Medical malpractice is a huge driver of medical costs . . . NOT!

[Fern]

I think the OP has made a persuasive case that the CBO number of .5% is pretty close to accurate

- wolf

Must strongly disagree.

The CBO prepares estimates based on the parameters mandated by Congress.

The CBO's estimate of .5% is based on just capping payouts and adjusting the statute of limitation. Given that how could they come up with anything higher?

But yeah, if that's all Congress does in any bill, that's all we'd see.

This just highlights that when discussing tort reform etc, we need to be more specific about what we're all actually talking about. You limit the tort reform, you limit the savings. Personally I'm not even interested in caps and SOL, that's the wrong direction IMO.

BTW: The study linked above saying 2.4% is an outlier and should be treated as such.

Fern

 

[woolfe9999]

Must strongly disagree.

The CBO prepares estimates based on the parameters mandated by Congress.

The CBO's estimate of .5% is based on just capping payouts and adjusting the statute of limitation. Given that how could they come up with anything higher?

But yeah, if that's all Congress does in any bill, that's all we'd see.

This just highlights that when discussing tort reform etc, we need to be more specific about what we're all actually talking about. You limit the tort reform, you limit the savings. Personally I'm not even interested in caps and SOL, that's the wrong direction IMO.

BTW: The study linked above saying 2.4% is an outlier and should be treated as such.

Fern

I agree, the more extreme the tort reform, the bigger the savings. But my post pointed to a tradeoff. Look, we HAVE tort reform here in California and have had it since the late 1970's. It caps general damages at $250,000 per plaintiff. That means if you are rendered paralyzed for life due to a doctor's negligence, you can only collect $250,000 for pain, suffering and emotional distress. This is the same cap that was in place in 1978 when the law was passed, and it hasn't been adjusted for inflation. I'd call it fairly harsh, but of course it COULD always be harsher. So now tell me, are California healthcare costs lower than the national average? Not that I've heard.

Anyway, the point of my posts is that there is a tradeoff. The "savings" don't just come out of thin air because you pass a law. It's a zero sum game, so these savings are coming out of someone's hide, and that is injured plaintiffs. So sure, make it harsher to save more money, but don't pretend that there is no tradeoff.

Get injured because someone ran you over in a car? Sure you have access to the courts. Injured because you car was defectively designed? Sure you have access to the courts. Injured because doctor screwed up? Sorry buddy. Live with it. Yup, that's America.

- wolf

 

[manimal]

People expect tort reform to be a magic wand that fixes everything. Same thing with pork and pet projects in washington.....

 

[shira]

Perhaps I'm misunderstanding you, but from another article on this study:



Defensive medicine alone, at $46.5B annually, over a decade would be half a trillion $'s.

Fern

You're making the absurd assumption that defensive medicine would vanish if there were tort reform. Tort reform would NOT banish lawsuits. Almost all tort reform caps awards for non-financial loss ("pain and suffering") caused by malpractice, not actual loss (cost of medical care to treat the damage, lost earnings, lifetime care, etc). So doctors will still practice defensive medicine to reduce their chance of being found negligent.

Next time, try reading and then COMPREHENDING.

 

[shira]

Shira.. tell me which is cheaper... a caesarian birth or natural birth? Thanks to John Edwards and convincing the courts that natural birth can cause cerebal palsy and a host of other issues.. many of the doctors in the area where he conducted over 60 malpractice suits... would simply not do natural child birth for fear of a lawsuit. Malpractice suits have forced large numbers of OB/GYN docs to leave that specialty. In some areas of the U.S. there are no OB/GYN within reasonable distance.

I say your thread is fail and that talking point is more than valid.

Not related to Edwards... but still... fear of lawsuits is why 33% of all births are the much more expensive c-section.
http://www.cleveland.com/healthfit/index.ssf/2010/01/post_26.html

Caesarian deliveries are practiced to reduce the chance of complications, to reduce the chance of being sued. Tort reform won't change that. See my previous post: Capping non-financial losses doesn't eliminate lawsuits for actual damages.

 

[Darwin333]

stfu inbred. .5% and of that .5% how much is ACTUALLY medical malpractice.

If you would have read the article Couillon, 2.4% is medical malpractice and .5% is what the CBO says we can save from reforming it.

 

[shira]

Why is this particular study superior to the ones Fern cited?

This is a quote from the link provided in the Wiki article on Medical Malpractice:

http://www.bloomberg.com/apps/news?pid=newsarchive&sid=az9qxQZNmf0o

About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans.

2 Percent of Spending

The figures were taken from a March 2003 study by the U.S. Department of Health and Human Services that estimated the direct cost of medical malpractice was 2 percent of the nation’s health-care spending and said defensive medical practices accounted for 5 percent to 9 percent of the overall expense.

A 2004 report by the Congressional Budget Office also pegged medical malpractice costs at 2 percent of U.S. health spending and “even significant reductions” would do little to reduce the growth of health-care expenses.

In other words, that 10% figure is assuming that 8% of costs are attributable to defensive medicine tied to malpractice. However, that CBO report makes clear that that isn't the case:

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf

Effects on Defensive Medicine

Proponents of limiting malpractice liability have argued
that much greater savings in health care costs would be
possible through reductions in the practice of defensive
medicine. However, some so-called defensive medicine
may be motivated less by liability concerns than by the
income it generates for physicians or by the positive (albeit
small) benefits to patients. On the basis of existing
studies and its own research, CBO believes that savings
from reducing defensive medicine would be very small.
A comprehensive study using 1984 data from the state of
New York did not find a strong relationship between the
threat of litigation and medical costs, even though physicians
reported that their practices had been affected by
the threat of lawsuits. More recently, some researchers
observed reductions in health care spending correlated
with changes in tort law, but their studies were based on a
narrow part of the population and considered spending
for only a few ailments. One study analyzed the impact of
tort limits on Medicare hospital spending for patients
who had been hospitalized for acute myocardial infarction
or ischemic heart disease; it observed a significant
decline in spending in states that had enacted certain tort
restrictions. Other research examined the effect of tort
limits on the proportion of births by cesarean section. It
also found savings in states with tort limits, though of a
much smaller magnitude.

So, earlier studies citing large savings are making the unwarranted assumption that tort reform will greatly reduce defensive medicine.

 

[Double Trouble]

UK, France, and Germany all spend about the same per capita (not just per covered person).

I haven't personally experienced France, but I have plenty of experience with Germany and the UK. I prefer the German version, but the Germans are also quickly figuring out that they can't afford to keep the system they have in place either. Further, as I said before, you can't compare the US to Germany or the UK for a variety of reasons (society, general health, lifestyle, demographics, population density, food choices etc etc etc).

There are pros and cons to everything. For example, the Dutch system (when I lived there) essentially assigned you a GP (general practitioner) based on where you lived. Don't like your doctor, or your doctor is an incompetent fool? Tough shit, you have no choice in the matter, and you couldn't just go to any other doctor on your own dime either. I believe the system has changed somewhat since then, but how happy would you be to have the government assign your doctor and you have no choice in the matter? I'll trade off increased cost for being able to select a doctor I'm comfortable with.

People get fixated on how other places do it for less, but when you take a closer look and see exactly how each system works, you quickly find issues that you may or many not find to be "show stoppers" or otherwise objectionable. There are pros and cons to every setup, otherwise everyone would have already switched to the one perfect system.

 

[Double Trouble]

I think the OP has made a persuasive case that the CBO number of .5% is pretty close to accurate

I've seen no such persuasive case. I've seen loads of research articles pegging the costs at a much higher percentage. The CBO estimate is based on the idiotic notion that simply taking a couple of steps by themselves is going to change everything. Clearly, tort reform is but one part of the puzzle, but a necessary one.

When people are injured by other people's mistakes, they have a right to compensation, but if it's a doctor making the error, the right to compensation is curbed, but why?

Because, when it comes to health and the human body, there are millions of variables, and there simply isn't a perfect black and white guide on how to tackle something. If there was, we wouldn't need second opinions. Tort reform is not about taking away people's rights to compensation for genuine injury -- it's about curbing excessive frivolous litigation that ends up costing us all billions every year for no other reason than we have a society that is overly litigious and always looking to blame someone.

If "tort reform" could save more, even in the vicinity of 4-5% of our medical costs, I'd be all for it, but not at this level of savings.

Tort reform is just one of a number of things that are needed. As Fern mentioned, standards in the industry would be a good step as well, but it would have to be a balanced approach or you'd risk any doctor ever trying anything new because it would go "off standard" and open them up to litigation.

 

[GuitarDaddy]

When the healthcare debate was raging I immediately dimissed anyone who used the tort reform argument as dishonest and trying to deceive.

The republicans used this argument like a shinny object to distract the mentally challenged. Oh look! you have a hangnail! Pay no attention to that gushing chest wound, we must fix that hangnail.

 

[alphatarget1]

So lets say 1/2 of those costs could be avoided by reforming malpractice. That's close to 30 billion dollars a year we could save. It certainly is not the silver bullet many make it out to be, but doesn't it make sense that if there was something we could do that could actually save us all tens of billions per year that we should take a hard look at it?

Yeah you can almost bail out GM with 30 Billion.

 

[alphatarget1]

other reforms, such as changing the fee-for-service reimbursement system and its incentive for overuse of services, probably are more promising

To me this is EXACTLY what defensive medicine is: we aren't 100% sure what's going on, we are 90% sure, but just to be sure we will order another bunch of tests. Maybe some doctors are doing this to make their buddies (specialists) rich, I don't know. I have heard from family members in the medical industry about medicare fraud which is related to what I just described.

 

[alphatarget1]

I haven't personally experienced France, but I have plenty of experience with Germany and the UK. I prefer the German version, but the Germans are also quickly figuring out that they can't afford to keep the system they have in place either. Further, as I said before, you can't compare the US to Germany or the UK for a variety of reasons (society, general health, lifestyle, demographics, population density, food choices etc etc etc).

(new) German doctors aren't paid worth crap and they leave the country in droves for better pay elsewhere.

http://www.springerlink.com/content/d1r6604p00653342/

Peer reviewed journal paper!

 

[GuitarDaddy]

To me this is EXACTLY what defensive medicine is: we aren't 100% sure what's going on, we are 90% sure, but just to be sure we will order another bunch of tests. Maybe some doctors are doing this to make their buddies (specialists) rich, I don't know. I have heard from family members in the medical industry about medicare fraud which is related to what I just described.

Yep, its also no coincidence that the number of doctors and doctors groups that have diversified into owning their own labs and diagnostics centers has skyrocketed.

My wifes doctor did this a couple of years ago, now it seems every time she goes to the doc they come up with a reason to do more bloodwork
What a racket

 

[alphatarget1]

Yep, its also no coincidence that the number of doctors and doctors groups that have diversified into owning their own labs and diagnostics centers has skyrocketed.

My wifes doctor did this a couple of years ago, now it seems every time she goes to the doc they come up with a reason to do more bloodwork
What a racket

I guess in a capitalistic system they are just doing things legally to maximize their profits... Not that I agree with it.

We should just train a whole bunch of new people to flood the market with lab techs. Maybe that'll bring the costs for lab tests down.

I've been a vocal opponent to many of Obama's policies, but can anyone explain whether Obamacare addresses defensive medicine?

 

[ElFenix]

I haven't personally experienced France, but I have plenty of experience with Germany and the UK. I prefer the German version, but the Germans are also quickly figuring out that they can't afford to keep the system they have in place either. Further, as I said before, you can't compare the US to Germany or the UK for a variety of reasons (society, general health, lifestyle, demographics, population density, food choices etc etc etc).

if the germans can't afford to spend half as much as we can then wtf are we doing?

and it's not like the UK or germany are scandinavia. the UK is fairly diverse and is not far behind us on the obesity scale. i bet they smoke more too.

 

[CycloWizard]

What we need is a voice of reason. We need mal-practice reform, but we need to realize that there will be virtually no money savings from that reform. The reform should be done just to fix the obvious flaws, and not to save money.

Democrats are idiots for opposing reform. Republicans are idiots for thinking that reform would solve any significant money issues. So, we have a political stalemate.

This. How can you aggressively oppose fixing something when you admit that it's broken?

 

[LunarRay]

The cost of insurance in any sector has risen to 'beyond the beyonds' and adds cost to the end product... Liability insurance in Construction or Engineering (depending on the product) is only about 5% of revenue... Generally...
It is all about the risk... Medicine creates so many risks that to obviate the most of them the general costs have gone up in terms of added tests and procedures involved.... That to me is the greatest increase of the cost of the Medical sector. Newer and better machines to provide a better look see adds to that as well... the Cost of medicine is the other factor that goes well beyond the earnings increase to the professionals.....

Where is BaliBabyDoc.... hehehehe

 

[Hayabusa Rider]

I guess in a capitalistic system they are just doing things legally to maximize their profits... Not that I agree with it.

We should just train a whole bunch of new people to flood the market with lab techs. Maybe that'll bring the costs for lab tests down.

I've been a vocal opponent to many of Obama's policies, but can anyone explain whether Obamacare addresses defensive medicine?

Unfortunately there is no health care in health care reform and that's been a major concern of mine. It's all about money and even then the approach is ass backwards.

 

[Bateluer]

I suggest a lengthy and expensive study to determine the actual savings. At the tax payers expense, of course.