Numbers disputed in Mcare argument

A debate in Pennsylvania focuses on the future of a program that, since 2003, has spent nearly $1 billion to help keep doctors in the state.

The Mcare abatement program pays part of doctors' medical malpractice insurance expenses. Most of the money comes from a cigarette tax.

Amid the debate, lobbyists for doctors, and some politicians, have renewed claims that doctors are fleeing Pennsylvania because of high medical malpractice insurance costs and lawsuits.

Gov. Ed Rendell insists that's not true. He says the number of doctors has held steady, and doctors are being sued for malpractice less often since lawsuit reforms passed in 2002.

The Pennsylvania Medical Society is using a new report from the state Department of Health to argue otherwise.

According to that report, Pennsylvania had 24,696 doctors involved in direct patient care in 2006. The medical society says that's 1,652 fewer doctors than in the 2004 report.

But Amy Kelchner, a spokeswoman for Rendell's Office of Health Care Reform, says those figures are based on voluntary surveys and aren't the true numbers. She contends the best source is the number of doctors who sign up for Mcare abatement.

As of late November, 33,522 doctors had signed up for the 2008 abatement program. Since doctors often wait until the end of the year to sign up, the final tally should be comparable with the 35,879 who received abatements this year, Kelchner contends.

So how many doctors does Pennsylvania have?

It's uncertain whether anyone really knows. But it seems likely Pennsylvanians will continue to hear claims that doctors are leaving the state.

Here are some numbers that might shed light on the situation:

The Association of American Medical Colleges says Pennsylvania had 35,565 doctors at the beginning of 2007. That gave it 286 doctors per 100,000 residents -- the 10th-highest number nationwide and one that has been consistent in recent years.

According to the state Health Department, 45,029 doctors renewed their Pennsylvania medical licenses in 2006, up from 43,972 in 2004. That includes doctors whose primary practices might be in a different state, who are retired or who, for whatever reason, want to maintain an active Pennsylvania license.

PMSLIC, one of the largest medical malpractice insurers in the state, reduced premiums by 11 percent for 2008. It said this was due to a decrease in claims.

Some examples of the annual insurance premiums charged to doctors in Dauphin County are: family doctor, $14,844; obstetrician (delivers babies), $72,844; orthopedic surgeon, $55,498.

On top of those premiums, doctors are charged for the state-run Mcare fund, which pays toward malpractice awards that top $500,000. Here is the additional amount they would be charged: family doctor, $2,969; obstetrician, $14,569; orthopedic surgeon, $11,500.

The state program, if continued, would pick up half the family doctor's Mcare cost and the full Mcare cost for the obstetrician and the orthopedic surgeon.