When the 2017 session of the New York State Legislature opens in early January, those who carefully follow action or inaction in Albany will be waiting to learn what Governor Andrew Cuomo will include in his State of the State Address and proposed state budget. The annual battle of the budget will be the major focus of state legislators and others for the next three months.
Last fall, as in every year, the Medical Society of the State of New York, in conjunction with county medical societies and state specialty societies, prepared its 2017 Legislative Program. This six-page document was the end product of two separate meetings of several hours each that could be attended in person, on the phone or by teleconference by physicians and medical societies staff. The legislative program titled “Enhancing and Assuring Quality Patient Care,” was approved by the state medical society’s Council in November.
The 2017 Legislative Program outlined the following ten goals for the year:
- The need for fair and comprehensive health insurance coverage
- The need for comprehensive medical liability reform
- Attracting and retaining physicians in New York State
- Enhancing quality of care through peer review
- Enhancing care through e-prescribing
- Enhancing quality and integration through HIT
- Eliminating health disparities
- Quality through physician-led, team-based care
- Assuring clinical clerkships for U.S. medical school students
- Public health initiatives
Increased paper work for physicians is one of many challenges for practices. The September 6, 2016, issue of Annals of Medicine reported that for every hour a physician spent seeing patients, another two hours was spent on paperwork. Nearly 21 percent of responding physicians indicate that one-quarter to one-half of their patients now face deductibles of $2,500 to $5,000. Also highlighted was the ever-increasing cost of medical liability insurance in New York state. For example, here are five premiums paid by downstate physicians in five different specialties for the 2016-2017 premium years: $338,252 for a neurosurgeon; $186,630 for an obstetrician; $141,534 for an orthopedic surgeon; $132,704 for a general surgeon; and $134,902 for a vascular surgeon.
The legislative program cited a recent report by Diederich Health Care that lists our state as having the highest number of cumulative medical liability payments in excess of $711 million. This amount is nearly two times greater than the state with the next highest amounts, Pennsylvania, with more than $370 million, and far exceeding states such as California, with nearly $264 million, and Florida, with nearly $249 million. California has a population with almost twice the population of New York state. Following the national medical liability insurance crisis in 1975 California saw fit to enact “comprehensive medical liability reform.”
Fourty-two years later, the New York State Legislature still continues to refuse to approve similar reform measures. Not to be overlooked are significant increases in practice expenses substantiated by the Medical Group Management Association. Practice expenses per physicians have risen more than 50 percent in the past decade, nearly twice as much as inflation. New York state is also encountering a significant drop in retention of physicians. The Center for Health Workforce Studies claims that the in-state retention of new physicians has declined from 54 percent in 1999 to 45 percent in 2015.
Moe Auster, MSSNY’s new Senior Vice President and Chief Legislative Counsel, emphasizes how vital it is for physicians to be heard in support of measures that will improve patient care and to speak out against measures that negatively impact patients and physicians. State legislators, he says, do pay attention to physicians and their views on pending legislation. Auster worked in the State Senate and the State Assembly before joining MSSNY’s Albany office in 1999. He stated that last year the legislature strongly considered but did not pass the Statute of Limitation bill due in part to strong advocacy efforts of MSSNY and many other healthcare associations and strong grassroots efforts. Trial lawyers are expected to try again to pass the bill in the 2017 session.
Gerald N. “Jerry” Hoffman was chief executive officer of the Onondaga County Medical Society from 1981 until his retirement on Jan. 31, 2014. He is co-author of two books, “Medical Malpractice Insurance: A Legislators View” and “The History of Local Medical Care: Celebrating Physicians Past and Present 1806-2006.”