Tort reform the key to cutting health-care costs?

posted at 10:12 am on July 30, 2009 by Ed Morrissey

So argues IBD Editorials, and they claim they have the data to prove it.  According to data from a study performed by the accounting group Pricewaterhouse Cooper, malpractice actions account for at least 10% of all medical costs — 2% by jacking up legal insurance and as much as 9% from the defensive medicine lawsuits create.  Instead of looking at overhauling the nation’s health-care system, we should pursue tort reform, and points the finger at a rather well-known former candidate for President:

Trial lawyers helped create a medical crisis through malpractice suits that raise costs while driving doctors from their practices.

Old Democratic presidential aspirant John Edwards won $175 million in judgments over a 12-year period suing doctors, hospitals and insurance companies, everyone but the candy stripers, over infant cerebral palsy cases allegedly caused by mishandled deliveries.

As the American College of Obstetricians and Gynecologists noted in a study in 2003, cerebral palsy could not be blamed in the “vast majority” of cases on delivery trouble. Edwards enriched himself by using bad science to bankrupt innocent physicians. …

The accounting firm PricewaterhouseCoopers says about 10% of the cost of medical service is attributable to medical malpractice lawsuits. Roughly 2% is caused by direct costs of the lawsuits; an additional 5% to 9% is due to expenses run up by defensive medicine.

I’ve heard this claim made a number of times, but have not seen much data in support of it.  Certainly it costs providers something, and the explosion in lawsuits have made it a lot more expensive in recent years.  Edwards is a good example of attorneys who latch onto particular specialties in malpractice actions and exploit them for all they’re worth — usually socking it to the insurers who cover the providers.  Afterward, everyone wonders why insurers have to keep hiking their rates for coverage and reassessing the risks for new applicants.

However, that doesn’t fully explain the ongoing increases in care or in premiums.  The rapid development of technology and therapies also means higher costs as we succeed in curing disease or allowing people to cope with them.  The Washington Post noted that over forty years the likelihood of dying from a heart attack went from around 50-50 to 6% — but that the costs of treating that heart attack had increased rapidly during that period.  It costs a lot of money to rescue people from death, and usually those rescued don’t gripe about the bill when it comes.  Also, the 44% of people whose lives are saved will live long enough to use more medical care, raising the overall costs of care over their lifetimes.

However, the biggest driver of health-care cost increases come from our inefficient insurance model, and ObamaCare only makes it worse.  In our present model, consumers are disconnected from costs by third party intervention, either insurers or the government in the case of Medicare/Medicaid, etc.  Because consumers do not deal with prices, they do not efficiently use the medical system and their resources.  In markets without third-party intervention, such as Lasik and plastic surgery, we see much more efficient pricing through competition, which also promotes an expansion of providers from the incentives of market payment.

IBD-E’s argument works across the entirety of the American economy, which is too vulnerable to predatory lawsuits.  If Congress passed sensible tort reform that creates substantial penalties for plaintiffs and their attorneys for filing nuisance suits and baseless claims — in other words, make them bear the costs of abuse rather than the defendants — we could lift a serious burden from the entire economy, not just the health-care industry.  However, as long as Democrats remain married to the trial lawyers, the chances of that kind of reform approach zero.


Related Posts:

Breaking on Hot Air

Blowback

Note from Hot Air management: This section is for comments from Hot Air's community of registered readers. Please don't assume that Hot Air management agrees with or otherwise endorses any particular comment just because we let it stand. A reminder: Anyone who fails to comply with our terms of use may lose their posting privilege.

Trackbacks/Pings

Trackback URL

Comments

Comment pages: 1 2

Let’s see them publish their data with regard to how federal tort reform would affect healthcare costs. I’d be willing to bet that the vast, vast majority of medical malpractice cases are filed in state versus federal courts. State tort reforms should be left to the states, and the feds ought to keep their paws off it.

My .02.

Tennman on July 30, 2009 at 11:27 AM

ChePibe on July 30, 2009 at 11:18 AM

I agree with your description of how the awards are divvied up. My problem has always been, Why should a lawyer be paid the same amount as the aggrieved party? A family member was in an automobile accident,horribly maimed for life both physically and mentally. Why was the lawyers fee equal to the amount received for pain and suffering.
Let’s not even go into the expenses that lawyers charge on top of their fees. Doctors fees include expenses as do all the HONEST professions.

oldernwiser on July 30, 2009 at 11:27 AM

Most states cap the lawyer’s cut in a contingency fee based case somewhere between 30% and 40%. However, costs – such as expert witness fees, filing fees with the court, mailing fees, etc – are tacked on to this.

ChePibe on July 30, 2009 at 11:18 AM

So, basically all of the costs needed to sustain the lawyer in his profession are taken out of the plaintiff’s judgement, but are not counted as part of the lawyer’s cut.

Vashta.Nerada on July 30, 2009 at 11:28 AM

I agree with your description of how the awards are divvied up. My problem has always been, Why should a lawyer be paid the same amount as the aggrieved party? A family member was in an automobile accident,horribly maimed for life both physically and mentally. Why was the lawyers fee equal to the amount received for pain and suffering.
Let’s not even go into the expenses that lawyers charge on top of their fees. Doctors fees include expenses as do all the HONEST professions.

I would be careful about legislating a change to the fee structure – or about legislating compensation for anybody, as a matter of fact.

If you look, you can find plenty of lawyers who will take personal injury (including malpractice) cases for a lower percentage – younger, inexperienced, hungry lawyers. It’s the experienced ones with the established track record for winning big judgments that get the high percentages.

Would you rather have 50% of $1,000,000 – or 80% of $100,000? It’s the market; I wouldn’t mess with it too much.

ManUFan on July 30, 2009 at 11:33 AM

So, basically all of the costs needed to sustain the lawyer in his profession are taken out of the plaintiff’s judgement, but are not counted as part of the lawyer’s cut.

Vashta.Nerada on July 30, 2009 at 11:28 AM

you got it.
Any other businessman in this world calculates his costs,adds a profit on that and quotes you a price. You take it or leave it. A lawyer basically says I get X, you get Y, but you have to pay all my expenses.Nine times out of ten they will way under estimate the expenses.

oldernwiser on July 30, 2009 at 11:35 AM

Tort reform should be pursued regardless of whatever health situation or plan that is proposed. Lawyers taking 30-40% of settlements, when they were never personally ‘harmed’, is ludicrous. We could socialize that and make being pond scum pay like pond scum.

Punditpawn on July 30, 2009 at 11:35 AM

Rovin on July 30, 2009 at 11:14 AM

Doctors take the perpetual malpractice insurance, as “Physician, heal thyself.”

Where’s the parallel for Lawyers? “Lawyer, sue yourself” still leaves all funds in the lawyer’s pockets, just shuffling the wallet.

Tort Reform is doomed as a cure-all for high costs given that the Democrats will legislate more Socialism.

maverick muse on July 30, 2009 at 11:36 AM

However, that doesn’t fully explain the ongoing increases in care or in premiums.

That’s because lawsuits are only part of the problem.

You have insurance company XYZ that you have health insurance through. XYZ has contracts with your local area hospitals. There is an agreement between XYZ and hospital. In that agreement is a price that XYZ covers some costs of the uninsured at said hospital. You get passed that cost through your insurance premium.

Everyone knows that the influx of illegals have been a burden on our hospitals, but you also have lawsuits, medical fraud and research all contributing to the increase in our insurance premiums. You really can’t mention one without mentioning the others if you want to solve the problem.

moonsbreath on July 30, 2009 at 11:38 AM

Yup, tort reform is a must; however, it is just part of the problem.

The AMA limits entry into the medical profession in an effort to keep demand up. (The Bar association, and even barbers do the same thing.) We need the more doctors. Certainly there are many who could be excellent doctors if the medical schools would only make room for them.

If insurance were to pay for the following (and nothing else)

1. Preventive medicine.
2. Prenatal and infant care.
3. Catastrophic care (above $5,000)
4. Require a basic course in family and home nursing to graduate from high school, or enroll in insurance.
5. Charge people who engage in risky behavior or do not take care of themselves a higher premium. I am over weight and should pay more because of it. Same goes for people at high risk of contracting AIDS.

Then only make the catastrophic care available to those who participated with the preventive medicine, our health care costs would drop like a rock because market forces would reenter the equation.

We would need medical savings accounts to make this work.

The Rock on July 30, 2009 at 11:39 AM

highhopes @ 10:56
Thank you to reiterate what I wrote:

“Tort reform is a prime key to cut costs.”

Tort reform is not going to be the panacea to fix all the funding problems. It may be an element of the final solution

A prime key is by no means the only key on the chain, as I’ve written above of several concerns.

maverick muse on July 30, 2009 at 11:40 AM

+iikujmyhntgbrfvedcwsxqaz

zQSXWXQAZ

oldernwiser on July 30, 2009 at 11:43 AM

Most doctors amputate extra limbs because of the reimbursement tables.

crash72 on July 30, 2009 at 11:44 AM

What the ?

oldernwiser on July 30, 2009 at 11:45 AM

Yup, tort reform is a must; however, it is just part of the problem.

The AMA limits entry into the medical profession in an effort to keep demand up. (The Bar association, and even barbers do the same thing.) We need the more doctors. Certainly there are many who could be excellent doctors if the medical schools would only make room for them.

I think you’ve hit upon a major area where good reform could be implemented. Without forcing medical schools to take people they don’t want, you could still end the limitations on entry to the market. Simply permit people, like RNs, EMTs and others trained in medicine, to practice what they can practice. Much of the medical care that’s rendered in this society does not require a full-blown MD (aspirin for a headache, etc.) Many RNs know more than young docs.

Let ‘em practice. Sure, you have to be sure they’re responsible – and that they disclose the limitations they have. But free up a lot of the routine stuff by expanding the supply of medical personnel; “It’s the market, stupid.” (to quote an eminent economist).

ManUFan on July 30, 2009 at 11:45 AM

Would you rather have 50% of $1,000,000 – or 80% of $100,000? It’s the market; I wouldn’t mess with it too much.

ManUFan on July 30, 2009 at 11:33 AM

80% of $1,000,000.
thank you very much
plain and simple,lawyers coming away with more than their clients is wrong.

oldernwiser on July 30, 2009 at 11:48 AM

I think Texas has is about right, if you can sue for loss of wages + a cap on the “pain and suffering” part, then I’d say we’re in the right ballpark. The thing that bothers me is how to compensate the lawyers without (a) hurting the injured party by taking monies from them that might be needed for a lifetime, and (b) giving so much incentive that the law firm will chance a few borderline cases in the off chance they hit the jackpot.

Tort reform is a (partial?) solution for rising costs because it cuts insurance costs to doctors and it lowers the need for CYA defensive medical treatment. A doctor friend of mine told me that while medicine is based upon science, its more a form of art. Making diagnosis isn’t like it is in House where some magically enlightened being can make the correct call all the time. It takes experience, seeing a wide range of cases, keeping up with the field, etc. that’s why doctors specialize. Humans make mistakes, but I trust my doctor is capable enough to rely on his experience/instincts and will prescribe the right tests to determine my problem(s). Tort reform has to hit the sweet spot of incentivizing doctors to do their best (which I think the majority do already) and yet provide the patient ample protection when someone is negligent.

.

Geministorm on July 30, 2009 at 11:48 AM

Most doctors amputate extra limbs because of the reimbursement tables.

crash72 on July 30, 2009 at 11:44 AM

Care to prove that?

grapeknutz on July 30, 2009 at 11:51 AM

80% of $1,000,000.
thank you very much
plain and simple,lawyers coming away with more than their clients is wrong.

oldernwiser

Great! Right now, you’re free to negotiate for that. If you get it, congrats, Bro.

But I’d feel a little queasy about it if you got the legislature to say you could force that on someone.

ManUFan on July 30, 2009 at 11:51 AM

The AMA limits entry into the medical profession in an effort to keep demand up.

I don’t know if I necessarily buy that. Do you have any evidence of this? I mean, if we expect the colleges to just churn out doctors like a factory then it is inevitable that the quality of medical care will drop drastically. We want the best and brightest, not any ol’ shmoe. When I was in engineering school, Georgetown came and spoke to the top 5% of those in their Junior/Senior years, they offered to raise our GPAs one point and provide partial scholarships (in addition to any we currently held) to transfer to their school and enter the medical program. That makes me think that they are actively searching for talent and not holding back to keep demand high.

Geministorm on July 30, 2009 at 11:54 AM

BTW, doctors aren’t required to be members of the AMA. How can they prevent entry into the medical profession? So, how would they prevent anyone from entering if they have no power in regards to licensing or employment? I’d bet not even 50% of MDs are members of the AMA.

Geministorm on July 30, 2009 at 11:57 AM

This is one of the most specious and or dishonest arguments of all time, that our tort system, our constitutional right to seek redress of losses in the civil courts, should be ignored when the injury is caused by a phyician to save some ephemeral “system” money.

There are strong incentives for physicians, hospitals and other care providers to shortchange individual patients to save time, money, and effort, and a poor track record of internal discipline and control of rogue physicians as it is. Blocking redress in the courts is not going to improve the lot of any patient for injury caused by negligent care.

SarahW on July 30, 2009 at 11:57 AM

I don’t know if I necessarily buy that. Do you have any evidence of this? I mean, if we expect the colleges to just churn out doctors like a factory then it is inevitable that the quality of medical care will drop drastically. We want the best and brightest, not any ol’ shmoe. When I was in engineering school, Georgetown came and spoke to the top 5% of those in their Junior/Senior years, they offered to raise our GPAs one point and provide partial scholarships (in addition to any we currently held) to transfer to their school and enter the medical program. That makes me think that they are actively searching for talent and not holding back to keep demand high.

To speak definitively to this, you would want to know: (i) how many new medical schools have been opened in, say, the last 10 years? and (ii) how many qualified med school applicants are turned away – from all med schools – every year?

Yes – we all want the brightest and best, but how many are going to get that? And shouldn’t we be free to choose less if we feel we will get value? I mean – you don’t really suggest we should all be able to see the best doc in the country do you? IMO, there’s a market for med services – just like everything else – and if it’s free to operate the way a free market operates, it’ll work out.

Right now, it’s not, and that’s a lot of the problem. Maybe the AMA has something to do with it – maybe they’re innocent. But the question is worth asking.

ManUFan on July 30, 2009 at 12:02 PM

BTW, doctors aren’t required to be members of the AMA. How can they prevent entry into the medical profession? So, how would they prevent anyone from entering if they have no power in regards to licensing or employment? I’d bet not even 50% of MDs are members of the AMA.

The AMA is probably the most powerful lobby in the country (NEA, I’m sure is close, maybe more powerful?). You’re right, AMA doesn’t limit entry – but it’s got a lot of influence with those that do.

ManUFan on July 30, 2009 at 12:04 PM

But I’d feel a little queasy about it if you got the legislature to say you could force that on someone.

ManUFan on July 30, 2009 at 11:51 AM

I guess you’ve missed my direction. First, I never want the legislature to ever set prices. On anything. I endured Nixon’s price and wage control socialism. Nuf said on that.
I do believe that lawyers should never come away with more than the party they represent,including expenses.
I also believe that lawyers,like any other working stiff, shouldn’t be paid if they don’t do their job.including their expenses.

oldernwiser on July 30, 2009 at 12:04 PM

What a great scam. You can bill the crap out of the insurance companies for unnecessary tests while saintly claiming you’re only trying to protect yourself from the wicked lawyers. How do you make $1200 an hour chatting with patients? $100 for a 15-minute visit and $200 in commissions/kickbacks from the wide array of tests you order. Plus you can bill the patient again for your resultant conclusions and recommendations.

You know, as long as he gets to perform the actual repair my mechanic never charges for diagnostic time. We’d be seeing a whole lot less medical testing if that policy became law.

T J Green on July 30, 2009 at 12:07 PM

I guess you’ve missed my direction. First, I never want the legislature to ever set prices. On anything. I endured Nixon’s price and wage control socialism. Nuf said on that.
I do believe that lawyers should never come away with more than the party they represent,including expenses.
I also believe that lawyers,like any other working stiff, shouldn’t be paid if they don’t do their job.including their expenses.

OK. But there are only two ways to set lawyers’ fees – negotiate them or legislate them. You and I agree, I guess, that legislating isn’t good.

So, I hear what you want, and – as I said above somewhere – I think you can negotiate it. But you won’t necessarily get the best lawyer. Just depends on … the market!

ManUFan on July 30, 2009 at 12:09 PM

Based on who is uninsured in the country, the problem demographic seems to be 18-34 year olds… around 18 million uninsured. Now this is a very low healthcare utilization bracket for males, so cut the number to around 9 million females in that age bracket who represent the bulk of the true “uninsured” universe with a major coverage problem.

For women in this age bracket, a primary health care issue revolves around OBGYN services, the malpractice specialty of the wanna-be ambulance-chaser-in-chief johnboy Edwards. Because of prohibitively expensive malpractice insurance rates, many parts of the country have little-to-no OBGYN doctors. So tort-reform could represent a major impact in cutting the costs of a major sector of healthcare sector (In Texas, which has enacted tort reform, OBGYN malpractice premiums are around $15-25k per year, in the northeast, those premiums run from $100-250k per year. That would effectively cut the cost of a visit to an OBGYN for an annual check-up by over 50%, making a yearly visit self-insurable for most women in the age bracket.

phreshone on July 30, 2009 at 12:18 PM

I’ve heard this claim made a number of times, but have not seen much data in support of it. Certainly it costs providers something

However, that doesn’t fully explain the ongoing increases in care or in premiums.

However, the biggest driver of health-care cost increases come from our inefficient insurance model

Ed is there some reason why you fail to mention illegal aliens when your hunting for the leak in our health care raft? I think your boss found it.

DFCtomm on July 30, 2009 at 12:18 PM

To speak definitively to this, you would want to know: (i) how many new medical schools have been opened in, say, the last 10 years? and (ii) how many qualified med school applicants are turned away – from all med schools – every year?

I think it would be easy enough to look at the entrance numbers going into the schools we have now and compare that with the graduation rates and ratings (grades?) of the doctors that come out. If qualified candidates have been turned down/away and the candidates that failed, didn’t graduate or were at the bottom of their class get through does that mean that the turned away candidate would have been better? Doubtful. Its subjective at some level when you are trying to fill the last few positions, but its probably the exception and not the rule that someone that was denied entry would turn out to be a great doctor.

Also, it would be worth investigating why a candidate couldn’t apply at a different school. If the candidate was denied at Harvard Medical School, does that mean that they can’t become a doctor? No, it means they apply somewhere else, perhaps less prestigious.

As a graduate of engineering school, I can definitely tell you that those that didn’t get in probably couldn’t have made the cut anyway. If they didn’t have the discipline, drive, determination and focus to do well in school up to that point, they were certainly not going to succeed in a rougher environment with highly competent and competitive nerds. I went into the EE program with 121 other students (all with strong backgrounds in math/science), I graduated with 17. One of my professors was a 6-time astronaut/cosmonaut. He told us he’d be willing to fail the entire class (our senior year) if we couldn’t be good enough to trust his life with…I’d imagine that many doctoral students have had similar experiences. And, that seems like a pretty good thing.

Geministorm on July 30, 2009 at 12:19 PM

As part of tort reform the losing party should bear the burden of paying ALL the costs of the litigation. There are a lot of prosperous lawyers that very rarely make it inside a courtroom. The threat of litigation is a very powerful club and that threat usually ends in an out-of-court settlement. When you make the loser pay, the frivolous and nuisance lawsuits will go away.

belad on July 30, 2009 at 12:23 PM

A thought struck me last night while reading this article. The entitlement system has to go or America will, eventually, collapse. Health care is just a symptom of the larger disease.

DFCtomm on July 30, 2009 at 12:27 PM

Even if it is only an aggregate 5% cost, it that amounts to billions, and would be a good place to start.

holdfast on July 30, 2009 at 12:27 PM

Tort reform is to health care reform as the fence is to immigration reform…

don’t talk to me until you’ve done it.

phreshone on July 30, 2009 at 12:33 PM

I think it would be easy enough to look at the entrance numbers going into the schools we have now and compare that with the graduation rates and ratings (grades?) of the doctors that come out. If qualified candidates have been turned down/away and the candidates that failed, didn’t graduate or were at the bottom of their class get through does that mean that the turned away candidate would have been better? Doubtful. Its subjective at some level when you are trying to fill the last few positions, but its probably the exception and not the rule that someone that was denied entry would turn out to be a great doctor.

It would be illuminating to research the reliability of applicant-placement (in the admission queue) vs actual school success. You assume the highest ranking candidate for admission is reliably finishing at the top of his graduating class (you are a bit more explicit about making that assumption about the bottom of the class – but let’s assume you are consistent).

I doubt it – and I certainly don’t think it holds true at the lower end. And – again – I think it would also be illuminating to know what the total picture is (both demand and supply): how many candidates for how many spots? And how do we know (other than your doubting it) that those that don’t make it anywhere wouldn’t make a qualified doc? Again – not sure I’m with you.

Also, it would be worth investigating why a candidate couldn’t apply at a different school. If the candidate was denied at Harvard Medical School, does that mean that they can’t become a doctor? No, it means they apply somewhere else, perhaps less prestigious.

Here, too, I disagree with you implicit assumption that everyone applies to Harvard, regardless of his qualifications (which he knows as well as the schools do) – and that he just throws up his hands and walks away if he doesn’t make it at Harvard. Fact is, med school applicants are very well counseled – and are usually pretty well on the mark about where they apply (OK, probably several apply to a place like Harvard hoping for a lightning strike, but on the whole …)

And you’re not suggesting, are you, that if one more new med school were built, it would turn out docs who are unqualified?

Many of those who fail to complete med school do so for the same reasons students fail to complete, say, engineering school. They find out the parental wish is not really their wish, they fall in love and can’t wait, they find out they can’t afford to finish, they start drinking, etc. etc. Doesn’t always mean they would have been lousy docs if they’d finished. And (IMO) doesn’t mean the guy who didn’t get into the school in the first place would have been an even worse student.

ManUFan on July 30, 2009 at 12:33 PM

ManUFan on July 30, 2009 at 12:09 PM

the one thing above all else that I’d like to see become standard practice is that lawyers have to stand for all expenses from their piece of the pie.
If a client was going to bring suit to the tune of $1,000,000 but found out that he would only be getting 20% because the lawyer wanted to be sure he covered his expenses,maybe the client would then go lawyer shopping.
☺ Brings to mind, many years ago I stopped in to see my lawyer,he offered me a drink and we spent about a half an hour talking football b4 getting down to business. You just know that when I got the bill that snake tried to bill me for the half hour.

oldernwiser on July 30, 2009 at 12:38 PM

Tort reform is to health care reform as the fence is to immigration reform…

don’t talk to me until you’ve done it.

phreshone on July 30, 2009 at 12:33 PM

Yeah, both are bullshit responses to the problem. The wall is a great way to use eminent domain and funnel money to contractors. Illegal immigration wasn’t as bad in the past because businesses couldn’t overtly break the laws like they currently do. A fence is not going to stop the construction sites just blocks away from the Capitol from hiring illegals en masse like they currently do, that’s one reason why I laugh when they act like they want to fix the problem, its going on right outside their offices in plain view and they could care less.

Tort reform, when they tried to put 250k caps on judgements was just a way to help insurance companies from paying out on the doctors that screwed up. If a doctor injures you due to their negligence, they should pay up. Are there frivelous lawsuits? Yes, but they are everywhere, not limited to health care, and there is not going to be a decent way to discern the bad from the good, that is what judges and juries are for, not the corrupt congress.

Moving insurance from companies to the individual is to health care reform what enforcement is to immigration.

LevStrauss on July 30, 2009 at 12:41 PM

Here is my idea

First, I support the idea of loser pays…keeps people honest.

Second, trial by your peers…the jury should have a medical understanding….nurses, pharmacists, other doctors.

Conservative Voice on July 30, 2009 at 12:47 PM

And also I might say that the two are related. Companies like illegal immigrants because they are cheap labor. A recent survey or poll or study I saw said that about a third of hispanics do not have insurance, and I’d wager that most of those that do not have insurance are illegal based on the figures for other races. So we are paying the price for the cheap price of picking fruit and building, its just that they are spread among health care costs and not in the final price of a given product, not to mention the opportunity cost of an American citizen or legal immigrant not having that job and not having insurance as a result. That’s the thing, we can either pay higher prices for goods that illegal immigrants or chinese manufacturers make, we are just paying for it elsewhere. The costs are not eliminated, they are just transferred.

LevStrauss on July 30, 2009 at 12:48 PM

Here is my idea

First, I support the idea of loser pays…keeps people honest.

Second, trial by your peers…the jury should have a medical understanding….nurses, pharmacists, other doctors.

Conservative Voice on July 30, 2009 at 12:47 PM

I find the trial by peers interesting, not because I agree, but because I remember that prosecutors in criminal usually ax lawyers from the jury pool right away. And when I served on a jury I found out why.

LevStrauss on July 30, 2009 at 12:51 PM

the one thing above all else that I’d like to see become standard practice is that lawyers have to stand for all expenses from their piece of the pie.
If a client was going to bring suit to the tune of $1,000,000 but found out that he would only be getting 20% because the lawyer wanted to be sure he covered his expenses,maybe the client would then go lawyer shopping.

I understand your point – and, frankly, what it means is that the client needs a bit of sophistication in negotiating a fee agreement. Most don’t have it (like needing a lawyer to negotiate your deal with your lawyer), and that causes problems. But the expense situation is a matter for negotiation. You’re right – it should all be clear before the atty-client relationship is formalized. And a lot of the better attys do that.

And you’re definitely correct that lawyer shopping is something people should do; again, most don’t. They see an ad, or get a word-of-mouth reference, and that’s it. But you’re absolutely right, shopping pays off with lawyers – just as it does with anything else. There are a lot of them (some say too many; where’s my friend that thinks we have enough med schools? Maybe we can convert some law schools to med schools …), and you’d be surprised what deals you can get if you’re smart about it.

Brings to mind, many years ago I stopped in to see my lawyer,he offered me a drink and we spent about a half an hour talking football b4 getting down to business. You just know that when I got the bill that snake tried to bill me for the half hour.

Client relations – absolutely billable time!

ManUFan on July 30, 2009 at 12:55 PM

Amazing. And this is the same American College of Obstetricians and Gynecologists which would require their members to refer abortion patients to abortionists if the member has a moral reservation — or, as the College puts it, a deviation from standard practice.

So, when the liberal doctors start calling for tort reform, the opera ain’t over till the bar association sings — or rather, contributes.

unclesmrgol on July 30, 2009 at 12:58 PM

The tort thing is onerous for another reason. … While John Edwards is channeling dead babies for fun and profit while playing lawsuit lottery jackpot bingo, some poor schmuck is forced to sit on jury duty for 9 bucks a day.

First of all, apoligies to the decent non-ambulance chasing attornies out there. I happen to know a few.

However, there are a lot of bottom feeders out there. Guys like John Edwards who make a multimillion dollar business out of litigation. The system would collapse if jurors had to be paid a fair wage for their time.

Don’t give me the “It’s your duty to serve” garbage either. I have done thousands of hours of documented service. I’m authorized to wear two ribbons from the navy and never spent a day in the service. I received a medal from the CG wwhere the Commandant came down from governor’s island to pin it on this volunteer personally. Don’t get me wrong, I’m not saying that to brag. I know a lot of people who have done a LOT more. Just saying that I do give to the community.

Jury duty is part of the grease that smooths the tort industry.

BTW – when our state passed an illegal pay raise, a lot of the legislators claimed “I did it for the judges”. The idiots in the press never published the fact that those same legislators were senior partners in multimillion dollar tort firms. Imagine, every multimillion dollar case the firm takes is in front of a judge that their senior partner just gave a 15000 dollar a year raise to. Oh, no, that isn’t bribery, it’s just business as usual.

bullseye on July 30, 2009 at 1:11 PM

Has anyone else seen any of these clips on Fox today from their Med student forum at Auburn U? Am I the only one who’s hearing WH talking points? Some of these “Med” students, including a PhD in public policy candidate and physician’s assistant students (?), are quoting Obama almost verbatim. And the jargon is spot on.

My favorite part was the student gushing about how the gov’t is going to pay for her loans if she works where they want her to work! Wait ’til she sees her office and her paycheck!

Who are the yahoos and who vetted them? I swear one of them is wearing an ACORN t-shirt.

gopmom on July 30, 2009 at 1:11 PM

This is one of the most specious and or dishonest arguments of all time, that our tort system, our constitutional right to seek redress of losses in the civil courts, should be ignored when the injury is caused by a phyician to save some ephemeral “system” money.

There are strong incentives for physicians, hospitals and other care providers to shortchange individual patients to save time, money, and effort, and a poor track record of internal discipline and control of rogue physicians as it is. Blocking redress in the courts is not going to improve the lot of any patient for injury caused by negligent care.

SarahW on July 30, 2009 at 11:57 AM

I’m sorry, but I just disagree. There are a large number of hospital systems that are run as not-for-profits. They have missions to provide care to their communities. What exactly, then, are the strong incentives to provide bad care? Is it possible that some systems (like some businesses) provide less than stellar care? Absolutely. And I don’t think ANYONE is advocating the removal of redress when a patient has been wronged. But allowing a lawsuit to ask for millions when someone spills coffee is ridiculous. An extreme example, sure, but it has happened. Reform doesn’t mean removal. Indiana has caps on what a claim can pay out, which I feel is a good start.

search4truth on July 30, 2009 at 1:18 PM

ManUFan on July 30, 2009 at 12:55 PM

If anyone is reading these posts beside you and me, there is one thing I’d like them to take away from them.
The client is the boss!
Seems like every lawyer I ever dealt with started out by taking a top dog attitude,so they could set the relationship on their terms. (ever notice their chair was a bit higher off the floor than yours?)
When I first had to use a lawyer I was as green as I could be. The lawyer led all through that dance because I assumed he would do right by me. I learned from that and I hope anyone reading this will learn from my tale.

oldernwiser on July 30, 2009 at 1:22 PM

I agree with you Ed,the first part of any healthcare policy should be torte reform.A few things that you didn’t mention:
In addition to the costs of lawsuits(legit or not),there is also the cost of unnecessary tests presribed by doctors to avoid further suits.
You mention that while the survival rates for heart attacks(I assume you also meant many other conditions also)has gone up,the cost of treatment has also gone up.Well in 40 yrs.,the cost of everything has gone up,and the cost of developing new technology has also gone up.

DDT on July 30, 2009 at 1:22 PM

oldernwiser on July 30, 2009 at 1:22 PM

You’re absolutely right. Once you have an agreement with the lawyer, he is obligated (within its terms) to act as your fiduciary (even then, it’s sometimes a good idea to watch what they’re doing). But negotiating the initial agreement is an arm’s length deal, and you need to know what you’re doing – where you’re going.

ManUFan on July 30, 2009 at 1:33 PM

even then, it’s sometimes a good idea to watch what they’re doing).
ManUFan on July 30, 2009 at 1:33 PM

After I say treat them cynically, it’s time for me to say “good ‘talking’ to you”. Else I’d go on all day with this.

oldernwiser on July 30, 2009 at 1:45 PM

agree with your description of how the awards are divvied up. My problem has always been, Why should a lawyer be paid the same amount as the aggrieved party? A family member was in an automobile accident,horribly maimed for life both physically and mentally. Why was the lawyers fee equal to the amount received for pain and suffering.
Let’s not even go into the expenses that lawyers charge on top of their fees. Doctors fees include expenses as do all the HONEST professions.

Why? Because Lawyers are a**holes.

bloggless on July 30, 2009 at 2:03 PM

The Obama administration’s cost controls are based on the British and Canadian systems. Tucked in the stimulus bill was an entity called the Federal Coordinating Council for Comparative Effectiveness Research (Pages 190-192). Its purpose is to decide which treatments you should get, whether you should get them and whether they should even be available.

I believe this was a misprint. Surely they are not saying this is already law via the stimulus bill, are they?
Christian Conservative on July 30th, 2009 at 2:05 pm

Christian Conservative on July 30, 2009 at 2:08 PM

What a great scam. You can bill the crap out of the insurance companies for unnecessary tests while saintly claiming you’re only trying to protect yourself from the wicked lawyers. How do you make $1200 an hour chatting with patients? $100 for a 15-minute visit and $200 in commissions/kickbacks from the wide array of tests you order. Plus you can bill the patient again for your resultant conclusions and recommendations.

You know, as long as he gets to perform the actual repair my mechanic never charges for diagnostic time. We’d be seeing a whole lot less medical testing if that policy became law.

T J Green on July 30, 2009 at 12:07 PM

Who the hell makes $1200 an hour “chatting with patients”, or $200 dollars in “commissions/kickbacks” for ordering tests? What planet are you living on, because I want to go there and work instead of practicing medicine in the real world. You honestly think doctors get paid for ordering a test? So when I send a patient for blood work or an MRI I get a $200 kickback? I’ve been in practice for 20 years, and I’ve yet to see this. Somebody owes me a whole shitload of kickbacks goddammit!

eyedoc on July 30, 2009 at 3:06 PM

malpractice actions account for at least 10% of all medical costs — 2% by jacking up legal insurance and as much as 9% from the defensive medicine lawsuits create.

Using the 10% figure, that works out to around $225 billion dollars per annum. That’s a big enough number for even congress to pay attention to if cost containment truly was their goal.

But there is nothing in this bill that addresses this at all. Zero, Zip, Nada. We all know why, but that’s not the point. It’s a big dripping meatball that opponents can hit right at the Democrat’s single biggest source of support. And not a very sympathetic one at that.

Getting lost in the tall weeds of this issue isn’t helpful. Democrats simply need to be hammered as to why this 1000+ page monstrosity doesn’t speak to this issue at all.

The left is very good at creating imaginary villains and repeating the accusations over and over to great effect. Conservatives need to at least do the same when the villain is real.

RadClown on July 30, 2009 at 3:14 PM

I think a serious problem in the tort business isn’t so much when the lawyers win against a doctor… I think we are missing an important point.

The largest cost to lawyerly misconduct to a doctor comes in his malpractice premiums. If the lawyers bring up frivolous charges on a repeated basis, that doctor’s premiums will go up as a result of the complaints, even though said complaints are groundless and would never actually hold up in court.

That’s another problem that needs fixing I think.

Chaz706 on July 30, 2009 at 3:36 PM

This is one of the most specious and or dishonest arguments of all time, that our tort system, our constitutional right to seek redress of losses in the civil courts, should be ignored when the injury is caused by a phyician to save some ephemeral “system” money.

There are strong incentives for physicians, hospitals and other care providers to shortchange individual patients to save time, money, and effort, and a poor track record of internal discipline and control of rogue physicians as it is. Blocking redress in the courts is not going to improve the lot of any patient for injury caused by negligent care.

SarahW on July 30, 2009 at 11:57 AM

I am starting my career as a Physician Assitant, but have worked in healthcare (military healthcare) for 10yrs. This arguement is not dishonest… it MUST be had. It is you who is being dishonest. You just sound like a disgruntled patient. Maybe you had a bad doctor or you are just one of those who expects too much of us. either way, it doesn’t change the fact that I know Doctors (Surgeons, FP and OB/GYN) who are in the military because malpractice insurance premiums were too high in private practice. NONE Of them have ever even been sued. OB/GYNs in Florida pay 200k a yr in malpractice insurance (add to that staff/operating costs… Many physicians don’t provide certain services because the cost of malpractice is not worth it. Tx has it right, let them recoup all lost wages/medical costs/etc, and cap punitive damages to 200K per provider. Make the patient, w/in 30 days) get a signed memorandum outlining to the court how the Dr being sued did not meet the standard of care or the case is trouwn out. I’m all for “Loser Pays” the others legal bills.. Right now it’s a win/ not lose scenario. sue the doc, if I win: $$$$$, if I lose: no skin off my back. that alone would cut down frivilous lawsuits. If you’ve worked in medicine for 10 min you’d see that people sue for the dumbest stuff hoping you’ll just settle.

The example of John Edwards is a perfect example. Cerebral Palsy (CP) was blamed on fetal distress during labor. Continuous Fetal monitors are now routine. Have they improved outcomes? Not really, but C-Section rates(along with lengh of stay, risk, and cost) have skyrocked… and the incidence of Cerebral Palsy has not changed. woo-hooo….!

BadBrad on July 30, 2009 at 9:44 PM

Instead of Gov’t Health care, how about Gov’t run free legal system for everyone. Gov’t bureaucrats can dictate to attorneys how much they can charge who they have to defend as well as paying 10 time what they now pay for liability insurance. Seems only fair.

Waldoni on July 31, 2009 at 1:11 AM

Paris, why don’t you go buy a new account on MeFi, or something? They love this stuff. Just don’t get started on Israel.

‘Loser Pays’ is the law in most of the world. And in most of the world, contingency fees are a crime, the crime known as ‘barratry’. Which is why the rest of the world does not have the problem with abusive lawsuits and robber baron lawyers that the US does.

Especially so, since the lawyers currently get a larger percentage of the award than the plaintiff.

Just to make it clear, this includes the lawyers on both sides, plus the court system. The majority of money that changes hands in a lawsuit goes to the lawyers and the courts, not the plaintiff.

This should make it obvious that the US’s current tort system is designed by lawyers for their own benefit. Lawsuits are a business, designed to make money for lawyers.

Bartrams Garden on July 31, 2009 at 2:00 AM

Comment pages: 1 2