Sunday, August 30, 2009

Health Reform without Tort Reform is Dead

"Since the days of Harry Truman, Democrats have wanted universal health coverage, believing that if other industrialized countries can achieve it, surely the United States can. For Democrats, universal coverage speaks to America’s sense of decency and compassion. Democrats also believe that it will lead to a healthier and more productive country."

"Since the days of Ronald Reagan, Republicans have wanted legal reform, believing that our economic competitiveness is being shackled by the billions we spend annually on tort costs; an estimated 10 cents of every health care dollar paid by individuals and companies goes for litigation and defensive medicine. For Republicans, tort reform and its health care analogue, malpractice reform, speak to the goal of stronger economic growth and lower costs."

"The bipartisan trade-off in a viable health care bill is obvious: Combine universal coverage with malpractice tort reform in health care."

Bill Bradley, former Democratic Senator from New Jersey, “Tax Reform’s Lesson for Health Care Reform, “ New York Times, August 30, 2009

Bill Bradley has it right - health reform without tax reform is dead. Perhaps it’s the lawyer in him, or maybe it’s the lobbying strength of Trial Lawyers, but President Obama has it wrong. He should stop talking about the “public option,” villainous health plans, and opposing "special interests," and more about establishing medical courts – like bankruptcy or admiralty courts - with special judges to make determinations in cases of medical injuries to reward patients for the compensation they deserve.

No one, least of all doctors, denies medical injuries occur in these days of rampant hospital infections, invasive medical procedures, the rush to get people in and out of hospitals, and hazards high tech medicine, powerful anti-cancer drugs, and cross-reactions between multiple medications.

And no should doubt, as Senator Bradley says, that tort reform “ would lower health care costs, reduce errors (doctors and nurses oftren don’t report errors for fear of being sued, and guarantee all Americans adequate health care.”

There is another aspect to tort reform as well. Tort reform would help abort,and lessen, the next big, imminent health care crisis already upon us – lack of access to doctors because of the doctor shortage and increased demand for their services.

In my book Obama, Doctors, and Health Reform, I feature an interview with Louis Goodman, CEO of the Texas Medical Association. and President of the Physicians' Foundation, which represents 650,000 practicing physicians in state and local medical societies.

In that interview, I asked:

"What do you regard as your greatest accomplishments at the Texas Medical Association?"

Here was his reply:

Our 2003 tort reform effort would fall into the category of a major accomplishment for the state of Texas, and it’s now used as a national model. That reform put a cap of $250,000 for noneconomic damages for physicians, a $250,000 cap for hospitals, and another $250,000 cap for a second hospital or nursing home. This is referred to as a stacked cap, $250,000 for each party. The total is $750,000, but only $250,000 of that falls on the doctor’s side.

This model appeals to legislators because it’s fair and differentiates between physicians and other providers in the system. The model also can help attract physicians to a state. Before we passed our tort reform, Texas was losing all of its liability carriers. But now we have 15 or more in the state, all competing for the business.

Most important, access to care was shrinking in rural and other underserved areas. But during this past year, the number of physician licenses increased from 2,000 to 4,000, and physicians are now settling and practicing in underserved parts of Texas, such at the Rio Grande Valley. Both primary care and specialist physicians are coming to Texas. The specialists aren’t restricting access to high-risk procedures for fear of liability penalties. Patients are getting better care and highly specialized procedures are being done. All of this is attributable to the tort reform legislation.”

Case closed.

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