Politics infected health care bill

A majority of the Arizona House of Representatives decided last week that politics was more important then access to emergency health care services.

Senate Bill 1032 was about raising the standard for proving when medical negligence occurred for cases coming through the emergency department (ED) - setting it to a level of "clear and convincing" over "preponderance."

The sole motivation behind SB 1032 was to improve the liability risk of on-call specialists and ask them to come back to our EDs. A similar bill was passed and worked in the 1980s to improve obstetrical coverage for EDs.

Gov. Janet Napolitano vetoed a similar bill last year. As a postmortem compromise to demonstrate her interest in solving the ED crisis, she appointed a task force. This task force then returned a recommendation to the governor for passing legislation like SB 1032.

This year, Arizona patients should have expected even greater support and overwhelming passage of this legislation for the governor's signature. But to the contrary, SB 1032 was unable to get the necessary votes to send it to the governor's office.

The Senate passed the bill. Unfortunately, the special interest politics of a small group killed the bill in the House, despite what appeared to be wide support. Arizonans cannot let a small interest group go unchecked against what was broad bipartisan support for SB 1032. Public accountability is needed.

Where is the integrity of a process that engages a task force and then ignores its recommendations in exchange for party politics? Each representative who voted "nay" should answer to their constituents about what led them to vote against this bill.

In the history of this bill, no one (trial attorneys included) has ever suggested that the problems physicians have been screaming about regarding our crumbling emergency care system are false, overstated or exaggerated.

What is our crisis? It is twofold: We are having a very difficult time attracting residency-trained emergency physicians to meet the needs of Arizona's growing population. Also, trained specialists, such as neurosurgeons, hand surgeons, general surgeons, ear, nose and throat specialists, neurologists, gastroenterologists, and urologists, are unwilling to accept the increased liability that comes with providing care for an emergency patient.

If physicians believed the only cases of medical liability they would have to worry about were those resulting from unacceptable negligence, we would not have a problem. However, most physicians know that a bad outcome, over which they may have had no control, could be grounds for being hung by our litigation system. This is a deterrent that makes doctors not want to accept greater risk than already exists.

Ask your ED and primary care physicians about access to specialists. Ask them why our Arizona ED wait times are 50th in the nation as reported last year in USA Today.

This bill was not going to save anyone a dime in liability insurance premiums. It would not have limited a patient's right to sue in any way.

Senate Bill 1032 was about trying to keep the crumbling Arizona emergency system that everybody talks about from accelerated destruction.



The writer is an internal medicine specialist practicing in Phoenix and president of the Arizona Medical Association.