Posts Tagged ‘private insurers’

Jay Stevens

Jhwygirl brought up tort reform yesterday as a possible salve for rising health care costs, and quoted Governor Dean as saying it wasn’t in the bill because reformists didn’t want to fight too many enemies, including trial lawyers.

Probably what’s more likely is that Dean knows tort reform is bogus, but acted friendly towards it because the rising cost of malpractice insurance p*sses off doctors. But here’s the deal: high payouts aren’t the culprits for rising malpractice insurance costs, it’s (surprise!) private insurers who are to blame.

Some facts.

First of all, tort reform has had no effect on so-called “defensive medicine,” the over-treating of a patient (with loads o’ unnecessary procedures) to avoid malpractice suits:

A team at the University of Alabama looked into this last year. Their survey of studies related to malpractice insurance, defensive medicine and consumer health insurance premiums looked at 27 states with limits on non-economic damages, including Texas.

Their conclusion – “Tort reforms have not led to health care cost savings for consumers” – was published in the December issue of Health Sciences Review.
“It’s had a really small effect, or else it doesn’t seem to change defensive medicine,” said Michael Morrisey, a professor of health economics and health insurance and the director of the university’s Lister Hill Center for Health Policy.

(Update: A reader emailed and noted that periodical carrying the U of Alabama report was in “Health Services Research.” Here’s the citation:

Morrisey, M.A., Kilgore, M.L., and Nelson, L.J., “Medical Malpractice Reform and Employer Sponsored Health Insurance Premiums,” Health Services Research 43[6]:2124-2142 [December 2008])

(One possible answer as to why “defensive medicine” still proceeds can be found in Atul Gawande’s oft-cited piece, “The Cost Conundrum.” It’s the private hospitals seeking profit spurring on their doctors to pursue expensive treatments.)

Secondly, tort reform has no effect on the cost of malpractice insurance. Even insurance-friendly studies show variable outcomes in capping non-economic damages in malpractice cases. But nowhere is there evidence these lowered malpractice rates translate into lower healthcare costs, just higher profits for insurers and healthcare providers.

And getting away from economics, what kind of effect does tort reform have on patient care? According to Matt Jerzyk, quoting The Journal of the American Medical Association, “medical errors are the THIRD leading cause of death in the United States.” This problem is so serious and pervasive – yet rarely discussed – that Hearst newspaper reporters banded together to create “Dead by Mistake,” a website dedicated to medical errors and promoting better medical reporting procedures to help identify and avoid common mistakes.

Nowhere in this site do reporters advocate giving health care providers a disincentive to offer good patient care. If anything, the incentive for doctors to treat patients with procedures instead of patient care likely contributes to medical malpractice. That is, it’s likely the “free market” principles of private hospitals contributes to poor patient care.

As the evidence piles up, it’s readily apparent tort reform achieves only limited benefits, and none for you or me:

It’s apparent that tort reform has limited benefits, and only for certain parties: Tort reform serves Republican political interests by taking money out of trial lawyers’ pockets – traditional supporters of the Democratic party. Tort reform servers private insurers by increasing their profits without any corresponding increase in service, and protecting insurers and healthcare providers from the people they have wronged, often fatally.

And that’s the thing, isn’t it? Civil suits are the last recourse individual citizens have to punish large corporations for wrongdoing. Laws protect the big fish. Regulatory legislation is riddled with loopholes for corporate lawyers to steer their massive ships-of-commerce through. Big industry can afford almost exclusive access to our lawmakers (as evidenced by our current state of health care reform). Crack down on lawsuits and you take the last legal protections for the little guy against corporate America.

Tort reform = bad.




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