May 7, 2002 3 min read

Back when he was Pennsylvania insurance commissioner in the early 1970s, Herb Denenberg had a saying: “Populus iamdudam defutatus est.” For those whose Latin is a little rusty, that translates, “The consumer has been screwed long enough.” Amen, brother Herb, especially when it comes to health care. In every aspect of the present crisis -malpractice insurance, hospital costs and profitability, the quality of care, the costs of drugs, lack of regulation in the insurance industry -it’s the consumer who ultimately pays the price.

This is an extremely complicated problem, and we get no closer to solutions when we engage in simplistic finger-pointing. It’s easy to single out the lawyers, or the doctors, or the insurers, or the politicians. The fact is, all of the above helped create the current situation, and all will have to be involved in straightening it out.

This isn’t just a Pennsylvania problem, either. Many other states are wrestling with how to ensure quality health care at affordable prices. It may be that this problem is just too big for one state to handle, in which case there may be some merit in federal legislation being sponsored by Congressman Jim Greenwood. The Greenwood bill, HR 4600 and known as HEALTH -for Help Efficient, Accessible, Low-cost, Timely Health care act -specifically targets medical malpractice awards.

The thinking is that controlling the amount of damages awarded in malpractice suits will help control insurance costs, which in turn will improve the bottom line of hospitals and keep physicians from relocating to avoid skyrocketing premiums.

Maybe. But that may be more simplistic thinking. If you believe what Denenberg and some other experts in the consumer field say, then any long-term solution for Pennsylvania will require a laundry list of changes:

– Doctors will have to get better and do a better job of policing themselves and the quality of care they deliver.

– Some version of tort reform must be instituted that both guarantees fair compensation to legitimate victims of medical errors and prevents frivolous suits and excessive monetary judgments.

– Politicians, from the governor down, will have to bone up on what’s happening so they can work on sound legislative solutions.

– Last but certainly not least, the state Insurance Department and its present commissioner (Diane Koken) must start doing their job of regulating the industry rather than serving it. If there’s one part of the health care problem that gets too little attention and is largely misunderstood, it’s the role insurers play.

We might start with a question for Commissioner Koken, who, incidentally, worked for Provident Mutual Life Insurance Co. for 22 years before she became the state’s insurance “watchdog”: How is it that an industry supposedly monitored and regulated at the state level finds itself and the health care community it serves headed for disaster?