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NEWS AND NEWSLETTERS

PCS Planning to stop operations
Dr. Meier's decision to resign is firm
PMS Does Not Adopt Resolution Calling For Action
PA Mcare Fund Politics
Letter sent to all Pennsylvania State Legislators
Pennsylvania's unholy alliance
Gov. Rendell's Assertion
October 23, 2007, Update
Suggested Reading
Pennsylvania Legislature Urged to Implement Corrective Measures
HB 1093. An eighteenth century method of securing indentured servants?
Citizen Alert, February 26, 2007:
MEDICINE FOR THE COMMON GOOD
Open Letter to All Pennsylvania Physicians
The November 7, 2006, Election
July 31, 2006, letter to all PCS members and supporters
Letter of April 18, 2006
AN APPEAL TO ALL HONEST LAWYERS AND LEGISLATORS
News and Updates,January, 2006: A Twentieth Anniversary Summary
Letter to Governor Rendell
Public Hearing
July 26, 2005, HB 501 Hearing
PENNSYLVANIA HEALTH CARE PROVIDER AND CONSUMER ALERT
A MESSAGE TO ALL PENNSYLVANIANS
February 16, 2005 Newsletter     From the February, 2005, News and Updates
October 20, 2004 Newsletter
June 25, 2004 letter to Pennsylvania's legislators
LCMS Forum, Wilkes-Barre, April 14, 2004
Important Message!!     Letter to Pennsylvania's Legislators
SUBROGATION ISSUE RELATED BY DR. MEIS
From the PCS NEWS & UPDATES, November 2003, Vol.II, N.8
Letter to the Governor
July 14, 2003, Message to all PCS supporters
To All Concerned Pennsylvanians
February 10, 2003, letter to all Pennsylvania General Assembly members
Dr. Meier addresses Physician Regional Meeting
October 26, 2002, Newsletter   Crisis Short- and Long-term Solution
July 30, 2002, Update On Medical Malpractice Insurance Crisis
June 3, 2002, letter to the members of the Pennsylvania General Assembly
PCS President Testifies at Public Hearing
A Message To All Practitioners, May 1, 2002
March 18, 2002 Newsletter   March 13, 2002 Newsletter
March 11, 2002 letter to the members of the Pennsylvania General Assembly
February 27, 2002 letter to the members of the Pennsylvania General Assembly
February 15, 2002 letter to the members of the Pennsylvania General Assembly
February 5, 2002 Newsletter
January 2, 2002 letter to the House Majority Leader    December 22, 2001 Newsletter
Open letter to the members of the Pennsylvania General Assembly, January 21, 2002
SB 556, HB 1802 and 'Right-to-Know Law'    January 15, 2002 Dr. Castillenti's December 18, 2001 letter    November 30, 2001 Newsletter
November 11, 2001 Appeal to PA Senate Majority Leader, David J. Brightbill
Testimony at Public Hearing, Febr.9, 2001    Letter to Medical Staffs, Jan.5, 2001
Follow-up Letter to Legislators    November 13, 2000 Newsletter
Representative Fargo's Letter    PCS Sends Appeal    Shocking News
September 28, 2000 Newsletter    June 1, 2000 Newsletter
Unifying for Pro-active Action    March 8, 2000 Newsletter
Trial Lawyers True to Form    Dr. Speck's Note   Outlandish CAT Fund Surcharges
January 18, 2000 Newsletter    PCS Attorneys File Appeal   September 4, 1999 Newsletter


Dr. Meier's November 10, 2008 letter to PCS members and supporters:

Dear PCS Members and Supporters:

To follow up on my October 27 letter, the Board of the Physicians' Cincinnatus Society has concluded that the Society cease operations permanently by the end of this year. It is important now that all of you remain active and work within your respective organizations and specialties to preserve the medical profession with high standards. Remember the PCS motto, medicine with justice. Physicians must not allow themselves to be put into positions by politicians to inflict injustice on others, including their fellow physicians. This is particularly true for physicians serving on Pennsylvania's Board of Medicine. It may be necessary to resign in protest with honor and respect to avoid being used as a hatchet person inflicting injustice to promote a political agenda.

May I use this opportunity to thank you for all the support you have given me and the Physicians' Cincinnatus Society over the years. Thank you.

Sincerely,

Louis A. Meier, MD, FACS.


Note: This website will be maintained for an indefinite period of time.



In his latest letter to the members and supporters of the Physicians' Cincinnatus Society Dr. Meier confirms that his decision to resign is firm.

October 27, 2008

Dear Members and Supporters of the Physicians' Cincinnatus Society:

As expected, Reference Committee D of the Pennsylvania Medical Society House of Delegates referred my Resolution (a copy of which was enclosed in my September 8 letter) to the Board of Trustees for decision. All I can say is, "you can lead them to the water, but you cannot make them drink." In Pennsylvania, young physicians are either afraid to make waves, or care little about what happens to their profession, with the seeming attitude of apres moi le deluge. It is time for me to move aside and let others step up to the plate.

I want to thank all of you for the support you have given me and the Physicians' Cincinnatus Society over the years. For more than twenty-two years, I have worked hard to improve the lot of physicians in Pennsylvania so that they would remain able to advocate for their patients and practice medicine as it should be, with compassion. The time has now come to turn the work over to younger, more energetic people. More than a year ago, I informed our Board of my decision to resign as president effective December 1, 2008. At our Board meeting on December 18, 2007, I made it clear to the Board that my decision to resign was firm and that I would continue to support the Physicians' Cincinnatus Society in any way I can, other than as the head of the organization. The time for younger blood to take over is long overdue. The colleague who was to take over more than a year or two ago eventually concluded to leave Pennsylvania because of the unaffordable cost of the mandated amount of medical malpractice insurance, most particularly the MCARE Fund surcharges.

To my knowledge, no one has stepped forward and expressed a willingness to serve. The main reason given is always the same, "I don't have the time. I have to bust my tail just to survive." It will be up to the Board to decide how to proceed. A definite decision should be forthcoming after the next Board meeting. I will keep you informed. In the meantime, I would like to have your input. Kindly drop me a line. Thank you.

Most Sincerely,

Louis A. Meier, MD, FACS


PMS Does Not Adopt Resolution Calling For Action
Despite the fact that the MCARE Fund assessments are devastating Pennsylvania's physicians, the Pennsylvania Medical Society House of Delegates did not adopt the resolution Dr. Meier introduced at its recent House of Delegates meeting in Hershey and instead referred it to the Board of Trustees for decision. The resolution had been assigned to Reference Committee D, to which Dr. Meier made the following statement:

Dr. Meier, Montgomery County, author of the Resolution.

I think we all can agree that under our Federal Constitution, physicians and podiatrists are entitled to equal protection under the law. We all know by now that while chiropractors are exempt from buying the mandated amount of liability insurance if such insurance is not available or affordable due to market conditions (Chiropractic Act of 1986), physicians and podiatrists are denied the same protection and lose their license to practice in Pennsylvania.

For patients, the most important stakeholders, it would be far better to be able to retain their doctor carrying only $500,000 insurance than forcing their doctor to stop practicing in Pennsylvania because he or she can no longer afford the additional $500,000 coverage, whether it be through the MCARE Fund or a private insurer.

By allowing practitioners to buy liability insurance in the amount they need and can afford, they will not "go bare" but buy insurance to protect their families and their patients to the extent they can afford, as they always have prior to the passage of Act 111 of 1975, and as they do in the vast majority of the States. Moreover, by converting a sellers market to a buyers market, premiums will be significantly lowered. Forcing practitioners to buy a specific amount of insurance under threat of license revocation has the opposite effect.

Using the unfunded liability as an excuse to keep the MCARE Fund as long as possible is continuing defrauding the taxpayers and practitioners for the benefit of the greedy. The unfunded liablity can easily be handled with the funds appropriated for the abatement program.

What is important about petitioning the legislature is to force an up or down vote and bring transparency to the process.

Resolution 08-402

Subject: The Pennsylvania Medical Society taking the lead and becoming a signatory to a three part petition calling for abolition of the MCARE Fund.

Introduced by: Louis A. Meier, MD, Montgomery County Medical Society.

Author: Louis A. Meier, MD.

Whereas, The Pennsylvania Medical Society and its very competent lobbyist have not succeeded in bringing about sufficient change to ease conditions under which Pennsylvania physicians are required to practice, and

Whereas, The experts in the Hofflander/Nye Report recommended the abolition of the CAT Fund, now renamed the MCARE Fund, as far back as 1985, and

Whereas, The General Assembly enacted the Chiropractic Act of 1986 containing a provision exempting chiropractors from buying malpractice insurance if such insurance is not available or affordable due to market conditions and no such protection is provided for physicians and podiatrists, and

Whereas, The official Pennsylvania Medical Society policy approved by the Society's House of Delegates is that the license to practice medicine should be de-linked from insurance, and

Whereas, A sitting PMS president actually testified at a public hearing against de-linkage, contrary to established PMS House of Delegates policy, and

Whereas, All House and Senate Bills which would have de-linked our license from insurance have been allowed to die in Committee, denying the members of the General Assembly the opportunity to vote on important proposed legislation, therefore be it

Resolved, That the Pennsylvania Medical Society take the lead and be a signatory of a three part petition to the Pennsylvania Legislature calling for
      1. Immediate abolition of the MCARE Fund without increasing basic insurance requirements;
      2. Having the unfunded liability of the MCARE Fund paid using the funds now appropriated for the abatement program, and
      3. Enact legislation allowing all medical practitioners to opt out of buying the mandated amount insurance, if such insurance is not available or affordable due to market conditions. This protection is already provided for chiropractors in the Chiropractic Act of 1986.

Fiscal Note: No significant fiscal impact.


PA Mcare Fund Politics
April 8, 2008

To All PCS Members and Supporters

You all must realize by now that as long as your license to practice is tied to specific amounts of insurance without regard to availability or affordability, you are a second-rate citizen vis-a-vis chiropractors. The fact that you have to purchase $500,000 coverage from a Fund run by politicians responsible only to the governor, this enables the administration in power to jerk you around as they are doing now. Much of the fault of this must be laid at the steps of the Pennsylvania Medical Society, because it consented to the creation of a politician-run Fund without public oversight and insisted on having mandatory participation in that Fund written into the 1975 Act 111.

Now in its March 27, 2008, "Capitol Insight Special Alert" mailing, the Pennsylvania Medical Society states it "will continue to work for comprehensive legislation that will:
      Reinstate the Mcare abatement for 2008,
      Address the retirement of the Mcare Fund,
      Expanding health care coverage for the uninsured."

No mention is made of seeking legislation to provide equal protection under the law for physicians and podiatrists. How long can physicians in Pennsylvania respect their State Medical Society if it is not able or willing to seek legislation to provide the same protection under the law for physicians as is afforded chiropractors in the Chiropractic Act of 1986? This Act allows chiropractors to opt out of buying the mandated amount of professional liability insurance, if such insurance is not available or affordable due to market conditions. Working "with PNC Bank to create a special-rate loan for members to help ease the financial hardships some physicians will face due to the Mcare assessment payment" is not a solution to the problem. It just prolongs the problem and gets young doctors still deeper into debt.

I am again calling on the Pennsylvania Medical Society to take the lead and be a signatory of the three-part petition to the Pennsylvania Legislature with emphasis on part three, calling for legislation allowing all medical practitioners to opt out of buying the mandated amount of insurance, if such insurance is not available or affordable due to market conditions. This protection is already provided for chiropractors in the Chiropractic Act of 1986.

I urge you, let your feelings be heard. Contact the Pennsylvania Medical Society and your State Senators and Representatives.

Sincerely,

Louis A. Meier, MD, FACS.


Letter sent to all Pennsylvania State Legislators
November 16, 2007

Honorable Members of the Pennsylvania General Assembly:

The high cost of the mandated medical malpractice insurance and its many negative consequences make it imperative to enact legislation which serves all Pennsylvanians. We appeal to you to put aside politics and approach the problem as "statesmen" for the common good of all Pennsylvanians.

The public is becoming well aware of the undue influence the trial lawyers have on the Governor and some legislators. Governor Rendell's veto of the bipartisan "Fair Share Act" bill, which would have provided some badly needed joint and several liability tort reforms, raised a red flag about the Governor's relationship with the trial lawyers. Now with Steven E. Riley Jr., President of the Pennsylvania Trial Lawyers Association, stating no problem exists (referring to the Mcare Fund, July 27, 2007, letter to the editor, Patriot-News, Harrisburg) and Gov. Rendell declaring the "medical-malpractice crisis is over," the public is becoming aware that there is a concerted effort to mislead the public on this issue. The public is not buying it, especially since the taxpayers have to pay on average $180 million a year to support a welfare program for medical specialists ($900 million over the past 5 years, according to Gov. Rendell).

As long as that big cookie jar (the Mcare Fund) is filled, no problem exists for the trial lawyers, even if this means maintaining a welfare program for medical specialists paid for by their non-specialist colleagues and the taxpayers. A frequent excuse (used since 1985) not to eliminate the CAT Fund, renamed Mcare Fund, is the trial lawyers "pie in the sky," the unfunded liability. This ignores the fact that by not abolishing the Fund as recommended by the experts as far back as 1985 (Hofflander/Nye Report), the cost for the excess coverage kept climbing to the point requiring the present welfare program for specialists.

For patients it would be far better to be able to retain their doctor carrying only $500,000 insurance than forcing their doctor to stop practicing in Pennsylvania because he or she can no longer afford the additional $500,000 coverage, whether it be through the Mcare Fund or a private insurer.

Whatever happened to equal protection under the law? The Chiropractic Act of 1986 provides chiropractors with the opportunity to opt out of mandatory insurance if such insurance is not available or affordable due to market conditions. No such protection is provided for physicians and podiatrists.

For all the above reasons we urge you to
            A. Abolish the Mcare Fund now without increasing the basic insurance requirement;
            B. Having the unfunded liability paid with the funds now appropriated for the abatement program;
            C. Enact legislation allowing all medical practitioners to opt out of buying the mandated amount of insurance, if such insurance is not available or affordable due to market conditions. This protection is already provided for chiropractors in the Chiropractic Act of 1986.

By de-linking practitioners license from specific amounts of mandated insurance, the present sellers' market will be converted to a buyers' market, which will bring premiums down to more reasonable levels and enable practitioners to buy insurance in the amount they need and can afford.

We urge you to act in a bipartisan way to enact the above suggestions. If you want what is best for the patients, you will agree that it is far better for patients to be able to retain their doctor carrying only $500,000 insurance than forcing their doctor to stop practicing in Pennsylvania because he or she can no longer afford the additional $500,000 coverage, whether it be through the Mcare Fund or a private insurer.

Thank you very much for your help.

Sincerely,

Louis A. Meier, MD, FACS
President, Physicians' Cincinnatus Society.


Pennsylvania's unholy alliance
All Pennsylvanians, except the trial lawyers, were ill served when Governor Rendell vetoed the bipartisan "Fair Share Act" bill which would have provided some badly needed joint and several liability tort reforms. This veto raised a red flag about the Governor's relationship with the trial lawyers.

Now with Steven E. Riley Jr., President Pennsylvania Trial Lawyers Association, stating no problem exists (referring to the Mcare Fund, July 27, 2007, letter to the editor, Patriot-News, Harrisburg) and Gov. Rendell declaring the "medical-malpractice crisis is over," the unholy alliance between Governor Rendell and the trial lawyers becomes clear. Anyone who Googles "medical-malpractice crisis is over" will immediately be struck by the coordinated, concentrated campaign embarked on by the Governor and the trial lawyers, trying to pull the wool over the eyes of Pennsylvania voters on this issue. As long as that big cookie jar (the Mcare Fund) is filled, no problem exists for the trial lawyers, even if this means maintaining a welfare program for medical specialists paid for by their non-specialist colleagues and the taxpayers. Doing away with the Mcare Fund and thus the need for a welfare program for medical specialists will save Pennsylvania taxpayers on average $180 million a year ($900 million over the past 5 years, according to Rendell), but it would kill the goose that lays the golden eggs for trial lawyers. A frequent excuse (used since 1985)not to eliminate the CAT Fund/Mcare Fund is the trial lawyers "pie in the sky," the unfunded liability. This ignores the fact that by not abolishing the Fund as recommended by the experts as far back as 1985 (Hofflander/Nye Report), the cost for the excess coverage kept climbing to the point requiring the present welfare program for specialists.

For patients it would be far better to be able to retain their doctor carrying only $500,000 in insurance than forcing their doctor to stop practicing in Pennsylvania because he or she can no longer afford the additional $500,000 coverage, whether it be through the Mcare Fund or a private insurer.

What ever happened to equal protection under the law? The Chiropractic Act of 1986 provides chiropractors with the opportunity to opt out of mandatory insurance if such insurance is not available or affordable. No such protection is provided for physicians and podiatrists.

Louis A. Meier, MD, FACS


Gov. Rendell's Assertion

At a news conference at the College of Physicians of Philadelphia yesterday (Oct. 24, 2007), Gov. Rendell asserted that Pennsylvania's medical-malpractice crisis is over. At the same time he acknowledged that the state has spent $900 million on Mcare abatement over the last five years. This averages out to $180 million a year. If the abatement program, a welfare program for specialists, is needed costing the state $180 million a year, anyone stating the "medical-malpractice crisis is over" is in denial, or worse.

Louis A. Meier, MD, FACS


October 23, 2007, Update


Dear Colleagues:

The October 26 letter going out will bring you up to date regarding what happened at the Pennsylvania Medical Society House of Delegates meeting in Hershey last week in relation to our initiative to get the PMS "to take the lead and be a signatory of a three-part petition" (see enclosure in the letter being mailed to you). While I am disappointed, I am not surprised. It indicates that we still need a separate organization like the Physicians' Cincinnatus Society which has as its only purpose "the protection of the rights of healthcare providers individually and collectively as they relate to their professional lives and to the practice of medicine in general." Multipurpose medical societies continue to be hampered by internal and regional politics and provide politicians with the opportunity to pit one group of practitioners against another. A perfect example of this is the abatement program, which is in every respect a welfare program for specialists paid for by their non-specialist colleagues and taxpayers.

What lies ahead? The MCARE Fund, the cause and reason for the need of a welfare program for specialists will continue at $500,000 for two years as called for by current law. The same cannot be said for the abatement program. Taxpayers may demand a stoppage of the "welfare program for specialists" before that, precipitating a crisis. By not fighting for equal protection under the law, physicians and podiatrists do not have the option enjoyed by chiropractors who may opt out of purchasing the mandated amount of insurance if such insurance is not available or affordable due to market conditions. For patients it would be far better to be able to retain their doctor carrying only $500,000 insurance than forcing their doctor to stop practicing in Pennsylvania because he or she can no longer afford the additional $500,000 coverage, whether it be through the MCARE Fund or a private insurer. By having the same protection under the law as chiropractors, practitioners would not be prevented from buying $1,000,000 coverage or more, if they can afford it. A free market environment will lower premiums. It will convert a sellers' market to a buyers' market. Forcing practitioners to buy a specific amount of insurance under threat of license revocation will have the opposite effect.

When the trial lawyers' "pie in the sky" (the unfunded liability) is presented to you as an excuse not to abolish the MCARE Fund now, you must remind them that the experts who studied the cause for the high cost of medical malpractice insurance in Pennsylvania have determined that the increase was not due to an increase in occurrence, but was associated with the CAT Fund, now renamed MCARE Fund, and recommended the abolition of the Fund. By not implementing this recommendation, the cost of excess coverage kept climbing to the point now requiring a welfare program for specialists.

We will continue to fight for principle and fairness. Support us by paying your dues promptly. Thank you.

Sincerely,
Louis A. Meier, MD, FACS
President,
Physicians's Cincinnatus Society.


Suggested Reading

August 7, 2007

Dear Colleagues:

For your information, my article published July 12, 2007, in the Harrisburg newspaper The Patriot-News, the response to it by Steven E. Riley Jr., President Pennsylvania Trial Lawyers Association, and my response to Mr. Riley are posted on our website. Click on "PA Malpractice Crisis," and read the last three entries in "THE SEQUENCE OF IMPORTANT EVENTS IN THE PENNSYLVANIA MALRRACTICE INSURANCE CRISIS." Enjoy.       Dr. Meier



Pennsylvania Legislature Urged to Implement Corrective Measures

The needed measures are detailed in a letter sent to every member of the General Assembly.

June 25, 2007

To All Pennsylvania State Legislators

Honorable Members of the Pennsylvania General Assembly:

Not being a total cynic yet, I appeal to you to give serious consideration to all sides of the debate about how to remedy the high cost of health care, the high cost of medical malpractice insurance, and the looming doctor shortage crisis in Pennsylvania which Representative Shapiro is trying to address with HB 1093. I urge you to do so without giving more weight to special interest groups, euphemistically called "stakeholders."

Representative Josh Shapiro may mean well, but HB 1093 is a band-aid solution with negative consequences to the taxpayers without stopping the hemorrhage. As some of the members of the General Assembly may know, solutions to this problem were spelled out by independent experts as far back as 1985.

The MCARE Fund, formerly called the CAT Fund, plays an all important roll in Pennsylvania's medical malpractice insurance crisis dating back to before 1984, when the Pennsylvania Medical Society, the Pennsylvania Bar Association, the Pennsylvania Trial Lawyers Association, the Hospital Association of Pennsylvania and others recognized a medical malpractice insurance crisis was looming and commissioned the MAC Group, Inc. of Menlo Park, California to study "Medical Malpractice Insurance in Pennsylvania." Their report was issued in 1985 by Alfred E. Hofflander, Professor of Finance and Insurance at the Graduate School of Management, University of California, and Faculty Principal with the MAC Group, and Blaine F. Nye, Senior Associate with the MAC Group. The Hofflander/Nye report stated (p. 3), "The important point to be made is that the current crisis in Pennsylvania is not based on increased malpractice occurrence." The experts in this report recommended two important changes:
      1) Abolition of the CAT Fund, now called the MCARE Fund;
      2) Underwriting using experience rating as opposed to class or even
           specialty rating, because it "would not only permit reduced medical
           malpractice insurance premiums for quality physicians in terms of
           eliminating the problem of intra-class or intra-specialty subsidization,
           but would also provide economic incentive to reduce malpractice
           incidence overall."

These recommendations were not implemented and any attemps to do so were vigorously opposed by PMSLIC, the insurance company owned until recently by Pennsylvania Medical Society; the trial lawyers for whom the CAT Fund had become "the goose that lays the golden eggs" (Michael J. Stack III, "Don't Kill The Goose That Lays The Golden Eggs," The Pennsylvania Lawyer, March/April, 1995), and the self-insured medical centers for whom the Fund paid out each year millions of dollars more in claims against them than they paid surcharges into the Fund. (Annual reports of the CAT Fund).

As long as the license of Pennsylvania's physicians is held hostage to insurance requirements which are prohibitive, especially hostage to mandatory participation in the MCARE Fund, young doctors could not afford to practice in Pennsylvania. Measures like forgiving student loans (HB 1093) are not addressing the underlying problem. Since student loan forgiveness is contingent on practicing in Pennsylvania, these young doctors would become the indentured servants working for hospital systems and big corporate practices. These indentured physicians would not be in a position to advocate for their patients. The negative impact of this would be felt by all Pennsylvanians, except the very wealthy.

The problems which are peculiar to Pennsylvania and make the medical malpractice insurance crisis worse in Pennsylvania than in any other state can easily be solved by implementing the two recommendations made by the experts in the Hofflander/Nye report. This involves eliminating the MCARE Fund now, not four years from now. This should not be a problem for the legislature which was able to pass the Chiropractic Act of 1986 which exempts chiropractors from buying professional liability insurance, if such insurance is not available or affordabale due to market conditions. No such protection is provided for physicians. Physicians who can no longer afford to participate in the MCARE Fund lose their license to practice in Pennsylvania. Rather than giving physicians the same rights under the law as chiropractors, the Commonwealth uses enormous sums of taxpayer money to feed the MCARE Fund. Of all the money paid into the MCARE Fund by practitioners and the Commonwealth, only about 10% actually reaches victims of medical malpractice.

Medical malpractice insurance costs can and must be further lowered by enacting caps on pain and suffering and making lawyers not entitled to any part of the awards for pain and suffering, just as they did in California. The reasoning behind this was that attorneys are not entitled to a windfall from a patient's pain and suffering.

Why can we not work together for the good of all Pennsylvanians and implement the recommendations so clearly stated in the Hofflander/Nye Report? The report was issued in 1985! What are we waiting for? and for whose benefit? I sincerely hope the General Assembly can find the political courage to stand up against the pressures of the special interest groups, the so-called stakeholders, for the good of all Pennsylvanians.

Sincerely,

Louis A. Meier, MD, FACS
President, Physicians' Cincinnatus Society.



HB 1093, if enacted, would be a reversion to the eighteenth century practice of securing indentured servants, except in this case the State of Pennsylvania is the procuring agent and the indentured servants would be working for hospital systems and corporations.

The present cost of Pennsylvania's mandated amount of medical professional liability insurance for physicians is prohibitive. As long as their license to practice is held hostage to these requirements, especially mandatory participation in the Mcare Fund, these future doctors could not afford to practice on their own. Since the student loan forgiveness is contingent on their practicing in Pennsylvania, they will become the indentured servants working for hospital systems and big corporate practices. These indentured physicians would not be in a position to advocate for their patients. This would be felt by all Pennsylvanians, except the very wealthy. On this issue the Pennsylvania Medical Society seems to take the side of those who would most benefit by having future physicians indentured. I hope the public will recognize the negative impact this will have on them and will urge our legislators to oppose this scheme. If enacted into law, HB 1093 will have severe, long-term negative consequences.

Louis A. Meier, MD



THE FLEECING OF THE PUBLIC, PATIENTS, AND MEDICAL PRACTITIONERS IN PENNSYLVANIA

        I feel it is my obligation to alert the public when an egregious wrong is compounded and left uncorrected year after year.
        Pennsylvania voters rightfully responded with outrage to the passage of the unlawful 2005 legislative pay raise. But as outrageous as this legislative pay raise was, it pales when compared with the fleecing of the public, patients, and medical practitioners through the CAT Fund/MCARE Fund. From the National Practitioners Data Bank statistics we know that in Pennsylvania only about 10% of all the money collected for medical malpractice insurance (premiums on primary insurance and CAT Fund/MCARE Fund surcharges) actually reach victims of medical malpractice. Pennsylvania tax payers have an enormous stake in this, considering that the Commonwealth paid into the Fund $700,000,000 in the first two years of the abatement program, according to Governor Rendell. This means $630,000,000 of that abatement money went to entities other than victims of medical malpractice. To claim all that money is to subsidize doctors so that victims of medical malpractice can be compensated is deceiving the public. All this is possible because the Fund is state-run by political appointees without public oversight, and is responsible only to the Governor. As far back as 1985, the experts in the Hofflander/Nye report recommended the abolition of the CAT Fund, now re-named the MCARE Fund.
        Even though only a shamefully low 10% of all the money collected reaches victims of medical malpractice, the Commonwealth has failed all these years to correct the underlying problems. The Fund became "the goose that lays the golden eggs" for many, to quote a former executive deputy director of the CAT Fund, Michael J. Stack, who is now a Pennsylvania State Senator.
        In California, when they discovered that only about one third of the malpractice insurance dollar reached the victims of medical malpractice, their Governor was outraged, and rightfully so. California law requires that two thirds of workman's compensation insurance dollars be returned to workmen for injuries suffered. They corrected the problems not by tying physicians' license to insurance, but by enacting the Medical Injury Compensation Reform Act, or MICRA. They identified and addressed the underlying problems by analyzing what consumed all the malpractice insurance dollars over a ten year period.
        The misuse of funds and mismanagement cannot be denied when only about 10% of all the money goes to those for whom it is intended. The voters of Pennsylvania should insist that the MCARE Fund be eliminated now and a Pennsylvania law similar to California's MICRA legislations be enacted, to stop the grand scale fleecing of the public, patients, and medical practitioners in Pennsylvania.

Louis A. Meier, MD, FACS.



MEDICINE FOR THE COMMON GOOD IS THE 2007 NEW YEAR'S MESSAGE TO PENNSYLVANIA PHYSICIANS


Dear Colleagues:

As we begin this New Year, let us resolve to not repeat the mistakes of the past, to work hard to correct past mistakes, and to move forward together with political courage and forthrightness. This requires recognizing the mistakes made and admitting to them, starting with Pennsylvania's Health Care Services Malpractice Act, Act 111 of 1975. The Pennsylvania Medical Society grievously erred in insisting that this legislation provide for a specific amount of mandatory professional liability insurance for medical practitioners without regard to affordability and availability and in requiring mandatory participation in a CAT Fund run by political appointees and without public oversight.

Another grievous error was to bargain away physicians' basic rights, as occurred during the negotiations which gave us Act 135 and no real tort reforms. At various times, the Pennsylvania Medical Society officials involved in these negotiations have admitted that they had sacrificed, under a handshake agreement, three basic constitutional rights of physicians to meet the demands of Governor Tom Ridge and his administration. These included
      1. Not to seek any medical tort reforms for four years;
      2. Not to rally in Harrisburg for four years; and
      3. Not to contribute over $100,000 to the Civil Justice Coalition
          for 4 years.

(I hope all of you remember this lack of concern for the constitutional rights of others should Governor Ridge decide to run for President of the United States.)

Grievous acts were again committed after HB 2417 was introduced in 2002. This Bill would have corrected the injustice inherent in Pennsylvania's Health Care Services Malpractice Act. The president of the Pennsylvania Medical Society testified against HB 2417 at a public hearing contrary to policies established by the House of Delegates of the Pennsylvania Medical Society. In addition, officials of the Pennsylvania Medical Society instructed the Society's lobbyist to actively lobby against HB 2417 after it was attached to other legislation and had a realistic chance of being passed.

Even though it had become quite clear that Representative Nicholas A. Micozzie, Chairman of the House Insurance Committee, had blocked all important legislation opposed by insurance companies by letting it die in his Committee, the Pennsylvania Medical Society failed to oppose Micozzie's re-election, nor did it support his serious challenger, who supports much needed tort reforms. The Bills allowed to die in the House Insurance Committee include HB 1877 of 1997, HB 2417 of 2002, and HB 501 of 2005, all of them important to medical practitioners.

If we turn over a new leaf by taking corrective actions in all these areas and, being forthright at all times, move forward united with political courage, our politicians in Harrisburg will no longer feel comfortable not seeking much needed tort reforms. It will also restore Pennsylvania Medical Society's credibility. In our young physicians, it will restore confidence in organized medicine. The politicians in Harrisburg will become aware that medicine in Pennsylvania is now speaking with one voice and is a force to be reckoned with.

To implement our resolve, let us form a Medicine for the Common Good Committee, with one representative from every state medical society and podiatric society and one member from each specialty group. Non-medical people with experience working with the Civil Justice Coalition can be part of this working committee whose job it will be to educate the electorate on an ongoing basis about what our legislators in Harrisburg are doing, or not doing, and should be doing. The Committee should work closely with the grassroots organizations which successfully forced from office some of the lawmakers responsible for pushing through the notorious legislative pay raise in violation of Pennsylvania's Constitution. With continuous scrutiny of the lawmakers in Harrisburg, we will force them to work first and foremost for the common good. Doctors can then again practice medicine that will serve the common good. This means the elimination of the corrupt, mismanaged CAT Fund, re-named MCARE Fund, because only about 10% of the money it collects actually reaches victims of medical malpractice. The millions the state now pays to the Fund to cover abatements go primarily to the entities feeding at the CAT Fund (MCARE Fund) trough at the discretion of the political appointees. These millions could be used for property tax relief. For politicians the CAT Fund (MCARE Fund) continues to be a big cookie jar, well suited to "pay to play" politics. For medical practitioners, it is a millstone around their necks. For the public, it is one of the main causes threatening access to affordable quality medical care in Pennsylvania.

Have a happy and healthy New Year!

Sincerely,
Louis A. Meier, MD, FACS
President, Physicians' Cincinnatus Society.




Open Letter to All Pennsylvania Physicians

November 8, 2006


I came away from the last Pennsylvania Medical Society House of Delegates meeting with the conviction that the Society must "clean house" to improve its image among physicians and at the Capitol in Harrisburg. It must adhere to its established policies. Those "running the Society" must not be allowed to operate behind the scene against policies established by the House of Delegates.

As one active Pennsylvania legislator told me, "Harrisburg can be a strange place where your friends are really your enemies. It is not uncommon here for legislation to be offered simply to curry political 'cover' when in fact there is no intention of seeing the legislation advance." This must never be tolerated within our state medical society.

The PMS officials who, contrary to established Society policy, opposed HB 2417 in 2002 must be held accountable for their action. This includes Dr. Howard Richter who, as President of the Pennsylvania Medical Society, testified against HB 2417 at a public hearing. It also includes those who instructed the Society's lobbyist to actively lobby against HB 2417 after it was attached to other legislation and had a realistic chance of being passed. Such violations of the trust placed in them by the membership demands an official apology to all the members of the Society. Unwillingness to apologize for their action is reason to ask for their resignation.

If we do not take corrective actions, our legislators in Harrisburg will continue to feel comfortable not seeking meaningful tort reforms, because they know medicine in Pennsylvania does not speak with one voice. As long as this situation is allowed to persist, it impacts negatively on how the public and Pennsylvania physicians perceive the Pennsylvania Medical Society.

To attract young physicians, the Pennsylvania Medical Society must earn their confidence. It must defend physicians' basic rights and not bargain them away, as they did during the negotiations which gave us Act 135. They actually agreed to (a) not seek any medical tort reform for four years; (b) not rally in Harrisburg for four years, and (c) not contribute over $100,000 to the Civil Justice Coalition for four years.

We need a strong state medical society. So let's clean up our act and move forward together with forthrightness and political courage. As soon as our state medical societies do that, I urge all Pennsylvania physicians to join them.

Sincerely,

Louis A. Meier, MD, FACS
President,
Physicians' Cincinnatus Society





The November 7, 2006, Election

Because the Pennsylvania Medical Society chose not to get involved in the 163rd Legislative District race between the incumbent, Nicholas A. Micozzie, and the challenger, the Rev. Marie E. deYoung, the Physicians' Cincinnatus Society deemed it important that the voters be informed about the performance of the 27-year incumbent. For that reason, the following was prepared for release to the public:

Voter Information

        Representative Nicholas A. Micozzie, Chairman of the Pennsylvania House Insurance Committee, has repeatedly undermined the democratic process by letting important proposed legislation opposed by insurance companies die in his Committee. This reflects a blatant disregard for the democratic process because it denies legislators the opportunity to vote on important proposed legislation.
        It turns out that Rep. Micozzie's granddaughter is the Insurance Federation of Pennsylvania's lobbyist and Director of Government Affairs.
        Representative Micozzie, a 27-year incumbent, also voted for the legislative pay raise in violation of the Constitution of this Commonwealth.

                                                                        The Physicians' Cincinnatus Society



July 31, 2006, letter to all PCS members and supporters


Dear Colleagues:

The enclosed copy of my July 28 letter to Representative Micozzie, Chaiman of the House Insurance Committee, is self-explanatory. Chairman Micozzie has a serious challenger in the upcoming election, Rev. Marie E. DeYoung. We will keep you informed about where they stand on HB 501. Your best interests are represented by the candidate who is unwavering about our constitutional rights, which means in support of HB 501. As long as our license is held hostage, we have no bargaining position, neither with insurance companies, nor with any entity benefiting from the MCARE Fund. Presently, the MCARE Fund abatements funded by the state are nothing more than subsidies for the many feeding at the MCARE Fund trough. For practitioners depending on the abatements to stay in business, it is nothing less than a program to indenture physicians. This is demonstrated by the fact that if you do not serve an extra year in Pennsylvania because you simply can no longer afford to practice, or practice in Pennsylvania, the MCARE Fund will demand that you repay all of the abatements at the threat of license revocation. Examples of this are already appearing.

I am asking all of you to be active in the political process and vote for your interests and not party-line. Particularly, look carefully at the challengers of incumbents, realizing that in the past, in plain English, we have been screwed by incumbents of both parties.

In closing, just a reminder for those who have not yet paid their 2006 dues. Please submit your $100.00 as soon as possible. Thank you.

Sincerely,

Louis A. Meier, MD, FACS
President,
Physicians' Cincinntus Society




Letter of April 18, 2006


To All Pennsylvania Legislators:

Dear Senators and Representatives:

Some weeks ago we mailed you an appeal in the hope that you will correct the injustice unique to Pennsylvania, i.e., demanding $1,000,000 liability coverage at unaffordable prices at the threat of license revocation. This problem could easily be corrected by bringing HB 501 or SB 79 to the floor for a vote. These Bills are presently in the House Insurance Committee and the Senate Banking and Insurance Committee respectively.

We urge all Pennsylvania legislators who respect the Constitution of the United States and the rights of citizens under the Constitution, including the rights of medical practitioners, to take a good hard look at HB 501 and SB 79 (similar Bills), as well as the legislature's responsibility to protect the constitutional rights of every citizen. If no corrective actions are taken, we have to assume the responsibility for this lies with the leadership of both the House and the Senate. By the same token, we must hold chairmen of Committees responsible for any Bill that is allowed to die in Committee and not being brought to the floor for a vote.

The issues are clear and simple when one works within the framework of the Constitution. We are getting the information out to the voters. Those who have read our "Appeal Ad" in the Norristown Times Herald find it incredible that something like this is allowed to go on anywhere in the United States. Some offered the suggestion that the Judiciary Committees of the House and Senate should look into this issue.

We appeal to every member of the Pennsylvania General Assembly to address and correct this problem unique to Pennsylvania before the summer recess. Thank you very much.

Sincerely,

Louis A. Meier, MD. FACS
President,
Physicians' Cincinnatus Society.



AN APPEAL TO ALL HONEST LAWYERS AND LEGISLATORS


         In the hope that they will see that passing HB 501 is the right thing to do, the PCS sent the folloing to every member of the Pennsylvania House and Senate:

          We appeal to all honest lawyers and Pennsylvania legislators who respect the Constitution of the United States and every citizen's rights under the Constitution. Judges have agreed that the right to practice one's chosen profession, including medicine, free from unreasonable government interference is protected by the Constitution. Yet, in Pennsylvania, a law is allowed to stand that demands $1,000,000 liability coverage at unaffordable prices at the threat of license revocation. The fact that the demanded liability coverage is unaffordable is recognized, admitted, and underscored by the initiation of the MCARE Fund abatement program by the Commonwealth of Pennsylvania. Still, the law is allowed to stand and continues to demand the $1,000,000 liability coverage under threat of license revocation. It makes no sense to have young people fight and die to protect the Constitution and our way of life and at home, we show such total disregard for the constitutional rights of medical practitioners.

                                                                               The Physicians' Cincinnatus Society




News and Updates, January, 2006: A twentieth Anniversary Summary

THIS YEAR THE PHYSICIANS' CINCINNATUS SOCIETY CELEBRATES ITS TWENTIETH ANNIVERSARY WITH A SENSE OF PRIDE.

         Incorporated on July 18, 1986, The Physicians' Cincinnatus Society has faithfully pursued its mission "to protect the rights of healthcare providers individually and collectively as they relate to their professional lives and to the practice of medicine in general." It has done so with the help of committed members and supporters across Pennsylvania. Initially our greatest opposition came from our own State Medical Society and the Medical Centers. Their role in constructing and defending THE HEALTH CARE SERVICES MALPRACTICE ACT, Act 111 of 1975, often with vicious personal attacks on members of our Society, together with the exploitation of the CAT Fund provisions of the Act by the self-insured medical centers at the expense of private practitioners, constitute the darkest chapter in Pennsylvania medicine. The following data give some insight into this.

         Confirmed by the Fund's own annual statistical reports and Director Reed's June 17, 1996, letter to Representative Nicholas A. Micozzie, the amount of Fund money paid out in claims for self-insured providers in excess of surcharge receipts from self-insured providers are as follows:

        1988   $   15,782,270    *This could be as high as
        1989   $   15,238,101      $32,900,418, or as low as
        1990   $   10,602,240      $10,891,012. The lowest
        1991   $   13,175,028      figures were used to be
        1992   $     8,862,222      totally objective.
        1993   $   11,713,213
        1994   $   14,364,368
        1995   $   10,891,012*        
        Total: $ 100,628,454.

         The self-insured contributed nothing to the administrative costs of the Fund for all these years, which for 1996 was about $17,000,000. These are additional sums private practitioners and community hospitals had to subsidize. Add to this the $8.7 million "discount" the Fund Director approved for two institutions for 1996, then the enormity of the problem becomes clear.

         The following are the figures from CAT Fund Director Reed's letter to Dr. Greco, showing what health care system "A" paid in premiums and surcharges for its various practitioners in 1996:

        Specialty:                                Premium:          Surcharge:*          Total:

        OB/GYN                                  $1,885                $3,091                   $4,976;
        Orthopedic Surgery                 $1,885                $3,091                   $4,976;
        Emergency Medicine              $   808                $1,325                   $2,133;
        General Surgery                      $   808                $1,325                   $2,133;
        Anesthesiology                        $   634                $1,040                   $1,674;
        Diagnostic Radiology              $   634                $1,040                   $1,674;
        Ophthalmologic Surgery          $   414                $   679                   $1,093;
        Pediatrics                                  $   324                $   531                   $   854;
        Endocrinology                           $   277                $   454                   $   731;
        Internal Medicine                     $   184                $   303                   $   487;
        Pathology                                   $     54                $     88                   $    142.

*Note that this surcharge was for $1 million CAT Fund coverage.

        For comparison, the surcharges private practitioners were required to pay in 1997 are as follows:

        1997 SURCHARGE - 75% OF PMSLIC GENERATED JUA RATES

        Specialty            Territory
           Class          1                    2                    3                    4                    5

           100          41,328          20,209           21,573            37,236             26,821;
           080          29,970          14,655           15,645            27,003             19,450;
           070          26,883          13,146           14,032            24,222             17,446;
           060          20,928          10,234           10,924            18,856             13,582;
           050          17,589            8,601             9,181            15,847             11,415;
           035          13,230            6,469             6,906            11,920               8,586;
           030          12,168            5,950             6,351            10,962               7,896;
           020            9,123            4,461             4,762              8,220               5,920;
           015            5,898            2,884             3,078              5,314               3,828;
           010            4,764            2,329             2,487              4,293               3,091;
           007            3,268            1,597             1,705              2,944               2,121;
           006            2,686            1,314             1,402              2,421               1,744.

        These surcharges were for only $900,000 CAT Fund coverage and required practitioners to purchase an additional $100,000 coverage from their primary insurers. Note that private practitioners paid more than ten fold what practitioners under the umbrella of the self-insured were paying. Act 135 protected the self-insured centers from being surcharded according to their claims experience by limiting the amount their surcharge could be increased above their 1996 contribution.

NATIONAL PRACTITIONER DATA BANK STATISTICS

The NPDP data bank figures for Pennsylvania show that in 1995, $807,000,000 were collected in premiums and surcharges and only $80,000,000 reached victims of medical malpractice, or 9.9%. In California, prior to the enactment of the MICRA legislation, less than 34% of premium dollars actually went to victims of medical malpractice. California law requires that 67% of workman's compensation dollars be returned to victims for injuries suffered.

THE PENNSYLVANIA MEDICAL SOCIETY'S POSITION EVOLVED OVER TIME.

This change became especially apparent after PMS sold its insurance company, PMSLIC. The Physicians' Cincinnatus Society and the Pennsylvania Medical Society are now working hand in hand. The medical centers, representated under the umbrella of the Hospital and Health Systems Association of Pennsylvania, continue to exploit practitioners by insisting that physicians must carry $1,000,000 liability insurance to protect the hospitals from becoming "deep pockets" pursued by malpractice plaintiffs.
The Physicians' Cincinnatus Society insists on the right of physicians to buy insurance in the amount they need and can afford. Physicians buy insurance to protect themselves and their patients. They should not be forced to buy excess insurance they cannot afford to protect hospitals, Blue Cross, or other third party payers.

1997 POCONO MEETING MARKED A TURNING POINT

The president of the Pennsylvania Medical Society, Dr. Victor Greco, and Physicians' Cincinnatus Society president, Dr. Louis Meier, met each other half way. After their memorable meeting, the relationship between the two organizations steadily improved. Official policy established in 1997 continued to be undermined by some in leadership position within the Pennsylvania Medical Society. Drs. Greco and Meier, initially adversaries, continued to work towards unity to pursue a common goal consistent with the mission of the Physicians' Cincinnatus Society. As part of the agreement of co-operation reached at the 1997 Pocono meeting, Dr. Meier, who in 1988 resigned in protest from the board of the Montgomery County Medical Society and the Pennsylvania Medical Society, rejoined the State and County Society.

PCS TESTIMONY BEFORE SENATE COMMITTEES

        At a Joint Public Hearing of the Senate Banking and Insurance and Senate Judiciary Committees, February 9, 2001: PCS president outlined a four-step approach to permanently solve the recurring malpractice insurance crisis. These included 1) abolishing the CAT Fund as proposed by the experts in the 1985 Hofflander/Nye report; 2) the unfunded liability can and must be dealt with separately and not be used as an excuse to continue the Fund. This unfunded liability burden must fall on all entities earning healthcare dollars in Pennsylvania; 3) practitioners must be allowed to purchase liability insurance in the amount they need and can afford and not be forced to buy what they cannot afford under threat of license revocation; 4) replace the Pennsylvania HEALTH CARE SERVICES MALPRACTICE ACT, Act 111 of 1975, with a California-type of Medical Injury Compensation Reform Act (MICRA), which now has a more than 25-year proven track record.
        Senator Edwin G. Holl, Chairman of the Senate Banking and Insurance Sommittee, wrote Dr. Meier that right after the joint public hearing he requested the lawyers in the Senate to prepare a Pennsylvania law similar to the California MICRA law.
        As we all know, what the lawyers in the Senate prepared had no resemblance to MICRA.

PCS TESTIMONIES BEFORE THE HOUSE INSURANCE COMMITTEE
On May 30, 2002, in support of HB 2417, to rescind the insurance mandate. In its testimony, the PCS pointed out that physicians and podiatrists in Pennsylvania can be forced out of their chosen profession by insurance companies simply by canceling policies or raising premiums to unaffordable levels. Forcing them out of their chosen profession deprives communities of the services provided by these practitioners. Such violations of basic rights cannot be justified under state banner, because they do not serve any legitimate state purpose. This Bill never reached the floor of the House for a vote.

On July 26, 2005, in support of HB 501, similar to HB 2417 of 2002. In his testimony, the president of the PCS stated five good reasons why HB 501 should be enacted into law:
       1. Forty-two States do not have mandatory medical malpractice insurance. In these States, practitioners buy insurance in the amount they need and can afford. Patients who become victims of medical malpractice have the right to sue and are adequately compensated for injuries suffered, because in these States, practitioners can buy insurance at affordable premiums. Consequently, the legislators in these States are not constantly plagued with addressing continued or recurring crises.
       2. Doctors will no longer have to choose between leaving Pennsylvania, or stopping to practice medicine.
       3. When insurance companies no longer have a captive clientele, the free market will bring premiums down to more reasonable levels. It will encourage them to use experience rating, not class or specialty rating.
       4. Sufficient accurate data are available, according to the experts (see the Hofflander/Nye report of 1985), to use experience rating as opposed to class or even specialty rating. This would not only permit reduced medical malpractice premiums for qualified physicians in terms of eliminating the problem of intra-class or intra-specialty subsidization but would also provide economic incentive to reduce malpractice incidence overall.
       5. The CAT Fund, now called the MCARE Fund, should be abolished as recommended in the Hofflander/Nye report.

        He made it clear that physicians buy insurance to protect themselves and their patients,and that they should not be required to purchase excess liability insurance they cannot afford to protect hospitals or third party payers.

THE PRESENT STATUS OF HB 501

At present, this legislation remains in the House Insurance Committee. It does not appear that any further hearings will be held. In letters to PCS members and supporters, a number of Representatives have indicated that they signed on as co-sponsors of this Bill. The Electronic Bill Room version has not been updated and reflects only seven of these additions. It appears from the feed-back the PCS has received that "the votes are there," once HB 501 reaches the Floor of the House for a vote. Much depends now on the House Insurance Committee and its chairman.

WHAT ALL THE EXPENSIVE LEGAL CHALLENGES REVEALED

Striking was the pervasiveness of the political corruption of the Pennsylvania courts, both at the state and federal level. Constitutional rights of individuals are sacrificed for political reasons in the most shameful way. Physicians and podiatrists in Pennsylvania are denied equal protection under the law and due process and are deprived of their basic right of earning a living in their chosen profession without unreasonable government interference. Demanding of them to purchase $1,000,000 liability insurance at unaffordable prices as a condition to practice their chosen profession is unreasonable government interference in any rational person's mind. Judge Crumlish, in his dissenting opinion in McCoy v. Commonwealth Board of Medical Education and Licensure, 391 A2d 723, Pa. Cmwlth., 1978, stated, "financial security has never been a condition precedent to the practice of medicine, or any other profession, and so to impose such a condition constitutes an unreasonable restriction of a property right resulting in an unconstitutional deprivation of property." Federal Judge Edward Cahn, in Meier, et. al. v. Anderson, et. al., U.S. District Court, E.D. Pa., Civil Action No. 87-3145, July 26, 1988, conceded in his opinion that the right to practice one's chosen profession, including medicine, free from unreasonable government interference comes under the "property" and"liberty" concepts of the Fifth and Fourteenth Amendments and is protected by the Due Process Clause and Equal Protection Clause of the Fourteenth Amendment. He avoided the crucial decision by stating that since no actions were pending against the plaintiffs, the issue "is not ripe for adjudication." When years later plaintiffs made the issue ripe for adjudication, Federal Judge William Yohn refused to admit the incriminating evidence of license suspensions without due process for inability to pay the 1995 emergency CAT Fund surcharge. A hearing examiner's suspension ruling is not final until the full Medical Board hears the appeal, yet legal notices of suspensions were published before the full Board even met.

PUTTING A HUMAN FACE ON THE INJUSTICE INFLICTED ON PRACTITIONERS

Dr. Louis A. Meier has five years of specialty training, is board certified in surgery, and is a Fellow of the American College of Surgeons and the Philadelphia College of Physicians. In twenty-plus years in practice he did not have a single claim against him, yet his license was suspended when he could not afford the 1995 emergency CAT Fund surcharge of 67%, which came on top of the 104% surcharge he had already paid for the year. He documented for the Board of Medicine that he could not afford this additional surcharge and provided copies of his federal tax returns. The medical examiner who heard his case, Chere Winnek-Shawer, did not rule on it. Months later, another hearing examiner, Suzanne Rauer, ruled on it without ever seeing him or interviewing him in any way, and, even in the face of the federal tax returns provided by him, stated in her ruling that she did not believe him. She suspended his license for 6 months and fined him $7,000. His license was to be re-instated only after he served the 6 months suspension, paid the $7,000 fine, and paid the emergency surcharge which he could not afford when he was practicing. Needless to say, that effectively deprived him of earning a livelihood in his chosen profession, for which he trained six years beyond medical school (one year of internship and five years of specialty training).

GROSS INJUSTICE AWAKENED CONSCIENCES WITHIN GOVERNMENT AGENCY

Someone in a high-level position sent to the Physicians' Cincinnatus Society a copy of the August 5, 1992, report by Inspector General William G. Chadwick Jr., which documented the corrupt management of the CAT Fund. The investigation, the basis for this report, was cut short after only 5 months as it was about to investigate how Hahnemann Hospital was allowed to reduce their malpractice insurance premium from nearly $1,000,000 in 1990-91 to approximately $100,000, reducing Hahnemann's CAT Fund surcharge by 90%. An investigational meeting scheduled for 10 A.M. on May 13th, 1992, never took place. It would have revealed that the self-insured centers were similarly defrauding the CAT Fund at the expense of private practitioners. It is noteworthy that when this report was subpoenaed, Governor Thomas Ridge refused to release it, claiming absolute executive privilege. The report, therefore, could not be submitted as evidence in court. This prompted the PCS to send a copy to every member of the Pennsylvania House and Senate.

LOOKING TO THE FUTURE

        Medical practitioners need their own independent civil liberties union with the single purpose of protecting their rights. Multipurpose medical and medical specialty societies cannot do this effectively and consistently because of internal and regional politics and different self-interests.
        It makes eminent sense for all medical societies and associations to join in forming and supporting a national, independent American Medical Practitioners Civil Rights Organization, or AMPCRO. This organization must challenge civil rights violations against any practitioner when ever and where ever they occur. This is the only way to arrest the cancer which continues to erode the rights of practitioners and their patients. Third party payers have triangulated themselves between physicians and patients, making it practically impossible for practitioners to advocate for their patients and provide the best possible care. When, where, and how to treat patients is often decided not by the treating physicians but by unqualified third party payers. Physicians and nurses hired by them are not employed to make quality care available and accessible but to save money for the organization at the expense of the treating physicians and their patients.

THE PHYSICIANS' CINCINNATUS SOCIETY'S ULTIMATE GOAL

        The Physicians' Cincinnatus Society (PCS) intends to continue its mission to protect the rights of healthcare providers individually and collectively as they relate to their professional lives and to the practice of medicine in general. It will do so until an American Medical Practitioners Civil Rights Organization is established. At this point the PCS would turn its operation over to the new entity. Until this occurs, we urge you to read the brochure enclosed in the January mailing and distribute it to your fellow practitioners and encourage them to join us. Our future will be what we make it. Your participation is important and necessary for ultimate success. Join us in defending our rights and our ability to function as patient advocates.



Letter to Governor Rendell


Letterhead

October 18, 2005

Honorable Edward G. Rendell, Governor
Commonwealth of Pennsylvania
225 Capitol Building
Harrisburg, PA 17120

Dear Governor Rendell:

Thank you for taking the time to speak to the Pennsylvania Medical Society House of Delegates last Sunday. I know, and so do many others, that you inherited a big and escalating medical malpractice insurance problem. For years band-aide solutions were applied, which obviously did not solve the problem. The Pennsylvania Medical Society, too, was side-tracked for years by conflicting interests. The Pennsylvania Medical Society now fully supports separating the license to practice in Pennsylvania from insurance and testified in favor of HB 501 which would accomplish just that. At the July 26 hearing on this Bill, testimonies in support for the Bill were given by Dr. William Lander, President of the Pennsylvania Medical Society, myself as President of the Physicians' Cincinnatus Society, George Isajiw, MD, Internal Medicine, Lansdowne (private practice), and Emerita Gueson, MD, Gynecologist, Jenkintown (private practice). Testifying against the Bill were Mary Ellen McMillen, Vice-President-Legislative Policy, Independence Blue Cross, and James Redmond, Senior Vice-President, Hospital and Health Systems Association of Pa.

Since colonial times, the bulk of medicine in Pennsylvania has always been provided by private practitioners in the trenches, so to speak, and it is private medicine which is threatened, in Pennsylvania more so than anywhere else. Much of it has to do with having practitioners' license to practice tied to $1,000,000 professional liability insurance and particularly having to purchase $500,000 of it through the CAT Fund, now the MCARE Fund. The amount of money paid into that Fund and the money the Fund actually pays to victims of medical malpractice is a shamefully low percentage.

HB 501 deserves your support for the following reasons:

1. Forty-two States do not have mandatory medical professional liability insurance. In these States, practitioners buy insurance in the amount they need and can afford. Patients who become victims of medical malpractice have the right to sue and are adequately compensated for injuries suffered, because in these States practitioners can buy insurance at affordable premiums. As a consequence, their legislators are not faced repeatedly with having to address a continued or recurring crisis.

2. Doctors will no longer have to choose between leaving Pennsylvania, or stopping to practice medicine. This has actually happened to me and others. I have five years of specialty training, am board certified in surgery, and am a Fellow of the American College of Surgeons and the Philadelphia College of Physicians. In my twenty-plus years in practice I did not have a single claim against me, yet my license was suspended when I could not afford the 1995 emergency surcharge of 67%, which came on top of the 104% surcharge I had already paid for the year. I documented for the Board of Medicine that I could not afford the additional surcharge and provided copies of our federal tax returns. The medical examiner who heard my case, Chere Winnek-Shawer, did not rule on it. Months later, another hearing examiner, Suzanne Rauer, ruled on it without ever seeing me or interviewing me in any way, and even in the face of the federal tax returns provided by me, stated in her ruling that she did not believe me. She suspended my license for 6 months and fined me $7,000. My license was to be re-instated only after I served the 6 months suspension, paid the $7,000 fine, and paid the emergency surcharge which I could not afford when I was practicing. I need not explain to you that this effectively deprived me of earning a livelihood in my chosen profession, for which I trained six years beyond medical school (one year of internship and 5 years of specialty training).

3. Enactment of HB 501 has additional benefits. When insurance companies no longer have a captive clientele, the free market will bring premiums down to more reasonable levels. It would encourage them to use experience rating as opposed to class or even specialty rating. As pointed out in the Hofflander and Nye Report,* this would not only permit reduced medical malpractice premiums for qualified physicians in terms of eliminating the problem of intra-class or intra-specialty subsidization but would also provide economic incentive to reduce malpractice incidence overall.

      *The 1985 Hofflander/Nye Report is a report on Medical Malpractice in
       Pennsylvania, issued by Alfred E. Hofflander, Ph.D., Professor of
       Finance and Insurance at the Graduate School of Management,
       University of California, Los Angeles, and Faculty Principal with
       The MAC Group, Inc., and Blaine F. Nye, Senior Associate with The
       MAC Group, Inc., 1000 El Camino Real, Suite 250 Menlo Park,
       California 94025-43. This report also recommended the abolition of
       the CAT Fund, now called the MCARE Fund.

4. The unfunded liability can easily be covered by the mechanism now used to finance the MCARE Fund abatements. It is not a valid reason for not enacting HB 501.

5. Considering the sums practitioners still pay into the MCARE Fund in addition to the $700,000,000 you mentioned government paid into the Fund since the abatements were initiated in 2003, we and the tax payers should have the right to know how much is actually paid to victims of medical malpractice. As you acknowledged to the Pennsylvania Medical Society House of Delegates last Sunday, the abatements will be necessary for at least two more years. From a tax payer's point of view, enactment of HB 501 makes particularly sense, because the money government allocates for the abatements could soon be used for property tax relief.

Again my sincere thanks for taking the time to speak to the Pennsylvania Medical Society House of Delegates. You rightfully asked us to work with you. It is in this spirit that I am writing this letter and offer my suggestions.

Respectfully Yours,

Louis A. Meier, MD, FACS
President,
Physicians' Cincinnatus Society.





Public Hearing


The House Insurance Committee held a public hearing in Harrisburg on House Bill 501 on July 26, 2005. HB 501 is aimed at de-linking physicians' license to practice in Pennsylvania from insurance. Testifying in favor of this Bill were William Lander, MD, President, Pennsylvania Medical Society, Louis Meier, MD, President, Physicians' Cincinnatus Society, Emerita Gueson, MD, Gynecologist, Jenkintown, and George Isajiw, MD, Internal Medicine, Lansdowne. Testifying against the Bill were Mary Ellen McMillen, Vice-President-Legislative Policy, Independence Blue Cross, and James Redmond, Senior Vice-President, Hospital and Health Systems Association of Pa.

The President of the Physicians' Cincinnatus Society, Dr. Louis A. Meier, gave the following testimony:

        Chairman Micozzie, members of the Committee. Thank you for the opportunity to speak in favor of HB 501. This Bill, by repealing the medical liability insurance mandate, will solve many problems engendered by the HEALTH CARE SERVICES MALPRACTICE ACT. Enacted into law, it will assure that quality medical care will remain available and affordable throughout the Commonwealth, avoiding the need for critically ill patients to be transported long distances when time is of the essence to assure survival.

        Forty-two states have no mandate at all, while the others require much less and do not have a mandatory CAT Fund. As it stands now, practitioners in Pennsylvania can be forced out of their chosen profession by insurance companies simply by canceling policies or raising premiums to unaffordable levels. Clearly the true "stakeholders" are the doctors and their patients. A distinction must be made between interest groups and the real "stakeholders" so that the common good can be served.

        The present condition of "take it or leave it and lose your license" puts doctors at the mercy of poorly regulated insurance companies. The enactment of HB 501 will correct this and the misuse of the functions of the Boards of Medicine, which have as their stated mission the protection of the public, addressing quality of care issues, not the suspension of the licenses of good practitioners merely because they can no longer afford the mandated amount of liability insurance. This has actually happened to me and others.

        I have five years of specialty training, am board certified in surgery, and am a Fellow of the American College of Surgeons and the Philadelphia College of Physicians. In my twenty-plus years in practice I did not have a single claim against me, yet my license was suspended when I could not afford the 1995 emergency surcharge of 67%, which came on top of the 104% surcharge I had already paid for the year. I documented for the Board of Medicine that I could not afford this additional surcharge and provided copies of our federal tax returns. The medical examiner who heard my case, Chere Winnek-Shawer, did not rule on it. Months later, another hearing examiner, Suzanne Rauer, ruled on it without ever seeing me or interviewing me in any way, and even in the face of the federal tax returns provided by me, stated in her ruling that she did not believe me. She suspended my license for 6 months and fined me $7,000. My license was to be re-instated only after I served the 6 months suspension, paid the $7,000 fine, and paid the emergency surcharge which I could not afford when I was practicing. I need not explain to you that this effectively deprived me of earning a livelihood in my chosen profession, for which I trained six years beyond medical school (one year of internship and 5 years of specialty training). I might add here that the National Practitioners Data Bank figures for Pennsylvania show that in 1995 a total of $807,000,000 were collected in premiums and surcharges, but only about $80,000,000 actually reached the victims of medical malpractice, or 9.9%. Yet a 67% emergency surcharge was imposed on top of the 104% already levied.

        The perversion of the functions of Pennsylvania's Boards of Medicine is a cancer in its early stages and has to be addressed. The enactment of HB 501 would automatically let the Boards of Medicine stick to their stated mission of protecting the public by addressing quality of care issues.

        An additional benefit derived from the enactment of HB 501 is that practitioners would no longer be captives of the oppressive MCARE Fund. The MCARE Fund abatements started in 2003 are a recognition and admission that physicians can no longer afford the outlandish surcharges. This Fund serves primarily the lawyers and not the victims of medical malpractice. In the words of Michaeal J. Stack III, a former attorney and executive deputy director of the CAT Fund, now MCARE Fund, "Members of the Pennsylvania plaintiff's bar refer to the CAT Fund as the goose that lays the golden eggs." (in his article titled "Don't Kill The Goose That Lays The Golden Eggs," published in the March/April 1995 issue of The Pennsylvania Lawyer). The abolition of the Fund was recommended in the Hofflander/Nye Report* as far back as 1985 by the experts commissioned by the Pennsylvania Medical Society, the Hospital Asssociation of Pennsylvania, the Pennsylvania Bar Association, the Pennsylvania Trial Lawyers, and others to study Pennsylvania's malpractice insurance crisis. The "unfunded liability" of the Fund can be covered by the mechanism used to pay for the abatements. It is no longer a valid scare tactic to be used by those who want to maintain the Fund for their benefit. I refer here not just to trial lawyers. In his testimony before a Senate Banking and Insurance Committee hearing in 2003, Mr. James M. Redmond claimed that requiring physicians to carry $1,000,000 liability insurance is necessary to protect hospitals from becoming "deep pockets" pursued by malpractice plaintiffs.

        Finally, when insurance companies no longer have a captive clientele, the free market will bring premiums down to more reasonable levels. It would encourage them to use experience rating as opposed to class or even specialty rating. As pointed out in the Hofflander/Nye Report, this would not only permit reduced medical malpractice premiums for qualified physicians in terms of eliminating the problem of intra-class or intra-specialty subsidization but would also provide economic incentive to reduce malpractice incidence overall.
______________________________________________________________________
*This is a report on Medical Malpractice Insurance In Pennsylvania issued by Alfred E. Hofflander, Ph.D., Professor of Finance and Insurance at the Graduate School of Management, University of California, Los Angeles, and Faculty Principal with the MAC Group, Inc., and Blaine F. Nye, Senior Associate with The MAC Group, Inc., 1000 El Camino Real, Suite 250, Menlo Park, California 94025-4327.



July 26, 2005, HB 501 Hearing


July 11, 2005

To All PCS Members and Supporters:

Late Friday, July 8, the Pennsylvania Legislature's Electronic Bill Room posted on the Internet that the HB 501 hearing was scheduled for 1 pm on July 19, 2005, in Room 205 of the Ryan Office Building in Harrisburg. This is incorrect. The actual date of the hearing is July 26, 2005, at 1 pm in Room 205 of the Ryan Office Building. Rather than calling the Chairman of the Committee to be allowed to testify, call the Executive Director of the House Insurance Committee, Robert Archibald, at 717-787-7978, or email him at rarchiba@pahousegop.com. This Bill, as you know, will de-link our license to practice in Pennsylvania from insurance. A strong response from the medical community in favor of HB 501 is extremely important.

I urge all of you to make an effort to attend that hearing. Also contact the Chairman of the Committee, Rep. Nicholas A. Micozzie, and thank him for holding the hearing (phone: 717-783-8808; 610-259-2820).

Since time is short, I suggest you call Mr. Archibald and ask to be allowed to testify. Your support and participation at this time is crucial. Thank you very much.

Sincerely,

Louis A. Meier, MD, FACS
President, PCS.




PENNSYLVANIA HEALTH CARE PROVIDER AND CONSUMER ALERT

          HB 501, because of its beneficial effects on the availability and affordability of quality medical care for all Pennsylvanians, must be enacted into law. This Bill is endorsed by the Physicians' Cincinnatus Society and the Pennsylvania Medical Society. It was introduced February 14, 2005, by Representative Thomas P. Gannon and was referred to the House Insurance Committee where it is awaiting action. It calls for the repealing of the medical liability insurance mandate. As it stands now, practitioners in Pennsylvania can be forced out of their chosen profession by insurance companies simply by canceling policies or raising premiums to unaffordable levels.
          All Pennsylvanians should urge the Chairman of the House Insurance Committee, the Hon. Nicholas A. Micozzie, to call for well-publicized hearings so that the real "stakeholders," the physicians and their patients, will be heard. A distinction must be made between interest groups and the real "stakeholders" so that the common good can be served.
          The present condition of "take it or leave it and lose your license" puts doctors at the mercy of poorly regulated insurance companies. The enactment of HB 501 will correct this and the misuse of the functions of the Boards of Medicine, which have as their stated mission the protection of the public, addressing quality if care issues, not the suspension of the licenses of good practitioners merely because they can no longer afford the mandated amount of liability insurance. In Pennsylvania, the perversion of the functions of the Boards of Medicine is a cancer in its early stages and must be addressed. It was this kind of perversion of the functions of government agencies in Germany which eventually culminated in the Nuremberg Laws of 1935.
          An additional benefit derived from the enactment of HB 501 is the elimination of the corrupt, oppressive MCARE Fund, the most expensive umbrella insurance on earth, which serves primarily the lawyers and not the victims of medical malpractice. In the words of Michael J. Stack III, a former attorney and executive deputy director of the CAT Fund, now MCARE Fund, "Members of the Pennsylvania plaintiff's bar refer to the CAT Fund as the goose that lays the golden eggs." (in an article titled DON'T KILL THE GOOSE THAT LAYS THE GOLDEN EGGS, published in the March/April 1995 issue of The Pennsylvania Lawyer). If an independent investigation would reveal the dollar amounts which actually reach the victims of medical malpractice and the total amount taken in by the Fund each year, the public would be horrified. The abolition of the Fund was recommended as far back as 1985 (Hofflander/Nye Report) by the experts commissioned to study Pennsylvania's medical malpractice insurance crisis. The "unfunded liability" of the Fund can be covered by the mechanisms used now to pay for the abatements. It is no longer a valid scare tactic to be used by those who want to maintain the Fund for their own benefit.
          Finally, when insurance companies no longer have a captive clientele, the free market will bring premiums down to more reasonable levels.





A MESSAGE TO ALL PENNSYLVANIANS

          Regardless what politicians are telling you, the problem in Pennsylvania was created by the legislature and is simply this. Physicians are mandated to purchase $1,000,000 professional liability insurance with no provisions regarding the availability or affordability of such insurance. They are deprived of their license to practice when, through no fault of their own, they cannot get or afford the full $1,000,000 coverage. Revoking a physician's license to practice under this condition is an unconstitutional taking of property. So far, state lagislators have refused to address and correct this, even though every one takes an oath to uphold and defend the Constitution of the United States upon taking office. Holding a physician's license hostage to $1,000,000 insurance is unique to Pennsylvania.

          On February 14, 2005, Representative Thomas P. Gannon again introduced legislation, HB 501, referred to the House Insurance Committee. This proposed legislation would free physicians to buy professional liability insurance in the amount they need and can afford. Urge your State Senator and State Representative to support HB 501 and restore to physicians their constitutional rights. Urge the Chairman of the House Insurance Committee, Representative Nicholas A. Micozzie not to allow this bill to languish and die in committee. By doing so, you will help to create a situation which allows doctors to practice in our state if they choose to do so. This will assure that quality medical care remains available and accessible to all Pennsylvanians. Thank you.

                                                                                 Dr. Louis A. Meier.




February 16, 2005 Newsletter


Dear Colleagues:

      As promised, here are the numbers assigned to the two bills I mentioned in my February 10 letter, HB 501, repealing the medical liability insurance mandate, and HB 503, the Fair Managed Care Contract bill. You can read the text of these bills by following these steps:

      1, Go to our website www.cincinnatussociety.org;
      2. Click on the Electronic Bill Room link;
      3. When the Session Information page appears, type in HB 501 (or HB 503);
      4. Click on Bill Number;
      5. Click on Text.

      We ask you all to be active advocates, particularly for HB 501, by encouraging your legislators to support the bill. You can get the information about how to contact your state legislators by again going to our website and clicking on the links PA STATE SENATORS and PA STATE REPRESENTATIVES. By clicking on the name of your legislator, you will get the page which gives you all the information about him/her.

      There will be those who do not want the gravy train, the MCARE Fund, to end. You should remind these people that the MCARE Fund abatements are a recognition and admission by the legislature that Pennsylvania's physicians and podiatrists are mandated to purchase liability insurance coverage in the amount they cannot afford. To make up what practitioners can no longer afford, the legislature has extended the MCARE Fund collections to the taxpayers.

      Some legislators are telling us and the public that they provided doctors with $440 million to pay for their malpractice insurance. Everyone should know that these millions are not given to the doctors, but to the MCARE Fund. They should also know that of all the money the Fund collects, less than 10% goes into the hands of victims of medical malpractice. It does not take a genius to figure out that all the money paid into the MCARE Fund by practitioners and the money allocated to the Fund by the legislature serve to maintain the pot for those who sponge off 90% of that money. Yet those who collectively consume most of the MCARE Fund money and leave only 9.9% for the victims of medical malpractice have the audacity to state that all they want is to make sure that those who are medically injured get just compensation.

      In our February issue of News and Updates, we identify precisely the problems and needed solutions. Do not get sidetracked by statements like, "Since its inception in 2003, this MCARE abatement program has provided doctors all across Pennsylvania with over $440 million in real relief from rising malpractice rates." Some of the spin masters have presented this to the public as, "we have already given these rich doctors $440 million, what more do they want?" They fail to mention that the money went into the MCARE Fund and less than 10% of it was paid out to victims of medical malpractice. National Practitioners Data Bank figures for Pennsylvania have shown that when $807,000,000 were collected in premiums and surcharges, only $80,000,000 reached victims of medical malpractice, a dismal 9.9%. This indicates that the Fund exists primarily for those who sponge off 90% of all the money the Fund collects.

      You must tell the skeptics that the more affordable liability insurance is, the more practitioners will buy to protect themselves and their families. This can be achieved by tort reforms. The gold standard for lowering medical professional liability insurance premiums is the California MICRA legislation. See our February issue of News and Updates. It summarizes what the California Medical Injury Compensation Reform Act encompasses. If you need more copies of this issue, call 610-279-9343 and leave a message.

      Remember that our success depends on your participation in the political process. Contact your legislators repeatedly. Have the organizations you belong to and your patients do the same. Passage of HB 501 is crucial for our survival as independent practitioners capable of being patients' advocates and providing quality medical care. Thank you very much.

Sincerely,

Louis A. Meier, MD, FACS
President, PCS




From the February, 2005, News and Updates


                 PRACTITIONERS' RIGHT TO BUY PROFESSIONAL
                 LIABILITY INSURANCE IN THE AMOUNT THEY NEED
                 AND CAN AFFORD AND THE ABSURDITY OF ANY
                 LEGISLATURE TO ORDER THEM TO BUY WHAT THEY
                 CANNOT AFFORD

      The Mcare Fund abatements are a recognition and admission that Pennsylvania's physicians and podiatrists are mandated to buy professional liability coverage in the amount they cannot afford. Rather than restoring to these practitioners their right to buy liability insurance in the amount they need and can afford, a right enjoyed by lawyers and other professionals, the Pennsylvania legislature has extended the Fund's surcharge collection to the tax payers. This fact must be fully explained to the public. Pennsylvania tax payers must be informed that less than 10% of all the medical liability insurance premiums and Mcare surcharges collected goes to the victims of medical malpractice. Therefore the medical liability insurance crisis is caused by those who consume more than 90% of all the moneys thus collected. Elimination of the Mcare Fund will do much to alleviate some of the crisis. This should be a no-brainer! What pays for the abatements now can be the mechanism to take care of the unfunded liability, which was so often used as an excuse why the CAT Fund, now Mcare Fund, should not be eliminated. The simplest solution is the re-introduction of Rep. Gannon's HB 2417 of 2002 with the language agreed upon by both the Pennsylvania Medical Society and the Physicians' Cincinnatus Society.

      The more affordable liability insurance is, the more practitioners will buy to protect themselves and their families. This requires tort reform. Those who are opposed to caps on pain and suffering should instead demand that victims of medical malpractice receive a greater share of premium dollars collected. This is what the California MICRA legislation addressed. California compensation laws require that about two-thirds of every premium dollar go to victims for injuries suffered. So let's compensate the victims and not those who sponge off 90% of premium dollars collected.




October 20, 2004 Newsletter


Dear PCS members and supporters:

As I have indicated in my October 6 letter, we will work with the Pennsylvania Medical Society, and I personally will introduce two resolutions at the Society House of Delegates meeting. My hope was that I would leave that meeting with a sense that Medicine will speak with one voice on the issue of having our license to practice de-linked from insurance. A Delaware County Resolution sought to "REAFFIRM PENNSYLVANIA MEDICAL SOCIETY POLICY WITH RESPECT TO ELIMINATING THE REQUIREMENT FOR MANDATORY PROFESSIONAL LIABILITY INSURANCE." This Resolution was combined with mine. The Resolve passed by the House of Delegates reads, "Resolved, That the Pennsylvania Medical Society work actively to reintroduce House Bill 2417 of 2002, and make the elimination of mandatory liability insurance requirement a high priority legislative action item for the Society."

House Bill 2417 of 2002 is straight forward and reads as follows:

      "The General Assembly for the Commonwealth of Pennsylvania hereby enacts as follows:
      Section 1. Section 701 of the act of October 15, 1975 (P.L.390, No.111), known as the Health Care Services Malpractice Act, is amended by adding a subsection to read:
      Section 701. Professional Liability Insurance and Fund.-**
*
      (d.1) For the calender year 2002, and each year thereafter, a health care provider, other than a hospital, who would otherwise be required to annually insure or self-insure its professional liability in the amount mandated by this section, may elect not to be insured or self-insured in the mandated amount if the health care provider has so indicated in writing to the board that license that health care provider. The licensing board may develop a form for this purpose.
      Section 2. This act shall take effect in 60 days."

When HB 2417 was introduced on March 13, 2002, it was done with 20 sponsors. This is a hopeful sign. This is not misplaced optimism. A Lebanon County Delegate told the House of Delegates that their State Senator and Representative told her that such a Bill has a reasonable chance of being passed, provided Medicine speaks with one voice. I expect this to happen. The Physicians' Cincinnatus Society will work to this end.

No doubt, there will be those who will engage in the old familiar scare tactics, such as, "if we don't have mandatory insurance, the hospital may require even more insurance or deny you privileges." Think about this rationally. If the State does not require you to carry any specific amount of insurance to practice in Pennsylvania, on what grounds can the hospital require you to carry a specific amount of insurance or deny you privileges without facing charges of restriction of trade. How do you think the community will respond when the best and most respected doctors in their community are not allowed to take care of them in their own community hospital because