Local healthcare providers told a state legislative committee about issues they feel are making it hard to practice in New Mexico. KC Counts spoke with District 53 State Representative Sarah Silva about those concerns. Here's a transcript of their conversation:
KC Counts:
Why don't you tell us some of the things you heard from those health care workers, first of all, and who were they?
Sarah Silva:
Yeah, there were four health care providers. All actually live or work in my house district, in House District 53, which is, you know, East Mesa, Las Cruces or in Chaparral. And we heard from a broad range of experiences of the things that keep doctors from coming to New Mexico to practice or continuing their practice here rather than moving it out of state.
KC Counts:
Okay, so let's start with, I guess there were three kind of top issues that we're hearing about. One is the medical malpractice issue.
Sarah Silva:
Right, that was the top issue that they were saying that they hear from their own peers across New Mexico and in southern New Mexico. They had put up some numbers of the premium payments that doctors have had to make. And in some cases, from 2020 until now, so five years, in some cases, their insurance premiums have doubled. And so, you know, a primary care or an OB/GYN is paying anywhere between $30,000 and $100,000 a year, whereas their counterparts in Arizona or Colorado are paying significantly less. to practice in the same exact way.
KC Counts:
This is because there's no cap on what could be awarded in court.
Sarah Silva:
I think there's a number of issues of why insurance premiums here in New Mexico are higher. One, we do have a high number of medical malpractice cases, but that's partly because of the rule of evidence is so low in New Mexico. And so lots more people can seek damages or take doctors to for much less proof than comparatively to other states. And so that's one of the issues. And so you have doctors who have never had a medical malpractice suit against them, still paying these exorbitant amounts of money just so that they can practice and in some ways practice really defensively, like they are practicing with a lot of pressure on them to not mess up. And like we want to see and And I would like to see the state representative make sure that people are compensated for harms that come to them. And again, the burden of proof in New Mexico is so low that it just creates a really a ballooning effect of what we see. And then that has direct impacts on people's insurance payments.
KC Counts:
It really does seem like a tight wire to walk in terms of balancing the mechanisms that bring doctors here and keep them here between, you know, compensating people when there's real harm done. What do you think is the right path for the legislature?
Sarah Silva:
You know, I so I co-sponsored legislation to reform medical malpractice last session and will continue to do so just because of all the things that I hear from my own constituents who are also providers but also people who live and try to find specialty care in Las Cruces. And so one, I think a number of the proposals that these doctors put forth in front of the committee are really important. So, one is medical malpractice reform, ensuring that we can pass policies that bring those premiums down while still honoring and bringing justice to patients who are hurt. And that is way out of balance right now. Two, I think they are also looking at reforming the gross receipts tax on healthcare services and equipment. So we're one of the. a few states who charges tax on healthcare services. And so, as we're seeing, you know, more doctors having to pay higher premiums on their insurance, they're also having to have this huge tax bill. And so, looking at how can we relieve some of that burden on healthcare professionals is really important. And then there's some other fixes that they mentioned around venue shopping and ensuring, you know, that trials or cases that get tried, get tried in their local communities rather than looking for the best venue for a case. And then the others around recruitment and retention when we have residencies. So, in order to expand our residency programs in places like UNM or even here at Burrell, we need doctors. And so, making sure that even though we pass policies that say, yeah, we're going to increase residency slots, we need to have the doctors that can train those residents. I think there's a number of things that we can look at, but... Primarily, as we heard from doctors today, medical malpractices, the thing that is putting a lot of financial strain on their practices.
KC Counts:
Is New Mexico an outlier when it comes to this type of structure? And why is that, do you think?
Sarah Silva:
You know, we're an outlier one for our tax structure because of all the federal dollars that come to the state. And so, in order for us to leverage that income and that revenue source from our national laboratories, from White Sands Missile Range, we needed to have this tax structure in order to tax the federal government. So, that's one of the main reasons we have that. And we can make those adjustments to ensure that independent practitioners, in particular, can have less of a tax burden. So, I know our bigger hospitals could most likely cover the cost of GRT. They're doing it right now. They're covering the cost of, you know, paying taxes on some of these services. But it's those independent practitioners, the specialty doctors that aren't working in our hospitals that are getting hit the hardest. So, I think that's unique to New Mexico. And I think there's a number of different issues that make the medical malpractice insurance premiums and retaining doctors here, particularly challenging because we're more rural than Arizona or Colorado or Texas. So I think there's a number of factors that also lend to this being a really big issue here.
KC Counts:
Are you an attorney?
Sarah Silva:
No, I'm not.
KC Counts:
I understand that our legislature, there's a lot of attorneys. in the legislature, and they're taking a lot of heat in terms of, creating this environment. Do you think that the political will exists to make some changes?
Sarah Silva:
I have to give credit to the doctors and patients, especially here in southern New Mexico, that have really been building their knowledge and their power and their relationships. to move the needle on this. So I'm a new legislator, and the very first constituent phone calls and emails I got were about this issue, were about med mal and not finding a doctor. And so that's why it's part of and will always be part of my campaign. And so I think the tide is turning on this issue solely because there are patients and doctors that are now organizing themselves, telling their stories, and getting the real truth and experience of what is happening on the ground rather than like these big titans of either trial attorneys or the big hospitals or the think tanks. These are actual people that are telling their actual experience with how these policies are impacting them. and that's making a difference.
KC Counts:
With the 30-day session being kind of budget oriented in such a whirlwind, what odds do you give legislation in this 30-day session on this issue a chance? Like what kind of odds do you think it has of seeing something happen in this upcoming session?
Sarah Silva:
Yeah, you know, we are at the leadership of the governor. So, whatever the governor puts on her call, like, that's what we will get to work on. And so, that remains to be seen. I know there's a number of folks that are working hard to get this issue on her agenda. And we're going to be addressing compacts. I know that for sure, because a special session set us up to do some compacts that will help support telehealth and bring more professionals into the state. But again, that is a band-aid and we'll buy us some time until we can address these bigger issues.
KC Counts:
What else do you think is important for people to know on this issue? And, is there any action they should be taking?
Sarah Silva:
Yeah, thanks, Casey. I think it's important to, you know, talk to your legislators. Now, we are thinking about the bills we're sponsoring. We're getting ready to go up to Santa Fe in a few weeks for the 30 day. And so your legislators are still in your community. And so Along with that holiday card, send them a note about your experiences accessing health care or being a health care practitioner here in New Mexico.
KC Counts:
And how would someone get ahold of you if they're in your district?
Sarah Silva:
If they're in my district, they can go to Sarah, S-A-R-A-H.silva, S-I-L-V-A at nmlegis.gov. Or they can also find me at New Mexicans for Sarah across most social media platforms.
KC Counts:
All right, Sarah Silva, thank you so much for spending this time with us on this important issue. We hope to speak to you again. You mentioned your legislators a moment ago. That's the name of our program that we air on KRWG. TV during every legislative session. We hope to be able to catch up with you for it. I know it's tight, but we hope to see you then.
Sarah Silva:
All right, sounds good, KC. Thanks.
KC Counts:
Thank you.
