Congress hears insurance woes from ex-LV doctor

Benjamin Grove

Wednesday, Feb. 12, 2003 | 9:38 a.m.

WASHINGTON -- A former Las Vegas obstetrician who fled to Maine to escape skyrocketing malpractice insurance rates told Congress that a federal cap on malpractice lawsuits would help curb a nationwide crisis.

"Liability isn't about fault or bad practice anymore," Shelby Wilbourn told a Senate panel Tuesday. "It's about hitting the jackpot."

Doctors, lawyers and insurance companies nationwide are in the midst of a heated debate about who's to blame for spikes in insurance premiums. The rate hikes have caused doctors in Las Vegas and other cities to walk off the job. Others are retiring early or moving.

Twelve states including Nevada are now in "crisis" over the issue, and 30 others are near-crisis, Sen. Bill Frist, R-Tenn., a surgeon, said Tuesday, citing American Medical Association statistics.

As Congress opened debate on how to fix the problem, a partisan rift has already developed, with Republicans generally blaming lawyers and Democrats generally blaming insurance companies.

Republicans, backed by President Bush, say lawyers are filing more malpractice suits and they advocate capping non-economic damages in lawsuits at $250,000.

Democrats generally defend trial lawyers and victims scarred by malpractice. In many cases patients have suffered life-altering -- sometimes life-ending -- damage at the hands of careless doctors and deserve more than $250,000, Democrats say. Democrats say insurance companies have driven up rates because their stock market investments tanked in recent years.

Sen. Harry Reid, D-Nev., is co-sponsor of a bill introduced by Sen. Patrick Leahy, D-Vt., that would close a loophole exempting insurance companies from anti-trust laws that allow them to fix higher premiums, Reid said.

"They shouldn't be allowed to fix prices," Reid said. "That's what they did."

But a spokesman for insurance companies said companies don't fix prices.

Lawrence Smarr, president of the Physician Insurers Association of America, stressed that more lawsuits and bigger jury awards were driving insurance rate increases, not relatively minor company losses in market investments.

Sen. Orrin Hatch, R-Utah, agreed and said "there are no data to suggest that collusion is the cause of rising malpractice insurance rates," Hatch said.

Sen. Ted Kennedy, D-Mass., tried to press Smarr into acknowledging insurance companies had lost money in the stock market and were trying to recoup losses from doctors.

"The reasons for skyrocketing premiums cannot be found in the courtroom," Kennedy said. Kennedy added that it was "absurd" to offer $250,000 to someone left in a wheelchair by doctor error.

Wilbourn said that last year he left Las Vegas with a heavy heart for Belfast, Maine, population 6,400. He abandoned 8,000 active patients, a teary-eyed few of whom begged him to stay, he said. He left his practice to the University of Nevada medical school because no doctors wanted it.

Wilbourn left after he learned his insurance rates in Nevada would jump from $33,000 a year to $108,000, he said. What's more, he would have had to reduce his deliveries from 300 to 125 a year.

After 12 years in Las Vegas, he had only one lawsuit filed against him, and that was after he joined a task force studying the issue, he said. Wilbourn said lawsuits were filed against all but one of the doctors on Gov. Kenny Guinn's task force, implying that it was revenge by lawyers who opposed an award cap.

Wilbourn said he is happy in Maine, where he said people are less litigious. But he lamented that obstetrician-gynecologists in Clark County had dwindled to 106, left to deliver an estimated 23,000 babies in 2003 -- 216 per doctor.

"This is the real issue," Wilbourn said. "Patients around the country are losing access to good doctors and quality health care. The end game of the current system is a society without enough doctors to care for its citizens."

The Senate panel heard its most emotional testimony from three women caught in the malpractice crisis. Laurie Peel of Raleigh, N.C., said her beloved obstetrician was driven out of business by high insurance rates. Leanne Dyess said her husband was denied immediate specialist care at a Gulfport, Miss., hospital after an auto accident because specialists had abandoned their practices due to insurance rates.

And Linda McDougal of Wisconsin said doctors removed her breasts eight month ago after they mistakenly diagnosed breast cancer.

"The pathologist switched my biopsy slides and paperwork with someone else's," McDougal said.