Forum Post: Limit health care inflation - tort reform, etc
Posted 12 years ago on Nov. 2, 2011, 1:29 a.m. EST by armchairecon1
(169)
This content is user submitted and not an official statement
Understand the reasons for health care inflation:
1) Treatments/procedures are getting more safe. Whereas in the past, a particular operation may only be available to say 25% of patients with a particular conditions, advancement of technologies, improved medical understanding, improved physician comfort with the procedure now means the are offering that procedure to more people (ie: older and sicker people because there is less of a chance of complications). In the end, this means more burden on insurance companies (and the govt) to pay for all of these procedures.
2) Fear of litigation - You hear stories about how an admitted patient sees 4 different specialists during their stays. Why? Because of fear of litigation. Say a fairly healthy 65 year old guy with high blood pressure, diabetes is admitted for a gall bladder removal surgery, expected he will only stay for 1 night. He gets an EKG which isnt entirely normal, the hospitalist might call a cardiologist to look at the EKG to make sure he is safe to undergo the surgery. The might just be a normal variant, but the hospitalist, afraid of getting sued for missing something would call a cardiologist to confirm/defer liability. He will also be seen by the anesthesiologist and the surgeon. When he is recouperating, he happens to ask the hospitalist why he has this rash on his back that has been there for 4 months. The hospitalist might call a dermatatoligist to do a biopsy to make sure it isnt cancer. Its even worse i you have a 85 yr old from a nursing home that has 10 different conditions. The hospitalist doctor will basically call all teh specialists because 1) he isnt an expert on everything and 2) he is afraid that if he missed something, he will get sued.
This is not to say there arent REAL problems... ie: procedures performed that haven't been proven to benefit patient outcome, overutilization/expectations by patients.. but tort reform is a good way of changing the defensive mind set of physicians.
Lawsuits account for 1% of the cost of healthcare. Your solution is to surrender more rights to corporations who flood the market with defective and harmful products?
Lawsuits may be 1% of healthcare.. but consider the overhead of fighting the lawsuits. (Very few suits are ever paid out, so 1% is still pretty high considering the enormous health care budget... but ALL require lawyers to respond against whose cost is not included in the 1% cost)
defensive medicine accounts for MUCH more.. in that example above, it means an extra day or two of hospitalization, two consults that probably were not needed and probably an additional couple of procedures that might have been needed (say the cardiologist orders an echocardiogram or the derm wants a biopsy).. these are costs that make lawsuit judgements trivial.
and not necessarily tort reform across the board.. but change in the way judgements are made by an expert panel
That option is available now. Parties to civil suits can choose a jury, single judge, or 3 judge panel as the trier of fact. Juries are not left to determine what the law means, they are simply asked to decide who is telling the truth, and apply the law, as laid out before them in jury instructions, to the facts of the case. In most instances, award limits are set by law, not determined by a jury. The only time punitive damages are permitted (where you see the largest awards) where it involves "intentional" misconduct or harm, in which case, those SOBs are getting exactly what they deserve.
The 1% figure includes the cost of defense, it's not a separate issue.
1000 lawyers at the bottom of the ocean... I am in total agreement, and would add the effect of government medical programs on driving up the cost of healthcare. There is a great deal of reform that can be undertaken there as well.