCUM, administrator, Tanana Valley Clinic, testified in support of SB 67. He said the bill would bring badly needed physicians into Alaska. There is a growing shortage of doctors in Alaska's interior. A 2003 American Medical Association review found that between 1965-2002 non-federal physicians increased at a rate of 213% while the US population only grew about 51%. 9:30:50 AM The data suggests the problem of physician shortages is a localized problem. A recent editorial in Modern Healthcare predicts a shortage of up to 200,000 doctors by 2020. 9:32:40 AM This shortage computes that approximately 465 patients will not be seen daily by the year 2008. 9:36:01 AM Medical malpractice insurance costs new doctors $250,000 in Alaska, which causes them to decide to practice elsewhere. Passing SB 67 will curb a healthcare collapse. 9:37:03 AM SENATOR FRENCH asked Mr. Slocum what role the Division of Insurance played in approving the recent medical malpractice premium increase. MR. SLOCUM said he didn't know. SENATOR FRENCH asked for a link between medical malpractice caps and doctor availability. 9:38:46 AM MR. SLOCUM said he did not have specific information on that. SENATOR GUESS asked Mr. Slocum to comment whether the clinic has had an arbitration case go to a review panel. MR. SLOCUM said they did have a case that was settled before trial. Typically attorneys make the decision regarding arbitration and review panels. 9:41:08 AM SENATOR GUESS asked whether he had any information to show that the two existing insurance companies wouldn't leave if a cap is put in place. MR. SLOCUM had no proof of that. 9:43:10 AM MR. JIM JORDAN, executive director, Alaska State Medical Association, testified in support of SB 67. The six states that have fewer doctors per capita than Alaska are Idaho, Oklahoma, Mississippi, Nevada, Wyoming and Iowa. One reason why the Medical Indemnity Corporation of Alaska (MICA) disappeared is it was an effective victim of it's own success. It produced positive gains and the Internal Revenue Service taxed it federally. There was concern that same theory would be applied to other state organizations i.e. the Permanent Fund. 9:50:21 AM Mr. Jordan disagreed with concern expressed that if the cap were established at $250,000 it would impact the ability of people to go to court. Two of the three insurance companies who left Alaska do business in Idaho with a premium rate of 48 percent lower. 9:54:59 AM An OBGYN working in Nome could no longer afford the premiums and had to quit doing certain medical procedures. 9:55:54 AM SENATOR THERRIAULT asked Mr. Jordan to speak of punitive damages. MR. JORDAN said AS 09.17.020 explains that. SENATOR GUESS asked whether Mr. Jordan knew of case law on how future economics work for children. MR. JORDAN knew of no case law. The Alaska State Medical Association's attorney does medical malpractice awards and he indicated it is very unusual for the plaintiff and defense to differ on the value of future economic earnings, including children. 9:57:45 AM SENATOR GUESS asked Mr. Jordan whether the Legislature should attempt to increase the Washington, Alaska, Montana, Idaho (WAMI) program in order to address the shortage of physicians. 9:59:24 AM MR. JORDAN agreed expansion of the WAMI program would help. 10:00:54 AM SENATOR FRENCH advised Mr. Jordan much of the information the Legislature has received on SB 67 does not confirm that rates would change as a result of passage of the bill. He asked for a response. MR. JORDAN said all other things remaining equal rates would decrease. However, other impacts will cause the rates to rise. CHAIR SEEKINS closed public testimony. He held the bill in committee.