Dear CHOICES Subscribers, As we are now at war, it may be hard for many to concern themselves with other issues. And yet, it may not be the dangers thousands of miles away but the danger in our own backyard that we should worry about most. Last Thursday, I attended an unreported and under-attended Town Hall Meeting organized by Lane County Commissioner Pete Sorenson. Terry McDonald of St. Vincent de Paul and others talked about how well the American health care system serves those with insurance -- and how poorly it serves those 40 million Americans without (#12, #13, #14). As we discuss access to hospitals in Lane County, location is but one factor. There are lots of opportunities to get more involved in Springfield. There are openings on the city council (#1), planning commission (#2), the historic commission, the library board, and the building board of appeals (#3). On Monday, the Springfield City Council will hear an update on nodal development. Terry Moore of ECO Northwest and other consultants have been hired by Springfield to determine the boundaries of nodes, which nodes the market can support, and how to better implement these nodes. Last week, Moore told the Springfield Planning Commission that Springfield probably can't support all five identified nodes but that the "PeaceHealth" node and others held promise (#4). A week from Monday, the Springfield City Council is set to decide on PeaceHealth's request to allow a new hospital in the Gateway area. Last Monday, the councilors had few questions of staff. Does that mean that councilors have already made up their mind, or that the issues are so confusing that they aren't sure what to ask? Soon we will know (#5). The issue over ambulance boundary rules -- whether a Eugene ambulance respond to a call in Springfield of vice versa -- is turning even uglier and getting rolled into labor negotiations between the city of Eugene and the firefighters union. As one EMT explained at Sorenson's Town Hall Meeting, between boundary rules, budget cutbacks and idle time at a hospital at Gateway, parts of Eugene are looking to see poor ambulance response times (#6). Other development is considered, planned, or frustrated near a new PeaceHealth hospital. Carolyn Chambers is considering a proposal to open a new Rogue Brewery in the space that was Spencer's Brewhaus in the Gateway area (#7). Symantec Corp. is moving 28 jobs from its headquarters in Cupertino, Calif., to its Gateway location (#8). Eugene businessman Roger Bullock last month filed preliminary plans to create about 10,000 square feet of dental and medical office space -- dubbed the Harlow Professional Center -- on just under an acre at the northeast corner of Pheasant Boulevard and Harlow (#9). Finally, Springfield's reputation for quickly approving projects and working cordially with developers may be undeserved. Steve Lee, who wants to build a 40-lot subdivision in Springfield, late last month filed a lawsuit against Springfield, alleging the city violated state land use laws and its own development code when it slapped on a series of costly and complicated conditions that Lee would have to meet in order to build the subdivision (#10). Springfield's new bus station should open by fall 2004, even though LTD is short $1.5 million on the $7.3 million project (#11). Lastly, Dr. Glenn Keiper, a 40-year-old neurosurgeon, is moving his practice to Idaho because of skyrocketing malpractice premiums in Oregon and a fear that one big lawsuit could put him out of business. While there is no indication Keiper's planned move has anything to do with decisions made by PeaceHealth, neurosurgery is one of two or three types of high-profit procedures conducted at PeaceHealth (#15, #16). If you have thoughts you would like to share, retain your freedom of speech by writing a letter to the editor of a local newspaper: Springfield News 746-1671, 746-0633 (fax) 1887 Laurel St., Springfield 97477 news@springfieldnews.com Register-Guard Mailbag (Letters to the Editor) 485-1234 x2351, 338-2828 (fax) P.O. Box 10188, Eugene 97440-2188 RGLetters@guardnet.com Eugene Weekly 484-0519, 484-4044 (fax) 1251 Lincoln St., Eugene 97401-3418 editor@eugeneweekly.com Perhaps even more important, hug someone you love today, and every day. Rob Zako, Editor 343-5201 rzako@efn.org ============================================================ Health Options Digest March 22, 2003 Coalition for Health Options In Central Eugene-Springfield ============================================================ * OPPORTUNITIES 1.rg - Vacancy on Springfield City Council, Ward 6 2.rg - Two Vacancies on Springfield Planning Commission 3.rg - Serve the city * CALENDAR 4.sn - Mon 3/24 - Springfield City Council * PEACEHEALTH HOSPITAL 5.rg - Councilors' questions already answered * AMBULANCE BOUNDARY RULES 6.rg - Tort claim targets fire, city officials * NEARBY DEVELOPMENTS 7.cn - Deep Dish with Dinah: Building Bridges in Eugene 8.rg - Symantec moves jobs to Oregon 9.rg - Harlow Road site to house dental office and more 10.rg - Springfield developer sues over conditions * TRANSPORTATION ISSUES 11.rg - Bus station * OTHER NEWS 12.rg - Health care system works 13.rg - Hospitals sue to block cuts in payments 14.rg - Insurance program keeps growing 15.rg - Doctors pushing legislators to provide malpractice relief 16.rg - Curb medical errors, critic urges * KEY, CREDITS, MORE INFO ====================== Opportunities ===================== ------------------------------------------------------------ 1.rg - Vacancy on Springfield City Council, Ward 6 ------------------------------------------------------------ The Register-Guard, 3/11/03, Page D3 Applications are available for anyone interested in filling [the late City Councilor Lyle] Hatfield's position on the council. [Applicants must reside in Council Ward 6, which is in east Springfield and is roughly bounded by the city limits on the north, south and east, and North 56th Street and 57th Street on the west.] The deadline to apply is March 28, and applicants will be interviewed in April. For more information, call City Hall at 726-3700. http://www.registerguard.com/news/2003/03/11/d3.cr.digest.0311.html News Release: http://www.ci.springfield.or.us/CMO/NewsRelease/NR%202003%20March%203%20Ward%206%20Vacancy.pdf Map of Springfield City Council Wards: http://www.ci.springfield.or.us/council.htm ------------------------------------------------------------ 2.rg - Two Vacancies on Springfield Planning Commission ------------------------------------------------------------ By Matt Cooper The Register-Guard, 3/8/03, Page B1 The city is accepting applications for two positions on the seven-member Planning Commission. Members are volunteers with no ward restrictions, appointed to four-year terms. The commission has authority over zone changes, variances, appeals and discretionary-use requests. It makes recommendations to the City Council about growth and development and works with staff in drafting amendments to the Metropolitan Area General Plan, the Eugene-Springfield blueprint for growth. The commission meets on the first and third Tuesday of each month, for about 2 1/2 hours. Applications are available in the City Manager's Office in City Hall, 225 Fifth St. The deadline to apply is 5 p.m. April 11. For more information, call Mel Oberst at 726-3783. Matt Cooper can be reached at 338-2317 or mcooper@guardnet.com. http://www.registerguard.com/news/2003/03/08/b1.cr.spcitybeat.0308.html News Release: http://www.ci.springfield.or.us/CMO/NewsRelease/NR%202003%20March%206%20Planning%20Commission%20Vacancy.pdf ------------------------------------------------------------ 3.rg - Serve the city ------------------------------------------------------------ By Matt Cooper The Register-Guard The city has openings on its historic commission, the library board and the building board of appeals. There is one opening on the seven-member historical commission, which promotes stewardship for historic preservation. Applicants don't need to be residents or property owners, but are required to meet State Historic Preservation Office guidelines. The city also seeks a volunteer for the Springfield Library Board. Applicants must be registered voters who live within the city limits, and the term will expire at the end of the year. The board provides recommendations for future library development and changes to policy. The city also seeks to fill all five positions on the building board of appeals, which determines the suitability of alternate materials and methods of construction, interprets safety codes and hears building and sign code appeals. Preference will go to applicants with a general background in construction, development, design, marketing, manufacturing or other related fields. Applicants must be residents, registered voters or property owners. Applications are available at the City Manager's Office in City Hall, 225 Fifth St. Application deadlines: 4 p.m. April 14 for the historic commission; 5 p.m. April 4 for the library position; and 5 p.m. April 11 for the board of appeals. For more information on the historic commission, call Kitti Gale at 726-3632. For the library position, call Bob Russell, library director, at 726-3756. For the board of appeals, call Lisa Hopper or Dave Puent at 726-3753. Matt Cooper can be reached at 338-2317 or mcooper@ guardnet.com. http://www.registerguard.com/news/2003/03/22/b3.cr.spcitybeat.0322.html ======================== Calendar ======================== ------------------------------------------------------------ 4.sn - Mon 3/24 - Springfield City Council ------------------------------------------------------------ Monday, March 24 Springfield City Hall 225 Fifth St. 726-3700 5:30 p.m. -- Work session, Jesse Maine Room. 1) Springfield Nodal Development Update. [Mark Metzger] (45 min.) 6:15 p.m. -- Executive (non-public) session, Jesse Maine Room 1) Property Acquisition Negotiations. [Al Peroutka] (10 min.) http://www.springfieldnews.com/articles/2003/03/21/calendar/news1.txt Agenda: http://www.ci.springfield.or.us/CMO/2003Council/032403%20agenda.pdf ================== PeaceHealth Hospital ================== ------------------------------------------------------------ 5.rg - Councilors' questions already answered ------------------------------------------------------------ By Matt Cooper The Register-Guard Springfield -- It was, unquestionably, the city's quickest public meeting on the PeaceHealth project. With the City Council set to vote in two weeks whether to approve the health organization's proposal to build a $350 million regional medical center in the Gateway area, city planners held Monday's meeting to answer questions that councilors may have felt were unaddressed in reams of public testimony recorded over the last three months. Staff members set aside 40 minutes. But it was over in five, because councilors found all their answers in stacks of testimony for and against that stand over a foot tall. "All the information we need to make our decision is within the 14 inches of documents you see," Council President Tammy Fitch said. Fitch and the other four councilors who will decide what Mayor Sid Leiken called "the largest land use decision in Springfield history" have 13 days to pore over the record, and their brevity confounded efforts to ascertain which way they're leaning. "It would have been nice to have heard something that would have tipped their hand," said Philip Farrington, PeaceHealth planning director. "We'll just have to wait two weeks." PeaceHealth announced in September 2001 its plans to build Sacred Heart Medical Center at RiverBend between Game Farm Road and the McKenzie River. Opponents and supporters have locked horns over the possible impacts to traffic, housing and the metropolitan area's job base. The Planning Commission approved the RiverBend proposal by a 4-2 vote on Jan. 22 with a 60-foot height restriction. That's about half as tall as the eight- to nine-story buildings that hospital designers envisioned. The council will decide the matter March 31. If approved, and pending appeals, the facility could open early in 2007. "The fireworks are all going to start in two weeks," Councilor Dave Ralston said. "Right now I need to do some homework." What's Next * The City Council will vote on the PeaceHealth project at 7 p.m. Monday, March 31, in the Council Chambers at City Hall, 225 Fifth St. For more information, call 726-3700. http://www.registerguard.com/news/2003/03/18/d1.cr.peacehealth.0318.html ================ Ambulance Boundary Rules ================ ------------------------------------------------------------ 6.rg - Tort claim targets fire, city officials ------------------------------------------------------------ By Joe Mosley The Register-Guard If a dispute over Eugene fire officials' new ambulance policies didn't start out as a sidebar to ongoing labor negotiations between the city and its firefighters union, it has now become one. The Eugene Firefighters Association served the city on Friday with a tort claim -- a prelude to a lawsuit -- alleging that Fire Chief Tom Tallon and other city officials have wrongly characterized union criticism of the new ambulance policies as bargaining tactics. "I understand the political game, and people playing the political game," union President Gary Nauta said. "But I think when it comes down to a life-and-death issue for the people of this community, you don't do that. It's an out-of-bounds ball." The 1 1/2 -page tort claim, delivered Friday to the city attorney's office, contends that "slanderous and defamatory statements have been made by Chief Tallon" and other city employees and officials. It seeks unidentified actual damages and damages related to emotional distress due to a "hostile work environment" resulting from the alleged statements. However, Nauta said an apology for the statements and acknowledgment of their inaccuracy "would be a substantial step" toward derailing a potential lawsuit. He also hopes for an unfettered re-examination of Tallon's decision last summer to institute a "hard boundaries" policy for dispatching ambulances within his service district. Tallon declined to comment when told of the union's claim. "This comes as sad news," he said. "You can imagine my position, so I will defer any comment to the city attorney's office." Jens Schmidt of the Eugene law firm of Harrang Long Gary Rudnick P.C., which represents the city, acknowledged receipt of the tort claim and called it groundless. "Based on what I know, we don't think there's any merit," Schmidt said. The claim will be turned over to the city's risk management office for investigation, he said. The tort claim could then either be denied by the city, setting the stage for the matter to be filed in court if the union follows up with a lawsuit, or the claim could be acknowledged and a settlement negotiated. Friday's action by the union was the latest round in a dispute over the hard boundaries policy, under which Eugene has laid claim to all medical calls within its ambulance service district -- even if an ambulance from Springfield to the east or Lane Rural Fire District to the northwest happens to be closer. The policy is part of a sweeping redesign of the Eugene department's emergency medical services that was instituted by Tallon on Aug. 1, following a two-year study that was intended to increase efficiency and save money. The hard boundaries policy -- criticized by union members and others as a potential threat to the lives of critically ill or injured patients -- reversed a long-standing "automatic aid" agreement under which Eugene and Springfield ambulances operated almost interchangeably within the two cities. The Eugene department backed away somewhat from its hard boundaries two weeks ago, agreeing after discussions with Springfield fire officials to lift the policy for a narrow category of ambulance calls in which immediate transport to a hospital is critical. Jurisdiction over ambulance calls has become an issue largely because of the money involved. Emergency medical service is a self-supporting function within both the Eugene and Springfield fire departments, and each ambulance ride to a hospital costs the patient more than $700 or more. The revenue stream became even more critical to the Eugene department after the Lane County Board of Commissioners awarded an ambulance service district to the Lane Rural Fire District in November 2001. http://www.registerguard.com/news/2003/03/22/b1.cr.firedispute.0322.html =================== Nearby Developments ================== ------------------------------------------------------------ 7.cn - Deep Dish with Dinah: Building Bridges in Eugene ------------------------------------------------------------ by Dinah Comic News (#429), 3/10/03 Jack Joyce has been trying to negotiate with Carolyn Chambers to open a new Rogue Brewery in the space that was Spencer's Brewhaus in the Gateway area. The back-and-forths have been happening for half a year, but it hasn't made it to either's front burner yet. Carolyn spent a couple months in Mexico producing a film based on Robert James Walker's novel Puerto Vallarta Squeeze. Ten million dollars is a lot to spend on a first effort, but Chambers doesn't see much risk. Walker's earlier novel, Bridges of Madison County, turned into a blockbuster for its genre. Chambers is back in Eugene editing the film for showings this summer, while fielding calls from major distributors who are anxious to bring the film to theaters before year's end. Meanwhile, Jack is splitting time between Seattle, where they will be expanding their pub, and San Francisco, where they plan to open one next. If both these projects come together at the same time, they may not want to add Springfield to their agenda this year. For the time being, it's all just talk. http://www.something2eat.com/features.cfm?columnist=1&RequestedArticleID=236 ------------------------------------------------------------ 8.rg - Symantec moves jobs to Oregon ------------------------------------------------------------ By Sherri Buri McDonald The Register-Guard Springfield -- In an effort to consolidate more back-office functions at its Springfield facility, Symantec Corp. is moving 28 jobs from its headquarters in Cupertino, Calif. By August, the Internet security company will transfer to Springfield 28 positions in purchasing, accounts payable, and internal expense reporting, spokesman Phil Weiler said Thursday. Symantec employs about 531 full-time workers in Springfield, mostly handling calls and e-mails from customers regarding Symantec software. Employees who currently do the back-office work in Cupertino have been offered the chance to move to Springfield. So far, at least one person has accepted, Weiler said. The new positions are in addition to the 41 openings for information technology workers at the Springfield facility that Symantec has been filling since late last year. As part of a corporate strategy, Symantec is moving information technology positions to Springfield as they open up elsewhere in the company. Symantec has succeeded in filling these highly skilled positions either through hiring locally or recruiting professionals from outside the area, Weiler said. Symantec employs more than 4,000 workers in more than 38 countries worldwide. The shifting of back-office work to Springfield underscores the company's plan to make that facility more than simply a service center that handles customer contacts concerning Symantec products. Symantec recently began running local ads for some of the back-office openings. The company is seeking a procurement specialist with a bachelor's degree in business and at least seven years of purchasing experience. Symantec also has openings for four senior buyers, two buyers and an associate buyer. Those positions require up to a bachelor's degree and two to three years of experience, the company said. During the past couple of months, Symantec has been rearranging some offices at the 190,000-square-foot Springfield facility to ensure that people doing similar work are located near each other, and to accommodate the incoming departments. http://www.registerguard.com/news/2003/03/21/d8.bz.symantec.0321.html ------------------------------------------------------------ 9.rg - Harlow Road site to house dental office and more ------------------------------------------------------------ By Joe Harwood The Register-Guard Springfield -- The rapidly growing Harlow Road-Gateway Street corridor of Springfield will soon be home to more professional offices. Eugene businessman Roger Bullock last month filed preliminary plans to create about 10,000 square feet of dental and medical office space -- dubbed the Harlow Professional Center -- on just under an acre at the northeast corner of Pheasant Boulevard and Harlow. Bullock intends to convert an existing home at 496 Harlow that formerly housed a day care center into a 4,300-square-foot dental clinic, according to documents submitted to the city. He would begin that portion of the project later this year. Once that extensive remodel is complete, Bullock would construct a 5,700-square-foot office building on a vacant parcel immediately to the north. The building would be designed for medical or dental offices, according to the documents. It's unclear whether Bullock has lined up tenants for one or both of the buildings. Bullock did not return telephone calls to The Register-Guard. Bullock and his wife, Linda, bought the property in January for $525,000, according to a deed on file with Lane County. Several professional offices have sprouted up in the corridor in the past three years, including a Pacific Continental Bank building, Selco Credit Union's Gateway Financial Center, AAA's new office and a handful of smaller office projects. With business booming and space at a premium, Metal Products Co. plans to expand its Springfield plant. The company, which makes residential and commercial building products, has submitted documents to the city to build an addition that includes a loading dock. The firm makes metal coverings and metal strapping, among other products, that are distributed at hardware and building supply stores across the country. Jon Jaqua, who co-owns the 50-employee company with Tim Stokes, said he wants to add about 20,000 square feet of space to the firm's existing manufacturing facility. He said the company has about 35,000 square feet of manufacturing space at 1652 N. 32nd St., and the addition would be used for storage and shipping operations. "We are busting out right now," Jaqua said. "We really need the space." Jaqua said the project, which still needs city approval, will likely cost about $500,000. He hopes to the complete the expansion by the end of the summer. Development Report runs every Tuesday. To suggest items, contact Joe Harwood, 338-2364. http://www.registerguard.com/news/2003/03/18/b1.bz.develop.0318.html ------------------------------------------------------------ 10.rg - Springfield developer sues over conditions ------------------------------------------------------------ By Joe Harwood The Register-Guard Springfield -- New homes don't necessarily go up any faster on the east side of the freeway after all. After creating more than 800 residential lots in Eugene over the past decade, developer Steve Lee last year decided to jump Interstate 5 and build a 40-lot subdivision in Springfield. Complaining that Eugene's planning policies and rules were too arduous and expensive, Lee said he wanted to take advantage of Springfield's reputation for quickly approving projects and working cordially with developers. [Map: Springfield Spat -- City, developer at odds over housing plan] The brief honeymoon is over. Lee late last month filed a lawsuit against Springfield, alleging the city violated state land use laws and its own development code when it slapped on a series of costly and complicated conditions that Lee would have to meet in order to build the subdivision. The legal action, in which Lee is asking a Lane County Circuit Court judge to act as a land use hearings official, is uncommon in Oregon. Most disagreements between developers and cities end up before the state Lane Use Board of Appeals, a three-member panel of attorneys who specialize in land use law. But developers in Lane County and elsewhere in Oregon are increasingly turning to the courts to settle disputes involving land use laws and property rights. Developer John Hammer is now leading a class-action lawsuit against the city of Eugene, claiming the city illegally forced him to donate land to the city. In 2001, Portland businessman Michael Kelly won a $4 million settlement from Eugene after he dropped a lawsuit that charged the city with illegally blocking his development plans. Lee's petition charges that Springfield's planning department made numerous errors with the Jordan Crest subdivision planned for a 9.5-acre parcel at the north end of Filbert Lane near Mount Vernon Elementary School. Under Oregon law, a city has 120 days to make a decision on a land use application. Springfield deemed Lee's subdivision application complete on Aug. 19, 2002, meaning that the 120-day clock started ticking, according to court documents. The city issued a tentative approval on Dec. 13, 2002, about a week before the 120-day deadline, according to the doc- uments. But Lee appealed several of the conditions attached to that approval. Lee argued that many of the conditions -- ranging from storm water collection and treatment to drainage issues -- were based on development code changes enacted after he applied to build the subdivision. Lee maintained that the city has to base its decisions on the rules in effect at the time he made his original application. The city partially agreed, and instead of continuing with the appeal, it issued an amended subdivision approval on Jan. 13. That approval still required extensive storm water treatment, based on earlier codes. "Initially, we did issue a decision based on the wrong code," said Meg Kieran, an attorney for the city. "We corrected that as soon as we realized what we did." Kieran said the results of amending the conditions were not significantly different than the original conditions of approval. In its retort to Lee's petition, the city did not respond to Lee's charges that the city failed to make a final decision on his subdivision application within the 120 day time frame. Kieran declined to comment on the issue. Jill Gelineau, a Portland-based land-use attorney representing Lee, said the fact that the city missed the deadline is important to her case, but the primary reason for going to court revolves around the city's requirement that Lee install storm water treatment equipment. Gelineau said the city adopted more stringent storm water treatment rules last October. Lee is not subject to those new rules because he applied for permission to build the subdivision before the city made the code changes, she said. "They are requiring him to put in a very expensive storm water pretreatment system, and those conditions are illegal," Gelineau said. Cities across the country, responding to changes in the federal Clean Water Act, are increasingly requiring developers to treat polluted storm water before the water goes into the drainage system. Springfield is far ahead of several cities, including Eugene, when it comes to treatment requirements, and for a number of years has required elaborate storm water treatment systems. Gelineau said she will ask the court to wipe out several of the conditions that Springfield attached to Lee's subdivision. In its response to the lawsuit, the city denies many of Lee's allegations and maintains it is acting within the scope of state land use laws and local development codes. Lee said he feels an obligation to fight back against what he considers strong-arm tactics by the city. "We think there is a wrong here, and after 11 years of (building subdivisions) we are blessed enough to have the money to challenge this," he said. "I can afford to spend just as much or more than the city of Springfield." Does he plan any more subdivisions in Springfield or Eugene? "Our residential land development days around here are probably over," Lee said. http://www.registerguard.com/news/2003/03/20/b1.bz.leesuit.0320.html ================== Transportation Issues ================= ------------------------------------------------------------ 11.rg - Bus station ------------------------------------------------------------ By Matt Cooper The Register-Guard Federal funding or not, Springfield's new bus station should open by fall 2004. That's the word from Mark Pangborn, assistant general manager for the Lane Transit District. LTD is short $1.5 million on the $7.3 million project to build a new bus station on the south side of South A Street, between Pioneer Parkway East and Fourth Street. Officials were recently in Washington, D.C., to ask for more federal money, but Pangborn said that won't make or break the bus station's time line. If the feds don't pony up, LTD will dip into capital reserves to make up the difference. That could mean the postponement of other projects, but it will allow LTD to start construction this summer on the bus station and a 5,000-square-foot building with LTD services and a commercial enterprise, Pangborn said. The bus station is planned at the east end of high-speed bus service between downtown Springfield and downtown Eugene. Matt Cooper can be reached at 338-2317 or mcooper@ guardnet.com. http://www.registerguard.com/news/2003/03/22/b3.cr.spcitybeat.0322.html ======================= Other News ======================= ------------------------------------------------------------ 12.rg - Health care system works ------------------------------------------------------------ By Jeff L. Jones, Eugene Letter to The Register-Guard, 3/16/03 While we have 45 million people without health insurance, we do not have 45 million without access to care. If you need health care in this country, even if you're not a citizen, it is available to you. This was substantiated when Jessica Santillan, an illegal immigrant, received two heart-lung transplants at Duke University. Health care in the United States is the best in the world. Why else would leaders of foreign countries seek their health care in this country, and why else would Canadians cross the border in droves to get care here? Ask any U.S. or foreign citizen where the best health care in the world is, and I doubt you will hear Canada, Sweden or any other socialized health care system. A universal health care system will never be adopted in the United States until it works in another country. By working, I mean it has to provide higher quality care at a lower cost. The voting majority of U.S. citizens would not consider any combination other than this. Like it or not, we as consumers feel entitled to the best. The health care system may not be perfect in this country, but if you have received care, the odds are good that you were satisfied with the outcome. In other words, you came out of the system well and healthy and, if that is the case, why would you vote for an inferior universal health care system? http://www.registerguard.com/news/2003/03/16/ed.letters.0316.html ------------------------------------------------------------ 13.rg - Hospitals sue to block cuts in payments ------------------------------------------------------------ By The Associated Press The Register-Guard Portland -- A group that represents 61 hospitals has filed suit in state and federal court to block reductions in payments by the Oregon Health Plan for care of low-income people. The Oregon Association of Hospitals and Health Systems filed the lawsuit Monday. The group hopes to halt one of the state's tactics in its effort to close a widening budget gap: paying hospitals and other providers less for care to health plan members. Hospitals are the latest of many groups to challenge the state Department of Human Services for tightening rules on eligibility and benefits for social and health programs. Previous suits were filed by pharmacists, Legal Aid groups and the Oregon Advocacy Center. Ken Rutledge, hospital association president, said Oregon had violated state and federal Medicaid law. http://www.registerguard.com/news/2003/03/19/d3.or.hospitalsuit.0319.html ------------------------------------------------------------ 14.rg - Insurance program keeps growing ------------------------------------------------------------ By The Associated Press The Register-Guard Bend -- A state insurance pool that guarantees coverage at rates 10 to 25 percent higher than private carriers has grown 50 percent in the past five years, according to a recent state report. The pool, the result of a 1990 law, costs an average of $348.40 per month, but cannot turn paying applicants away. It now covers 9,400 residents. http://www.registerguard.com/news/2003/03/20/b2.bz.pool.0320.html ------------------------------------------------------------ 15.rg - Doctors pushing legislators to provide malpractice relief ------------------------------------------------------------ By Tim Christie The Register-Guard In Eugene, a 40-year-old neurosurgeon is moving his practice to Idaho because of skyrocketing malpractice premiums in Oregon and a fear that one big lawsuit could put him out of business. In Reedsport, women must drive 30 miles to Coos Bay to give birth because the town's four family doctors quit delivering babies five months ago when their surgeon relocated and they couldn't recruit another. [Photo: Dr. Glenn Keiper shows patient Betty Amberg, 79, her X-rays. Keiper is leaving Eugene for Idaho because of skyrocketing malpractice premiums.] In Salem and Washington, D.C., doctors are putting a full-court press on lawmakers to contain trial lawyers and big jury awards. Doctors blame their rising insurance costs on greedy attorneys who, unhindered by a cap, are seeking bigger and bigger jury awards. Attorneys and consumer groups say arrogant doctors are acting in concert with the insurance industry to escape accountability. What doctors want is a cap on jury awards for noneconomic damages for pain and suffering. Attorneys and consumer groups counter that the caps are undemocratic and don't work to curb malpractice premiums. What's needed in Oregon, they say, is tough regulation of the insurance industry. The high-stakes political battle is heating up: In Oregon, a House committee took testimony all last week on a package of tort reform legislation pushed by the Oregon Medical Association. Gov. Ted Kulongoski suggested that the state's insurance company get into the medical malpractice business to help out doctors. In Congress, the House passed a bill last week that would cap medical malpractice jury awards at $250,000. In the meantime, patients, particularly in rural areas, are starting to feel the squeeze. Fewer doctors delivering babies More and more family practice doctors and obstetricians in Oregon are getting out of the baby business. It's a high-risk specialty with some of the highest malpractice premiums. Neurosurgeons, neurologists, trauma surgeons and heart surgeons find themselves in similar straits. Since 1999, 125 doctors have quit delivering babies in Oregon -- representing about 25 percent of doctors providing obstetric care, according to a statewide survey conducted by researchers at Oregon Health & Science University. Nearly half, 48 percent, cited insurance costs and 41 percent said they feared lawsuits. The survey also found that one-third of the doctors now delivering babies planned to stop within five years. Of those, 59 percent cited the cost of insurance and 43 percent cited fear of lawsuits. Rural doctors were more likely to say they planned quit than those in the Portland metro area. On the Oregon Coast, the four family physicians at Dunes Family Health Care in Reedsport gave up delivering babies after the town's only surgeon moved out of the area. The surgeon provided backup for the family doctors in case of an emergency C-section. "Without that backup we had to stop doing OB," said Dr. Robbie Law. His practice is still doing prenatal care through the first two trimesters, but Reedsport women must drive to Coos Bay to give birth, he said. Law's office hopes to re-establish OB care at some point, but recruiting a surgeon is proving difficult, and each month that goes by, "the odds are longer that my group would take it up again," he said. Rural communities are "the canary in the mine" for the state of health care in Oregon, Law said. "Things are going badly so the canaries are dying," he said. 'Open season on doctors' Dr. Ray Englander, a Eugene neurologist, decided to protect himself against lawsuits. "I've transferred all my assets to my wife," he said. Dr. Glenn Keiper decided to seek safer ground. He's leaving Eugene in August for Idaho, a state with stronger legal protections for doctors. The neurosurgeon is one of only nine doctors in Eugene who work on the brain, spinal cord nerves and bones that surround the central nervous system. Neurosurgeons also get called into emergency rooms to perform surgery on people who have suffered traumatic head injuries. "He's the kind of guy you work real hard to recruit," said Candice Barr, executive director of the Lane County Medical Society. "We have a young man with the rest of his career out in front of him and he's not going to practice here." Keiper said he's never been sued and has no pending lawsuits against him, but he's concerned he could get hurt if he ever does get sued. "I'm a target," he said. "In this state it's open season on doctors, and neurosurgeons and obstetricians are a big-time market for medical lawsuits, whether they're just or not." Since 1999, premiums for Oregon neurosurgeons have increased 187 percent, according to the Oregon Medical Association. An OMA survey found that 43 percent of the state's 89 neurosurgeons have stopped or will stop providing high-risk services because of high malpractice premiums. Cost of doing business Neurosurgeons covered by Northwest Physicians Mutual, a doctor-owned insurance company, have seen their premiums increase from $23,463 in 1999 to $62,704 in 2003. Obstetricians have seen their premiums increase from $21,895 to $61,203 in the same period. That's for base coverage -- $1 million per claim, $3 million aggregate per year -- and many doctors carry more coverage. Keiper said he's quit doing certain high-risk procedures and now practices "defensive" medicine. "If you think of a test, you order it," he said. "You have to." Keiper has other reasons for leaving Eugene. He'll be going into practice in Coeur d'Alene with a friend from medical school. He believes Sacred Heart Medical Center officials haven't given enough support to neurological services and technology. And he didn't want to spend the next five years waiting to see if PeaceHealth succeeds in building a new hospital in Springfield. He was attracted to Idaho, he said, because the state has safeguards in place for doctors. Idaho has had a cap on noneconomic damages since 1987. The cap started at $400,000 in 1987, and an automatic annual adjustment for inflation has increased it to $682,000, said Bob Seehusen, chief executive of of the Idaho Medical Association. The Idaho Legislature passed a bill last week to lower the cap to $250,000 with an annual inflation adjuster. Idaho also has pre-litigation screening panels, made up of a neutral doctor, neutral attorney and a lay person; if the case involves a hospital, a neutral hospital administrator serves on the panel as well. Plaintiffs' attorneys must go before a panel before filing a medical malpractice suit, Seehusen said. After listening to attorneys for both sides, the panel can find that a claim has merit, that it doesn't have merit, or that it's "discretionary" -- meaning too close to call. Regardless of the panel's finding, a lawyer can file a lawsuit, and the panel's finding can't be introduced in court. But about half of the claims that go before the panels never go any further, Seehusen said. Plaintiffs' attorneys don't like the panels, he said, viewing them as a barrier to filing a lawsuit. Such measures, along with Idaho's "conservative" legal environment, have kept malpractice premiums in check, he said. Neurosurgeons in Idaho pay about half what their counterparts in Oregon pay, he said. Doctors want caps Screening panels haven't yet been proposed in Oregon. Instead, the Legislature is considering a package of tort reform bills pushed by the Oregon Medical Association. The bills cover a range of issues. One requires expert witnesses to provide science-backed testimony in an effort to keep "junk science" out of the courtroom, said the medical association's Jim Kronenberg. Another would lower the interest rate that insurers must pay on judgments. The most critical bill would require that any awards in excess of $100,000 be paid in installments, rather than a lump sum, Kronenberg said. What doctors really want, though, are caps on noneconomic damages. Oregon had a $500,000 cap from 1987 to 1999, when the state Supreme Court ruled that such caps are unconstitutional. Voters resoundingly rejected a proposed constitutional amendment authorizing caps in 2000. "We're absolutely convinced based on our own experience that the cap worked," Kronenberg said. "It certainly reduced the cost of malpractice insurance. When the cap went away, we got huge awards." Since 1999, there have been 20 settlements and jury awards of more than $1 million, he said. Before 1999, there were three, he said. The Oregon Medical Association is weighing whether to ask the Legislature to refer another measure to voters, to sponsor its own initiative or to wait to see what Congress does, Kronenberg said. But it's a high-risk proposition, and the OMA isn't sure voters have changed their minds about an issue they decided in 2000, he said. Consumers want regulation Advocates of a cap often point to California as an example of a state where tort reform worked to keep malpractice premiums in check. But a leading consumer advocate in California said that tight regulation of the insurance industry -- not caps -- restrained premiums. California's tort reform was adopted in 1975 and included a $250,000 cap on noneconomic damages. Doctors and insurers said the cap would fix the problem of high insurance prices. But premiums continued to fluctuate dramatically, said Harvey Rosenfield, president of the Foundation for Taxpayer and Consumer Rights. A study prepared by Rosenfield's group found that malpractice premiums increased 450 percent in the 13 years after California imposed caps. Only after California voters passed Proposition 103 in 1988 did malpractice premiums stabilize. Among other things, the measure rolled back insurance rates and froze them for one year. In the 13 years after Proposition 103 passed, malpractice premiums decreased 2 percent, the group found. Rosenfield, who testified in Salem last week on the issue, said the push for caps disguises doctors' true agenda. "Their agenda is to escape accountability in the court system because doctors hate the court system just like crooks hate the cops," he said. Jim Dorigon, chief executive of Northwest Physicians Mutual, the doctor-owned insurance company, is skeptical of Rosenfield's claims. His company, like many in California, is owned by its policyholders and keeps its premiums as low as it can. "If they (state officials) told us to write lower premiums, we'd go out of business," he said. A new coalition of attorneys and consumer groups, called Oregonians for Insurance Reform, is pushing against the tort reform favored by doctors. They're calling for insurance reform, reduction in medical errors and creation of a professional liability fund for doctors. Oregon attorneys, for example, are required by law to pay a minimum amount into such a mandatory insurance pool. While lawyers don't face the same exposure as doctors, their premiums have stayed stable and predictable. As state legislators search for a solution, doctors and their allies continue intense lobbying in Congress for caps on awards and other tort reform. Last week, on a 229-196 vote, the House passed a bill capping noneconomic damages at $250,000. If the bill passes, states could pass their own caps in excess of the federal cap, but would have to establish some limit on noneconomic awards. But the bill's prospects in the Senate, where Republicans hold a one-seat majority, are uncertain. Senate Majority Leader Bill Frist, R-Tenn., a heart surgeon, has promised to bring it a vote. http://www.registerguard.com/news/2003/03/19/a1.malpractice.0319.html ------------------------------------------------------------ 16.rg - Curb medical errors, critic urges ------------------------------------------------------------ By Tim Christie The Register-Guard As doctors, lawyers and consumer groups debate the best way to rein in high medical malpractice premiums, Jerry Sagen thinks they're missing the obvious: Reduce medical errors. "No one is addressing the real issue," he said. Sagen, a Eugene real estate agent, knows from painful personal experience the consequences of mismatched prescription drugs. His wife, Mary Beth Sagen, an active, physically fit 45-year-old, died New Year's Eve 1996 when her heart went into irregular spasms, failing to pump enough blood and oxygen to keep her alive. An exhaustive investigation by the Lane County Medical Examiner's Office, prodded by Sagen, found that she died from toxic levels of an antihistamine in her body. Investigators believe an antibiotic she was taking at the same time prevented the antihistamine from breaking down in her body. She was taking the antihistamine, which has since been taken off the market, for seasonal allergies. She was taking the antibiotic for bronchitis. If the doctor had done his homework, he would have known the two drugs weren't supposed to be prescribed together, Sagen said. "My wife is a tragic case," Sagen said. "But the tragedy is, it's happening every day." He points to a 1999 report issued by the Institute of Medicine, part of the National Institutes of Health, that found that 100,000 people die each year in hospitals because of medical errors, such as mistakes with prescription drugs or malfunctioning equipment. The report prompted many of the nation's hospitals to make changes, such as using computer technology to prevent medication errors. Some researchers have questioned the report, saying it was flawed and exaggerated the number of deaths. They estimate that medical errors probably kill 5,000 to 15,000 people a year, not 100,000. Authors of the original report stand by their numbers. Sagen said a preventable medical error killed his wife. He sued Dr. Ole Hansen and won a judgment of $925,000 in 2001. A jury found that the doctor was 90 percent responsible and the drug company was 10 percent responsible. Hansen, 58, retired from his family practice last September. He told his patients in a letter that he was closing his practice because of an increase in his medical malpractice premiums. "I think there is a real threat to our health care system and would encourage you to write to your elected representatives at the state and federal level regarding tort reform," Hansen wrote. Hansen couldn't be reached for comment Tuesday at his home in Junction City. Doctors want to see a cap placed on noneconomic damages awarded by juries. Oregon had a $500,000 cap until 1999, when the state Supreme Court ruled that the cap was unconstitutional. Sagen said the cap made it hard for him to find an attorney willing to take his case. "For me, I'm upset they want to mess with the legal system," he said. "When they put on a cap, they're hurting patients, not attorneys." Jim Kronenberg, executive director of the Oregon Medical Association, said it's that clear doctors and hospitals need to address the issue of medical errors. Many mistakes, he said, are "system errors" that can be addressed through better checks and balances. The medical association supports a bill in the Legislature that would require hospitals to track, report and correct errors in a systematic way, he said. http://www.registerguard.com/news/2003/03/19/a7.malpracticeside.0319.html =========================== Key ========================== "Health Options Digest" is best read with an email program that recognizes links to web pages. It includes leads from and links to stories and opinions from the following publications: rg = The Register-Guard sn = Springfield News ew = Eugene Weekly cn = Comic News ode = Oregon Daily Emerald cce = City Club of Eugene Newsletter or = Oregonian ac = Arlie & Company For some stories, two links are given. 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