Why Medical Malpractice Reform Will Increase the Deficit, Not Reduce It

When people talk about medical malpractice "reform," they are usually not talking about reducing the epidemic of medical errors in hospitals or instituting proven measures to actually reduce injuries, deaths, claims and lawsuits. No, they're usually talking about making it more difficult for patients injured by medical negligence, including catastrophically-injured children, to be compensated.

Despite the enormous hardships on innocent patients caused by these measures, or the fact that they shift compensation burdens onto others, there is an argument circulating that these measures are worth enacting because they will reduce the deficit.

Well, no they won't. In fact, they will likely increase it.

In October 2009, the Congressional Budget Office (CBO) presented an analysis (in the form of a 7-page letter to Senator Hatch) on "the effects of proposals to limit costs related to medical malpractice ('tort reform')," finding that "tort reform could affect costs for health care." CBO said that even if the country enacted the entire menu of extreme tort restrictions listed, including a Draconian $250,000 cap on non-economic damages, it could go no further than to find an extremely small percentage of health care savings, "about 0.5 percent or $11 billion a year at the current level -- far lower than advocates have estimated."

On March 10, 2011, CBO provided a new analysis of H.R. 5, a bill before Congress that is considering these measures. CBO now says that enacting H.R. 5 would reduce total health care spending even less -- 0.4 percent. Yet to find even this small amount, CBO ignored factors that would not only lower this figure but also likely increase the deficit.

For example, CBO acknowledges but does not consider in its cost calculations the fact that these kinds of extreme "tort reforms" would weaken the deterrent potential of the tort system, with accompanying increases in cost and physician utilization inherent in caring for newly maimed patients. CBO notes, "The system has twin objectives: deterring negligent behavior on the part of providers and compensating claimants for their losses ..." In fact, CBO wrote, "imposing limits on [the right to sue for damages] might be expected to have a negative impact on health outcomes." Yet it brushed aside the fiscal impact of this not because it is untrue, but because there are too few studies on the topic.

However, of the three studies that address the issue of mortality, CBO notes that one study finds such tort restrictions would lead to a .2 percent increase in the nation's overall death rate. If true, that would be more than 4,000 additional Americans killed every year by medical malpractice, let alone the hundreds of thousands of additional patients injured. How could this possibly be an acceptable trade-off?

Ten years ago, the Institute of Medicine put the costs of medical errors at between "$17 billion and $29 billion." Nowhere does CBO consider those costs, let alone the additional costs of caring for these newly-maimed patients as a result of new liability limits

There will be new burdens on Medicaid and Medicare, as well, none of which were considered by CBO. If someone is brain damaged, mutilated or rendered paraplegic as a result of the medical negligence but cannot obtain compensation from the culpable party through the tort system, he or she may be forced to turn elsewhere for compensation, like Medicaid and Medicare. None of these increased costs are considered.

What's more, whenever there is a successful medical malpractice lawsuit, Medicare and Medicaid can both claim either liens or subrogation interests in whatever the patient recovers, reimbursing the government for some of the patients' health care expenditures. Without the lawsuit, Medicare and Medicaid will lose funds that the government would otherwise be able to recoup. Again, none of these lost funds are factored in by the CBO.

After CBO issued its original October 9, 2009 letter, members of the CBO staff agreed to meet with me and a panel of experts to discuss these issues. Among the things I learned at this meeting were:

• It may be true that liability restrictions will create new burdens on state and federal deficits since the costs of injuries are not eliminated by enacting "tort reform," but merely shifted onto someone else -- including the government. However, no good study had yet been done on this phenomenon and according to CBO, if a study doesn't exist about a problem, it need not consider it even though savings could be significantly less than what they say.
• Also, CBO arrived at these numbers by plugging selective studies into CBO's internal econometric models that no one ever sees. For example, I specifically asked how CBO could find a 0.2 percent savings due to lower medical malpractice insurance rates for doctors, when years of historical experience show this to be untrue. When Senator Jay Rockefeller (D-WV) asked CBO for a "complete empirical analysis of the cost savings associated with medical malpractice reforms," CBO's response was another seven-page letter. No empirical analysis, no econometric models, no data.

I have testified in Congress on this topic twice since January, and both times, I have tried to make clear that taking away the rights of the most seriously injured in our society has been and continues to be a failed public policy. This is the wrong way to respond to the important economic problems that face this country. Tort restrictions will add to the deficit and will reduce the financial incentive of institutions like hospitals and HMOs to operate safely, when our objectives should be deterring unsafe and substandard medical practices while safeguarding patients' rights. And effective insurance reforms are the only way to stop the insurance industry from abusing its enormous economic influence, which it uses to promote a legislative agenda that bilks taxpayers and severely hurts the American public.

 

 

 

Follow Joanne Doroshow on Twitter: www.twitter.com/centerjd

Comments

[timetrialer]

04:45 PM on 05/03/2011

The good news is there are health court models which do utilize a trial by jury. Of course they would be much less efficient. It is unfair to assume that health courts would be heavily weighted toward the medical industry. Powerless victims are standing by as we speak as their cases are passed over by plaintiffs attorneys looking for the big money cases. It is almost impossible for an injured victim who is elderly to be obtain any kind of compensation in our system today

[Joanne Doroshow]

06:29 PM on 05/03/2011

I don't know if I would call this "good news." All this seems to indicate is that by wiping out the right to jury trial, Common Good knows their health court model is too radical, creating wariness among legislators and rightly so. As we know, states have not rushed to adopt these radical, expensive and likely unconstitutional proposals. But while Common Good appears to have shifted somewhat its strategy to deal with this political reality, there continues to be considerable reason for concern. The new strategy seems to be to encourage states to establish "Health Courts" which include the following elements: taking civil court judges and sending them to “medico-legal school”; separating medical malpractice claims and directing them to these judges with judges being "advised" by people from the medical industry. Just let judges and juries be, and keep these political schemes out of it. The reason people have less access to justice today is because of all the cruel "tort reforms" that are now on the books. Doctors and hospitals have more liability protection­s for their negligence than any other industry or profession in the nation - by far. (See Appendix of this report from 2009 and today it's even worse now. http://ins­urance-ref­orm.org/Tr­ueRiskF.pd­f) Repeal these laws.

[timetrialer]

11:11 AM on 05/03/2011

Another possible reason President Obama is comfortable allocating funds for installing special health courts on a state level could be public opinion polls. A unbiased poll by Harris Interactive found the american public to be overwhelmingly in favor of Health Courts over the inefficient mess we have now. For more information on health courts go to cgood.org. Michelle Mello is an attorney and a professor and researcher at the Harvard School of Public Health. She is an expert on health courts including their feasibility and legality. State and federal legislators should call her in to provide an expert opinion on this issue.

[Joanne Doroshow]

12:49 PM on 05/03/2011

No Harris poll tests whether there is support for a system where the right to trial by jury for anyone injured by medical malpractice is eliminated, where decision-makers are heavily weighted toward medical industry, replacing an unbiased judge and jury, where patients with catastrophic injuries, including the families of brain-damaged babies, still have to fight a “causation” battle to obtain compensation. Taking compensation decisions out of courts always subjects it eventually to influence-peddling and future budgetary/solvency considerations that no lawmaker today can control. These problems are always resolved on the backs of more powerless victims, who gave up their legal rights with vague and unenforceable promises that are ultimately broken. There are many examples of this occurring, including workers’ compensation, whose fiscal problems are typically solved by reducing benefits and increasing obstacles for workers, and the federal Vaccine Injury Compensation Program, which tries to reduce costs by fighting parents who try to get in the system. These programs’ slow political capture, fiscal problems and in some cases, subsequent demise as adequate alternatives for victims should serve as a loud warning with respect to the vulnerability of so-called "Health Courts." Moreover, if you take "Health Court" proponents at their word, their goal is to bring currently non-claiming people into the process by large numbers. This would multiply the number of claims involving negligence by a factor between 33 and 50, with huge new potential costs.

[timetrialer]

10:23 AM on 05/03/2011

During his political career, President Obama has proven that he is an advocate of a strong civil justice system. He is against caps on non-economic damages favored by republicans. He has studied this issue and published an article on medical errors in the New England Journal of Medicine.He has reviewed findings of bipartisan commissions on how to reduce the deficit. He is taking political risk by going against the trial lawyers who favor the status quo. On this issue he knows exactly what he is doing by wanting to overhaul our medical justice system.

[timetrialer]

09:06 PM on 05/02/2011

You cannot claim to represent the interests of victims of medical malpractice without taking a serious look at the dysfunctional medical tort system in place now. With all these victims and all these deaths and all this malpractice, does it make sense for us to be locked into a system that compensates only 2% of victims? Should we be spending 3-5 years and tens and sometimes hundreds of thousands of dollars litigating just one case? Should we have plaintiffs attorneys compensated on a contingency basis carefully picking the most lucrative cases and frequently turning away victims with legitimate complaints simply because their losses won't cover the incredibly high cost of litigation? Does it make sense that only 45 cents of every malpractice insurance dollar ends up in the hands of victims? This amounts to billions and billions of dollars each year that should be going to victims. Should we have a system that doctors have so little confidence in that they feel a need to order up to 50-100 billion dollars annually in unnecesary tests to protect themselves in the event of a bad outcome. If our goal is to compensate more victims more efficiently while increasing accountability
and reducing medical errors we need to look at other options. Fortunately President Obama understands this and has allocated $250,000,000 to be utilized by states in part to establish special health courts. We need to rally behind him in this courageous move as he is taking on the trial lawyers

[Joanne Doroshow]

09:35 PM on 05/02/2011

Doctors and hospitals have more liability protections for their negligence than any other industry or profession in the nation - by far. The reason so few people get into court now is because of the number of harsh tort restrictions that are on the books creating enormous windfalls for the insurance industry - so lets start by repealing these cruel laws. (See Appendix of this report from 2009 and it's even worse now. http://insurance-reform.org/TrueRiskF.pdf) And believe me, doctors are not ordering $50-$100 billion in unnecessary tests. http://tinyurl.com/3tk7fc4 I mean really, even the Congressional Budget Office put the figure at a paltry 0.3% of total health care costs. "Health courts" are a horrible idea http://www.centerjd.org/archives/issues-facts/stories/MB_2007healthcourts.php. They are also unconstitutional. http://www.centerjd.org/archives/studies/HealthCourtsUnconstitutional.pdf If we just allowed judges and juries to do their job like they do in every other criminal and civil case, including deciding if people live or die, instead of having politicians in Washington DC or state capitals do this, patients would be a lot better off.

[Boston Doc]

11:48 AM on 05/03/2011

I am intrigued by Obama's idea of medical courts. Could you please post most information about it? I highly doubt that it has a realistic chance of getting through this Congress.

[alongst]

02:17 PM on 05/01/2011

Why don't we cap the percentage of the award that lawyers receive, say to 5% ?
After all, aren't they concerned about justice and their clients?

[Joanne Doroshow]

11:43 PM on 05/01/2011

If you want to provide practical immunity to unsafe hospitals, that’s one way to do it. Already we know (see Health Affairs article referred to in my post) that medical errors are ten times more frequent than we thought, occurring in one-third of all hospital admissions, and that only 2% of these patients sue. Under a contingency fee system, a lawyer takes one of the 2% of cases without expecting any money up front—which is important, as injured patients may be in pain, unable to work, or lack funds to pay next month’s mortgage or rent, let alone an hourly attorney’s fee. Fees are paid only if the attorney wins. If the case is lost, the attorney is paid nothing. That is a huge risk. The impact of capping fees way below one-third, as suggested here, would make it is virtually impossible for attorneys to risk bringing virtually any case, let alone an expensive complex or complicated case, providing practical immunity for unsafe hospitals. From a conservative viewpoint, this idea makes no sense at all. Many conservatives have written in praise of contingency fees because they screen out frivolous lawsuits and do not have any impact on increasing awards. See e.g., See, e.g., Alexander Tabarrok and Eric Helland, "Two Cheers for Contingent Fees," AEI Press, 2005; James Gattuso, “Don’t Rush to Condemn Contingency Fees," Wall Street Journal, 1986.

[MRB1973]

10:44 AM on 05/16/2011

"Why don't we cap the percentage of the award that lawyers receive, say to 5% ?"

Why don't we have the government set the profit margin for what everyone receives for their services? Physicians, who freely contract with the government, and can always go private pay, don't seem to like that much, though, so I'm not sure why we would make it more widespread.

[Razia Gupta]

12:41 PM on 05/01/2011

The argument goes back and forth but I think the issue is all about the amount of frivilous law suits. Some people don't like to hear the word frivilous however over 80% of medical malpractice insurance company claims are dismissed with no payment to the plaintiff. (see http://www.equotemd.com/blog )Regardless of whether there is a cap there are far too many people looking to make a buck off of their doctor. Tort reform is needed to reduce the number of frivilous cases, however caps does not seem to be the answer. Caps hurt patients far too much when they are seriously injured. We need original ideas for tort reform to reduce frivilous claims.
Razia

[alongst]

02:14 PM on 05/01/2011

"Loser pays" would fit that perfectly.

[Joanne Doroshow]

11:50 PM on 05/01/2011

Not really. Imagine you are injured by a negligent or reckless corporation and believe you have a strong legal case. The economic devastation you might face upon losing your case, having to reimburse a large company for its inflated, hourly legal bills, would chill your right to file suit and attempt to hold that company accountable in court.

[Muirwoods]

02:20 PM on 05/01/2011

Absolutely! At least 80% of med mal cases are frivolous (but the defense lawyers still get paid).

In most cases caps do not hurt patients, even when they are seriously injured. Caps only apply to non-economic (pain and suffering) damages. If they win their case, plaintiffs are still entitled to recover the full value of their economic damages (past and future medical costs, any future cost caused by the alleged malpractice - basically any cost a clever life-care planner can come up with). What hurts a legitimately injured patient is that their attorneys typically skim 40% of the award PLUS EXPENSES! Expenses are anything the attorney spends to win the case (expert witness fees, travel fees,other legal expenses etc). Imagine that the plaintiff is awarded a $350,000 cap for non-economic damages plus $5,000,000 needed to fund their future medical care and other legitimate expenses. The attorney gets $2,140,000 (40%) PLUS probably $50,000 in expenses. Net to injured patient = $3,160.000. Oh, and add to that the government or health care insurer who paid the original bills will come after the patient (not the attorney) with a lien on any proceeds (they want their money back). Sound like a racket to you? You bet it is and it's the patient and taxpayers who get screwed.

[Joanne Doroshow]

11:57 PM on 05/01/2011

See comment below debunking the ridiculous "80% of med mal cases are frivolous" figure. As far as non-economic damages caps, of course they hurt people, especially children. Non-economic damages compensate for injuries like permanent disability, disfigurement, blindness, loss of a limb, paralysis, trauma, or loss of a women's reproductive system. Caps have nothing to do with frivolous lawsuits. They apply across the board despite the merits of a case, the extent of the misconduct, the severity of an injury. In most cases, lost earnings make up the largest part of the economic damages that go directly to the injured victim. Essentially, then, limiting non-economic damages results in valuing the destruction of an individual’s life based on what that person would have earned in the marketplace but for the injury. The lives of low wage earners, children, seniors, and women who do not work outside the home, are thus deemed worth less than the life of a corporate executive. The state of California has had a 35-year track record with a non-economic damages cap in medical malpractice cases. According to an analysis by the Rand Institute for Civil Justice, such a cap comes from reductions in payments to the most seriously injured and those with the longest lifespan after the injury - babies less than one year of age. For more, see http://www.centerjd.org/archives/issues-facts/stories/MB_noneconomic.php and http://www.centerjd.org/archives/issues-facts/MB08_Womencaps.pdf

[MommyMD]

02:54 AM on 04/29/2011

Lawyer discussing tort reform aside (any cure for my blood boiling?)....tort reform goes a LONG way towards preventing MDs/NPs/PAs from practicing defensive medicine. In my practice, the patients simply MUST get the million $ work-up, despite my advice to the contrary. In the end, I don't want to see my career, my lost youth, my passion, and hundreds of thousands of dollars in debt still to be paid, go down the toilet because of one lawsuit. Even an unreasonable lawsuit is a complete nightmare with time/energy/monetary tolls. Without the spectre of getting sued I could cut many patients' fees in half. We have a terrible system..for our patients and our docs.

[Joanne Doroshow]

08:47 AM on 04/29/2011

The Medicare claim form (Form 1500) requires providers to expressly certify that “the services shown on the form were medically indicated and necessary for the health of the patient," so what tests are you performing that are not necessary? If the services are, to the doctor’s knowledge, medically unnecessary, the claim is false. Dr. Lora Ellenson, a pathologist at NY Presbyterian Hospital-Weill Cornell Medical Center, whose now 13-year old son, Thomas, was severely braindamaged at birth due to negligence, told the New York Daily News in March: “As a physician, I have also had to grapple with the implications for my profession. I have had to come face-to-face with the knowledge that mistakes are made. Like most physicians, I live with the reality that we might one day make an error and be sued. When that day comes, I will be grief-stricken, not because of the process - although I am sure that won't be pleasant - but due to the fact that I may have caused someone irreparable damage. My only hope is that the damaged person can get what they need to live in the best way that they are able. As a physician, I want to know that there will be compensation to rebuild a life that has been diminished. Yet, as a mother, I also know that no typical physician, nor the system within which they operate, can possibly understand the true depth of these mistakes.”

[Boston Doc]

01:59 PM on 04/29/2011

Here is the answer for your question 'what tests are you performing that are not necessary'.

Yesterday I have encountere­d a case which will very likely result in a lawsuit. Today I requested additional consult ($300) and several additional tests ($247). This is of no benefit to the patient, but if the case does go to the court, it might help me.

I don't see a dime from this money. I'm doing it simply to minimize the chance of getting sued, and convicted. I did it because I know how the malpractice game is played by the doctors, lawyers, jurymen, and patients.

I can always prove in the court of law that the consult was necessary, even though I personally think it was not. You have to understand, Mrs. Doroshow, that there are many gray area in medicine. what one doctor's think is 'necessary', another might consider 'optional'. You can always find a second opinion which is 180 degree contradiction of the first. This is the nature of the profession.

There you have it. This is how lack of caps on nonmonetar­y damages, jury composed of people who don't understand medicine, lawsuit-ha­ppy patients, expert-for­-hire industry, add up together.

This is what I see in my field. No amount of malpractic­e lawyer propaganda will change that. Medical malpractic­e reform will help to control costs.

I am a pathologist, too.

[Muirwoods]

11:41 AM on 05/01/2011

As someone with many years of experience in health care, malpractice insurance and malpractice lawsuits I feel the need to point out that the problem of "tort reform" is much more complex than you present. Our health care system is hopelessly broken and is indeed an industry. It functions as a tremendous money sucking operation that provides enormous profits to the pharmaceutical/medical supply companies, insurance companies, physicians/hospital systems and lawyers at the expense of patients and taxpayers. Lawsuits are are an integral part of the industry - the part that makes millionaires of plaintiff's attorneys and paid experts, and supports the practice of defensive medicine. You know (or should know) that most malpractice lawsuits are not about medical errors, they are about money. If you look at States that have enacted sensible tort reform you will find that the numbers of FRIVOLOUS lawsuits are down significantly but malpractice insurance rates are not. Until we take the obscene profits out of the health care industry at all levels, nothing will change.

[iflew]

06:42 PM on 04/28/2011

I could be wrong. To me the best way to reduce malpractice expenses is to reduce malpractice.

When someone flies or prepares to fly an aircraft they refer to a checklist. Some medical practicioners are now beginning to use checklists. Without a checklist, the wrong kidney has been removed, wrong leg, and some other really simple to avoid incidents have happened which a checklist in earlier use would have avoided.

Also from flying there is often a red banner or ribbon labelled "remove before flight" attached to something or other. It would not be difficult to tie a ribbon to each item of size placed temporarily into an incision. Each ribbon would be an unwritten signal to "remove before closing". An op room nurse probably uses a checklist now for what goes in and what is removed, but it's always nice to have a backup system.

[NotEve]

05:30 PM on 04/28/2011

Big surprise that a lawyer is arguing against tort reform.

Why do these efforts need to be mutually exclusive? How about we enact tort reform AND efforts to reduce the incidence of medical errors.

[jymbo53]

10:31 AM on 04/28/2011

What a joke this argument is:

First off- nobody is in charge of med mal deaths, nobody counts them. Who keeps track and reports med mal deaths? What is the phone number of the med mal death bureau? Yep, got another med mal death to report ! The plaintiffs bar hasnt found this guy yet. Think about it.

Re Health care saving due to med mal reform. They are separate issues. This is a diversionary argument. The real problem with the high cost of health care, wait ..., is the high cost of health care. It is a stand alone argument. Do not humor the Aetna, Blue cross lobbyists by honoring this stupidity. Huge monthly premiums for the honor of meeting a huge deductible for the privelege of coming up with the copay. When do they pay? What a racket. It is catastrope coverage, not health care.
There isno competition for the healthcare dollar. Each state has only a few companies due to protected borders and freedom from antitrust provided my McCarron- Ferguson, that actually prevented information sharing between insurance companies in the 40s. Without competition, would we be in that Ford F-150 or a shiney Model T ? Separate the arguments.

Healthcare is a joke, measured by full hospitals not empty ones! I had 7 stitches recently and a tetnus shot- Cost me $2219.00. Really? $2k paid by Us healthcare- has to be some fuzzy math someplace.


Jim O'HAre RPLU AIC AIS.
DIrector of Claims
Medicus Ins Co

[iflew]

07:07 PM on 04/28/2011

I think '"Med Mal' is a terrific name for a Doctor.

Seriously I believe it is very difficult to get big money to move against malpractice. The sheer threat of malpractice suits, or failure to issue a policy can be nightmare for the well intentioned physician. Like any other profession there will be a few who do risky business and make lots of money for a short time..

You are spot on about outrageous expenses.

Pharmacys put together a $20/bottle substance to prevent premature births. A drug company patented it and charged $1500/dose. When the public found out lowered the dose price to $600. Was covered nationally about 2 weeks ago.

[alongst]

11:56 PM on 04/29/2011

You are paying for you--- and the gang banger who got shot yesterday in a drug deal, the birth of the illegal alien's anchor baby and the 15th ER visit that week for a Welfare queen's kid who she has taken to 15 different doctors for "congestion".

[ian0000]

02:09 AM on 04/28/2011

fact 1 in australia if you sue for med malpractise or simply a slip and fall and lose the case you have to pay the winners legal bills automatically and if your poor then your lawyer has to pay what you can't . so guess what hardly any slip and falls in australia and only slam dunk malpractice cases.
fact 2 in australia private ins costs only 165 bucks a month and the insurance cos make big profits charging this small amt. for public ins the cost is a payroll tax of 1.5% and our av mean pay is roughly 50k a year so the av guy pays only 750 bucks a year for public health ins
any relation between fact one and fact 2?

[behavingbadly]

05:35 PM on 04/28/2011

Damn shrewd of you lot.

[nkurland]

11:03 PM on 04/27/2011

If an arbitrary cap on settlements is put into place, then it reduces the caution with which doctors perform procedures. Standards for hospitals, hygienic and otherwise will be eased. Prescriptions will be doled out freely. Either way, the costs are going to be pushed onto patients.

If doctors and hospitals want to shield themselves from medical malpractice, they can start enforcing the surgical checklist, which has been saving lives worldwide.

[RMankovitz]

10:29 PM on 04/27/2011

On this topic, it might be informative to look at studies of the “errors and omissions” history of the medical industry.

First, an article that appeared in JAMA in 2000, placing the medical community as the third leading cause of death in the U.S. See:

Is U.S. Health Really the Best in the World?

http://www.jhsph.edu/bin/s/k/2000_JAMA_Starfield.pdf

Then, we have a statistical review that places the medical community as the number one cause of death in the U.S. See:

Death By Medicine

http://www.whale.to/a/null9.html#ABSTRACT

Next, we have reports stating that when doctors go on strike, the death rate in the population stays the same or decreases. Of course, there could be reasons unrelated to poor healthcare. Here is a review. Draw your own conclusions:

http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-4TN2FGB-3&_user=10&_coverDate=12%2F31%2F2008&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1733294120&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=104076c126abd5f7ba7cece6b7904222&searchtype=a

The above are just some of the reasons I favor primary illness prevention, examples of which can be found in “The Wellness Project.”

Roy Mankovitz, Director
http://www.MontecitoWellness.com
A research organization

[No death panels]

12:48 AM on 04/28/2011

I don't see how a caveman diet, herbal supplements and detox are the solution to our country's malpractice insurance rates.

[iflew]

01:50 PM on 04/28/2011

I fanned you on this issue. We are living in an age when people want the ice ceam but don't want to turn the handle to make the ice cream. People do not feel responsible if their child, dog, car, truck, slip of hand or dropped sponge, or knife etc. in the operating room or whatever creates a problem for someone else. You have facts and sources. You are not guessing.

Do you have stats on chemical substance abusers in the operating room? I had a monogamous relationship with an abuser at one time for a few months. I didn't know what those tubes were for in the fridge until late in the relationship with that drug induced manic-depressive.

The general public should not have to ride a gurney into an operating room of drug addicts any more than ride an airplane operated by one, or ride on a flight where a flight controller at some airport is drugged.

[No death panels]

09:54 PM on 04/27/2011

A lawyer blogging about the evils of tort reform? How much money would ambulance chasers lose if it was enacted? Taking 30-40% off any reward the innocent patients receive ("including catastrophically-injured children"-nice exploitation) just wouldn't be the same with a cap, I guess.

[MRB1973]

10:51 AM on 05/16/2011

"Taking 30-40% off any reward the innocent patients receive"

Who is offering to give these "innocent patients" their compensation before the lawyer gets involved. I'm unaware of many physicians or their insurers rushing out to pay folks when they're injured.

[HST]

09:28 PM on 04/27/2011

"According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail."
http://prescriptions.blogs.nytimes.com/2009/08/31/would-tort-reform-lower-health-care-costs/

[makeck]

08:16 AM on 04/28/2011

So if the others guys data is correct, and 30-40% of all awards go to the trial lawyers, thats a $10 to $12 Billion dollar a year industry (2007 numbers of course). That does not take into consideration, of course, how much all the trials actually cost since the taxpayer foots the bill for that, both the trials that result in an award and the ones that do not.

Wow, now I know why she took the time to write the article.

[HST]

01:04 PM on 04/28/2011

"So if the others guys data is correct, and 30-40% of all awards go to the trial lawyers, thats a $10 to $12 Billion dollar a year industry (2007 numbers of course)."

Out of a 2 trillion dollar industry?

"Wow, now I know why she took the time to write the article."

Cause she got paid or needed the publicity?

To quote my article AGAIN:

"That puts litigation costs and malpractic­e insurance at 1 to 1.5 percent of total medical costs."

Get it? Trials included 1.5% of all costs max.

There's no "there" there... AKA big to-do about nothing.

[HST]

03:19 PM on 04/28/2011

"There was absolutely no substantiation for the number that was put there.."

I guess you have to read his book:

"Tom Baker, a professor of law and health sciences at the University of Pennsylvania School of Law and author of “The Medical Malpractice Myth,”

"I understand that you beleive them in toto, I do not."

More of those "unsubstantiated" numbers and their sources from the article:

" These data were the basis of the 1999 report from the Institute of Medicine, “To Err Is Human.”

"It was published in The Quarterly Journal of Economics by Stanford economist Daniel Kessler and Dr. Mark McClellan, who was head of the Centers for Medicare & Medicaid Services under President George W. Bush."

" Furthermore, the second study, published in 2002 in The Journal of Public Economics, found that much of the difference disappeared as managed care took hold in Florida in the 1990s."


So let's sum up:

You find that the author ( a professor of law and health sciences at the University of Pennsylvania School of Law) of a book entitled “The Medical Malpractice Myth,”
who uses figures from a top actuarial firm, a study by a Stanford economist and a MD who was the head of the CDC under Bush, and another study in the journal of Public Economics to be questionable and that he's using "absolutely no substantiation".

You are hilarious!

Have your ever given any thought to doing stand up?

[alongst]

10:23 PM on 04/28/2011

As usual, you lawyers use the term "direct costs of malpractice".
What you intentionally leave out are the indirect costs, mostly of defensive medicine, which amount to about 30% of the total costs of health care !
I cry for you bloodsuckers losing a few billion.....

[HST]

10:38 PM on 04/28/2011

"As usual, you lawyers use the term "direct costs of malpractic­e".

I have yet to see the people whining about tort reform mention anything about defensive medicine while they cry about insurance costs and jury awards.

You are really dense if you think some award caps are going to stop docs from doing CYA.

"I cry for you bloodsucke­rs losing a few billion...­.. "

Don't cry for me Argentina.

Btw, I work in the medical profession...for 27 years.