From state Sen. John Rafferty:

Seeking to keep doctors in Pennsylvania, state Sen. John C. Rafferty Jr. R-44th Dist., joined medical representatives at a Harrisburg news conference Wednesday to push for legislation he is sponsoring that would create an MCARE Commission to oversee the future disbursement of MCARE Funds.

Rafferty was joined by Dr. Wayne Sebastianelli, president of the Pennsylvania Orthopaedic Society, who said the legislation is crucial to keeping young orthopaedic surgeons in the state and make health care available for more state residents.

Under Senate Bill 1174, the MCARE Commission will consist of representatives from the physician and hospital communities, the four legislative caucuses, the administration and a medical student.

"The major focus of this legislation is to allow practitioners who pay into this fund to control its disbursements and to keep insurance rates at a high level to protect doctors and patients," Rafferty said. "The MCARE fund should not be used as a checking account to be tapped by the Administration when state funds are low. Those who pay in should be able to determine how it is used."

Rafferty said his legislation would also ensure that future physicians will have a part in decisions, since they will pay the MCARE liabilities for their entire careers.

The MCARE Fund is a medical liability coverage fund run by the state of Pennsylvania. Currently, physicians are required to have $500,000 in primary liability coverage plus $500,000 in excess coverage above that. They can get the first $500,000 layer either in the private market or through the Joint Underwriting Association. They get the second layer from the MCARE Fund.

The MCARE Abatement Program subsidizes 100 percent of the MCARE surcharge for high-risk specialty surgeons and 50 percent of the MCARE surcharge for other healthcare providers. The program is the keystone of the medical liability reforms enacted during 2002 and 2003.

The program was renewed annually three times. In late December 2007, however, it became evident that the General Assembly could not agree on how to allocate the MCARE Fund's surplus, and the MCARE Abatement Program was not renewed by the year-end deadline.

If the MCARE phaseout schedule contained in Act 13 remains, in a few short years physicians may be required to carry $1 million of private market coverage while continuing to pay MCARE annual assessments. This eventual outcome creates a huge medical liability burden for society members and puts in place a significant barrier to recruiting the best and brightest young orthopaedic surgeons to Pennsylvania. SB 1174 will finally put physicians in the decision loop in regard to their money.