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.

Blowback

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Comment pages: 1 2

Yup.

Tort reform’s the thing.

ExTex on July 30, 2009 at 10:14 AM

John “Channeler” Edwards:

I can ah hear-uh the baby-uh and she is saying….wait hold on….

help my mommy’s lawyer-uh buy ah a new expansion to his 45,000 square foot house uh to stave off two Americas….

sven10077 on July 30, 2009 at 10:15 AM

Of course this is the way to lowers costs, and the GOP should ram it home hard. No limits on compensation, just loser pays. That’s all. It’s simple. Voters will understand it. But why oh why isn’t it being discussed by the GOP?

Rational Thought on July 30, 2009 at 10:16 AM

Yes. It’s malpractice suit avoidance that leads to unnecessary tests. Not doctors trying to inflate bills by taking out the tonsils.

With the Dems in charge, Tort reform has zero chance of happening. The bribes have been made…

Ordinary1 on July 30, 2009 at 10:17 AM

The demorat creed: It’s always the fault of someone else.

Bishop on July 30, 2009 at 10:17 AM

I would think tort reform would have to be a key element for any health care reform. But, I doubt the bill winding its way through Congress will address this….

jbh45 on July 30, 2009 at 10:17 AM

Of course it’s key.

Of course it has zero chance of happening and if Republicans had half a brain they’d never agree to anything without such reform.

drjohn on July 30, 2009 at 10:19 AM

Tort reform with automatic loser pays is the way to go. I am not 100% sure that we need to reign in awards, but it is worth looking at. Limit lawyers fees and stop the class action lawsuits for anything medical. Lawyers make way too much money from those cases.

Johnnyreb on July 30, 2009 at 10:19 AM

More important is the question: WIll American’s be able to SUE the US Government for medical malpractice? If they are in a government healthcare program, can we sue the US for not providing adequate care?

Heck, can we sue GM anymore now that they are government owned?

How about a TAX on Lawyer fees?

originalpechanga on July 30, 2009 at 10:20 AM

How ’bout we take the billions “we” are giving to ACORN and put it in a “lock-box” for our Senior American citizens to use for their healthcare?

stenwin77 on July 30, 2009 at 10:20 AM

The elderly or tort reform… That’s about it.
http://sparks.brushfireoffreedom.org/post/2009/07/27/Shovel-Ready.aspx

TCJ on July 30, 2009 at 10:21 AM

Had a long talk earlier this week with the Chief of Staff at our local hospital, who noted that because Texas did tort reform and capped medical malpractice awards, it’s getting easier for smaller rural hospitals like ours to attract new doctors, because the state is getting an inflow of physicians feds up with both the threat of crippling judgments in other states and the cost of malpractice insurance, which of course is passed along to the patients.

The problem is the tort lawyers won’t quit — they tried to sneak a measure into an omnibus medical bill in the recent Texas Legislature that would have jacked up the cap on liability judgments, which ended up getting vetoed by Gov. Perry. But on the national level the tort lawyers and their $$$ control the Democratic Party, so there’s no possibility of this kind of change getting through Congress. A measure to outlaw caps on medical malpractice awards, yes, but the caps themselves, never.

jon1979 on July 30, 2009 at 10:21 AM

Oh please. Would tort reform save as much as printing on both sides of the paper?

reaganaut on July 30, 2009 at 10:21 AM

It’s one imp. part of health care reform.

But a bunch of commenters at HA could vastly improve the health insurance prob. in the US. The Republicans did nothing when they had the chance, and the Dems want to destroy everything. Nobody wanted to really improve the system. This is far less about health care, and much more about who gets what.

JiangxiDad on July 30, 2009 at 10:22 AM

More important is the question: WIll American’s be able to SUE the US Government for medical malpractice? If they are in a government healthcare program, can we sue the US for not providing adequate care?

Heck, can we sue GM anymore now that they are government owned?

How about a TAX on Lawyer fees?

originalpechanga on July 30, 2009 at 10:20 AM

Yes, there are provisions in the proposed plans (all of them) that docs & hospitals may be sued. They would never Pi55 off the trial attorneys.

stenwin77 on July 30, 2009 at 10:22 AM

And it’s not just medical malpractice. I have heard more than one CEO cite tort law as one of the things that keep them up at night.

BigD on July 30, 2009 at 10:22 AM

I would very much like to see numbers relating to how much money insurance companies pay annually to settle out of court, because that is cheaper than taking a winning case through all the legal hurdles it takes to get a final win.
I beleive that quickest cure for our medical/insurance costs is tort reform. Just one change is required. Loser pays.

oldernwiser on July 30, 2009 at 10:23 AM

What Obama, Barney Frank and their execrable ilk will do is limit the number of tests doctors can do and provide no further protection, which has the net result of increasing doctors’ liabiility.

That sucks.

As do Democrats.

drjohn on July 30, 2009 at 10:24 AM

Doctors run prices up because of billing difficulties and time to pay, and that’s because of bureaucracy.

TinMan13 on July 30, 2009 at 10:25 AM

I wouldn’t hold your breath on tort reform even though it would drastically decrease the costs associated with health care. I live with a doctor and she says she will get sued an average of seven times a year, even though she has done nothing wrong.

The tort lawyers represent one of the biggest groups of democratic party contributors and lobbying groups in Washington. As I said before, I wouldn’t hold my breath.

Did you know malpractice insurance for doctors can reach up to $84,000/year? Of course this is for OB/GYN doctors. Nevertheless, this cost gets tacked on to the cost of health care and the reason doctors order so many tests.

nazo311 on July 30, 2009 at 10:25 AM

This is a good post. TORT reform is good, but the points you make about the insurance model is the most important.

Every one of Obama’s proposals on ObamaCare will increase costs because they further insulate the patient from the cost of the treatment. Obama says that insurance companies have to have low out of pocket costs for preventive care and doctor visits. That will drive up utilization and further strain the system. . . not to mention increase insurance premiums.

He also says we can’t have ‘exorbitant’ deductibles. Again, it won’t lower the cost of health care. It increases it because rates will have to go up and patients won’t have incentive to question the costs of their procedures.

This post points out that the insurance model is an inappropriate way to reform health care. Especially if you propose a new GOVERNMENT insurance plan backed up with tax dollars.

We need patients to be connected with how much the service they get cost. That’s consumer driven health care and the idea behind HSA’s. That’s the only way we can get costs down and it won’t cost the government anything.

Well, that and living healthier. But living healthier wouldn’t cost the government anything either.

ThackerAgency on July 30, 2009 at 10:26 AM

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.

Ed, I don’t disagree with your statement, but you are missing an important point. In the current model providers have to follow the given standard of care based on diagnosis. If a physician goes outside the standard of care to treat a paitient because of (for lack of a better word) pressure to follow a less expensive path and that treatment doesn’t work, the trial lawyers will take full advantage of this.

Tort reform needs to be a key element in any proposed health care system if that system is seeking alternatives to the standard of care.

jbh45 on July 30, 2009 at 10:26 AM

Uncle Sugar said no tort reform. No means no cause he won.

Key West Reader on July 30, 2009 at 10:26 AM

I never went to an Ivy League school, but I could solve the healthcare problems right now.

1. Tort reform.

2. Border control.

3. Health saving accounts (deducted from paycheck pre-tax) for doctor visits and routine care.

reaganaut on July 30, 2009 at 10:26 AM

This is an issue that Republicans should be beating the Dems over the head with. Make sensible arguments and force Dems to defend lawyers, perhaps the only profession with a lower approval rating than themselves.

chromium on July 30, 2009 at 10:27 AM

Of course this is the way to lowers costs, and the GOP should ram it home hard. No limits on compensation, just loser pays. That’s all. It’s simple. Voters will understand it. But why oh why isn’t it being discussed by the GOP?

Rational Thought on July 30, 2009 at 10:16 AM

Both partys are filled with lawyers! Honor amongst thieves!

grapeknutz on July 30, 2009 at 10:27 AM

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.

It makes sense. I went to the doctor for something simple. I needed a blood test. The results came back fine but one reading was 3% out of normal so the doctor recommened I get two more diagnostoc tests. The test would cost me nothing and the doctor had no reason not to recommend them, but is 3% out of normal a good reason to have two more tests?

In this example the free market dynamic works to increase costs. I have no cost incentive to not have the test and the doctor has a cost incentive to recommend the test because of a potential malpractice suit.

Theworldisnotenough on July 30, 2009 at 10:27 AM

John “Channeler” Edwards:

I can ah hear-uh the baby-uh and she is saying….wait hold on….

help my mommy’s lawyer-uh buy ah a new expansion to his 45,000 square foot house uh house to stave off two Americas being outed by his mistress….

sven10077 on July 30, 2009 at 10:15 AM

:)

Monica on July 30, 2009 at 10:28 AM

Sadly, as a physician, I can’t see any student or parent being too interested in medical school in the future. And for those who are, why on earth the extra hours or training for cardiac or neurosurgery when Obama plans on “bundling” your paycheck not based on procedures but “outcomes”. I know I’d rather treat a sore throat at 3AM rather than a bullet through the brain if it means I get the same payment.

Marcus on July 30, 2009 at 10:28 AM

Finally. First time I’ve even heard this topic during this whole health care discussion. About time!!!!

THE CHOSEN ONE on July 30, 2009 at 10:28 AM

nazo311 on July 30, 2009 at 10:25 AM

I’m curious,about how many of those 7 law suits are settled out of court?

oldernwiser on July 30, 2009 at 10:31 AM

However, as long as Democrats remain married to the trial lawyers, the chances of that kind of reform approach zero.

Well, that just sucks.

bridgetown on July 30, 2009 at 10:32 AM

Marcus on July 30, 2009 at 10:28 AM

The reform also needs to include tort protection for the physician who may be encouraged to move away from standard of care to treat a patient. Without that protection, I don’t see where anyone would go into the medical fields.

jbh45 on July 30, 2009 at 10:35 AM

Texas has showed the way.

Losing hospitals and doctors due to loss of profits (anecdotal evidence would lead one to believe that illegal immigrants had a large part to do with this) led Texas to implement tort reform that allowed unlimited loss of wages (assuming cost of living increases) but only limited “pain and suffering” compensation. If I remember correctly, it was $250k. Now it appears that Texas’ medical system is thriving and able to withstand losses from Medicare, Medicaid, the uninsured and illegal immigration.

Isn’t it supposed to be the way things are done? If you’re a Federalist, you believe that the states should be the one’s in charge of this and then if they find a good solution that works it can be implemented elsewhere (nationally?).

The corruptocrats are either too slimy or too stupid to understand how our government is supposed to work…so there is no hope of tort reform being addressed. Dumbasses have to scrap the whole thing and built a socialist program to make themselves feel all warm and fuzzy. F***ing ideologues.

Geministorm on July 30, 2009 at 10:35 AM

Tort reform? When the majority of politicians are lawyers?

Hahahahahahaha

Forget it … we work for them … remember?

darwin on July 30, 2009 at 10:35 AM

I’ve been saying that for years, nobody listens.

kirkill on July 30, 2009 at 10:36 AM

TORT reform is a big part of the solution for the out of control costs of our medical system. Democrats are in bed with trial lawyers, that’s a fact. The only solution is to rid the country of the Democrat’s monopoly on power, and kick the Republicans in the behind long enough to put trial lawyers in the sewer where they belong.

Keemo on July 30, 2009 at 10:37 AM

For what it’s worth, I lived the defensive medicine nightmare. I was diagnosed in 1995 with diverticular disease, which caused me to periodically endure a burning pain in my lower intestine. In June of 1999 however, one bout pretty much floored me….high fever and severe pain. One day two of this, I noticed particulate in my urine, so I called our recently retired doctor and family friend, who in one minute diagnosed it as the diverticulitis abscessing and erupting into my bladder, forming a trap door (visceral fistula). Unfortunately, until my MD and various other medical experts were 100% sure of this, I had to endure very invasive and painful (and usually humiliating) test after test after test.

Finally, in October, an MRI showed them the fistula. By this time I had gone from 185 lbs. down to under 130, and had been literally living off of powerful antibiotics (so powerful I wasn’t allowed to even be in sunlight for more than minutes at a time….try that in San Diego in summer). During the course of this saga, various nurses and doctors made it clear that they were doing what they had to do to keep the lawyers away….and I could tell that they did not like putting me and others through this.

Patrick S on July 30, 2009 at 10:38 AM

Might I add this:

Lawyers have had their time running this country. Lawyers have taken our country to the edge of the cliff. Enough with them, their time has come and gone. Bring on the Palin’s of the country!

Keemo on July 30, 2009 at 10:38 AM

It would be interesting to know what the breakdown in cases is. How many cases are bottom-dwelling leaches who prey on the ignorant and how many legitimate malpractice claims are in that 10% number. As the Michael Jackson case demonstrates, not all medical professionals are ethical.

highhopes on July 30, 2009 at 10:39 AM

Marcus: can you expand? I really haven’t dug into the bundling issue.

Jed_Eckert on July 30, 2009 at 10:39 AM

reaganaut on July 30, 2009 at 10:26 AM

Might I add –

-a move away from employer based insurance, a big leap to independent policies

-an age tiered system – your policies are shaped by your age

Why not open up the health insurance market like the auto insurance market? Competition in the free market will cut costs across the board. And let’s get out of bed with the attorneys and “in bed” with our doctors. That the AMA is backing this is criminal.

Tort reform will only happen when we turn over DC. But I still feel we need to get to our doctors, ask them how they are dealing with and how they would change and show them we are on their side.

gopmom on July 30, 2009 at 10:40 AM

Ed, the real question is, what percentage of suits are of the “frivolous” variety?

You hear about the occasional outrageous law suit in the media, but as a percentage of all suits, but it’s tiny. I don’t think it’s possible to tease out the “frivolous suits” from the non-frivolous suits without significantly impairing the rights of people actually injured to recover.

Lawyers, like it or not, do perform a police function when it comes to medical malpractice; I’ve heard horror stories about botched surgeries in Europe where the patient/victim has no way to sue the MD/Hospital; we don’t want that aspect of Europe either!

ParisParamus on July 30, 2009 at 10:41 AM

Obama is becoming a health insurance salesman. I can tell people about low copayments and deductibles all day and they’ll love it. . . right up until I give them the quote for that Cadillac plan.

They inevitably ask, how can I lower my premiums? The answer is raise your deductible and copayments. . . maybe eliminate prescription drug benefits and pay for them out of pocket.

Insurance companies don’t force people onto high deductibles and high copays. People choose it to save money on the premiums. If Obama wants low deductibles and low copayments it will cost more (especially if it is a mandate).

People who like their insurance now will see an increase in their premiums that they’ve never seen before. If you thought it was bad before, wait until Obama starts putting regulations on it.

The reason insurance is so expensive in New York is because the insurance commissioner requires insurance companies to cover EVERYTHING. If Obama makes that the nation’s policy, expect the rest of the nation to have premiums like New York (the highest in the country).

Obama is selling it like people in Iowa would have lower premiums. . . but if ObamaCare passes, people in Iowa will have premiums like New York.

ThackerAgency on July 30, 2009 at 10:41 AM

Tort reform is a prime key to cut costs.

Can you imagine trying to sue the Federal Government for malpractice? Hewitt and guest noted that HR 3200 AAHCA of 2009 fails to address malpractice.

Watch Tort Reform get enacted with Obama’s Health Dictatorship.

maverick muse on July 30, 2009 at 10:41 AM

Wasn’t this one of Dan Quayle’s big issues he was being roundly put down for?

Republican Yogi on July 30, 2009 at 10:42 AM

As a General Surgeon, I pay 80k/yr for malpractice insurance. I have been in practice 12 years and have yet to be successfully sued. Personally, I probably account for $1 million in unnecessary tests to cover my ass annually. Multiply me by a hundred thousand more docs.

This crap sandwich of a bill has no tort reform in it, nor do the libtards have any intention on addressing the issue. This isn’t about reform. It’s about control over our lives.

And I for one am very much looking forward to being told what I can do and what I can order by some beauracrat, while limiting how much I can make with no limit as to how much I can be sued for when I don’t order the test or do the procedure I was told I didn’t have permission to do….

/sarc

Paul Revere on July 30, 2009 at 10:42 AM

No, tort reform is not the key to controlling health care costs. That is absurd. Medicare is a catastrophe. Many elderly people are taking upwards of 20 pills a day. Controlling unnecessary medical costs caused by lawsuits may be of benefit, but doctors should quit prescribing an avalance of medication.

In my uncle’s case, he has been prescribed blood pressure pills, cholesterol pills, diuretics, steroids, beta blockers, you name it. He does not take any of it. 15 years after hitting Medicare, he’s still ticking.

The whole pharmaceutical cloud is a myth.

eaglesdontflock on July 30, 2009 at 10:42 AM

Obama’s rejection of tort reform in this area amounts to the situation described in this parody: “Obama Plan Calls for Making Health Care System More Efficient by Having Trial Lawyers Provide Medical Services More Directly”: http://optoons.blogspot.com/2009/06/obama-plan-calls-for-making-health-care.html

Mervis Winter on July 30, 2009 at 10:42 AM

Obama’s Actuarians have it in for Americans.

maverick muse on July 30, 2009 at 10:42 AM

(by the way, medmal suits are already incredibly expensive to bring…as an attorney, I find it hard to believe that many attorneys are ready to bet they can get through a summary judgment motion, and BS a jury, or even get a significant settlement on a frivolous claim)

ParisParamus on July 30, 2009 at 10:43 AM

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.

You’ve got it exactly right!! And it works the other way as well – using draconian defense tactics to wear down plaintiffs with decent cases – this also escalates litigation expenses to the benefit of attorneys (the defense bar, in this case – just as bad, imo). The abolition of the “American rule” on attorneys fees fixes this problem, too.

There’s no need to warp the justice system by telling juries there are limits to the awards they can make. This simple adjustment takes care of all of it. But you’re exactly right about getting Dems to do it – way to cozy with the plaintiff’s bar, which would be largely out of business without frivolous cases and the means (fees) to intimidate defendants.

ManUFan on July 30, 2009 at 10:46 AM

Marcus: can you expand? I really haven’t dug into the bundling issue.

Jed_Eckert on July 30, 2009 at 10:39 AM

O said in a speech that basically he’s going to reform medicine by paying the Family Practitioner (and nurse practitioner, probably) what a specialized surgeon would make. No more fee for service, whether you remove one brain tumor or ten brain tumors. A salaried monthly paycheck type thing. And you say there are waits for MONTHS in Canada and Britain for a hip replacement?

Marcus on July 30, 2009 at 10:46 AM

Told a lib friend of mine that any health care reform bill that doesn’t include serious tort reform was useless. He said “Huh?”

flipflop on July 30, 2009 at 10:47 AM

No, tort reform is not the key to controlling health care costs. That is absurd. Medicare is a catastrophe. Many elderly people are taking upwards of 20 pills a day. Controlling unnecessary medical costs caused by lawsuits may be of benefit, but doctors should quit prescribing an avalance of medication.

In my uncle’s case, he has been prescribed blood pressure pills, cholesterol pills, diuretics, steroids, beta blockers, you name it. He does not take any of it. 15 years after hitting Medicare, he’s still ticking.

The whole pharmaceutical cloud is a myth.

You’re right that this is a problem – but it is not unrelated to the litigation crisis. Many of the medicines being prescribed (that you complain about) are prescribed for the purpose of covering the doc’s rear end – against litigation. Not all of it, granted – but enough to be a significant factor.

ManUFan on July 30, 2009 at 10:48 AM

When over 54 cents over every dollar get spent on Malpractice Insurance & Administrative costs uh yeah it should be a big big part of reform!!! Quick comparison a surgeon pays about $200,000/yr in malpractice insurance….A Veterinarian surgeon (with the same level of training, residency etc.) pays $800/yr. My wife is a Vet. and my dads a Surgeon!!! You might say its apples and oranges, but after experiencing Kaiser Insurance and their quacks…I would much rather see my wife for my Primary Care…Like Kramer says she needs to be able to treat a Dog, Cat, bird, lizard…etc.

Political Chef on July 30, 2009 at 10:48 AM

ParisParamus on July 30, 2009 at 10:41 AM

In Europe, the gov’t is your healthcare and you cannot sue them. My sister in law has been trying to get access to her records for three years after a transcription error almost killed her with an overdose. She is permanently disabled and her life expectancy has been cut by 20 years.

There are common sense solutions to this. If a mistake is made, fine. Maybe there should be some compensation for expenses, lost time, pain and suffering. But aren’t punitive damages supposed to be based on intent – whether malicious or simply lazy negligence? I think our doctors and their insurers are so defensive at this point, they cannot be genuinely “sorry” for the mistakes that do happen.

My sister in law is not looking for a “lottery ticket winning” but she also does not want to be a ward of the state for the rest of her life. I would trust my doctor to help find a balance between the two before I would trust and attorney.

gopmom on July 30, 2009 at 10:49 AM

Of course tort reform is the key. 90% of Americans don’t know what tort means though.

Mojave Mark on July 30, 2009 at 10:50 AM

Loser pays is not good either. It simply means that a large percentage of those with valid claims will be too frightened to sue because they might lose; that the jury will simply get it wrong. The Plaintiff who loses already has to pay thousands to their experts; the law firm that loses already gets nothing (and usually eats the costs and expenses of the law suit).

ParisParamus on July 30, 2009 at 10:51 AM

Tort reform is long overdue.

I advocate low caps on negligence. People should self insure against injuries at whatever limits they choose. As it is, the public at large is acting as the insurer with no limits. That’s absurd.

Willful, wanton and intentional conduct should not subject to limitations.

EconomicNeocon on July 30, 2009 at 10:52 AM

Dems will never take this up, and the GOP seems gutless about it.

The insurance model is probably the first item to be addressed. But among the next five or so, tort reform should be addressed.

On a larger point, the GOP has to decide what it stands for. Sure, reps and senators must represent constituencies, but when their “representation” begins to be nothing more than being shills for various special interests, they’re simply not acting in the greater good.

The general public hates lawyers–and plaintiffs’ lawyers especially. I don’t understand why the GOP doesn’t have attack ads running against Obamacare using this issue among others. Hell, one of these bills doesn’t merely maintain the status quo. It actually makes it easier for lawyers to scour the national landscape to look for qui tam actions that they can bring “on behalf of the government” to punish supposed bad actors in the health care system–those with deep pockets: hospitals, drug companies, and the like.

The Dems aren’t serious about reform until they face up to this national disgrace. The GOP can show how things have improved in Texas and either Alabama or Mississippi where tort reform has been enacted.

BuckeyeSam on July 30, 2009 at 10:53 AM

eaglesdontflock on July 30, 2009 at 10:42 AM

Cutting corruption precedes “tort reform” as dealing with what is already legislated prior to complicating the mess with more rhetoric.

I agree with you, that too much pharmaceutical clout is a bad thing. As part of the government health “care” program, pharmaceutical interests would enforce medication and vaccinations that not everyone wants, let alone needs.

Making medications AVAILABLE is one thing, focusing on antivirals rather than viral vaccines in particular.

Having County health clinics serve American citizens (indigent whites turned away in Travis County, TX) rather than illegal aliens is fundamental.

Severing illegal residents from tax funded services is PRIME.

When the hand that feeds you is also the hand that bleeds you, it deserves a bite. I support Tort Reform so long as there is no legislated reform for more Government Health Care Bureaucracy than America already has.

maverick muse on July 30, 2009 at 10:54 AM

Loser pays is not good either. It simply means that a large percentage of those with valid claims will be too frightened to sue because they might lose; that the jury will simply get it wrong. The Plaintiff who loses already has to pay thousands to their experts; the law firm that loses already gets nothing (and usually eats the costs and expenses of the law suit).

I disagree. If it’s a good claim, you should not be afraid to bring it; remember, if the defense over-litigates, and loses, they pay the fees.

Another protection that goes with this program is the “offer of settlement”. If you make an offer that is refused, and the other side goes no spending on lawyers, they pay even if they prevail – if they fail to do better than the settlement. That’s a key part to it – offer a fair settlement and refusing it can cost.

ManUFan on July 30, 2009 at 10:55 AM

When over 54 cents over every dollar get spent on Malpractice Insurance & Administrative costs uh yeah it should be a big big part of reform!!!

Yes, but what percentage of those two items is the Malpractice? And how was that calculated? Face it–lawyers police physicians. Some fine-tuning is, perhaps possible, but don’t pretend this hasn’t already been tried. Don’t kid yourself.

ParisParamus on July 30, 2009 at 10:55 AM

Nonsense. Tort reform will save some money, and that should be done, but to think it will save health reform is crazy talk. I suppose you could make doctors judgment proof, that might lower insurance premiums because they would no longer be necessary. I doubt you would be safer if that occurred.

Alternatively (and more reasonably) you could get rid of punitive damages and make the burden on plaintiffs higher, although in most states lawsuits against doctors are not easy. The burdens are already high. It is doubtful medical costs would be significantly changed, but there might be some savings.

Mr. Joe on July 30, 2009 at 10:55 AM

Edwards enriched himself by using bad science to bankrupt innocent physicians. …

Was Al Gore inspired by Edwards practice by using BAD SCIENCE?

Mr. Morrissey,

Can we assume from your post here that there is currently NO TORT REFORM in the healthcare bill before the House or the Senate? And, (again, assuming), that no democrat has attempted to introduce legislation, is there any evidence that a Republican has provided an amendment that has been “shot down” by the majority?

Rovin on July 30, 2009 at 10:56 AM

Tort reform is a prime key to cut costs.

maverick muse on July 30, 2009 at 10:41 AM

I’m not so sure.

Consider this, Washington DC public schools has one of the highest per capita spending rates in the nation. Yet nobody would suggest that the system is functional and providing an excellent education for all its students. The solution to fix the DC public schools is far more complex than cutting costs and involves decades of mismangement and well-meaning neglect. Nor is the solution achievable overnight with a simple stroke of the pen.

I would argue that the same holds true for healthcare. Tort reform is not going to be the panacea to fix all the funding problems. It may be an element of the final solution but the real savings are going to be found by structural changes, not just tinkering around with peripheral issues. As for Obamacare, that just takes the current system and makes it worse by installing a DMV-like cadre of bureaucrats into the current structure.

highhopes on July 30, 2009 at 10:56 AM

Tort reform has worked very well in the individual states in which it has been passed to stabilize malpractice insurance premiums, and significantly reduce the number of lawsuits, proving beyond a shadow of a doubt that probably the majority of these cases are frivolous. We’ll never see it on a national level though without a filibuster proof Senate majority and a Republican president because the Democrats are in the pocket of the trial lawyers and the bribes are just too great an inducement to block malpractice reform.

I’ll tell ya one thing though. A public option without malpractice reform is going to be a disaster for the health care providers, hospitals etc. because the quality of medical care is going to decline severely and the doctors and hospitals are going to get the blame, as opposed to the government. Who’s going to get sued when the government denies a procedure, a consult, a test etc. to a patient and there’s a negative outcome? You can’t sue the federal government.

eyedoc on July 30, 2009 at 10:56 AM

Of course tort reform is the key. 90% of Americans don’t know what tort means though.

Mojave Mark on July 30, 2009 at 10:50 AM

Tort was the Taco Bell dog’s name?

maverick muse on July 30, 2009 at 10:56 AM

Loser pays is not good either. It simply means that a large percentage of those with valid claims will be too frightened to sue because they might lose; that the jury will simply get it wrong. The Plaintiff who loses already has to pay thousands to their experts; the law firm that loses already gets nothing (and usually eats the costs and expenses of the law suit).ParisParamus on July 30, 2009 at 10:51 AM

Isn’t that what you lawyers are paid to properly advise your clients of? Weather or not they have a winnable case?
The law firm gets nothing? Humbug! Win or lose the lawyer always sends a bill.

oldernwiser on July 30, 2009 at 10:57 AM

The point about most Americans not knowing what “tort” means is valid. I know it drives everyone around me crazy but I’m beating this drum non-stop. We’re a pretty smart bunch of people here. We need to be out there just like the crap bag, hammering away at this. Everywhere is a platform. Too many of us are so caught up in the day to day, we can’t see beyond it. This is the strategy – overwhelm them.

No gov’t health care. No more gov’t interference. Give the power and the knowledge back to the people.

I think I’ll print up some business cards with key points on them and hand them out at he beach, grocery store, park, etc.

gopmom on July 30, 2009 at 10:57 AM

In our present model, consumers are disconnected from costs by third party intervention,

Bingo!

In our present model, consumers are disconnected from costs by third party intervention

HEALTH CARE SAVINGS ACCOUNTS It’s your money!

It is also whats wrong with payroll withholding of income taxes. It is also whats wrong with corporate taxes embedded in the prices of everything we purchase.

As long as taxpayers remain ignorant of the true costs, none of these problems can be fixed. Too many people stubbornly, willfully delude themselves about the costs. Too many people don’t care what it costs especially when someone else is paying. It’s just gimme, gimme, gimme.

Skandia Recluse on July 30, 2009 at 10:58 AM

It’s about time IBD and other media took note of this problem.

Obstetricians are especially at risk. Naturally, fewer docs do an obstetrical residency and more leave the ranks either by retiring or taking up family practice. I read about the north east corner of Wyoming a few years ago and don’t remember the details but I’m sure of the message. The nearest OB for some people is in another state, North Dakota or possibly South Dakota, and is of the order of one hundred miles or more away.

burt on July 30, 2009 at 10:59 AM

Another way to reduce malpractice insurance would be to eliminate the ability of lawyers to get a percentage of the verdict and allow them only to charge for their hours (still outrageous). You would see a reduction in the monetary compensation that they seek if they dont have a financial interest and are paid for their work not as a portion of their clients damages.

chromium on July 30, 2009 at 10:59 AM

You can’t sue the federal government.

eyedoc on July 30, 2009 at 10:56 AM

Exactly.

The Tort “reform” that the Democrats would pass would be to enact your worst nightmare, and your patients’ worst nightmare.

You can’t sue Big Brother or your Nanny State.

Any attempt would be denied standing.

maverick muse on July 30, 2009 at 11:00 AM

“Tort Reform” depends on how it is defined, via Textualist Urtext or Revisionism.

maverick muse on July 30, 2009 at 11:02 AM

I disagree. If it’s a good claim, you should not be afraid to bring it; remember, if the defense over-litigates, and loses, they pay the fees.

(1) you fail to account for the potential stupidity of juries–in a criminal context, remember OJ?; (2) The insurance company always has much deeper pockets than a law firm. (3) You fail to account for the reality that most claims, in med mal or elsewhere are not black or white, or at least aren’t so clearcut that they defy wrong decisions in court; that why cases are reversed on appeal, etc.

So what you will get with most of the “reform” I’ve read about is that most valid malpractice claims simply not being brought.

And yes, outlawing law suits will reduce medical malpractice premiums. And create more screw-ups by MDs…

ParisParamus on July 30, 2009 at 11:03 AM

Of course tort reform is the key. 90% of Americans don’t know what tort means though.

Mojave Mark on July 30, 2009 at 10:50 AM

Tort? Isn’t that like a cupcake with a crust and filling?

Seriously, I’m interested in knowing how many people have actually sued over medical malpractice. I don’t know of anyone who has participated in upping costs through litigation (frivilous or otherwise). It would seem to me that the insurance companies deal with legitimate cases by trying to settle before it gets to litigation but the basic question is how much of what is being spent on tort cases is by the Johnnie Cochran type of class-action lawsuits.

highhopes on July 30, 2009 at 11:03 AM

First thing we do, we shoot about 2/3 of the lawyers…

mojo on July 30, 2009 at 11:04 AM

Lawyers are pond scum, wherever they show up to make a buck.

I watch these commercials on TV where these shysters brag about how they can reduce the dollar amount owed to the IRS for people who are unable to pay their taxes. Then they parade one of their clients in front of the camera to say, “I owed $30,000 in back taxes and thanks to Duey Fockem & Howe, I didn’t have to pay a nickel”.

So who wins here?

The lawyer, who gets paid a heft fee for his services.
The tax delinquent, who doesn’t pay Uncle Sam what he owes.

And the big loser?

That would be us, law-abiding, tax-paying citizens.

Shakespeare had it right.

fogw on July 30, 2009 at 11:05 AM

Another way to reduce malpractice insurance would be to eliminate the ability of lawyers to get a percentage of the verdict and allow them only to charge for their hours (still outrageous). You would see a reduction in the monetary compensation that they seek if they dont have a financial interest and are paid for their work not as a portion of their clients damages.

chromium on July 30, 2009 at 10:59 AM

Which means that only rich people could bring law suits–no thanks; THATS EUROPE.

ParisParamus on July 30, 2009 at 11:05 AM

Another way to reduce malpractice insurance would be to eliminate the ability of lawyers to get a percentage of the verdict and allow them only to charge for their hours (still outrageous). You would see a reduction in the monetary compensation that they seek if they dont have a financial interest and are paid for their work not as a portion of their clients damages.

Problem is you just change the emphasis from a big dollar victory (which is good for the plaintiff) to a time-consuming (i.e., fee building) slug-fest that’s good for nobody (except the lawyers). Defense attys already bill this way – and it shows; check out some malpractice cases with good claims, and look at the defense tactics: time, time, time …

ManUFan on July 30, 2009 at 11:07 AM

nazo311 on July 30, 2009 at 10:25 AM

I’m curious,about how many of those 7 law suits are settled out of court?

oldernwiser on July 30, 2009 at 10:31 AM

Almost all of them. It is cheaper to settle than to drag it out in court most of the time. It depends on the amount they are seeking.

nazo311 on July 30, 2009 at 11:07 AM

Know what else leads to malpractice suits?

Malpractice.

I’ve worked (briefly) in the insurance industry, and I’m presently a law clerk with a firm that does some occasional personal injury work.

Doctors screw things up quite often – they’re human, after all. And lawyers, quite frankly, do file an awful lot of nuisance and ridiculous lawsuits.

I’ve looked through insurance claims where a family claims the death of a 450 lb. 65 year old man who had been diagnosed with a litany of ailments was due to a “misdiagnosis” of some small part of his diabetes. Yeah, right. There are a lot of claims like this, and they truly are frivolous.

On the other hand, I’ve looked through insurance claims for things like AMPUTATING THE WRONG ARM on a man in his mid-30s. Right now, there’s a guy walking around with NO arms, when he should have one. What price can you put on that? Really? The man now has virtually no opportunity for work. How much is his enjoyment of life completely destroyed by an undeniable act of malpractice by a doctor who should’ve known better? Further, how can we best prevent this from happening in the future?

It’s those extreme cases that make me wary of any sort of malpractice caps. Malpractice, as with any other practice, will increase if the cost is reduced. And there’s a reason that American hospitals are among the cleanest and safest in the world – those dirty lawyers and their demands. (Incidentally, as it is very hard to sue the VA due to sovereign immunity, their facilities and personnel don’t come even close – such are the perils of government-run healthcare.)

I’m not opposed to some sort of reform as regards suits which are really, truly frivolous. Speaking as someone with a legal education, I’m not entirely sure how you would avoid this – discovery is an expensive step that most want to avoid.

On the other hand, the thought of a cap on damages isn’t a great idea, either. Doctors do a whole lot of good, but when they screw up, they can also do an awful lot of harm.

ChePibe on July 30, 2009 at 11:07 AM

Did you know malpractice insurance for doctors can reach up to $84,000/year? Of course this is for OB/GYN doctors. Nevertheless, this cost gets tacked on to the cost of health care and the reason doctors order so many tests.

nazo311 on July 30, 2009 at 10:25 AM

I know several that pay almost twice that. The one thing that could be done by government that would improve the health care situation without impacting level of care would be tort reform. Of course, if they did, a huge amount in campaign contributions would dry up overnight.

Vashta.Nerada on July 30, 2009 at 11:08 AM

Somehow, we must reestablish control of our government. There is no doubt in my mind that regional solution groups comprised of business, private, church and charity can develop health care plans for their communities. One size does not fit all.

How do you eat the elephant? One bite at a time. You try all at once, you choke. We are going to choke on Obama.

eaglesdontflock on July 30, 2009 at 11:10 AM

(1) you fail to account for the potential stupidity of juries–in a criminal context, remember OJ?; (2) The insurance company always has much deeper pockets than a law firm. (3) You fail to account for the reality that most claims, in med mal or elsewhere are not black or white, or at least aren’t so clearcut that they defy wrong decisions in court; that why cases are reversed on appeal, etc.

So what you will get with most of the “reform” I’ve read about is that most valid malpractice claims simply not being brought.

And yes, outlawing law suits will reduce medical malpractice premiums. And create more screw-ups by MDs…

ParisParamus on July 30, 2009 at 11:03 AM

Well, your problem is you have no faith in the system – at all – or in your fellow man (who makes up the jury panel). Sorry, can’t help you there. There have been proposals to resolve malpractice claims by expert panel, but there are big problems with that, too.

Can’t fix the “human error” problem, but the theory on the fees is valid. It destroys the “deep pockets” problem because all the deep-pocket defense does is increase the fee they’ll have to pay when they lose.

Also, bear in mind the “offer of settlement” option – it’s a pretty important part of preventing abuse.

ManUFan on July 30, 2009 at 11:11 AM

ParisParamus on July 30, 2009

Several times you have written that lawyers police the Md’s. Whom else do you police? Dentists,Veterinarians,Plumbers,Brick layers?
The arrogance of that is driving me to distraction.
Who then polices the lawyers?

oldernwiser on July 30, 2009 at 11:11 AM

Another way to reduce malpractice insurance would be to eliminate the ability of lawyers to get a percentage of the verdict and allow them only to charge for their hours (still outrageous). You would see a reduction in the monetary compensation that they seek if they dont have a financial interest and are paid for their work not as a portion of their clients damages.

chromium on July 30, 2009 at 10:59 AM

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

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

When the hand that feeds you is also the hand that bleeds you, it deserves a bite. I support Tort Reform so long as there is no legislated reform for more Government Health Care Bureaucracy than America already has.

maverick muse on July 30, 2009 at 10:54 AM

Agreed. Even a cap on the top end of jury awards would not require a huge bureaucracy. It’s the out-of-control 10 and 20 million awards that are driving lawyers to not even consider an amicable settlement. Private insurance companys, (owned by shareholders), have to pay these huge sums, hence the high premium cost are passed onto the Doctors and eventually to the consumer/patient.

Rovin on July 30, 2009 at 11:14 AM

Marcus: thanks. FYI the salary approach is used in Canada. There have been strikes over the years over salary levels. It keeps getting better / sarc off

Jed_Eckert on July 30, 2009 at 11:17 AM

The past 25 years have been the Golden Era for slip & fall ambulance chasing Lawyers. They run up the costs of more than the medical sector.

portlandon on July 30, 2009 at 11:18 AM

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

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

Not so, although litigation can cost more than 50% of the judgment.

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. Sometimes the lawyer ends up with a bigger piece of the pie than the plaintiff due to the often high costs of medical malpractice actions, but the lawyer isn’t pocketing all of that money.

ChePibe on July 30, 2009 at 11:18 AM

Agreed. Even a cap on the top end of jury awards would not require a huge bureaucracy. It’s the out-of-control 10 and 20 million awards that are driving lawyers to not even consider an amicable settlement. Private insurance companys, (owned by shareholders), have to pay these huge sums, hence the high premium cost are passed onto the Doctors and eventually to the consumer/patient.

There is something to what you say here. Another problem with the system as it is today is not limits on verdicts – but on the limits of what arguments can be made to the jury about the size of damage awards. Right now, the rules on closing arguments definitely do tend to favor plaintiffs; there needs to be some liberalization of the arguments defendants can make about how to value an award. And, especially, about what it means economically; plaintiffs get away with quite a bit here, and it is not evenly balanced (imo).

ManUFan on July 30, 2009 at 11:19 AM

And I for one am very much looking forward to being told what I can do and what I can order by some beauracrat, while limiting how much I can make with no limit as to how much I can be sued for when I don’t order the test or do the procedure I was told I didn’t have permission to do….

/sarc

Paul Revere on July 30, 2009 at 10:42 AM

That is the point I’ve been trying to make. This reform bill has a deep chasm between standard of care and what a beaurocrat deems to be the standard of care. The trial lawyers are on one side and the physician will end up on the other side. The physicain needs to be protected from lawsuit for following a beaurocrat “orders” especially when those “orders” are outside the standard of care. without protection, physicians will be eaten alive…and no one will seek jobs in the medical professions.

jbh45 on July 30, 2009 at 11:21 AM

Great. So, the libs are choosing to line the pockets of lawyers and ration our healthcare vs. limiting the Lawyers’ judgments. Where’s the compassion? This issue ALONE speaks to the hypocrisy of the Democrats.

marklmail on July 30, 2009 at 11:23 AM

Edwards enriched himself by using bad science to bankrupt innocent physicians. …

A liberal would never…no…bad sciene? Wow, I’m just at a loss for words…

Grafted on July 30, 2009 at 11:25 AM

Skandia Recluse on July 30, 2009 at 10:58 AM

I’m with you.

Until out entire tax system is rescinded and cut back to FLAT rate, the Feds have no business driving us further and further into their Obama Black Hole of Bankruptcy and Slavery.

The Feds live high on the hog. Taxpayers aren’t even granted hog bodies by Socialists. We are merely the dust of the earth, the muck and the mire. Legislators are made of better clay than we are.

Socialism is legal plunder that violates ownership; and Legislators desire to mold and manage mankind. “You who wish to reform everything! Why don’t you reform yourselves? The task would be sufficient enough.”

Bastiat, prescient.

maverick muse on July 30, 2009 at 11:26 AM

One of the best things about blogging is that now, when I claim to have been saying something for a long time, I can prove it:

http://hotair.com/greenroom/archives/2009/07/14/the-major-obstacle-to-serious-health-care-reform/

I was a little uncomfortable being nakedly partisan on the topic of tort reform, because I dislike pure partisanship – there’s no shortage of chuckleheads in the GOP, and I’m always delighted to win the support of conservative Democrats on such an important topic. The problem is that tort reform is one of the most purely partisan issues of the day. I don’t see any way to separate the grip trial lawyers have on the Democrats, except to increase the number of Democrats totally owned by that lobby… and I don’t see any way to do that, other than reducing the overall number of Democrats. Anyone who finds that to be an ugly, partisan appeal should direct their anger at the people who made it that way. You can get their names off a trial lawyer’s donation list.

Doctor Zero on July 30, 2009 at 11:26 AM

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