In a 14-1 decision Monday, the Public Health Trust that runs Jackson Memorial Hospital backed UM’s School of Medicine in its proposal in the Florida Legislature to instate a $200,000 cap on medical malpractice claims as immunity for its medical staff.
What makes Jackson Memorial Hospital so exclusive is that most of its medical staff is furnished by UM’s School of Medicine. Though the camaraderie between this public institution and its benefactor, a private institution, has lasted 51 years, the medical malpractice crisis has shoved it into rocky waters.
In contrast to many South Florida doctors, Jackson cannot deny healthcare to indigent and Medicaid patients. Because of this situation, UM’s medical school is taking the hit.
UM wants to be protected by the same “sovereign immunity” principle as other doctors for its 700 doctors working at Jackson, which itself, as a public institution, is innately protected by this cap.
In 2002, the University’s total malpractice insurance expense was more than $32 million. Last year, it soared to almost $50 million. This debacle led to the School of Medicine losing $30 million last year, and according to Dr. John Clarkson, dean of the medical school, this year’s forecast is not any brighter.
However, Clarkson’s was the one vote in opposition of this decision. His reason is one with which many agree – that imposing a cap on all patients may divert even paying patients to other hospitals.
According to The Miami Herald, results from a trust-commissioned telephone survey of 82 Miami-Dade residents with health insurance showed that, for more than half, the cap would possibly affect the selection of doctors, especially if they are protected by the cap. Half said that, despite this, they would still keep the same physician.
According to Clarkson, two-thirds of all patients at Jackson are either financially covered by state programs such as Medicaid or not covered at all. The other third, private patients of the 700 UM doctors, bring in more than half of the hospital’s annual revenue. This crucial contribution would otherwise be on the shoulders of the Miami-Dade and Florida taxpayers. There are about 500,000 uninsured people and 400,000 Medicaid recipients in Miami-Dade County.
“The relationship between UM and Jackson is strained because of the amount of money UM must put in reserve for lawsuits. If the relationship ceases to exist, that could really hurt the residents of Miami-Dade County.”
– Marcelo Llorente, State Rep. (D-Miami)
“This is incredibly important to our community and to the quality of care at Jackson Memorial Hospital,” state Rep. Marcelo Llorente, D-Miami, who plans to sponsor the bill, told The Daily Business Review. “The relationship between UM and Jackson is strained because of the amount of money UM must put in reserve for lawsuits. If the relationship ceases to exist, that could really hurt the residents of Miami-Dade County.”
Ron Book, the chief UM lobbyist, told the Daily Business Review that the cap will save UM about $40 million annually, and that money can be directed toward education and the recruitment of new faculty.
Book also said that UM is the only medical school in the country without the proper immunity. He cited Emory University and Baylor University as examples of schools treated differently, but representatives from those schools refute his statement.
UM President Donna Shalala, the former secretary of Health and Human Services in President Clinton’s administration, is backing the decision and has called upon legislators to pass the malpractice plan.
The late Jay Weiss, a UM medical school patron who recently passed away, dedicated his final weeks to passing the malpractice cap.
According to The Miami Herald, his efforts were passed to the hands of Senate President Jim King, who had told Weiss that he “would do everything [he] could to get [the bill] passed.”
Some lawyers, namely The Academy of Florida Trial Lawyers [AFTL], question the bill’s constitutionality and claim that UM wants the best of both worlds: the advantages of being a private institution and the sovereign immunity of being employees at a public organization.
“They have it better than any other doctor in the state,” Debra Henley, the AFTL’s legislative director, told The Miami Herald.
Whether or not this is true, the final decision has saved the UM-Jackson relationship from a potentially detrimental ending.
Shalu Patel can be contacted at s.patel16@umiami.edu.