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    Liability reform takes giant leaps forward

    This article is part of an ongoing series from the American Association of Clinical Urologists (AACU), based on a partnership between the AACU and Urology Times. Articles are designed to provide monthly updates on federal and state legislative issues affecting urologists. We welcome your comments and suggestions about topics for future articles. Contact Ross Weber, state affairs manager, or Joe Arite, federal government affairs manager, at 847-517-1050 or

    Arguments abound as to whether the Patient Protection and Affordable Care Act will drive health care costs up or down. Until provisions related to health insurance, information technology, Medicare, and Medicaid are implemented over the next several years, those battles will mostly be fought in arenas that do not impact the practice of urology today.

    In the immediate term, lawmakers at the state and federal levels are beginning to grasp the fact that medical liability reform can (and does) promote access to care and bend the "cost curve" downward. Liability pressures increase health costs between $84 and $154 billion every year. Indeed, a 2010 study found that more than 60% of physicians agreed with the statement, "I order some tests or consultation simply to avoid the appearance of malpractice."

    When pushing liability reform, advocates often point to long-standing reforms in California and Texas. The National Association of Insurance Commissioners reports that while liability insurance premiums increased 945% nationwide between 1976 and 2009, they rose less than one-third of that amount (261%) in California after the state approved the Medical Injury Compensation Reform Act of 1975. Following sweeping 2003 reforms in Texas, the state has experienced a 59% growth in newly licensed physicians.

    In 2011, lawmakers in Florida, Michigan, Pennsylvania, and Tennessee, to name just a few, expect to introduce legislation that will ultimately reign in liability insurance premiums and thus make their states more attractive to business.

    During an early special session in Wisconsin, Gov. Scott Walker (R) secured approval for a number of tort reforms, including rules of evidence in medical malpractice actions.

    A number of states have already drafted measures to limit damages in medical liability cases. These states include Connecticut, New Jersey, New York, and Oregon. Oregon and Virginia alternately propose to increase the cap on certain damages. In the case of Virginia, this change was agreed to by the Medical Society of Virginia and the Virginia Trial Lawyers Association.

    Damages caps are supplemented in the medical liability realm with measures concerning special courts, insurance premium tax deductions, expert witness qualifications, and evidence admissibility standards. As the only national organization with the sole purpose of promoting the professional autonomy and financial viability of all urologists, the American Association of Clinical Urologists is monitoring these efforts and mobilizing physicians whenever action is warranted. Visit aacuweb.org for more information and to register for a Feb. 22 Health Policy Update conference call on this issue.

    To learn more about legislative issues in your state, please visit AACU's Action Center today at www.aacuweb.org

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