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Full Speed Ahead on Health Care Reform — Dragging Their Feet on Liability
Questions about whether the new Democratic Congress will proceed with health care reform in the face of an on-going financial crisis and ballooning deficit appear to have been decided in the affirmative. President-elect Obama’s pick of Tom Daschle to head HHS (the erstwhile Senate Majority Leader has devoted himself to health care reform since leaving the Senate and has even written a book on the subject) clearly signals the intention of the incoming administration to move ahead with all deliberate speed. And at a recent gathering of Senate big-wigs to discuss health care, Senate Finance Chair Max Baucus said he and his colleagues would “hit the ground running.” This was a week after the Senator unveiled a major white paper on health care reform that will serve as the basis for a bill he and Senator Kennedy plan to introduce next January.
The Baucus white paper, therefore, gives us a good preview of how the new Congress will address medical liability reform. On the plus side, the Baucus paper acknowledges the problem with our current system. It discounts the effects of the liability crisis on patient access to medical care and overall health care costs, but acknowledges that defensive medicine “may contribute to unnecessary health care spending.” It proposes developing alternatives to civil litigation, such as health courts or other administrative models.
As we have written before on the subject of health courts, the devil is in the details. If implemented properly, health courts may be a step in the right direction. However, there is no evidence that health courts alone will protect patients and solve the patients access to care crisis. Health courts should not be a substitute for reforms that have a proven track record of success in many states across the country. Click here to read the white paper in full, or here for the pages devoted to medical liability reform.
Double Take on Liability Reform
The constitutional challenge to Illinois’ successful medical liability reforms, which passed the state legislature after a hard-fought battle in 2005, has now made it to the state’s Supreme Court, which began hearing opposing sides earlier this month.
We hope the justices will remember just how bad it was before 2005, when premiums were sky-rocketing and it was becoming increasingly difficult for patients in Illinois to find doctors in high-risk specialties. Since reforms were enacted, obstetricians in Cook County have seen their premiums drop to an average of $125,000 from the pre-reform high of $200,000. There are now a dozen carriers for medical malpractice insurance in the state, double the number in 2005, which translates into more doctors providing Illinois patients with vital medical care.
The Court is likely to issue a ruling early next year. So if you live in Illinois, you may want to schedule that appointment with your doctor soon. To read an op-ed supporting the existing law from the Belleville (IL) News-Democrat, click here.
Doctors on Defense
A new study by the Massachusetts Medical Society is proof of just how expensive the practice of defensive medicine – and the fear of medical lawsuit abuse – really is. Last year in Massachusetts, doctors ordered $1.4 billion worth of unnecessary diagnostic tests and hospital stays to avoid litigation and legal action. Here’s a look at some of the report’s conclusions:
- An average of 28 percent of CT scans were ordered for defensive reasons. One-third of CT scans ordered by obstetricians, emergency docs and family practitioners were done for defensive reasons, while about 20 percent of those ordered by neurosurgeons and orthopedic surgeons were considered medically unnecessary.
- An average of 27 percent of MRIs were motivated by liability concerns, with the highest rates reported among obstetricians and family practitioners and the lowest rates among neurosurgeons and emergency doctors.
- An average of 18 percent of all lab tests can be traced to liability concerns, with emergency doctors reporting the highest rate (25 percent) and anesthesiologists reporting the lowest (9 percent).
The group said the actual numbers are likely much higher than those figures because several key specialties were not included in the survey.
“This survey clearly shows that the fear of medical liability is a serious burden on health care,” said Dr. Manish Sethi, an orthopedic specialist at Massachusetts General Hospital and one of the report’s researchers. We’d say he’s understating the case.
Senators Baucus and Kennedy might want to take a look at these results and think again about how severely defensive medicine can drive up overall health care costs, not to mention the unnecessary burden on patients. Click here to read more.