Dr. Valerie Zarcone was among some 40 physicians from Westchester County who rallied in Albany last week for a legislative health care reform package that would increase physicians”™ bargaining clout with managed-care companies and lower the rates they pay for malpractice insurance. For Zarcone, the issues at stake that drove her to organize a bus trip from Cortlandt Manor to the state Capitol have been felt both professionally and in her family.
About four years ago, her brother, like her an internist with a general practice in Putnam Valley, moved to a small town in Texas to open a medical practice there. Dr. Gregory Zarcone left a state with the highest medial liability insurance rates in the nation for one that through tort reform has put a cap on the malpractice premiums that doctors pay.
In New York, Zarcone said on the bus ride home with 17 other physicians from Hudson Valley Hospital Center, “The cost of running an office as a sole practitioner is so exorbitant that we”™re seeing an exodus of many internists out of the state.” Part of that cost also is due to the legal inability of physicians operating individual businesses to band together and collectively negotiate medical reimbursement rates with the large managed-care companies that set those rates.
Zarcone”™s brother was part of that exodus that state officials and business groups such as the Westchester County Association want to curb by reforming the state”™s health care system and reducing physicians”™ costs to do business here. The Medical Society of the State of New York brought about 1,100 physicians to Albany on March 3 in pursuit of those same goals. It expected to spend more than $150,000 to mobilize them last week and more than $800,000 in an ongoing advertising campaign for medical liability reform.
In Westchester County, said Zarcone, the average payment for malpractice insurance for an internist is about $22,000 a year. A specialist in obstetrics and gynecology, or OB/GYN, on average pays about $140,000 a year in the county. At the highest end, a Westchester neurosurgeon pays about $300,000 a year for medical liability coverage, she said.
Zarcone said many OB-GYNs are dropping their obstetrics practices because of those high premium costs.
After some 2,000 physicians rallied in protest at the Capitol last year, state lawmakers imposed a one-year freeze on proposed medical malpractice premium hikes of 11 percent to 30 percent, which would have followed a five-year period in which liability premiums for most New York physicians increased by 55 to 80 percent, according to state medical society officials. The one-year moratorium expires July 1.
Dr. Michael Rosenberg, president of the state medical society and a plastic surgeon at Northern Westchester Hospital”™s Institute of Aesthetic Surgery and Medicine in Mount Kisco, said physicians were “encouraged” by what they heard last week from Gov. David A. Paterson and state commissioners and legislators who spoke at the outdoor rally.
He said top Democrats in the Assembly are sponsoring a bill that would package measures to relieve the high cost of malpractice insurance, allow doctors to directly negotiate more favorable reimbursement rates with managed-care companies ”“ five of which enroll 75 percent of insured patients in the state, Rosenberg said ”“ and increase patients”™ insurance coverage, especially for the uninsured.
“We”™re very concerned that there be an adequate safety net in New York to provide that care,” Rosenberg said.
“That was our theme: We need to get a higher percentage of health care dollars going into health care,” rather than into malpractice premiums and health care insurers”™ profits, he said. The state”™s medical liability system “is a tremendous drain of needed financial resources in health care into something that has nothing to do with care,” he said.
Addressing his rallying colleagues last week, Rosenberg said in his travels around the state for the medical society he has seen “the fear and frustration of physicians who worry about the future of New York”™s health care system.” Hospitals are closing, including three in Queens, and six counties in the state have no practicing obstetricians, he noted.
“We are here today to save the practice of medicine in New York and it”™s going to take all of us working collectively to do that,” he said.
“Physicians as a group usually are a complacent bunch and don”™t get too much involved in government or health care reforms,” Zarcone said on the bus ride home. “I think we have to take an active role.”
