A Specter On Malpractice Caps

During his long career, Sen. Arlen Specter (R-Pa.) has often been at the center of controversy. His support for Justice Clarence Thomas's appointment to the U.S. Supreme Court, and his opposition to the impeachment of President Bill Clinton, has earned Specter both the respect and animus of colleagues and constituents.
But a bitter reaction to his endorsement for re-election in the April 27th primary by the 20,000-member Pennsylvania Medical Society's Political Action Committee (PAC) may be something new even for Specter. It highlights the sensitivity of physicians in most regions of the country on the topic of medical malpractice.

The president of another medical group -- the Pennsylvania Orthopaedic Society -- told local media that the vote to endorse Specter in late January 2004 was "nauseating." Specter's opposition to a federal law that would cap noneconomic damages in medical malpractice cases upsets them.

Pennsylvania is one of the most challenging places for physicians to practice, with malpractice insurance rates even higher than most. Premiums are pushing physicians away from their patients: 25 percent of Pennsylvania OB/GYNs plan to drop obstetrics and 16 percent of physicians will move out of state or reduce their surgical services. Malpractice insurers are leaving the state. Hospitals are reducing patient services.

There's little likelihood the Pennsylvania state legislature will provide relief for physicians. Federal action may be the only hope.

Last year, the House passed a bill establishing $250,000 caps in noneconomic damages. But when the measure went to the Senate, supporters failed to win the required 60 votes to avoid a filibuster and earn the bill a vote on the merits. Specter -- walking a tightrope -- voted to break the filibuster, but indicated he would have voted against the measure. Specter says he would support caps in medical malpractice cases so long as they did not apply to "egregious cases." 

In endorsing Specter, the Medical Society rebuffed his GOP primary challenger, Rep. Pat Toomey, a proponent of caps. Toomey earned his GOP stripes in Congress as aggressively pro-business and a bulldog budget-cutter. Unfortunately, among the budgets he wanted to cut were physician Medicare reimbursements. 

When the Medical Society compared the Specter and Toomey records, they preferred Specter. According to the Medical Society, Specter has consistently voted to increase physician reimbursements; Toomey was the only GOP Pennsylvanian to oppose them.

Polls show Specter likely winning the general election. The Medical Society did not want to be responsible for the GOP losing its slim 51-49 Senate lead. Optimistic cap proponents believe Republicans can gain a tighter grip on the Senate, thus paving the way for victory on caps. 

In the end, losing Specter was not worth the risk on bigger stakes.

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This article originally appeared in the April 2004 issue of Physicians Practice.