The financial impact of the rise in professional liability insurance (PLI) premiums has been widely recognized, and improving the cost and quality of health care has been the focus of government reports1 and policy recommendations. Although affordability of a service is a key predictor of its availability, the malpractice crisis has not been widely recognized as a public health issue. Brooks and colleagues2 make clear that, as a result of the liability crisis, access to care is declining significantly, and that effect is marked, especially in vulnerable populations where access is already problematic. The health care system of rural Florida is the particular canary in the coal mine that they have studied to examine the noxious effect on access caused by skyrocketing liability premiums.
Schroeder J. Canaries in the Coal Mine: The Noxious Effect of the Liability Crisis on Rural Health Care: The Malpractice Crisis Becomes a Public Health Crisis. Arch Intern Med. 2004;164(20):2195–2196. doi:10.1001/archinte.164.20.2195
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