Note: From 2006-2012, I was an editor and contributor to BlogHer.com. Because of changes in ownership, the content I created is no longer visible on the site. I have been retrieving some of the work that I did on the site that got the most response and republishing it here.
This particular blog post was part of a 2009 BlogHer collaboration with the Sunlight Foundation to stimulate informed discussion on what would become the Affordable Care Act. Sunlight had created a tool, OpenCongress.org, that allowed one to read the full text of proposed legislation and annotate it paragraph by paragraph with comments and questions. One could track the progress of the bill by adding a widget to a personal blog or website.
This was one of several blog posts I wrote on particular aspects of the act. This is the opening post in the series. Other members of the staff also researched the bill and posted from their respective beats. For the most part, the discussion, while passionate, was informed and civil.
Malpractice reform and the health care overhaul: the truth behind the rhetoric
March 9, 2010 by Kim Pearson
I used to have a gynecologist that I absolutely loved – at least as much as you can love someone who wields a speculum. She saw me through a difficult pregnancy. She made me feel as if she really cared about my health. She listened to me and answered my questions.
Then my insurance plan went out of business. I found an HMO that had a roster of doctors I wanted, including my gynecologist. That was fine for a while, until the day I called for an appointment for my regular checkup only to learn that she was dropping my insurer, along with several others. As with many other ob-gyns, I was told she’d concluded that her reimbursements from the insurance companies didn’t cover her malpractice premiums.
Fortunately, I found another great gynecologist. However, stories about doctors’ complaints about excessive malpractice insurance premiums and frivolous lawsuits have persisted. Indeed, one of the few areas of apparent agreement between Pres. Obama and his Republican opponents in the health care reform debate is that finding ways to limit medical malpractice suits might be one way to reduce health care costs. Of course, supporters and opponents of the current health care reform legislation differ about the best way to approach that reform.
Republicans favor laws that limit liability, while the Democrats have emphasized reducing medical errors. Republicans tout a Congressional Budget Office estimate that tort reform could cut medical expenditures by $54 billion over ten years.
But there is the problem that little evidence exist to show that malpractice reform really reduces patients’ costs, while considerable evidence suggests the wrong kind of reform could cost patients’ lives. At Pres. Obama’s televised health care summit with Congressional leaders last month, Sen. Dick Durbin (D-IL) drew on his experience representing both plaintiffs and defendants in malpractice suits to make precisely that point:
(You can also read the transcript.)
Tort reform has long been a central tenet of health care reform proposals by Republican leaders. The alternative health care reform legislation sponsored by Rep. John Boehner limits plaintiff’s non-economic damages to $250,000. (Read the bill .pdf)
During Pres. Obama’s televised health care summit, Rep. Joe Barton (R-TX) touted Texas’ tort reform law which he said had attracted 18,000 doctors to the state and reduced malpractice premiums by 27 percent. But Seminal at Firedoglake cites a study by Public Citizen which found that since Texas passed its law limiting defendants’ liability to $250,000, more people are uninsured, health care costs are rising faster than the national average, and the numbers of doctors in under-served areas has actually declined. The full Public Citizen Study is here (.pdf)
As Pres. Obama noted at the summit, both his plan and the health reform bill passed by the Senate include grants to states for programs to reduce medical errors. Health and Human Services Secretary argued for the merit of this approach in this exchange about controlling costs with David Gregory during a March 7 appearance on Meet The Press:
MR. GREGORY: But you, but you don’t, you don’t deal with tort reform, which the president has talked about more recently.
SEC’Y SEBELIUS: Actually, we do deal with tort reform. That’s just not true. He moved ahead on tort reform early on, directing me to…
MR. GREGORY: Pilot programs is what you supported.
SEC’Y SEBELIUS: …pull money out. Well, but states are in various stages.
MR. GREGORY: Right.
SEC’Y SEBELIUS: And many states, like my own state of Kansas, have already passed full tort reform; others haven’t at all. This is really a state-level situation…
MR. GREGORY: But whether it comes to…
SEC’Y SEBELIUS: …where we want to see the best ideas that work.
MR. GREGORY: …malpractice reform, whether is comes to…
SEC’Y SEBELIUS: Which is in the bill.
MR. GREGORY: …subsidizing volume, whether it comes to, you know, salaries for doctors and so forth, do you really assert–you disagree with Warren Buffett that this adequately bends the cost curve?
The strange thing to me is that critics of the proposed health care reforms deride it as a government takeover of health care, but on this point, they seem to want a mandate from Washington instead of allowing local governments to take the lead. Seems a curious contradiction of Republican ideology, in addition to being of dubious fiscal soundness.