ANNAPOLIS -- Gov. Robert L. Ehrlich Jr. yesterday signed an executive order for a special General Assembly session on the medical malpractice insurance crisis to be held Dec. 28.
Mr. Ehrlich, a Republican who has led the tort reform effort, remained silent as he signed the order during a break in an evening budget meeting.
"The lives and health of the citizens of the state are threatened by rising cost of malpractice and resulting limitations on access to health care," the order reads. "Immediate action is necessary to ensure that the costs of medical malpractice insurance are curtailed and that access to health care is maintained."
The signing marks the end of weeks of talk among House Speaker Michael E. Busch, Senate President Thomas V. Mike Miller Jr. and Mr. Ehrlich.
"We are between 90 to 95 percent there, and that's enough in order to call a special session," the governor said on Friday.
But Mr. Miller, Prince George's County Democrat and a trial lawyer, said yesterday the three have agreed only on particular points for a draft bill, and he is concerned that a special session could be endless.
"The governor doesn't understand that there are 46 senators, and each of them have a vote and are entitled to debate the bill," Mr. Miller said.
He said he is also concerned about how a bailout of the state's largest insurer would be funded.
State regulators have authorized the Medical Mutual Liability Insurance Society of Maryland to increase its malpractice premiums 33 percent by the end of the year. Doctors have said such an increase could force them out of their practices or out of the state.
Mr. Busch, Anne Arundel County Democrat, has said he supports aggressive tort reform, but has doubts about using as much as $70 million in taxpayer money for a bailout.
"This is going to be a minimum $60 million-a-year investment by the state," Mr. Miller said. "I did not believe in all honesty that the majority of the members of the House will support a program that will require a $70 million revenue stream from the general fund."
Both lawmakers said the state should repeal an exemption on a tax for health maintenance organizations (HMOs) to finance a stop-loss fund aimed at covering the 33 percent premium increase. Mr. Ehrlich has said he will not support an HMO tax.
Meanwhile, doctors attending a Maryland Public Policy Institute forum yesterday were critical of the bailout plan.
Dr. John Caruso, a neurosurgeon at Washington County Hospital in Hagerstown, said he supports the governor's effort but does not favor any type of bailout.
"Not a single physician in the state of Maryland wants a stopgap bill," Dr. Caruso said. "I don't want the citizens of Maryland to pay my bill. I want my bill to be based on a system that works ... and change the concept of what goes to court, how it gets to court, the psyche of America, of the lottery mentality and its existence in all of us ... is not about paying our premiums, it's about changing the concept of why we get sued."
Courtney A. Marshall, secretary of the state chapter of the American College of Nurse-Midwives, agreed.
"It's going to provide a never-ending pot. There have to be caps on noneconomic damages within reason," she said. Doctors and nurses "want the people that have been wrongly harmed to be able to obtain compensation, but at the same time we have to be able to stay in business."
Hearings on the Ehrlich administration's bill will begin Monday, and the special session will begin Dec. 28. It will be the first special session since a budget-focused session was held in 1992.
A special session will cost taxpayers $45,000 a day, according to a study by the state's Department of Legislative Services.