Belleville News-Democrat, February 25, 2010

BY TOM KEEFE

Most folks agree there are two sides to every story.

It seems that only one side of the malpractice story has been told. There is another side; and while I freely admit I am an advocate for this side of the story because it benefits me and my clients, it is still a side worth considering.

The malpractice story is not just about doctors versus lawyers; it is also about insurance companies.

Everybody hates lawyers (until they need one). I've been practicing for more than 30 years; I get that. As long as insurance companies, through their lobbyists such as the Chamber of Commerce and the Civil Justice League, can make this story about lawyers, then to many the case is closed. But what about insurance companies that are making exorbitant profits at the expense of patients and physicians?

Ask your doctor whether he feels adequately reimbursed by your health insurance company. The reality is that he is not. Ask your doctor how much she must pay office staff to process insurance claims so that she can be reimbursed 50 percent of the value of her services, and then compare those percentages to the percentage of profits "earned" by the insurance industry.

And Doctor, ask your own malpractice insurance company -- Illinois State Medical Insurance Exchange (ISMIE) -- how much profit it "earned" during the "malpractice crisis" between 2006 and 2008. Nearly $125 million -- $124.2 million to be precise.

We know all this because the legislature passed a law that required ISMIE to open their books, and when they did, other insurance companies realized there were "profits" to be made in Illinois. The result? Competition in the market place, which lowers premiums.

And please, Doctor, ask ISMIE if they really thought when they were setting your premiums that the caps wouldn't be declared unconstitutional. I assure you the actuaries at every insurance company writing coverage in Illinois predicted this result.

Doctors will not experience an increase in malpractice premiums unless ISMIE is permitted to return to their time-honored practice of putting their profits ahead of doctors and patients.

Please don't believe me; just ask the Illinois Department of Insurance, which has called on these companies to continue to comply with the insurance reforms that have actually lowered premiums by 10 percent. (http://www.insurance. illinois.gov/newsrls/ 2010/02202010 a.asp).

The answer to the malpractice problem is to recognize it is also an insurance problem which was addressed by insurance reform, and which will remain addressed by re- enacting laws that hold insurance companies accountable -- the same kind of laws that could have held AIG accountable last year and saved taxpayers billions of dollars.

I hope no one has to experience what my clients have experienced during the past 30 years: a brain damaged baby; a dead mother or child; a blind or paralyzed father. Medical negligence does occur -- perhaps not often, but when it does should we as a society bear that burden? The insurance companies think so because for every dollar we pay, it is another dollar of profit for them.

Every citizen of this state, including doctors and patients, is entitled to equal protection under the law; and no one, including insurance companies, is above the law.

Tom Keefe is a Belleville lawyer who represents patients and doctors.