Medical liability caps; for the benefit of corporations

[LynnTheDem]

If it'll cost me $ billions in research to ensure my medical product is safe...but only a few thousands in lawsuits when my shoddy unsafe product kills your family, why should I pay out the $ billions???

That would make me a pretty stupid person. Also a greedy uncaring nasty immoral person, but hey, that's BUSINESS. The whole purpose behind high liability settlements is to prevent corporations from selling crap products.

And what, exactly, do the rightwingnuts NOT understand about the FACT that medical liability is less than 1% of costs???

So dear republicans, when YOUR child is killed or damaged for life because a corporation decided to just take the cheaper route and pay you a capped liability rather than spend billions on making sure their product is safe, (and what corporation wouldn't so choose??!) I hope you'll just endorse the check, spend it on a new TV or washing machine, and STFU.

[Kagemusha]

1. Actually, it's not that at all.

It's not to benefit corporations.

It's to hurt the Democratic Party by starving malpractice lawyers of funds.

Once I realized that, I understood why the "it's all for the corps" sounds so paranoid. It's because it's not a cynical enough statement; Republicans are not altruistic. They don't do things for corps just because it's in the interests of principle. They do things for themselves.

[LynnTheDem]

2. There are a couple of republican malpractice lawyers on bush's staff

bushCabal, of course, don't point that out very much.

It's to help corporations; republicans are fascists, that's what they do.

[Name removed]

3. Deleted message

Message removed by moderator. Click here to review the message board rules.

[LynnTheDem]

4. Bullshit.

You sure do spout a lot of the talking points. Wonder why?

In FACT, the insurance costs are LESS THAN ONE PERCENT of medical costs.


FACTS:

-Medical malpractice payments have dropped 11% in the last 9 years.

-Medical malpractice insurance is less than 1% of overall medical costs.

[ramadoss]

5. bullpuckey

Maybe I sound like that because that is the exact reason Bush is using to push the medical malpractice reform bill. I'll have to double check but I have never heard those percentages before. Everything seems to point toward rising costs for doctors, not reduced cost.

[LynnTheDem]

6. Yours is the bullshit, dear.

FACT: malpractice insurance is LESS THAN ONE PERCENT of medical costs.

DUers knew this FACT long ago; you'd know this FACT too if you did more research and far less koolaide drinking.

Want links to the FACT, or will you do your own research?

[ramadoss]

7. gimme some

I'm doing some searching but feel free to give me a few links.

BTW, what is this koolaid thing that keeps getting brought up?

[ramadoss]

8. found a good link

Check it out.

http://www.gao.gov/new.items/d03702.pdf

[LynnTheDem]

9. Yes. Check them out.

Impact of Legal Reforms on Medical Malpractice Costs

...the direct cost of the malpractice system is still less than 1 percent of total national health care...

http://www.wws.princeton.edu/cgi-bin/byteserv.prl/~ota/disk1/1993/9329/932904.PDF

Think Malpractice is Driving Up Health Care Costs? Think Again.

Medical malpractice payouts are less than 1% of total US health care costs. All "loses" (verdicts, settlements, legal fees etc) have stayed under 1% for the last 18 years.

http://www.centerjd.org/air/pr/AIRhealthcosts.pdf

The Bar Speaks

Well-sourced.

http://www.mobar.org/journal/1998/janfeb/barspeak.htm

Truths and Myths About Malpractice

Medical malpractice costs (this includes awards paid to victims, attorneys fees for both plaintiffs and defendants, and malpractice insurance premiums) are less than 1% of total health care costs. (Congressional Budget Office, October 1992) The cost of malpractice has, in fact, remained steady at less than 1% of health care costs since 1976. (Statistical Abstract of the United States, and Best's Aggregates & Averages). This means that if we eliminated the entire malpractice system (removed malpractice insurance and threw out people's rights to sue) we would decrease the cost of health care by less that 1%.

http://www.drrein.com/myths.htm

Public Citizen Watch

According to the Department of Health And Human Services actuaries' most recent report...malpractice costs (are) about 0.62% of national healthcare expenditures.

http://www.citizen.org/documents/BushDistortionFactSheet12-15-04.pdf

A Congressional Budget Office analysis said malpractice costs represented less than 2 percent of overall health care spending in 2002.

http://www.chron.com/cs/CDA/ssistory.mpl/nation/2987585

"The nation's largest medical malpractice insurer, GE Medical Protective, has admitted that medical malpractice caps on damage awards and other limitations on recoveries for injured patients will not lower physicians' premiums..."

According to the Medical Protective filing: "Non-economic damages are a small percentage of total losses paid. Capping non-economic damages will show loss savings of 1.0%."

http://www.consumerwatchdog.org/insurance/pr/pr004698.php3

Want more?

[ramadoss]

10. that's fine

Some of the info is out of date, you acknowledge this in the post. The other thing to note is that this is 1% of TOTAL healthcare costs in the US. I'm concerned with the doctors coverage of medical malpractice insurance. This has consistantly gone up every year since 2000. Check out the link I posted.

[LynnTheDem]

12. FACT: malpractice costs are LESS THAN 1% of healthcare costs.

Spin it any bushway you like, that is a FACT.
Get over it. ;)

[LynnTheDem]

11. Try READING your own link next time

When you're trying to back up bushit; as per your link:

The increase in insurance PREMIUMS is still LESS THAN 2% of overall healthcare costs;

The increase in insurance PREMIUMS is due to multiple factors, and malpractice caps WILL NOT LOWER the premiums.

Doctors' groups have misled, fabricated evidence, or, at the very least, wildly overstated their case about how medical malpractice problems have limited access to health care. -Analysis of Medical Malpractice: Implications of Rising Premiums on Access to Health Care, General Accounting Office, GAO‑03‑836, 2003 (pp.12‑24)

GAO: A study released by the congressional General Accounting Office in 2003, Medical Malpractice Insurance: Multiple Factors Have Contributed to Increased Premium Rates, found absolutely no support for capping damages as a solution to bring down insurance rates for doctors.

[Sgent]

13. How do you explain

Community Health Centers (which have federal immunity) and on average order significantly lower tests and other items with the same outcomes.

The cost for the entire industry maybe 1% of revenue, but for even a family physician it is 3-5%. For a surgeon or OB it can be as much as 50% (or more), plus one-two years premium on retirement.

In addition, the settlement of 1 case or loss of 1 case will increase premiums exponentially.

Do you honestly think that most doctors aren't ordering more tests for this reason? How come care hasn't improved while use of MRI's and the such have increased.

As someone who has worked in the industry, the system is broke. I do not think that limits are neccissarily the way to fix it, but credibility is lost quickly when you say there is no problem.

[LynnTheDem]

17. And just exactly WHERE did I say "there is no problem"???

I SAID what is in fact FACT;

-PAYOUTS for medical malpractice are and have been for years DECLINING.

-PREMIUMS account for LESS THAN 1% of healthcare costs.

-And obviously as everyone with any brain can figure out for themselves, capping PAYOUTS won't have any effect on PREMIUMS.

bush doesn't want to cap PREMIUMS; he wants to cap already-declining PAYOUTS.

bush is an idiot and a LIAR.

[ramadoss]

14. Actually

The last link you posted was the only one worth reading. The rest gave a date of 1995 as the most recent date for information. That is 10 years ago. All of the dates given for the collection of information you cite were in the 80's and early 90's. That's not valid info anymore and you should know better than to use old data to make a point in the present.

This is taken from the last link you posted.

"While medical malpractice caps limit the rights of injured patients, they do not lower doctors' premiums. If lawmakers and physicians want to reduce costs, they should start fighting to reform insurance companies rather than restrict patients' rights," said Heller.

Sounds kinda like what I wrote to begin with doesn't it?

I did read the link I posted. I am not disagreeing with you at all. I never said I was for a cap. I am pointing out that the 1% number you are giving gives the impression that there is no problem when there is. It uses the total healthcare costs(a huge amount)to offset the payout amount from medical malpractice insurance. Read my link again and notice how that number changes when you only count medical malpractice insurance which is the only insurance these lawsuits affect.

[LynnTheDem]

18. For the very last time...BUSH wants to cap PAYOUTS.

PAYOUTS have been DECLINING for YEARS.

PREMIUMS have been increasing, altho they are still LESS THAN 1% -your own link says less than 2%- of total healthcare costs.

These are FACTS regardless of how you spin it.

bush will NEVER advocate capping PREMIUMS; the insurance industry is one of his Have & Have Mores base.

bush wants to cap PAYOUTS. bush says PAYOUTS are the cause of rising healthcare costs. And that, in fact, is bullshit.

According to a Congressional Budget Office report issued last year, malpractice costs represented less than 2% of overall healthcare spending in 2002, and even a reduction of malpractice costs around 25% would only lower healthcare costs by roughly 0.4%.

[Name removed]

21. Deleted message

Message removed by moderator. Click here to review the message board rules.

[LynnTheDem]

22. I KNOW the PREMIUMS are rising, but that is NOT to do with the LAWSUITS

You posted that the LAWSUITS are causing rising PREMIUMS; that is NOT TRUE.

Your OWN LINK says it is NOT TRUE.

That is the flaw in YOUR arguement that I've been trying to point out.

:)

[ramadoss]

27. link

Multiple factors have combined to increase medical malpractice premium
rates over the past several years, but losses on medical malpractice claims
appear to be the primary driver of increased premium rates in the long
term. Such losses are by far the largest component of insurer costs, and in
the long run, premium rates are set at a level designed to cover anticipated
costs. However, the year-to-year increase in premium rates can vary
substantially because of perceived future losses and a variety of other
factors, including investment returns and reinsurance rates. Moreover, the
market for medical malpractice insurance is not national, but depends on
the varying framework of insurance, legal, and health care structures

[LynnTheDem]

15. Malpractice payouts declining, NOT increasing per bushit

INSURERS CONTINUE TO PRICE-GOUGE DOCTORS DESPITE
DROPPING MEDICAL MALPRACTICE PAYOUTS

Contrary to what the insurance and medical lobbies have alleged, the years 2002 and 2003 saw no “explosion” in medical malpractice insurer payouts to justify skyrocketing rate hikes. In fact, rather than exploding, inflation-adjusted payouts per doctor have dropped for the last two years. Payouts (in constant dollars) have been essentially flat or dropping since the mid-1980s.

http://insurance-reform.org/

False Alarm - How the media helps the insurance industry and the GOP promote the myth of America's "lawsuit crisis."

According to the National Center for State Courts, a research group funded by state courts, personal injury and other tort filings, when controlled for population growth, have declined nationally by 8 percent since the 1975, and have been falling steadily in real numbers since 1996. The numbers are even more dramatic in places with rapid population growth, like Texas, where the rate of tort filings fell 37 percent between 1990 and 2000. Even in liberal California, the rate of filings has plummeted 45 percent over the past decade.

http://www.washingtonmonthly.com/features/2004/0410.mencimer.html


Want more?

[LynnTheDem]

16. SOME people on this thread are confusing PREMIUMS with PAYOUTS

PAYOUTS are DECLINING and have been for years.

PREMIUMS are INCREASING. So put a CAP on PREMIUMS.

Only a MORAN would say gee we need to cap PAYOUTS, when it's PREMIUMS that are increasing, NOT PAYOUTS.

And it's still a FACT; medical malpractice insurance accounts for less than 1% of healthcare costs.

bush says the opposite; bush is LYING. That's also a FACT.

[ramadoss]

19. agree

I understand the difference and agree that we need to go after the insurance companies.

Yes, it is 1% of healthcare costs. Total healthcare costs in the US for 2002 were just over 1.6trillion dollars. That means 1% is 16billion dollars. 16billion dollars that just the doctors in this country are paying each year for medical malpractice insurance.

[LynnTheDem]

20. But that is NOT what bush keeps saying

1. The liar says it's the PAYOUTS causing the increase in HC costs. THAT is the tort reform bush is going after; he wants caps on the PAYOUTS. That will NOT lower HC costs.

2. Lowering malpractice PREMIUMS will also NOT lower HC costs by more than 1%.

3. There is a problem with rising HC costs; but malpractice is NOT where we need to start, because it accounts for LESS THAN 1% of total HC costs.

4. By capping PAYOUTS and NOT PREMIUMS, bush f*cks the American citizen over and shields his insurance industry base, and does NOTHING whatsoever about lowering total healthcare costs.

5. Your OP "The lawsuits are driving up insurance prices for doctors." is FALSE.

[ramadoss]

23. trying

1. Malpractice suits are responsible for rising medical malpractice insurance premiums, not all healthcare costs.

2. I agree, 1% would be a 16billion dollar reduction. It should however keep medical malpractice insurance premiums from rising anymore.

3. Agree

4. Agree

5. Disagree. Read my link and try to understand the difference between total healthcare costs and just medical malpractice insurance costs. Because, malpractice suits only affect this type of insurance.

[LynnTheDem]

24. WRONG.

1. WRONG. Malpractice suits ARE NOT RESPONSIBLE for rising PREMIUMS.

READ your own link! Malpractice suit payouts have been DECLINING for years. Yet PREMIUMS are INCREASING. The PREMIUMS are NOT tied to the lawsuits.

[ramadoss]

26. WTF

Are you reading the same link as I am?

Here is the conclusion of the study I posted the link for.

Multiple factors have combined to increase medical malpractice premium
rates over the past several years, but losses on medical malpractice claims
appear to be the primary driver of increased premium rates in the long
term. Such losses are by far the largest component of insurer costs, and in
the long run, premium rates are set at a level designed to cover anticipated
costs. However, the year-to-year increase in premium rates can vary
substantially because of perceived future losses and a variety of other
factors, including investment returns and reinsurance rates. Moreover, the
market for medical malpractice insurance is not national, but depends on
the varying framework of insurance, legal, and health care structures

[LynnTheDem]

32. Seems pretty clear to me...

First, the amount that medical malpractice insurers have paid out, including all jury awards and settlements, directly tracks the rates of medical inflation. Not only has there been no “explosion” in medical malpractice payouts at any time during the last 30 years, but payments (in constant dollars) have been extremely stable and virtually flat since themid-1980s.

Second, medical insurance premiums charged by insurance companies do not correspond to increases or decreases in payouts, which have been steady for 30 years. Rather,premiums rise and fall in concert with the state of the economy —insurance premiums (in constant dollars) increase or decrease in direct relationship to the strength or weakness of the economy, reflecting the gains or losses experienced by the insurance industry’s market investments and their perception of how much they can earn on the investment “float” (which occurs during the time between when premiums are paid into the insurer and losses paid out by the insurer) that doctors’ premiums provide them.

****

And then you said this sounded like what you originally posted:

While medical malpractice caps limit the rights of injured patients, they do not lower doctors' premiums.

Yet again now you're saying the opposite??? Make up your mind. ;)

FACT: Malpractice lawsuit PAYOUTS are NOT causing malpractice PREMIUMS increases. PAYOUTS have been STEADY and even DECLINING for years, yet INSURANCE PREMIUMS have been INCREASING.

The PREMIUMS are NOT increasing because of STEADY/DECLINING PAYOUTS.

[ramadoss]

34. WTF, seriously

I never said the opposite of that. I said caps will not lower premiums, I haven't said any different.

Read my link again and check out the tables and graphs.

After that, there is nothing more I can do for you.

[WillowTree]

29. Quote:

"Multiple factors, including falling investment income and rising reinsurance costs, have contributed to recent increases in premium rates in our sample states. However, GAO found that losses on medical malpractice claims—which make up the largest part of insurers’ costs—appear to be the primary driver of rate increases in the long run."

http://www.gao.gov/new.items/d03702.pdf

Page 2

[ramadoss]

30. hehe

:smoke:

[LynnTheDem]

33. WRONG. And you can post the same single line out ot the same report

as often as you like. It does not change the FACTS.

Read the CONCLUSIONS.

Jebus f*cking Cripes.

PAYOUTS have been DECLINING. Yet PREMIUMS have been INCREASING.

WTF do you NOT understand about this???!!

[ramadoss]

35. And that changes what?

Based on available data, as well as our discussions with insurance industry
participants, a variety of factors combined to explain the malpractice
insurance cycle that produced several years of relatively stable premium
rates in the 1990s followed by the severe premium rate increases of the past
few years. To begin with, insurer losses anticipated in the late 1980s did not
materialize as projected, so insurers went into the 1990s with reserves and
premium rates that proved to be higher than the actual losses they would
experience. At the same time, insurers began a decade of high investment
returns. This emerging profitability encouraged insurers to expand their
market share, as both the downward adjustment of loss reserves and high
investment returns increased insurers’ income. As a result, insurers were generally able to keep premium rates flat or even reduce them, although
the medical malpractice market as a whole continued to experience
modestly increasing underlying losses throughout the decade. Finally, by
the mid- to late 1990s, as excess reserves were exhausted and investment
income fell below expectations, insurers’ profitability declined. Regulators
found that some insurers were insolvent, with insufficient reserves and
capital to pay future claims. In 2001, one of the two largest medical
malpractice insurers, which sold insurance in almost every state,
determined that medical malpractice was a line of insurance that was too
unpredictable to be profitable over the long term. Alternatively, some
companies decided that, at a minimum, they needed to reduce their size
and consolidate their markets. These actions, taken together, reduced the
availability of medical malpractice insurance, at least in some states,
further exacerbating the insurance crisis. As a result of all of these factors,
insurers continuing to sell medical malpractice insurance requested and
received large rate increases in many states. It remains to be seen whether
these increases will, as occurred in the 1980s, be found to have exceeded
those necessary to pay for future claims losses, thus contributing to the
beginning of the next insurance cycle.

[WillowTree]

36. From the CONCLUSIONS

"Multiple factors have combined to increase medical malpractice premium rates over the past several years, but losses on medical malpractice claims appear to be the primary driver of increased premium rates in the long term. Such losses are by far the largest component of insurer costs, and in the long run, premium rates are set at a level designed to cover anticipated costs."

Page 43

also, from Page 44

"..........losses aggregated for the industry as a whole have shown elatively consistent upward trend over time.........."

Which kind of blows the "PAYOUTS have been DECLINING" argument out of the water.

Not that it will make a difference in the direction of this discussion. I harbor no delusions about that.

[LynnTheDem]

38. Incorrect. In fact, payouts have held steady and even declined

over the past decade.

And there are several US government reports that state that as a fact.

Get over it. :)

The NPDB is a U.S. government agency that collects reports of every judgment or settlement paid to malpractice victims throughout the country by insurance companies on behalf of doctors.

National Practitioner Data Bank (NPDB) records include the following:

-The number of medical malpractice payouts declined 13 percent from 1991 to 2002, dropping from 1,303 to 1,129. Moreover, the number of payouts declined 22 percent from 2001 to 2002.

-The median malpractice payout made to individuals declined by 9 percent from 1991 to 2002 when adjusted for medical inflation.

-The total amount of malpractice payouts has remained nearly flat over the past decade when adjusted for medical care services inflation.

Lawsuit PAYOUTS are STEADY or DECLINING; insurance PREMIUMS are INCREASING.

[Sgent]

25. The major problem with malpractice

usually isn't the money -- its the reverberation.

The average CHC physician orders $875 per patient visit in tests and medicines.

The average family physician orders about $2000.

Huge difference, the question is why? One answer, and one that I happen to buy into knowning doctors who worked in both systems, is the fact that they are concerned with malpractice. CHC physicians are immune to lawsuits.

Neither gets greater income by ordering more outside testing, but liability is reduced. Failure to diagnose is the action item for most lawsuits against medical (vs. surgical) practices.

Source: The Bureau of Public Health Service and the Medical Group Management Assn.

[ramadoss]

28. Word

From someone in the healthcare industry. :thumbsup:

[WillowTree]

31. 'Twould be pointless

From what I've seen, LynnTheDem will never concede even "LESS THAN 1%" of a point, even when confronted with documentation.

[LynnTheDem]

37. I've read all your prior posts, Willow dear.

Surprised you're still with us. ;)

FACT: Lawsuit filings and payouts have stayed flat virtually for a decade.

FACT: Malpractice insurance PREMIUMS have been INCREASING.

FACT: If premiums were linked to payouts, premiums would also be virtually flat.

FACT: Caps on payouts will not lower premiums or HC costs.

FACT: ALL malpractice costs are less than 1% of total healthcare costs.

And you can all post the same report as many times as you wish; it doesn't change the facts.

NEW GAO STUDY FINDS NO SUPPORT FOR CAPS ON DAMAGES; FINDINGS ON “LOSSES” CHALLENGED BY CONSUMER GROUPS

A new study released by the congressional General Accounting Office, entitled Medical Malpractice Insurance: Multiple Factors Have Contributed to Increased Premium Rates, finds absolutely no support for capping damages as a solution to bring down insurance rates for doctors. The report finds that “ultiple factors have contributed to the recent increases inmedical malpractice premium rates,” most of which have nothing to do with the legal system.

In fact, of the seven states examined by GAO, the one with the smallest increases in rates is Minnesota, which does not have a cap on damages. Moreover, to the extent the GAO report finds that insurer losses also contribute to rate hikes, actuary and spokesperson for Americans for Insurance Reform, J. Robert Hunter, finds that the methodology used by GAO to reach this finding was seriously flawed.

According to Hunter, former Federal Insurance Administrator and Texas Insurance Commissioner, had the correct methodology been used, GAO would have reached the opposite conclusion: that losses have not risen but have, in fact, been stable. (See, AIR study, Stable Losses/Unstable Rates,http://www.insurance-reform.org/StableLosses.pdf.)

http://www.centerjd.org/air/pr/AIRGAO.pdf

[WillowTree]

40. LOL!!

Amusing that the title of your article begins with the statement "NEW GAO STUDY FINDS NO SUPPORT FOR CAPS ON DAMAGES.........." when, in fact, the study itself found exactly the opposite. That fact alone demonstrates that the consumer group involved went into it with a pre-determined conslusion and worked backwards to get to that it.

But that's fine. One of the great things about our Country is that you're free to believe whatever you want. No skin of this nose.

I will say, however, that the condescending tone doesn't add credibility to your argument.

Have a super day now!

[LynnTheDem]

42. Better reread the GAO report then, hadn't you.

But how sweet of you to believe all government reports, even without actually reading them!

And do you also believe the many US Government reports that say Saddam Hussein did NOT "gas the Kurds"?

Or do you cherry-pick which US Government reports you choose to believe? ;)

It's not "my judgement"; it's the judgement of the experts, including the US government, whose own statistics show that in fact lawsuit payouts have held steady and even declined over the past decade, while insurance premiums have increased.

You have a super day yourself, dear.

[Bridget Burke]

39. We got Reward Caps in Texas some time ago.

Malpractice Insurance has kept going up. Health care has continued to become more expensive.

"Tort Reform" is a Republican scam. They're obviously eager to hide the truth.

[LynnTheDem]

41. I believe some 27 states have had caps for some time

And of course insurance premiums continue to rise, along with HC costs. And the state with the lowest increase in insurance premiums has no lawsuit caps.

It's simple, really; lawsuit payouts have held steady (or declined), yet insurance premiums keep rising. "Insurance scam" comes to mind.

And cameras are the Abu Ghraib problem; so the US military issues the order that cameras are not allowed. :eyes:

[WillowTree]

43. And all of this explains...

....why every year more insurance companies get out of the medical malpractice business altogether. They're making so much money on that line of business that they just can't handle it so they throw in the towel. That just makes perfect sense.

[LynnTheDem]

44. Fact; lawsuit payouts have held steady or declined

Insurance premiums have INCREASED.

Fact: Several states DO have lawsuit caps & have had lawsuit caps for a long while.

And you can argue bush's bushit all you like, but the facts are the facts.

[Bridget Burke]

45. Which poor insurance companies have abandoned...

Medical malpractice insurance? If I knew, I'd be properly sympathetic. I promise.

[WillowTree]

46. Well, most notably, St. Paul.

Medical malpractice used to be one of their specialty lines and at one time St. Paul wrote something in the vicinity of 20% of the malpractice market nationwide.

Other companies like Frontier, PIE Mutual, Reliance, and PIC, which all used to be players in the market to one degree or another are no longer writing medical malpractice because..........well..........they're no longer in business.

And here's an interesting little factoid. Below is a chart compiled by A.M. Best showing the industry-wide loss ratios for medical malpractice insurance during the nineties:

Year.....Net Premiums Written.....Combined Ratio*
1990.....$4,014,622,000...........101.9%
1991.....$4,067,803,000...........99.0%
1992.....$4,133,567,000...........123.4%
1993.....$4,370,812,000...........104.5%
1994.....$4,780,537,000...........94.2%
1995.....$4,800,552,000...........96.4%
1996.....$4,875,486,000...........102.6%
1997.....$4,892,496,000...........103.5%
1998.....$5,145,066,000...........111.9%
1999.....$5,104,147,000...........125.8%

Bear in mind that for most lines of insurance, if a company's loss ratio is above 50%, they're taking an underwriting loss on that line. These, however, are not pure loss ratio figures, but combined ratios, meaning that they take not only premiums and claims paid into account, but also administrative costs, claim costs (the cost to actually defend and/or adjust claims), commissions and policyholder dividends (dividends not being much of a factor, if at all, in a casualty line of business such as malpractice). So, a 100% combined ratio is the break-even point. Therefore, in that whole decade, in only two years did they make even a modest underwriting profit, one year they barely broke even, and in the other years they took a beating. And while it's true that insurance companies rely heavily on investment income for their profits, if they're taking an underwriting loss, not only is there nothing to invest, they have to draw-off investments to cover that loss. No insurance company would be in business very long if they continue to write lines of business that lose money.

And, for the record and to reiterate, those figures come from A.M. Best, the formost rater and evaluator of the financial stability of insurance companies. They're not part of the insurance industry nor are they paid by insurance companies. They have no ax to grind or reason to fudge their figures because their stock in trade is providing accurate, reliable and unbiased financial evaluations to investors and the insurance-buying public.

It's true that underwriting results in the last few years have improved somewhat, but that's because of much tighter underwriting restrictions and increased premiums. And that's for a diminished pool of carriers writing med mal because companies have been reluctant to re-enter that arena due to it's increasingly tenuous profitability in recent years. (Yes..........I know. Insurance companies are villains for making a profit on the losses of others. But until someone, or a bunch of someones, begin to start not-for-profit insurance companies and those not-for-profits find a way to cover the losses effectively, that's just a fact of life in an economy based on capitalism. I sometimes resent the auto makers for making a profit off the fact that I need to be able to get to work, but I deal with it.)

[Bridget Burke]

47. Glad to hear from a spokesman for the Insurance Industry.

Texas got award caps & malpractice insurance keeps going up.