Why such a gobsmackingly large increase in malpractice insurance?

One of the many current controversies in health care is who will pay for obstetrical malpractice insurance. The Province has traditionally paid the lion’s share of the annual premium.

This year the Province has balked at paying the traditional 90 per cent portion because the insurance premiums have jumped 252 per cent, over $30,000, in one year!

How in hell does a price soar so much in such a short time? Where but in a world where people rely on the seemingly bottomless public purse can you expect to introduce such a gobsmackingly high increase in such a short time frame? What caused such a jump? Have provincial doctors suddenly lost their medical ability and engaged in mass, catastrophic care for newborns and mothers?

On Monday, a Halifax-based personal liability lawyer appeared on CBC’s Information Morning. According to him, problem births and resulting legal action were down in Nova Scotia. However, he said this high premium was driven by the insurer’s refusal to negotiate settlements. He said, “They will spent $200,000 not to pay $100,000.”

Is this insurer the insurer of last resort or would a private insurer be cheaper? I have heard threats by obstetricians to leave the province if the government doesn’t pay for the coverage, but I have not heard any discussion about an alternative insurer. What are the numbers?

How do your costs rise so much in one year? Is this yet another example of the poor management across Canadian health care? Why wouldn’t you anticipate rising costs so that annual premiums could be gradually increased? If a person’t car, house or life insurance jumped this much in a year they’d be shopping around for a new insurer, why not malpractice insurance?

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6 Responses to Why such a gobsmackingly large increase in malpractice insurance?

  1. ausca says:

    Yesterday I attended a briefing with PC MLA Chris D’Entremont at Province House, introducing Dr. Robyn MacQuarrie, an obstetrician from the south end of the province. She said that obstetrics carries more risk than other specialties typically covered my malpractice insurance, and that is reflected in the huge premium. She painted a grim picture of obstetricians leaving and the few remaining being seriously overloaded. Interestingly she also described how obstetricians and family doctors work hand in hand, and as obstetric services become less available, that pushes further risk onto family practices who will ultimately have to draw the line at what risk exposure they can handle.

    If this policy remains, it means that women from the south shore will have to go to Halifax for these services, and where the sudden unexpected need for an obstetrician arises, this could actually put lives of mothers and unborn at risk.

    I don’t recall her explaining why the premium’s have increased as dramatically as they have (I think she said they rose to $38,000). She said that not only did the government did not renew their long standing support of this unusually high obstetrics malpractice insurance premium without warning, they backdated it to the start of the year, in essence reneging on their previous arrangement.

    This appears similar to the way they have ambushed the film and TV industry. Promise to extent the tax credit for 5 years before the last election, then suddenly render it worthless with no notice and without consultation, and try to tough your way out.

    • Women on the South Shore may have to drive to Halifax, but for several years women in Yarmouth and French Shore have had to drive to the Valley to deliver their babies.

      I’ve been wondering about these threats to leave the province. With malpractice insurance rising across the country, won’t they face the same costs wherever they go? Unless other provinces pay a higher portion of the premiums.

      I’m still trying to understand how an insurance premium rises so substantially in such a short time. Obstetrics may carry more risk, but if provincial claims and size of settlements are declining then there would seem to be no reason for such a jump, unless we are paying for the negligence of other provinces.

      • ausca says:

        I would guess obstetricians are in big demand, and provinces who can afford to lure them by malpractice insurance assistance would do so.

        I wonder at what point it might make financial sense for the province to insure them directly?

      • I have wondered about direct insurance. But I still wonder if a private insurer wouldn’t provide some competition to drive premiums down?

      • ausca says:

        As I understand it, the government is refusing to pay the obstetrics malpractice premiums because they just increased to something they consider unreasonable.

        Obstetricians cannot practice without malpractice insurance.

        If the people in the south end of the province are to have babies (like people elsewhere in it) they need obstetricians.

        So it seems to me, either the government decides that women in the south end of the province shall become pregnant at their increased risk (a significantly higher on than those in HRM) or they find a way to attract and keep obstetricians by insuring them against malpractice risks. If they feel private insurers are overcharging they might be able to insure them directly.

        So in the end, will the government allow women in the south of Nova Scotia face the same pregnancy risks as those in HRM?

        If the answer is NO (for whatever reason) then how does that comply with the Accessibility requirement of the Canada Health Act that states that they “…must provide for “reasonable access” to insured services by insured persons…”

        If it does not comply, doesn’t that expose the government to litigation?

      • Obstetrics is only one of the many uneven health services in the province. Had anyone done an audit at any time in the last 10 or more years Nova Scotia would have failed on universal access.

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