I’ve spent most of this summer driving across Oklahoma asking physicians how lawmakers should reform health care in our country (among other questions). As you might imagine, the answers are peppered across the political spectrum. A geriatrician adamantly supported a single-payer system that could grow from Medicare, which he praised; an internist wanted to tweak what we have, suggesting modifications in the same way she might consider adjusting the drug panel of a chronically ill patient. A vascular surgeon proposed cutting out most insurance policies altogether and unleashing a “free market” for health care in our operating rooms. The varied responses were not surprising, and perhaps they explain some portion of Washington’s seeming inability to resolve this problem. What was surprising was how every approach involved addressing medical malpractice and tort reform. Many of the doctors I spoke to grumbled about rising malpractice insurance premiums and shared the story of their lawsuits, which often left them second-guessing their career choice. They collectively described a broken malpractice system—one fueled by late-night television ads promising “entitled compensation,” which gives way to cases argued by expert witnesses hired by prosecutors to litigate instead of inform. These cases are then unpredictably arbitrated by juries confused by the complexity of difficult medical decisions or settled to avoid resource drain.
To them, the defensive medicine they feel forced to practice to avoid the courtroom is a key driver for soaring health care costs in recent years. (Evidence from 2008 suggests that its impact is large in value but likely overestimated by physicians, accounting for $45 billion per year out of the $2.3 trillion spent on health care.) But at the very least, they asserted, the status quo of medical malpractice today is a psychological burden that impairs clinical judgment and hardens cynicism.
AdvertisementWhile the drama around Obamacare repeal has dominated headlines, House Republicans took the advice of my physician-interviewees and quietly passed a tort reform bill on June 28. HR 1215, better known as the Protecting Access to Care Act, is straight from the conservative health policy playbook for controlling health care costs. Among other changes, it would create a $250,000 cap for non-economic damages in malpractice lawsuits (meaning payouts granted for damages like disfigurements, disabilities, or for pain and suffering rather than lost wages or future costs) and shorten the statute of limitations for suing—for any patients “using federally subsidized health care.”
