THE PHILADELPHIA INQUIRER
Friday, November 1, 2002

Free clinics have their day, finally
by Tom Ferrick Jr.

Two years ago, I used this space to verbally fillet State Sen. Alan Kukovich for what he did to a bill to help Pennsylvania’s free medical clinics.

There are 15 such clinics in the state. Mostly, they serve workers who earn too much to qualify for Medicaid but whose employers don’t provide health insurance.

How can the clinics offer care for free? Because the physicians, nurses and dentists who provide it volunteer their time.

To encourage this, the Pennsylvania legislature in 1996 gave medical personnel a measure of immunity from malpractice suits.

Asking physicians to volunteer their time and services is one thing. Asking them to pay up to $6,000 a year extra for malpractice insurance is something else.

The Pennsylvania Trial Lawyers Association never liked the idea of physician immunity – even for something so small potatoes as volunteer work.

In 2000, when the clinics sought to make a minor change in the law, the trial lawyers struck.

Kukovich – a Democrat from outside Pittsburgh – inserted amendments that gutted the law. No more immunity for volunteer physicians.

I thought that was the end of the story – and a sad ending at that.
But last week, I got a letter from Sister Lois McDonough, head of the HealthLink clinic in Southampton, one of three free clinics in the area.

Patron saint
She was singing the praises of Gerald McHugh for his role in getting a new law passed for the clinics.

Because of this law, Sister Lois said, her clinic no longer has to pay into the state’s catastrophic-loss fund to cover argue malpractice claims. (It had been paying $50,000 a year into the fund.)

Also, her volunteer physicians do not have to purchase additional malpractice insurance. Whatever insurance they have now will do.

Now, here’s the kicker
McHugh is a trial lawyer.

I rang up Sister Lois and asked her. Are you telling me that a trial lawyer is the patron saint of free medical clinics in Pennsylvania?
She laughed.

“I guess it proves that not all trial lawyers are bad,’ she said. “I just thank God our paths crossed. Jerry was absolutely an ace.”

McHugh who calls himself a “West Philly do-gooder,” contacted Sister Lois after we ran a letter from her on the Editorial Page, fretting over the future of free clinics because of Kukovich’s actions.

McHugh helped draft a new bill that was cosponsored by Kukovich and Sen. Bob Thompson (R., Chester).

Skin the cat
And McHugh helped shepherd the bill through the legislature, a process that took two years.

I talked to Thompson yesterday while he was home, recuperating from hip surgery.

“Everyone is happy it is over with,” he said. “The physicians are able to volunteer, and their current insurance covers them. And clinics are able to be served, which is the important thing. It’s proof there is more than one way to skin a cat.”

The new law skirts the issue of immunity. It simply states that whatever existing malpractice coverage physicians have will be considered sufficient for their free-clinic work.

To put it another way, if large malpractice awards result from a free clinic case, the physician’s insuranne company and the state’s catastrophic loss fund will have to absorb the cost.

Large claims are unlikely to occur. These clinics provide mostly routine care – no complicated surgery is done in them.

Helen Heidelbaugh, who runs a free clinic in Thompson’s district, isn’t as impressed with the new law.

She calls it "a band-aid, and not much more."

Heidelbaugh believes physicians should have immunity for their free-clinic work, but admits that is unlikely to come soon – unless the federal government steps forward and provides it in the same way it does for public-health physicians. I agree.

But I want to set the record straight. Two years ago, Kukovich told me he wanted a compromise. I publicly doubted his word. I was wrong.
Sometimes, I’m happy to be wrong.