Doctors in Congress

Preface: This previous blog of mine was recently reprinted in The Health Care Blog, the most widely read blog on health care issues. It has relevance because 15 of the 16 doctors in House and Senate are Republicans and will participate in the debate and will vote on whether to repeal Health Reform.As I go to press, I learn of a November 18 Washington Post article, "Many of the Doctor-Legislators Oppose Health Laws." It says, in essence, that of the 20 physician legislators, 18 oppose the law.


When new members of Congress are sworn in this January, there will be a total of 20 doctors in Congress – 3 Senators and 16 Congresspersons. That will be a 27% increase over 2009,from 15 to 19, in doctor members of Congress. These doctors will make up 3.5% of the 535 members of Congress, but will fall far short of the 10.7% who were signers of the Declaration of Independence.

Eighteen of the 19 new members are Republican. This may say something of the mood of America towards health reform, but it may have little effect on whether the health reform bill is repealed or retained in its present form.

Fifteen of the 19 are from the South or West, 5 are Ob-Gyn specialists, and 12 represent specialties who perform surgery. What this means or portends I do not know. Perhaps they will not hesitate to perform surgery on the bloated national budget and cut deficits. I take solace in recent polls, which indicate 77% of the public trust doctors to do right thing vs. 11% who trust Congress.

Here is the list of the 19 doctors in Congress:

Senate Incumbents

1. Tom Coburn (R, Republican), Oklahoma, family physician and ob-gyn
2. John Barasso (R, Wyoming), orthopedic surgeon New Senator
3. Rand Paul, (R, Kentucky), ophthalmologist

House Incumbents

1. John Boustany ( R, Louisiana), cardiovascular surgeon
2. John Fleming (R, Louisiana), family physician
3. Bill Cassidy (R, Louisiana), gastroenterologist
4. Tom Price, (R, Georgia), orthopedic surgeon
5. Paul Brown (R, Georgia), family physician
6. Phil Gingrey(R,Georgia), Ob-Gyn
7. Ron Paul (R, Texas), Ob-Gyn
8. Michael Burgess(R, Texas), Ob-Gyn
9. David “Phil” Roe (R, Tennessee), Ob-Gyn
10. Jim McDermott (D, Washington), psychiatrist

New House members

1. Larry Bucshon (R, Indiana), thoracic surgeon
2. Andy Harris (R, Maryland), anesthesiologist
3. Dan Benishek (R, Michigan), general surgeon
4. Nan Hayworth (R, New York), ophthalmologist
5. Scott DesJaris (R, Tennessee), family physician
6. Joe Heck (R., Nevada). emergency room physician
7. Del Donna Christensen (D,Virgin Islands), family physician

Richard L. Reece, MD, is pathologist, editor, author, speaker, innovator, and believer in abilities of practicing doctors and their patients to control and improve their health destinies through innovation. He is author of eleven books. Dr. Reece posts frequently at his blog, Medinnovation. He works with but does not speak for the Physicians Foundation, a 501C3 organizations that represents physicians in state medical societies.

Comments

I thought it interesting that almost all of the physicians in Congress are Republicans. From that I infer that they also support conventional 'tort reforms' as the panacea for cost-growth in healthcare. I'm not a physician but I know that this set of reforms will do absolutely nothing for patients and premiums.
Posted by: Richard D | Jan 13, 2011 6:25:59 AM

Thanks for sharing this information. I don't see this as a positive development, as specialty physicians are much more likely to support the status quo which favors specialty and invasive care reimbursement vs primary care. I would be shocked if they are willing to tackle the issue of primary care shortages given the implications for their own reimbursement.
Posted by: Bill | Jan 13, 2011 7:23:56 AM

3 Senators in senate, which is only 3 percent is not very encouraging. America needs more doctors as their representatives in Congress and Senate for better health care system and delivery.
Posted by: Online Health Guy | Jan 13, 2011 7:24:52 AM

Dear Richard D. Thank you for your comment. I appreciate it.
But I have a question: How do you “know” with certainty that tort reform “will do absolutely nothing for patients and premiums.” “Absolutely nothing” strikes me as a sweeping conclusion. Based on what evidence?

According to Towers Perrin, medical malpractice, including legal-defense costs and claims payment, cost the health system $30.41 billion in 2007. In 2003, HHS estimated that limits on malpractice awards could cost between $70 billion and $128 billion. In A 2008 report, the CBO said limiting malpractice awards would tend to limit malpractice spending. In Texas, which enacted malpractice caps in 2003-2005, liability rates have fallen 27.5% on average.

The costs of “defensive medicine,” the ordering of unnecessary tests in anticipation of a possible future malpractice suit, are unknown, but a study in JAMA FROM the University of Pennsylvania indicated 59% of high-liability specialists said they ordered unnecessary tests for defensive purposes. In 1996, David Kessler and Mark McClellan,writing in the Quarterly Review of Economics and Finance, estimated defensive medicine costs between $100 billion and $178 billion, 3.4 to 6.8 times the cost of defending malpractice suites, paying compensation, and covering administrative costs.

To be sure, I do not “know” with “absolute certainty” what tort reform would do for patients or if it would reduce their premiums. But, based on the Kessler and McClellan estimate of a 5% to 9% reduction in medical expenditures, there is reasonable chance these costs reductions could ripple down to reduced patient premiums.
Posted by: medinnovation | Jan 13, 2011 7:38:27 AM

Thanks for responding. There was a paper in Health Affairs by Michelle Mello that took the Kessler McClellan estimates and showed that it resulted in a max saving of 45-50b dollars. See here: http://www.ncbi.nlm.nih.gov/pubmed/20820010.

The Texas number that you cite is a little misleading: you need to also tell your readers that the growth rate of premiums fell everywhere (ie, not just in Texas). My point is not that conventional tort reform is small potatoes. The physicians in Congress will cite the same papers and numbers that you have, but if you do the extrapolation more carefully, it doesn't get you much.
Posted by: Richard D | Jan 13, 2011 7:56:32 AM

Sorry: in my post above, I meant to say that conventional tort reform is small potatoes even using the Kessler McClellan numbers. I managed to stick in a 'not' by accident.
Posted by: Richard D | Jan 13, 2011 7:58:50 AM.

High Performance Health Care – Learn from two recipients of the Malcolm Baldrige National Quality Award and help your health care organization take it to the next level. The Center for Performance Excellence at Poudre Valley Health System (part of Poudre Valley Health System – 2008 recipient), and the Monfort Institute (part of the Monfort College of Business at the University of Northern Colorado – 2004 recipient) will give you the tools and best practices you need to improve your leadership and your organization. Join us at the Foothills of the Rockies March 10-11 or June 9-10. Learn more: monfortinstitute.org/STP_HC_Main.html
Posted by: Andrew | Jan 13, 2011 9:05:34 AM

"To be sure, I do not “know” with “absolute certainty” what tort reform would do for patients or if it would reduce their premiums. But, based on the Kessler and McClellan estimate of a 5% to 9% reduction in medical expenditures, there is reasonable chance these costs reductions could ripple down to reduced patient premiums."
Show me in states (including TX) that have tort reform where this occurs? There is no trickle down - Reagan Myth.
Posted by: Peter | Jan 13, 2011 9:19:30 AM

There is no need to worry. http://cheapshop.burnbellyfats.com/asthma-medicine-usa.html rel=follow>Modern ASTHMA meds will help in a couple of days.$
At BBB Blog you can share results with your mates.
Posted by: Paul | Jan 14, 2011 7:25:41 AM

Readers, just watch out for the legal advocates here who want to dismiss and demean realistic calls for tort reform, because their lobby will be affected by it.
How fascinating, and equally repugnant, that there are those who so overty project their greedy agenda onto all physicians as the bad guys, yet have no negative commentary about the role lawyers play in this debacle of health care expenses.
Unfortunately, narcissism does not discriminate in professions as well. I rest my case!
Posted by: DeterminedMD | Jan 14, 2011 8:05:54 AM

Tort reform (or at least the GOP version where you have a $250k hard cap on pain and suffering) will do next to nothing to slow healthcare costs or to benefit doctors or patients. Hell, being more aggressive on fraud in Medicare/Medicaid would yield more savings.