“Malpractice Reform Won’t Do Much to Reduce Health Spending”

As the sister, sister-in-law and cousin of physicians, I pay attention to medical malpractice lawsuits and the twisty politics embedded in the cry for “malpractice reform” as a way of cutting health costs.

But here, as Aaron E. Carroll in the New York Times explains, Malpractice Reform Won’t Do Much to Reduce Health Spending – NYTimes.com.

Although my empathy is primarily with physicians, I note that the efforts to control malpractice litigation − and limit awards − are usually generated by Republican politicians and target lawyers defending and prosecuting medical malpractice cases. The GOP wants to cut lawyers, who do tend to vote Democratic, at the knees because that would restrict lawsuits against the GOP’s patrons, medical and insurance corporations. The operative (!) word is “corporations.”

Lawyers are easy to demonize. A lot easier than physicians, although insurance corporations have done a terrific job of semantically reducing physicians to Soviet-type “health care worker-bees,” like people who stack books in Amazon warehouses.

(It’s constantly amazing to me that people have bought into this dishonorable sales pitch and blindly demonstrate more loyalty to their insurance corporations than to their doctors. People, it ain’t your insurance company who keeps you healthy and saves your lives!)

So look at these paragraphs from the Times article:

…Researchers examined more than 15 million medical insurance claims in 30 states with varying levels of risk of malpractice suits. They compared how the same conditions were treated in states with high malpractice-suit risk and in states with low risk, to model what costs would be if more physicians were practicing in low-risk areas.

The effects were surprisingly minimal. They found that even if malpractice premiums fell by as much as 30 percent (which would be huge), overall spending on defensive medicine would drop only 0.4 percent.

There are a number of reasons this might be so. The first is that even as caps are put on damages, and indemnity payments are reduced, the savings are not always passed on to physicians in premium reductions that might cause them to change their behavior. Sometimes those savings are pocketed by insurance companies, as they appear to have been in Florida since malpractice reform passed there in 2003. If that happens, there’s no reason to believe doctors will practice much differently. [My bolding]

And since we all know my feelings about anything Texas:

In 2003, for instance, Texas passed a law that capped noneconomic damages at $250,000 per year. The idea was to decrease the number of suits, lowering overall indemnity payments, which would lead insurance companies to decrease premiums for malpractice insurance. This, coupled with reduced claims, would make doctors feel safer, and therefore reduce their practice of defensive medicine.

Health care spending didn’t go down in Texas, though. In fact, Medicare spending per beneficiary went up more quickly in Texas after the change than it did in the rest of the country.

Maybe the Republican animus toward lawyers can explain why Republicans like to run non-lawyers for elections (pig farmers seem to be currently in vogue, although doctor-politicians like the Rand boys are popular, too). Some of us sort of like to vote for people who have either law degrees, since “legislation,” i.e., writing laws, is a major job of elected officials and the “legi” in that word comes from the Latin word “legis,” and is related to the Latin word “lex,” meaning “law.”

O tempora, o mores! Oh dear!

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