I can do this all day......
New York hospitals will pay $1.3 billion in medical malpractice premiums in 2007, a figure that represents a 175% increase since 2000, according to a new analysis by the hospitals trade association.
Individual hospitals will pay tens of millions of dollars each, according to a Greater New York Hospital Association survey of its member hospitals.
Following the state Insurance Department's 14% hike in medical malpractice insurance rates for doctors that took effect July 1, hospital officials said their burden is likely to be felt even more acutely.
"Hospitals are being crushed by medical malpractice premium increases," the president of GNYHA, Kenneth Raske, said. "Hospitals can hire fewer nurses, and they are forced to delay capital expenditures."
For each hospital, there is a double-edged burden: the institution's liability costs and the expense of insuring doctors employed there.
Hospital executives said the recent hike in doctors' insurance rates, the biggest since 1993, would be tough to swallow. "To the extent that you're employing the physicians, it's a direct cost to the hospital," the senior vice president of finance at Montefiore Medical Center, Joel Perlman, said.
At New York-Presbyterian Hospital, insurance costs doubled between 2002 and 2006, hospital officials said. Currently, the hospital spends $150 million a year, or between 3% and 4% of its operating budget, on liability insurance.
"It's a necessary part of our operating budget," New York-Presbyterian's president and CEO, Dr. Herbert Pardes, said. He warned, however, that "enormous" liability costs were undercutting the ability of some doctors to run their offices.
For New York hospitals, whose average profit margin of 0.7% is among the thinnest nationwide, insurance eats up huge chunks of the budget.
"It's competing for dollars for things like staffing and the basic operation of the hospital," Dr. Pardes said.
Executives at hospitals in regions where malpractice insurance rates are higher said their burden is even more intense. Montefiore, which is in the Bronx, will pay more than $90 million in insurance premiums next year, a 300% increase since 2000, according Mr. Perlman.
He estimated that half of the hospital's malpractice insurance costs relate to maternity services. Currently, Montefiore pays $10,000 in malpractice insurance for each baby delivered, which amounts to a financial loss associated with each birth.
"It's a remarkably stark example of just how broken the system of malpractice is," he said.
In New York, where some have called for tort reform to alleviate the malpractice crisis, premiums are among the highest nationwide partly because of the number of suits brought and the increasingly high settlements.
"Hospitals are paying more, but I don't know what the alternative is," the vice president of the Medical Liability Mutual Insurance Company, Edward Amsler, said. The recent insurance rate increase has escalated a feeling among doctors that they can no longer afford to practice, and many have sought support from hospitals.
Last month, 12 neurosurgeons in Westchester County who provide emergency coverage to a network of community hospitals there concluded that they required increased financial support from the hospitals operator, Stellaris Health Network.
In a letter to Stellaris's president, Arthur Nizza, the doctors described their financial situation as "untenable."
"I think the hospitals are going to choke on this," the president of the Medical Society of the State of New York, Dr. Robert Goldberg, said. "It frightens me," he said of the potential for understaffed emergency rooms.
In the Bronx, some maternity wards are operating with depleted ranks.
Executives at Our Lady of Mercy Hospital in the Bronx said a shortage of obstetricians has resulted in the number of annual deliveries dropping to 1,700 from 3,600 10 years ago.
Hospital officials, including GNYHA's Mr. Raske, said they see a "glimmer of hope" in a task force appointed by Governor Spitzer last month that is charged with making recommendations for change. "There are proposals in Albany today that would serve to ameliorate these problems," Montefiore's Mr. Perlman said. "It would really be a shame if we had to wait for evidence of these consequences to health care providers because this malpractice situation isn't addressed."