McCoy v. St. Bd. of Med. Ed. and Licensure

391 A.2d 723, 37 Pa. Commw. 530, 1978 Pa. Commw. LEXIS 1303
CourtCommonwealth Court of Pennsylvania
DecidedSeptember 14, 1978
DocketAppeal, 881 C.D. 1977
StatusPublished
Cited by35 cases

This text of 391 A.2d 723 (McCoy v. St. Bd. of Med. Ed. and Licensure) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
McCoy v. St. Bd. of Med. Ed. and Licensure, 391 A.2d 723, 37 Pa. Commw. 530, 1978 Pa. Commw. LEXIS 1303 (Pa. Ct. App. 1978).

Opinions

Opinion by

Judge Wilkinson, Jr.,

The issue before us is the constitutionality of the mandatory insurance provisions of the Health Care Services Malpractice Act (Act)1 under the due process and equal protection clauses of the Fourteenth Amendment of the United States Constitution and Article III, Section 32, of the Pennsylvania Constitution. At issue is an order of the State Board of Medical Education and Licensure (Board) which suspended the license of petitioner, a practicing physician, pursuant to Section 701(a) of the Act, until such time as he has complied with the provisions of the Act. For the reasons set forth herein we find Section 701(a) constitutional and therefore affirm the action of the Board.

[534]*534In 1974, jurisdictions throughout the United States were confronted with what was popularly referred to as a “medical malpractice crisis” evidenced by precipitous increases ,in malpractice claims and awards, concurrent and equally precipitous increases in the cost of malpractice insurance and the threatened unavailability of such insurance at any cost.2 The Pennsylvania General Assembly responded to this “crisis” by enacting the Act. Its stated purpose is “to make available professional liability insurance at a reason[535]*535able cost and to establish a system through which a person who has sustained injury or death as a result of tort or breach of contract by a health care provider can obtain a prompt determination and adjudication of his claim and the determination of fair and reasonable compensation.”3 It implements this policy by establishing an arbitration system whereby claims against health care providers4 are initially heard5 and by limiting the dollar amount of liability of insurers on individual awards.6 This limitation on liability is achieved by the creation of a “Medical Professional Liability Catastrophe Loss Fund” [hereinafter referred to as the Fund], established by a' surcharge on insurance premiums or direct assessment by self-insurers.7 The Fund is guaranteed by requiring that all health care providers as defined by the Act either purchase insurance or develop a plan of self-insurance8 and by making insurance available ¡to high risk health care providers through a Joint Underwriting Association.9 The state licensure boards are required to suspend or revoke the license of a health care provider upon a failure to comply with the mandatory insurance provisions or to participate in the Fund.10

Petitioner, a practicing physician in Canton, Pennsylvania, licensed to practice medicine in this state since 1941, was cited by the Board on November 30, 1976 for failure to comply with the provisions of the [536]*536Act in (1) failing to secure professional liability insurance or to submit an approved self-insurance plan and (2) failing to pay the 10 per cent surcharge into the Fund. At a hearing held on December 9, 1976, petitioner told the Board that he did not have and did not intend to acquire professional liability insurance and that he had not and did not intend to contribute to the Fund. His sole defense to the Board’s citation was the unconstitutionality of the Act.11 Accordingly, the Board on April 28, 1977 ordered petitioner’s license suspended. On May 4, 1977, the Board issued a stay pending a determination by this Court.12

Preliminarily, we must note the parameters of our review where a state statute is attacked on allegations of substantive constitutional infirmities.

‘It is the province of the legislature, not the judiciary ... to determine the means necessary to combat’ public problems, for with means as with ends, ‘the legislature, which is more responsive to the people and has more adequate facilities for gathering and assembling the requisite data, is in a better position to evaluate and determine’ alternative approaches. Basehore [v. Hampden Industrial Development Au[537]*537thority, 433 Pa. 40,] at 49, 248 A.2d [212,] at 217 [(1968)]; see also Johnson v. Pennsylvania Housing Finance Agency, 453 Pa. 329, 337-38, 309 A.2d 528, 533 (1973). Our inquiry is limited to a determination of whether the means selected are so ‘demonstrably irrelevant to the policy the legislature is free to adopt’ as to bo arbitrary and irrational. (Footnote omitted.)'

Tosto v. Pennsylvania Nursing Home Loan Agency, 460 Pa. 1, 9, 331 A.2d 198, 202 (1975).

And, in distinguishing due process and equal protection standards under the United States Constitution, we begin with the general observation that in considering the due process clause we are concerned with the fundamental fairness of the State’s dealing with an individual while in considering the equal protection clause we evaluate the disparity of treatment by the state between classes of individuals whose situations are arguably indistinguishable. Ross v. Moffitt, 417 U.S. 600 (1974).

Due Process

Petitioner contends that the statutory requirement of mandatory insurance is unreasonable and unrelated to the objectives sought to be achieved by the Act and therefore violates his right to substantive due process guaranteed by the Fourteenth Amendment. Further, he argues, assuming the validity of the mandatory insurance provision, that enforcement by suspension or revocation of his license to practice medicine is likewise violative of due process as unreasonable and unrelated to the object of the legislation.

It is well established that a state may regulate professions, consistent with the substantive due process right of an individual to pursue the occupation of his choosing, so long as the matters regulated affect the public interest. Pirillo v. Takiff, 462 Pa. 511, 341 A.2d 896 (1975), cert. denied, 423 U.S. 1083 [538]*538(1976); Adler v. Montefiore Hospital Association, 453 Pa. 60, 311 A.2d 634 (1973), cert. denied, 414 U.S. 1131 (1974); State Board of Podiatry Examiners v. Lerner, 213 Pa. Superior Ct. 63, 245 A.2d 669 (1968). Where such regulations are attacked, substantive due process requires:

[A] law which purports to be an exercise of the police power must not be unreasonable, unduly oppressive or patently beyond the necessities of the case, and the means which it employs must have a real and substantial relation to the objects sought to be attained. Under the guise of protecting the public interests the legislature may not arbitrarily interfere with private business or impose unusual and unnecessary restrictions upon lawful occupations.

Gambone v. Commonwealth, 375 Pa. 547, 551, 101 A.2d 634, 637 (1954).

Certainly it cannot be gainsaid that health care providers, in particular the medical profession, stand in the forefront of guardians of the public health and welfare.

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Bluebook (online)
391 A.2d 723, 37 Pa. Commw. 530, 1978 Pa. Commw. LEXIS 1303, Counsel Stack Legal Research, https://law.counselstack.com/opinion/mccoy-v-st-bd-of-med-ed-and-licensure-pacommwct-1978.