LETTER TO THE EDITOR: Missouri health care will suffer because of Supreme Court decision

Friday, August 3, 2012 | 8:16 p.m. CDT

The Missouri Supreme Court’s July 31 decision to eliminate the medical malpractice awards cap might seem like a victory to some, but it has the potential for a significantly detrimental impact on health care in Missouri.

It’s no secret that before the 2005 tort reform, hundreds of Missouri doctors retired, left the state or quit their practices due to skyrocketing malpractice insurance premiums.

Once tort reform was enacted, many medical malpractice insurers entered or re-entered Missouri eager for market share, but then a new problem emerged: Many of these providers, whose industry experience had been limited to purchasing a policy, were charging actuarially unsound premiums insufficient to cover the long-term liabilities of this business. As a result, many are not equipped to cover the potential payouts for current and future claims.

As an insurance industry veteran and president of the Missouri-based insurer Missouri Professionals Mutual, I’ve seen this happen before and knew it would happen again. I proactively implemented a strategy to protect our insured and maintain rate stability in the face of this type of decision. However, other unprepared insurers will likely be forced to raise their rates drastically, once again creating an incredibly difficult climate for Missouri physicians.

Missouri Professionals Mutual and other opponents of the ruling will aggressively fight it, but history tells us that there is no quick fix. The cycle of tort reform typically takes years to resolve. In the meantime, it might be a good idea to for Missouri citizens to visit their doctors while they’re still here.

Timothy H. Trout is president of Missouri-based insurer Missouri Professionals Mutual. He lives in Creve Coeur. Questions? Contact Opinion editor Elizabeth Conner.

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Bob Brandon August 4, 2012 | 9:03 p.m.

Mr. Trout's letter highlights the essential problem with the "free market" in healthcare: it doesn't deliver health care to those who actually need it.

Hence, we need single payer and just cut the private insurance industry out of providing essential medical services to the people who need it.

(Report Comment)
Mike Martin August 5, 2012 | 6:08 a.m.

Disagree. We essentially have single payer in college costs -- the Federal government, guaranteeing student loans and providing some grants. What's happened to costs there -- they've skyrocketed, and now we're facing a student debt bubble that will certainly burst with devastating consequences.

I refer to this as the theory of the third party payer. Whenever you have a third party payer -- single or multiple -- costs soar because the consumer is detached from paying them directly.

A better solution , IMHO, would be to get ALL insurance -- Medicare, Medicaid, Obamacare, and private OUT of paying for office visits and non-catastrophic items, and have a variety of plans for catastrophic and emergency coverage only.

(Report Comment)
Bob Brandon August 5, 2012 | 2:36 p.m.

We already have a socialized health care system for a large number of U.S. citizens and their dependents. It's called the U.S. Armed Forces.

Jon Stewart got Bill Kristol to not only admit that it worked well but to continue to oppose anyone else getting access to similar medical care because no-one else "deserved" it.

BTW, no-one's found any "moral hazard" abuse of it, either.

(Report Comment)
frank christian August 5, 2012 | 4:31 p.m.

"Jon Stewart got..."?

Man, we are getting hit with the big shoes now!

(Report Comment)
Corey Parks August 5, 2012 | 4:39 p.m.

As someone that participates in the military healthcare primarily Triwest I would not say it works well. It is ok and affordable. Problems are the drive to military bases if you live under a hour away. Special waivers can be given to that are outside a coverage area. If your on active duty there is no preventive visits. The base hospitals are there in case you get hurt or sick. Healthcare for 2010 for Military is projected to cost about 53 billion. In 2001 it was only 17 billion.
Now if you are talking about the top of the line medical care the politicians get then yes I am sure it works really well. They do not have to pay for it out of their own pocket. It is available in their place of "business" everyday and they are in an elite club that few can join.

(Report Comment)
Rich C. August 5, 2012 | 5:16 p.m.

"Jon Stewart got..."?

"Man, we are getting hit with the big shoes now!"

Some would argue his shoe size already surpasses Rushbo's.

(Report Comment)
frank christian August 5, 2012 | 5:59 p.m.

"Some would argue his shoe size already surpasses Rushbo's."

Yeah, and some trust Obama and Democrats in our governments. Same bunch that watches Stewart.

(Report Comment)
Bob Brandon August 5, 2012 | 6:38 p.m.

When I was mobilized in 2007, my family went on Tricare while I was on active duty, and they were quite satisfied with it. Never had a problem with military healthcare.

Studies consistently show that the same folks who watch the Daily Show and the Colbert Report were better informed than those who insisted on getting their views from Fox News Channel. Had FNC found anything to show otherwise, we would've long heard about it.

(Report Comment)
frank christian August 5, 2012 | 7:52 p.m.

B. Brandon - What studies? Seems many now insist upon Fox News for knowledge of current events.
"Fox News dominated the top thirteen spots in July and secured 13 out of the top 15 programs in the coveted 25-54 age demographic."

Oddly, Stuart and Colbear, were not listed as contenders for those top spots.

You have indicated here that you might be among those whom like to believe that the people are not able to determine the best choice for their information.

(Report Comment)
Rich C. August 5, 2012 | 10:24 p.m.


Colbert and Stewart aren't contenders for the top spot in news because they are not classified as news....Look up "TV by the numbers" to understand the link you are posting in its entirety.

The pathetic thing Mr. Brandon was alluding to is that Colbert and Stewart inform their viewers of actual news (mixed with comedy) better than Fox News does.

Here is a link to that study:

Note that I'm on a mobile so not sure how that link will show for you.

(Report Comment)
Bob Brandon August 5, 2012 | 10:54 p.m.


Here's the latest Fairleigh Dickinson study with similar results:

As for Frank, the "many" who insist on Fox News for information are the same "many" who insist on being stupid.

(Report Comment)
frank christian August 6, 2012 | 7:34 a.m.

I'm embarrassed! For you people!

"The results of the new Pew Survey on News Consumption (taken every two years and released this afternoon) *suggest* that viewers of the "fake news" programs The Daily Show and The Colbert Report are more knowledgeable about current events (as judged by three test questions) than watchers of "real" cable news shows". Pew Research Center is now,or has recently chaired by Madeleine Albright, Clinton's Sec State, who publicly stated "there should be more than one "super power".

On Fairleigh Dickinson:

"Rather, the results show us that there is *something* about watching Fox News that leads people to do worse on these questions than those who don’t watch any news at all."

That someone would present these "in depth studies" as some sort of proof of anything, is imo where the stupidity lies. It would seem that you Are "among those whom like to believe that the people are not able to determine the best choice for their information."

(Report Comment)
frank christian August 6, 2012 | 7:49 a.m.

I should have noted that I saw and heard Madeleine on Fox News.

(Report Comment)
Rich C. August 6, 2012 | 9:05 a.m.

Boy if that's not a predictable response by Frankie.

(Report Comment)
Gary Straub August 6, 2012 | 9:39 a.m.

Back to the point of the story: Malpractice would not be such a problem if there was not so much of it. Funny how when it comes to how much a doctor or hospital stay is worth, it is felt there should be no limits, but when one of them injures or kills a patient due to malpractice there should be limits. Healthcare costs in this country are exorbitantly high because of insurance. The industry made so much money that they rarely questioned bills presented to them until even they felt the drain on profits. There are very few people that could afford a major health problem which is absurd because how could a product be worth many times more than the majority of customers could afford. Fortunately for the insurance companies, most people never need to use their product even though they pay for it, allowing them to make huge profits while still paying the bills. Yet most other countries manage to provide healthcare at a much more affordable cost. Many will say it is because our healthcare is far superior because of the high costs. This is rubbish as we are ranked 37th in the world for quality of healthcare.
Perhaps it is time we join the rest of the world and put citizens health above profits. Do no harm!

(Report Comment)
Mark Foecking August 6, 2012 | 10:19 a.m.

Um, Gary, health insurance company profits are about 6%. Removing all profit from insurance would not change the cost significantly. Plus, a lot of hospital care is provided at non-profit or government funded institutions.

Our health care is very expensive for a whole bunch of reasons (some of which might be solvable and others not), but exorbitant profit is not one of them.


(Report Comment)
frank christian August 6, 2012 | 10:24 a.m.

"Malpractice would not be such a problem if there was not so much of it. For one that knows, trial lawyers, advertise often nationwide, for clients to defend, that file shotgun lawsuits (sue every name of a medical provider mentioned, with a particular "case"), collect through settlement with defendant of legal Threat, rather than pay exorbitant costs of trial, this statement seems disingenuous.
"Perhaps it is time we join the rest of the world and put
citizens health above profits."

We are on the road that joins "the rest of the world" in bankruptcy of their central governments. Their corrupt health care systems are included with their other unsustainable spending. This is what our conservative, liberal argument is all about.

(Report Comment)
Gary Straub August 6, 2012 | 11:52 a.m.

Mark, you are right it would not change the cost as the damage is already done. Furthermore, profits are very elusive and in the case of large corps they are almost impossible to determine thanks to a 73,000 page tax code. But, I wasn't talking about profits but payments. I also said that not until it was affecting their profits did they try and bring the price down. We all know that once the cat is out it is near impossible to get it back in the bag. How about stating some of the "whole bunch of reasons".

Frank, do you have medicare?

(Report Comment)
frank christian August 6, 2012 | 12:50 p.m.

"do you have medicare?" As you well know, yes. If you have a point please share it.

(Report Comment)
frank christian August 6, 2012 | 4:02 p.m.

Gary S.- "The World Health Organization's ranking of the world's health systems was last produced in 2000, and the WHO no longer produces such a ranking table, because of the complexity of the task."

"it contains a number of techniques and biases that work against countries that rely on markets instead of government to provide health care."

W. Bush wrote WHO in approximately 2001 and asked that they drop their propaganda projects and pay more attention to improvement of personal health of worlds people. (paraphrase)

(Report Comment)
Bob Brandon August 7, 2012 | 1:55 p.m.

Frank just doesn't like reality: "That someone would present these "in depth studies" as some sort of proof of anything, is imo where the stupidity lies."

Ah, and it's just that "imo" that's of concern here, and not just about Frank.

(Report Comment)
mike mentor August 7, 2012 | 11:55 p.m.

Thanks for setting the record straight Mark. Health insurance companies are heavily regulated and are not the profit takers in the equation. They provide an invaluable service. Very few can afford to pay out of pocket for something as basic as having a baby or fixing a broken leg, much less more complicated treatments. By spreading that risk among many, the cost becomes affordable for many many many more people.

The WHO stuff is a joke to say the least. I could hire all of our TSA agents as doctors and have them see patients and we would suddenly be at the top of the WHO list because everyone would have much greater access to "care". Ridiculous!

The only people that leave this country for treatment, do so to get yet unproven treatments.

The hospitals on our norther borders do thriving business with cash paying Canadians who are not satisfied waiting for six months to get their broken leg fixed.

We do have the best healthcare in the world. That fact is easily discerned when you look at all the people who come here to see the best doctors and receive the best treatments in the world. The profit motive has a lot to do with the best and the brightest working very hard to be the best doctors and drug researchers in the world. Take away the profits and the best and the brightest go elsewhere. We already know this to be true as the best doctors currently don't accept medicare patients. Ask the best and the brightest who are currently undergrads if they would continue their career plans to become doctors if their potential incomes were to drop to middle class government workers making a set government wage. I am going to pay how much for four years of med school and train for how many hours to make what???

As with most liberal agenda, the empty promise sounds good, but only to those who are childlike in their inability to think things all the way through.

The answer of course lies in continued regulation of insurance and drug companies, tort reform, and personal resonsibility. The latter of course will never be talked about by the left for fear of alienating their, bought with our money, voter base.

(Report Comment)
Ellis Smith August 8, 2012 | 5:17 a.m.

Hey, Mentor, what's this talk about "personal responsibility"? I'm going to track you down and wash your mouth out with lye soap, and I can manage that 'cause I'm still pretty spry at my great age. The very idea that adult Americans should assume any responsibility for their lives is ridiculous. Mother told me I'd encounter dangerous people like you. :)

(Report Comment)
Mark Foecking August 8, 2012 | 7:55 a.m.

Gary Straub wrote:

"How about stating some of the "whole bunch of reasons"."

Billing procedures take up to 25% of the cost that insurance companies (or Medicare) are billed for. There are too many little line items and complexities, and too many bean counters.

Technology drives up the cost of diagnosis and treatment, as well as increasingly high tech drugs. But since we have all these things, would anyone really suggest we not use them, and maybe misdiagnose or mistreat a patient? Misdiagnosis or mistreatment is a significant problem as it sits (although they've made a lot of headway into that in the past 10 years).

There is a level of defensive medicine that drives testing, although it's not a big part of costs according to the CBO.

Insured patients tend to think less about going to the doctor for even minor problems. In one way, this keeps minor problems from becoming major ones, but it increases costs to insurers for office visits and tests. The alternative is not to insure preventive care, and that might make lower income people neglect minor problems until they become major, with a corresponding increase in treatment costs over what they might have been.

Health care provider salaries are high because there are shortages in many areas. There is a lot more specialization these days than in the past.

I linked 4 articles here that are very good at laying out the problems and suggesting ways to control costs:


(Report Comment)
Mark Foecking August 8, 2012 | 7:58 a.m.

Try this link instead:

If it takes tyou to the wrong comment, scroll up about 15 comments.


(Report Comment)
Gary Straub August 8, 2012 | 10:10 a.m.

Too many bean counters is the problem with so much of our new society.
Technology is not available only in the U.S.
Medicine is the biggest rip-off of all. WE can go to most any other country and buy the same drug from the same manufacturer for many times less than what we pay here.
Going to the doctor more often saves a lot of money for the insurance industry.
They say there is not a lot of profit in the industry, but when there are so many fingers in the pie and so many high salaries being paid the potential profit is very diluted.

(Report Comment)
frank christian August 11, 2012 | 9:47 a.m.

B. Brandon - I've been gone and just read yours: "Ah, and it's just that "imo" that's of concern here, and not just about Frank." I don't understand your meaning, but if my "imo"is problematic, then, read me this way.

"That someone would present these "in depth studies" as some sort of proof of anything, is where the stupidity lies."

(Report Comment)

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