STEVEN B. LARCHUK is co-chairman of the Health Education & Legislative Progress Fund of Pennsylvania.

Harrisburg Patriot News, Sunday, May 06, 2007

BY STEVEN B. LARCHUK

Is the medical community asleep at the switch, or what?

Pending in the General Assembly is legislation that would provide universal coverage and an efficient single-payer trust, reduce medical malpractice insurance premiums to zero, assure payment for 100 percent of health care services, dramatically reduce the cost of billing and collection and further reduce the cost of health insurance for every business, including the health care industry.

This is the same bill that would end medical malpractice litigation as we know it. In its place would be a no-fault administrative system that would guarantee swift and fair compensation to those injured by care providers.

At the same time, this approach would remove the specter of financial ruin that haunts Pennsylvania doctors while still providing a responsible quality assurance program to prevent avoidable infections and errors.

No, this is not Gov. Ed Rendell’s plan — far from it. Rather, these dream-come-true reforms are part of the bundle of uncommonly sensible innovations found within the Family & Business Health Care Security Act.

This is Pennsylvania Senate Bill 300, soon to be introduced in the Pennsylvania House. In the last session, this same proposal was co-sponsored by 10 percent of the General Assembly.

Of course, with all of the amazing things the Family & Business Health Care Security Act would do for doctors, you would think the medical societies across the state and especially their paid lobbyists would pull out all the stops to support the bill.

But, this being Harrisburg, you would be wrong. Fact is, Pennsylvania Medical Society lobbyists refused to participate in the drafting of the proposal and have repeatedly snubbed the drafters and sponsors of the bill.

Never mind that in October 2005 the proposal was endorsed by the city councils of Philadelphia, Pittsburgh and Erie as well as groups from all over the state. The society lobbyists even refused to comment on the proposal until pressed by the media. Their comment then: They had not had time to read it. More than a year later, it seems they still have not found the time.

How is this possible? With doctors complaining about the cost of malpractice insurance, why would their leadership ignore proposed legislation that would reduce those costs to zero? How much better than zero do they want? Is this not exactly what doctors have been asking for, and more?

Perhaps physicians actually prefer the current system of reimbursement, in which sizable percentages of their office overhead are devoted to billing and collection from scores of health insurers. Maybe they are just pulling our leg when they complain of having to spend far too much time battling with insurance company clerks who think they are better equipped to decide what a patient does or does not need.

Could we all have been hallucinating when we heard many doctors admit that the fear of being sued leads to “defensive medicine” — the practice of ordering expensive tests and procedures that are not indicated by the symptoms but are nevertheless done to help insulate the doctor from a potential negligence claim? If defensive medicine actually is a problem, why would physician lobbyists ignore proposed legislation that would protect doctors from the fear of financial ruin and thus eliminate the cause for such a wasteful and dangerous practice?

Unreimbursed care is another serious and growing problem for doctors and hospitals. Yet the organizations they pay to represent their interests have refused to embrace the very legislation that would completely eliminate this problem. Why?

In an era of declining reimbursements, hospitals and physician practices are having trouble providing health insurance for their own employees. Media reports of nurses going on strike to preserve their own health insurance are as routine as they are ironic.

As employers of hundreds of thousands of Pennsylvanians, medical providers stand to gain from the Family & Business Health Security Act’s universality and single-payer efficiency. Passage of this legislation would drop the costs of health care benefits for the health care industry, and every other business, to just 10 percent of payroll. As one businessman recently said of the plan, “Where do I sign?”

But the medical society will not sign. Nor will it offer a better idea or even welcome speakers at their functions who dare to suggest there are better ideas available. Physicians, you are being ill served by such narrow-minded representation. It is time for a change.

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