Legislature(2005 - 2006)HOUSE FINANCE 519
04/27/2005 08:30 AM House FINANCE
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| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| = | SB 67 | ||
HOUSE FINANCE COMMITTEE
April 27, 2005
8:46 A.M.
CALL TO ORDER
Co-Chair Meyer called the House Finance Committee meeting to
order at 8:46:21 AM.
MEMBERS PRESENT
Representative Mike Chenault, Co-Chair
Representative Kevin Meyer, Co-Chair
Representative Eric Croft
Representative Richard Foster
Representative Mike Hawker
Representative Jim Holm
Representative Reggie Joule
Representative Mike Kelly
Representative Carl Moses
Representative Bruce Weyhrauch
MEMBERS ABSENT
Representative Bill Stoltze, Vice-Chair
ALSO PRESENT
Rod Betit, President, Alaska State Hospital and Nursing Home
Association, Anchorage; Pat Luby, Advocacy Director, Alaska
Association of Retired Persons (AARP)
PRESENT VIA TELECONFERENCE
Ken Brewer, Fairbanks; John Bringhurst, Petersburg Medical
Center, Petersburg; Kathy Dale, Anchorage; Ray Brown,
Attorney, AATL, Anchorage; Roland Gower, Surgeon, Alaska
Physician & Surgeons, Alaska Regional Hospital, Anchorage;
Robert Sparks, Fairbanks; Tom O'Brien, Fairbanks; Valerie
Nelson, Former Mayor/Assembly Member, Sitka; Terrie
Gottstein, Anchorage
SUMMARY
CS SB 67(JUD)(efd fld)
An Act relating to claims for personal injury or
wrongful death against health care providers.
SB 67 was HEARD and HELD in Committee for further
consideration.
8:48:06 AM
SB67
CS FOR SENATE BILL NO. 67(JUD)(efd fld)
An Act relating to claims for personal injury or
wrongful death against health care providers.
KENNETH BREWER, (TESTIFIED VIA TELECONFERENCE), FAIRBANKS,
agreed that Alaska needs more good doctors and recommended
better insurance rates for doctors and all Alaskans. He
believed that the legislation was an "over-reaction".
Alaska does not have the population base to support too many
insurance companies. He urged that the $250 thousand dollar
insurance cap not be implemented. He mentioned his personal
experience with a mis-diagnosis dealing with a Fairbanks
doctor when his wife had lung cancer. He questioned why
unqualified physicians are allowed to accept emergency
patients. Placing a cap would not be the correct option
and that it should not be allowed.
8:57:46 AM
DR. ROLAND GOWER, (TESTIFIED VIA TELECONFERENCE), SURGEON,
ALASKA PHYSICIAN & SURGEONS, ALASKA REGIONAL HOSPITAL,
ANCHORAGE, addressed concerns regarding insurance premiums
existing throughout Alaska. He acknowledged that Alaska is
in a crisis mode and mentioned that physician's insurance
premiums have doubled over the past three years. Normally,
those costs are passed on to the patients, which drives up
the costs of medical insurance.
Dr. Gower pointed out statewide concern regarding
availability of medical care in Alaska and will become more
of an issue if the malpractice component is not addressed.
9:01:06 AM
Dr. Gower disagreed with legislative research indicating
there is not a statewide shortage of doctors. At present,
doctors going on vacation must hire someone to come from out
of state during that time. He added concern that over half
of the State's practicing physicians are now over 50 years
old and with the difficulty of insurance and premiums, some
of those physicians will consider retirement. Limiting
risks include "going bare" and could mean no longer treating
breast cancer. He said he personally treats over 100 breast
cancer cases a year and that some risks will no longer be
tolerated.
Dr. Gower stressed that consideration of the legislation is
a crisis choice.
9:06:24 AM
JOHN BRINGHURST, (TESTIFIED VIA TELECONFERENCE),
ADMINISTRATOR, PETERSBURG MEDICAL CENTER, PETERSBURG,
commented on his history in the medical care reform system
movement. He highlighted concerns occurring in Alaska:
· Shortage of physicians
· Loss of services
· Unavailability of coverage
Mr. Bringhurst pointed out that the need for torte reform
has reached a crisis phase across the nation. He urged the
Legislature to consider those needs.
9:09:32 AM
KATHY DALE, (TESTIFIED VIA TELECONFERENCE), SELF, ANCHORAGE,
noted that she and her family were victims of malpractice.
She pointed out it is difficult to bring a case against a
medical professional. The bill limits the victim's ability
to sue medical professionals when they are negligent. She
noted economic damages resulting for those families. In
Alaska, there are already existing caps. She stated that if
the proposed cap of $250 thousand dollars is adopted,
citizens of Alaska would be robbed of "their day in court".
The $250 thousand dollar cap is not satisfactory. She urged
that the bill not be moved forward.
Ms. Dale pointed out that the increased costs in medical
premiums over the past few years, has resulted from the
stock market crash. The market is recovering but the
premiums have not yet been reduced. She said insurance
companies were pocketing the extra money. California and
Texas both have the $250 thousand dollar cap. California's
cap was established in 1976 and the overall medical mal-
practice premiums there have decreased drastically following
the adoption of that cap; however, rates were not regulated
until 1988 through the adoption of Proposition #103. An
insurance crisis resulted from the move happening in
California in 1976. A similar situation resulted in Texas.
Ms. Dale pointed out that only patients with large wage
losses or huge medical bills are typically able to find
attorneys in California. She urged that the House Finance
Committee not to pass the bill out of Committee.
9:15:19 AM
RAY BROWN, (TESTIFIED VIA TELECONFERENCE), ATTORNEY,
ANCHORAGE, noted that he is one of the few attorneys that
actually litigates these type of cases. He pointed out that
his firm screens approximately 200 allegations of medical
malpractice a year. Of those cases, the firm takes between
5-7 cases following a rigorous and exhausting screening
routine. These claims are not filed furiously; it is very
expensive to get a case to trial.
Mr. Brown questioned why the premiums are so high if medical
malpractice cases are not occurring. He stressed the need
for insurance revision. He maintained the legislation does
nothing to solve medical malpractice issues. Mr. Brown
asked why California rates are not lower than Alaska's. He
maintained the legislation will negatively affect everyone
and that it eliminates children from bringing forward
claims. SB 67 would immunized grossly negligent doctors.
Mr. Brown pointed out that a 70% disability would have no
effect bringing claims onto the individual physicians. It
would increase the litigation costs in all cases. It would
also provide additional defense against women, rendered
sexually dysfunctional after malpractice suits. It would
not protect children disfigured from burns and facial scars.
Mr. Brown urged reconsideration of the bill. The bill is a
public policy issue affecting the most vulnerable of our
society.
9:23:21 AM
ROBERT SPARKS, (TESTIFIED VIA TELECONFERENCE), FAIRBANKS,
summarized that there is a malpractice crisis statewide, not
a lawsuit practice. He commented on injured victims of
malpractice. He worried that the important objective
evidence was not being considered. Hospitals and doctors
need to have systems in place to work to reduce medical
errors. In the current system, people injured are able to
recover damages from the person that injured them. He
warned about not being able to hold doctors accountable.
Mr. Sparks pointed out that some of the worst malpractice
occurrences are witnessed within the Veterans Administration
(VA) system.
Mr. Sparks stressed that statistics have been over-blown and
that the facts provided by the medical industry are
questionable. He addressed insurance premiums and the torte
reform system, summarizing that the legislation would make
Alaskans vulnerable to insurance companies.
9:28:24 AM
TOM O'BRIEN, (TESTIFIED VIA TELECONFERENCE), FAIRBANKS,
spoke in opposition to the legislation. He shared a
personal perspective of concerns having been a victim of
malpractice, himself. As a victim, many people must live a
more alternative lifestyle. It will be only those in the
higher income brackets that will be able to receive
representation in the future, if the bill passes. He
mentioned the need to be able to demonstrate high earnings.
If a victim were hit with medical negligence, they might not
be able to demonstrate economic stability. He emphasized
that it is very difficult to gain representation by a
qualified malpractice attorney. Those attorney's must be
thorough. With passage of the legislation, the victim would
not have any opportunity to have "their day in court".
He believed that the current system is "good and the caps
are adequate". He urged that members question the rights of
the victim. Mr. O'Brien maintained that the legislation
will create a huge burden for all victims.
9:32:19 AM
VALERIE NELSON, (TESTIFIED VIA TELECONFERENCE), ASSEMBLY
MEMBER, FORMER MAYOR, SITKA, outlined her concerns with
passage of SB 67. She explained that she is a breast cancer
survivor, interjecting that damages due to negligence are
humiliating for the patient. She pointed out that not only
doctors are faced with increased insurance costs and that
the charges are being raised for everyone in every
profession.
9:35:03 AM
TERRIE GOTTSTEIN, (TESTIFIED VIA TELECONFERENCE), ANCHORAGE,
urged that members vote against SB 67. She was disturbed
that the insurance companies are the guilty parties.
Malpractice insurance rates should be more focused on the
insurance industry. She mentioned doctors with good risk
records. To reduce medical malpractice insurance rates, the
Legislature should mandate that the medical malpractice
insurers "experience-rate" all doctors. She believed that
action could provide incentives for careful care.
Ms. Gottstein elaborated that she opposed the bill, as it
would limit an injured person from having their day in
court. She recommended that cases of negligence be
exempted. The standard of negligence should be high and
should be punished.
9:38:43 AM
PAT LUBY, ADVOCACY DIRECTOR, ALASKA ASSOCIATION OF RETIRED
PERSONS (AARP), JUNEAU, acknowledged that mistakes happen.
He stated that the issue of medical malpractice is often
perceived as a battle between trial lawyers and insurance
companies and physicians. AARP thinks that it is also
important to consider the victim of malpractice as well as
the ultimate goal of medical error reduction. AARP believes
that State Legislature should not place limits on the amount
of damages or on joint and severe liability, or unreasonable
limits on damage awards for pain and suffering. A cap of
$250 thousand dollars is unreasonable.
Reducing medical errors is in the best interest of all
Alaskans and is the real intent of SB 67. AARP encourages
the House Finance Committee to amend the bill to reflect the
recommendations of the Institute of Medicine for fair
compensation and error reduction.
9:41:28 AM
ROD BETIT, PRESIDENT, ALASKA STATE HOSPITAL AND NURSING HOME
ASSOCIATION, ANCHORAGE, provided an overview of his handout:
"Testimony by the Alaska Medical Injury Compensation Reform
Act of 2005". (Copy on File).
Mr. Betit addressed concerns for an adequate number of
doctors within the State. He stated that ASHNHA's members
strongly support SB 67. Passage of the bill is important to
protecting Alaskan's access to needed physician care. The
bill changes only one aspect of the medical liability laws,
the area dealing with non-economic damages. Alaska has a
per capita shortage of physicians right now and the
situation is expected to get worse. The situation is even
more serious in rural areas of the State.
Mr. Betit continued, the population forecast for Alaska
versus expected growth in physicians adds even more concern
to the picture. He observed population growth facts:
· The total population of Alaska is projected to grow
28% by 2020, which is in addition to 62% growth
between 1980 and 2000.
· The population over 65 is projected to grow 109% by
2020. That is in addition to a 229% growth in that
age group between 1980 and 2000.
th
· In 1998, Alaska ranked 47 in the number of hospital
th
beds per 100,000 population and 49 in the number of
nursing home beds for people 65 and older. Yet
Alaska will be experiencing the greatest growth rate
in the age group that most requires services in the
complex environments dependent on a wide range of
physician specialists.
9:48:13 AM
Mr. Betit referenced Page 3 - Other Aspects to the Physician
Shortage:
· Limiting Practice; and
· Use of "locum tenens".
Mr. Betit concluded, Alaska is already experiencing serious
trouble retaining and attracting physicians, and the
situation will get worse without intervention by the
Legislature to help stabilize the medical liability market.
Growth in Alaska's population, particularly the elderly,
will far outstrip growth in the number of physicians
available to meet that need.
9:49:58 AM
Representative Holm asked if providing proper medical care
in Alaska resulted from a lack of qualified physicians and
how SB 67 would attract those physicians. Mr. Betit did not
know. He pointed out that Alaska does not have a lot going
on to attract doctors. There are no medical schools and
only has a small residency program. Prospective doctors do
make malpractice considerations.
Mr. Betit pointed out that Alaska has made an effort to
increase graduating nurses. He believed that the nurse
situation will be improving.
9:53:13 AM
Representative Holm maintained that there should be a more
definitive answer regarding how many more doctors would be
drawn to Alaska with passage of the bill. He thought that
it would minimize the option for injured people to get
adequate compensation. Mr. Betit disagreed, suggesting that
the bill would attract more doctors to the State.
9:54:08 AM
Representative Croft asked if insurance would increase for
doctors based on the claim-expense. Mr. Betit did not know
the insurance rating system. Representative Croft requested
more information on that.
Representative Croft asked how the figure of $250 thousand
dollars had been determined, to make Alaska competitive.
Mr. Betit explained that the attempt was to determine a
balance and that $250 thousand dollars is the amount used by
some other states.
Representative Croft asked if it should be indexed for
inflation or if it would also be the correct number in 20-
years. Mr. Betit responded that it should not be indexed;
however, could be something the Legislature considers as
needed.
9:56:07 AM
Representative Croft requested more follow-up information.
9:56:58 AM
Co-Chair Meyer noted that the bill would come back before
the Committee at the afternoon meeting. He requested that
Senator Seekins, Sponsor, be present.
9:57:30 AM
Representative Kelly requested that his amendment be brought
forward during the afternoon session with Senator Seekins
present.
CS SB 67(JUD)(efd fld) was HELD in Committee for further
consideration.
ADJOURNMENT
The meeting was adjourned at 9:58 A.M.
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