Categorized | Suffolk Close-up

RX For Local Health Care

Posted on 14 January 2011

The medical system in Suffolk County needs treatment.
By Karl Grossman

The problems are numerous—many related to the situation nationwide of a health care system mainly based on a few gigantic profit-making health insurers. But there are also problems specific to this area.

Take malpractice insurance. The rates of malpractice insurance in Suffolk are high—“very high relative to other states and other areas of New York State,” explains Dr. Fred Weinbaum, chief medical officer at Southampton Hospital. Neurosurgeons pay as much as $270,000-a-year in Suffolk in malpractice insurance. Rates for obstetricians and orthopedic surgeons are nearing $200,000.

The high rates have been a factor in doctors leaving Suffolk for places where malpractice
insurance comes at a much lower cost, such as Texas and Virginia, and some have restricted their practices to lower the charge or retired.

For years physicians in New York have cited a need for tort reform—limits on monetary awards for damages—and pointed to State Assembly Speaker Sheldon Silver as the major obstacle to this. The doctors note the Manhattan Democrat’s other job is as attorney for Weitz & Luxenberg, P.C., a law firm with a major specialty of suing for malpractice.“Sadly, such negligence leads to thousands of deaths every year,” declares the firm on its website which currently highlights a verdict it received for $8.6 million for an improper delivery that, it says, left the child with cerebral palsy and retardation.

It may be a complex issue. But for us here: why the big disparity between Suffolk and other areas in malpractice insurance rates?

Then there’s a big disparity in reimbursement rates—how much the health insurers pay for treatment elsewhere and here. In “many parts of the country,” said Dr. Weinbaum, the private insurers pay more than the government’s Medicare rates. Here it’s less. “We are regarded by the insurers as being a rural environment similar to upstate New York where costs are lower,” said Dr. Weinbaum. But that’s not the economic reality of eastern Suffolk, he emphasized.
Because of inadequate reimbursement, the economics for the area’s medical practitioners have gotten “very difficult,” says Paul Connor III, president and CEO of Eastern Long Island Hospital.

Mr. Connor was a leader in getting fairer reimbursement rates from the health insurers for the three major hospitals here. In 2009, for the first time, Southampton and Eastern Long Island Hospitals and Peconic Bay Medical Center joined together to bargain collectively with the insurers. There’s strength in unity. It was a five-month battle with the insurers putting the hospitals “out of network” during that period. But, in the end, a settlement was reached and now the three hospitals receive reimbursement “at market rates,” said Mr. Connor.

What would it take for physicians and other health professionals to get the same?
Then there’s the cost of housing. Several hospitals in other parts of the country where housing costs are also high are providing housing for health care workers. Eastern Long Island Hospital owns several apartments and a small house to try to meet this problem.

The malpractice insurance rates for family practitioner Dr. Allen Fein of Southampton have been steadily rising to now over $24,000-a-year—“even though I’ve never been sued, never even got a lawyer’s letter.” Further, he’s on a committee that judges the work of other doctors. With 4,000 patient-visits a year, “we calculate six bucks a visit” to cover the insurance. Meanwhile, reimbursement rates from the health insurers are “dismal.” And costs continue to increase. Still, “I love our patients. We love it here. I’m not leaving,” said Dr. Fein.

Overall, “from a societal point of view, the American system is woefully lacking,” said Dr. Fein. “When I hear Americans say we have the best health system in the world, I believe this reflects a limited social perspective,” said the Canadian native. Michael Moore’s film “Sicko showed a lot of insight.”

As Dr. Fein spoke last week, the new Republican majority in the House of Representatives was getting ready to try to repeal the Obama health care reform law.

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