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December 1, 2011 in City
State may cut malpractice insurance for volunteer providers
Dr. Charles Wolfe treats a patient with a hernia at the Union Gospel Mission’s free medical clinic on Wednesday. Wolfe is among volunteer doctors across the state who could lose malpractice insurance to budget cuts.
(Full-size photo)
Among budget cuts Washington state lawmakers are considering is eliminating a program that pays for the malpractice insurance of health care providers who volunteer to treat the poor at free and low-cost clinics.
Though the state is struggling to close a $1.4 billion revenue shortfall, it is hard to imagine a more penny-wise and pound-foolish cut than eliminating Volunteer/Retired Provider Malpractice Insurance, say officials acquainted with the program.
“For less than $300,000, the state receives $82 million worth of care for the most impoverished citizens across Washington,” said Jodi Palmer, CEO and director of the Western Washington Area Health Education Center, which administers the program statewide.
“We would lose many volunteers across the state,” Palmer said. “Clinics would be forced to close, and their patients would end up in the emergency rooms of hospitals.”
On Wednesday, Dr. Charles Wolfe, a retired physician and former legislator, volunteered at the Union Gospel Mission clinic, which is open not just to shelter residents but to poor and uninsured patients from throughout the city.
Among his patients was a 50-year-old homeless man who showed up at the clinic when he could no longer bear the pain of an incarcerated hernia.
Wolfe, 80, who has volunteered at the mission for 16 years, said without state coverage of his malpractice insurance he could not treat any of the dozen or so men seated in the mission’s cramped waiting room.
“I can’t afford $10,000 a year,” said Wolfe, one of four retired physicians who volunteer at the clinic.
He estimated that the clinic receives about 2,400 patient visits a year. If just half of these patients ended up in hospital emergency rooms instead, Wolfe said, their care would cost more than $1 million. The cost would be passed on to taxpayers or insured patients in their premiums.
According to Palmer, the Union Gospel Mission, which also runs a clinic at Anna Ogden Hall, its long-term shelter for women and children, has nine volunteer providers covered by state malpractice insurance.
The House of Charity’s outreach clinic, run by Providence Sacred Heart Medical Center, has 18 volunteers covered under the program and has had more than 2,000 patient visits so far this year.
Christ Clinic has 10; Community Health Association of Spokane has two ; Camp STIX diabetes program has two; and the Spokane Guild School has one. These include physicians, physician assistants, nurse practitioners, nurses, dentists, hygienists, pharmacists and a chiropractor, among others, Palmer said.
Many of these providers, like Wolfe, are retired. In some cases, providers who volunteer at free or low-cost clinics are covered by their own insurance, but in many cases their carriers won’t cover volunteer work.
Among cuts proposed under Gov. Chris Gregoire’s budget proposal is a $297,000 reduction in Area Health Education Centers/Rural Health Capacity, most of which would be realized by elimination of the malpractice program.
Enacted by the Legislature in 1992, the program covers the malpractice insurance for 662 providers.
Palmer, whose Seattle-based agency administers the program under contract with the Department of Health, estimates these providers treat 67,500 clients who might otherwise seek treatment in emergency rooms.
Dr. Allen Seely, a physician with Rockwood Clinic in Liberty Lake, also volunteers at the Union Gospel Mission, though he is covered by his own group insurance.
“We could not have this clinic without Dr. Wolfe and our other (retired) partners,” Seely said.
Rights panel poorly understood 
oneanddone on December 01 at 3:55 a.m.
Dumb idea, which ever end of the political spectrum you look from. Rather than penny wise but pound foolish, it’s more like penny wise but gold brick foolish. Govt will do this but pay for Hoverounds. Go figure.
polistra on December 01 at 4:03 a.m.
What the state SHOULD do is fierce and strict tort reform. Take all the fun and profit out of lawyering. This would cut all medical costs in half.
Never happen, of course. Lawyers are in charge. The rest of us are dead.
Orphan on December 01 at 7:17 a.m.
I would like to know how much the insurance costs per patient visit. I have a feeling there is more to the story than what is being said here. Even the government is not this stupid.
oneanddone on December 01 at 7:27 a.m.
Hey Orphan - the French have a saying “au contraire.” Yes, indeed, the govt IS that stupid.
johnclarke on December 01 at 7:50 a.m.
polistra on December 01 at 4:03 a.m.
What the state SHOULD do is fierce and strict tort reform. Take all the fun and profit out of lawyering. This would cut all medical costs in half.
You are right on the ‘in half’ comment - one half of one percent of the total cost of health care. Tort reform is a wing nut urban legend.
Orphan agreed - something else is motivating this move.
IHike4Fun on December 01 at 7:59 a.m.
What would be interesting to know is how many volunteers don’t already have malpractice insurance. I doubt you can practice at all without it.
So if the coverage is redundant it would make sense to cut it since In general malpractice premiums are pretty high.
The article doesn’t give any details about redundancy. And I have no way of knowing so all that I said may be just gibberish. But that’s never stopped me before. :^)
Bruce (aka thatoneguy) on December 01 at 8:30 a.m.
Just FYI, back in 1980 or ‘81 my dad accidentally let slip that my mom, who was a doctor, was paying $40k per year in malpractice insurance. She was never accused of or sued for anything in her whole career, but it’s hard to imagine that her rates didn’t keep going up & up for the 15 years she continued working after that.
Malpractice insurance is a serious expense for doctors even if they’re rich. (Mom did pretty well $$-wise, but never to the point where she could sneeze at $40,000)
Bruce (aka thatoneguy) on December 01 at 8:34 a.m.
P.S. IHike – I’m pretty sure you can’t practice without malpractice insurance; or, if it’s legal, it would be really really stupid.
The article says “Many of these providers, like Wolfe, are retired. In some cases, providers who volunteer at free or low-cost clinics are covered by their own insurance, but in many cases their carriers won’t cover volunteer work.”
I’m guessing that retired = no longer insured, which means they’d be using the state insurance program.
IHike4Fun on December 01 at 10:59 a.m.
Bruce,
If your guess is correct (and probably is) then cutting the insurance program would stop retired docs from volunteering (along with those who are in active practice but whose carriers won’t cover volunteer work).
That would be a big loss.
gyrusx on December 01 at 12:17 p.m.
@polistra agreed: providers (MDs, ARNPs, PAs) bill around 1-5% of the total charge for your treatment, they are lucky if they receive 70 cents to a dollar billed. Bulk of the hospital and healthcare bills are used to pay insurance premiums, hire and pay people to keep the legal risk low. Without legal changes, the cost of health care will keep soaring and most healthcare systems are very likely to fail. Unfortunately people who are able to make these changes are lawyers and judges who will never let that happen. Even cost of medications made by the same company are 100-500% higher in the US because of all the lawyers ads you see on TV which increases the drug company bottomline and they just cannot provide you the medications at the same cost as other countries.
@IHike4Fun most states do not allow anyone to practice if they are not insured, and most insurances are site specific, so if they cover one clinic it does not mean they will cover another clinic.
Orphan on December 01 at 12:24 p.m.
^^^^^ unless of course the volunteer MDs are not seeing very many patients per year/month and the cost of insurance per patient visit is very high. I know malpractice insurance is individual for each MD and knowing insurance companies there is a minimum.
Orphan on December 01 at 12:42 p.m.
Gyrusx The clinic will have its own malpractice insurance that is separate from each MDs malpractice insurance dont confuse the two they are entirely different insurance policys.
The providers contract with the insurance companies to provide a sevice at a set rate that is the 70% give or take that you see on your EOB.
“Bulk of the hospital and healthcare bills are used to pay insurance premiums, hire and pay people to keep the legal risk low.”
No that is simply not true, sure insurance is a big expence for MD etc but so is rent for office space, utilities, supplies, nurses, equipment, bookkeepers etc. Insurance is why the legal risk is low not someone on the MDs staff. Not to mention the MDs salery and benifits. You see most likely the MD works for a corporation that he owns or ownes part of. Some MDs simply work for a hospital or a clinic and are simply employees of that hospital or clinic.
wobble506 on December 02 at 1:28 p.m.
here’s the deal. Retired doc’s don’t keep malpractice insurance, which, at a minimum, is 10K, and goes up from there. So the state buys a blanket malpractice policy to cover all these medical professionals that have kept their licenses active, and volunteer at the clinics, which costs about $300,000.
Dr. Wolfe wrote this piece of legislation that was enacted when he was in the state legislature in the mid 80’s for just this reason, retired docs could volunteer at clinics, without maintaining ultra expensive malpractice insurance. So, patients can see a doctor at no cost, get theh treatment they need, and no bills. UGM and Ogden hall (and the others) don’t bill the state for the services.
The state pays nothing, other than the cost of the malpractice
insurance. No, the doctors receive no compensation. That’s why they use the word volunteer.
If Gregiore vetos this, Dr. Wolfe and many others will not/can not provide this services to these most needy folks, so these patients will end up in the ER for treatment, which then bills the state for the treatment, etc. So, lets see, free physicians vs an average cost of $1500 - 2000 per ER visit. yes, the state really IS that stupid, orphan.
Just figuring out the patient cost to the state from UGM and Anna Ogden alone (2400 patients times $1500), comes in at over $3.6 million. Now multiply that by all the free clinics, etc. If Dr. Palmers numbers are accurate, (67,500 x 1500), that comes in at a savings of roughly 101 million. Kind of a no brainer. But, that’s Gregoire, no brain.