Lawmakers Deride Plan for Fees on Doctors

Several New York lawmakers are joining doctors in denouncing a proposal floated by the state's insurance superintendent, Eric Dinallo, in an interview with The New York Sun, of a $50,000 fee on every doctor in the state as a solution to New York's malpractice insurance crisis.

"This is not the right solution. This is a prescription for medical disaster," Rep. Vito Fossella, a Republican who represents Staten Island and Brooklyn in the U.S. Congress, said. "If it's an indication of what lies ahead, what lies ahead of this is not good."

In a letter sent to Governor Spitzer yesterday, Mr. Fossella and state Senator Andrew Lanza, also a Republican of Staten Island, said a surcharge on doctors should not be an option for addressing the state's malpractice insurance crisis.

"It would really place a penalty on doctors, and especially wreak havoc on specialists," Mr. Lanza said. "We'd drive good doctors out of business."

Yesterday, Mr. Spitzer indicated that the extra fee was under consideration. In July, Mr. Spitzer created a task force, chaired by Mr. Dinallo, to address the state's malpractice insurance crisis.

"It's going to be a smart package that I think doctors would be fully supportive of," Mr. Spitzer told the Sun.

In an interview last week, Mr. Dinallo suggested that he might impose a fee on doctors as a way to protect the solvency of the state's medical malpractice insurance companies. He is also weighing other options, he said. "I'm just very worried, as head of the Insurance Department, that we have carriers that are able to fulfill their obligations," he said.

Any solution would follow a 14% increase in malpractice insurance rates that went into effect in July. The rates, set by the Insurance Department, vary by county and by specialty. Specialists with the highest premiums are brain surgeons in Brooklyn, who currently pay $267,000 annually for malpractice insurance. Obstetricians in Queens pay $180,490.

Several other lawmakers, including some in Mr. Spitzer's own Democratic Party, expressed concern over the idea of a surcharge for all doctors, particularly those who have not been named in lawsuits.

"I certainly would not recommend an across the board per capita surcharge," the chairman of the Assembly's health committee and a member of the task force, Richard Gottfried, said. Mr. Gottfried said he would, however, support a surcharge on doctors with a history of losing malpractice verdicts.

"There is a very small number of physicians in New York who are responsible for a very substantial portion of malpractice payouts," he said. "Many of those physicians should not be practicing at all. Many of them, if they do practice, ought to be bearing a much larger portion of the cost of their coverage rather than spreading out on all doctors the burden of the misconduct of a few."

"A surcharge is the most ridiculous concept of all," state Senator Carl Kruger, a Democrat of Brooklyn, said.

Doctors said a $50,000 surcharge would create an impossible burden for them to sustain.

"We're running scared right now," an internist and pediatrician in Staten Island, Dr. Ralph Messo, said. Dr. Messo, who is president of the Richmond County Medical Society, said that a $50,000 fee would nearly triple his current annual premium of $30,000.

"There are a lot of physicians trying to figure out a backup plan if this goes into effect for how they will make ends meet and still provide for their families," he said. "Somebody's got to pay for it, and I don't know how long the physicians can keep bearing the brunt of it."

Other doctors warned that the insurance crisis may drive younger doctors out of New York.

The head of Lutheran Medical Center's obstetrics department, Dr. Iffath Hoskins, said applicants to the hospital's residency program increasingly ask her about the malpractice insurance crisis during interviews.

"Five years ago, they would say, 'Tell me about the program, what about the working hours?'" Dr. Hoskins said. "Now, in the top five questions is, 'What do you think about this malpractice crisis'?"

Mr. Fossella warned that the "real losers" would be the patients. "Specialties will become so problematic or burdensome that the patients ultimately will suffer," he said.