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Courtroom meets emergency room in health care debate
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Several dozen parents came to the Capitol to ask the Legislature to scale back their fee increases for services for their children. Joni Metcalf of White Bear Township says her families fees to care for their son Michael went from $222 a month to $532 a month. (MPR Photo/Laura McCallum)
The debate over health care costs began in earnest at the Capitol on Wednesday. A couple of doctors urged a House committee to pass medical malpractice reform. Caps on malpractice awards are part of a Republican bill designed to control rising health care costs. Testimony also focused on pain inflicted by the 2003 Legislature when it raised the fees paid for services by parents of disabled children.

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Image Dr. Gary Gosewisch

St. Paul, Minn. — A bill sponsored by Rep. Fran Bradley, R-Rochester, contains a number of measures that Bradley says will rein in health care costs. He wants to prohibit new health care mandates for three years and allow for-profit HMOs to operate in the state. His bill would also cap damages in malpractice lawsuits at $250,000, and prohibit punitive damages against non-profit hospitals.

An emergency room doctor told a House committee that Bradley's bill is badly needed. Dr. Gary Gosewisch heads a group of emergency room physicians. Gosewisch says the group's medical malpractice rates have gone up 1,000 percent in the last three years. Gosewisch says five malpractice cases cost his practice $7 million in the last five years.

"It's no longer reasonable outcomes. It's now the lottery. As I said before, you're much better off to go to a hospital if you want to win the million dollar lottery than you are to go out to Mystic Lake," he said.

Gosewisch says some doctors don't want to deliver babies anymore because of the fear of lawsuits. Gosewisch says he's told his partners to run extra tests on patients, because they can't afford to face a malpractice suit. He says that leads to longer waits for patients in the emergency room, and unnecessary health care costs.

The Minnesota Trial Lawyers Association opposes a cap on damage awards, and points out that Minnesota's malpractice rates are among the lowest in the country.

Some DFL lawmakers say malpractice reform won't do much to lower health care costs.

"There are quite a few states that have capped damages. Show me one of those states that has reduced their health care costs," said state Sen. Linda Berglin, DFL-Minneapolis, who is widely considered the lead health care expert in the Senate.

Berglin also says states with for-profit HMOs haven't lowered their health care costs. Berglin plans to introduce her own cost containment bill that will take a much different approach than the Bradley bill. She's proposing that doctor's offices and hospitals switch from paper medical records to an electronic system, and wants to limit health insurance premium increases to six-percent a year.

"We want the savings to be translated to the consumer. And we believe the only way that will happen is by putting caps on the inflation in health care," she said.

Berglin also wants to restore some of last year's health care cuts. The 2003 Legislature reduced eligibility and increased co-pays for state health care programs. Berglin says low-income Minnesotans who've lost benefits will end up in the emergency room more often, boosting health care costs.

Another cut some lawmakers want to restore affects parents of children with disabilities. Several dozen parents came to the Capitol to ask the Legislature to scale back their fee increases for services for their children.

Joni Metcalf of White Bear Township says her son Michael, 11, has a degenerative brain disease. Her fee went from $222 a month to $532 a month.

"I'm here today to tell you that this is wrong for the state of Minnesota to cut these programs and place financial burdens on the back of those that are already less fortunate, when all we are trying to do is survive and live respectable lives," Metcalf said.

Several lawmakers plan to introduce legislation to lower the fee increases at a cost of around $2 million.

House and Senate health care committees have their work cut out for them this session; they'll be inundated with requests to restore funding cut last session, and they'll try to find consensus on health care reform.

Rep. Bradley says he thinks he and Sen. Berglin can find common ground on some issues. He says it's critical that the 2004 session do something.

"If the Legislature leaves here and does nothing on the health care cost issue, we're all going to be held accountable, and I don't think we want to be there," he said.

Bradley and the other 133 House members face re-election in November, while the Senate won't be on the ballot for another two years. Berglin says it's too early to say if the House and Senate can agree on a cost-control bill.

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