Saturday, October 10, 2009

CBO Changes its Mind on MedMal Reform

CBO Director Doug Elmendorf, never one to acquiese to political pressures, is now stating that medical malpractice reform will lead to over $50 billion in savings over the next ten years. This new claim is based entirely on the premise that defensive medicine has heretofore been underestimated as a source of skyrocketing health care costs. (Previously, atempts to quantify med mal reform were limited to effects on liability insurance premiums). He hints that punitive damages caps ($250,000-$500,000) are a necessary adjunct to any serious attempt at reform.

Now I'm not married to the idea of capping damages. But there's no doubt that physicians in America are driven by fear of potential litigation. It's nice to finally see the federal government acknowledge this reality with objective data...

4 comments:

Attorney Andy said...

Buckeye, you're killing me. The truth is right under your nose (and even mentioned in your post). The problem is defensive medicine and the legitimate fear doctors have of getting sued for a minor mistake, right? How are caps on punitive damages going to solve this problem? You don't pay these awards, your insurance company pays them. Is this debate about helping the health care industry or the insurance industry? Caps on damages are not the answer. There are many common sense reforms to the legal system that can help physicians avoid frivilous lawsuits (extending the statute of limitations, requiring affidavits of merit, sanctions to the lawyers filing frivilous suits). Caps on damages have nothing to do with accomplishing those goals, they only save insurance companies money. If you get hit with a $250,000 capped verdict, or a $1,000,000 uncapped verdict, guess what -- your insurance premiums are going up the same in each instance. The medical community needs to get serious and propose a combination of common sense legal system reforms AND insurance industry reforms (prohibit the exorbitant premiums thrust on doctors to make up for bad insurance company investments). Only in this way will doctors have the confidence to practice medicine without the thought of a lawsuit in the back of their minds. Stop getting sucked into the temptation to think all lawsuits are bad and look at the motivations behind the proposals you comment on in your blog.

Buckeye Surgeon said...

Take it east Mr Attorney! I agree that punitive caps are the wrong approach. I highlighted this article because (finally) we see an alternative to the CW that defensive medicine is insignificant. You're right: a common sense, rational approach to med mal reform is needed....sounds like a future blog post.

Anonymous said...

sorry Andy.
This isn't about a 250 K vs 1,000 K difference. This is about 250 K vs 10,000 K. In my own city a peds was hit with a 10 million dollar verdict recently, This woman will be uninsurable if it stands. Her career will be over. All because a jury of the 12 lowest common denominators wanted to "send a message" (doctors get these messages, don't practice medicine longer than you have to).. Trust me, I have gone enough jury duties to see your brethran's lawyer games in picking a jury. In general, the stupider the better. The problem is a good system has been bastardized and gamed to the point of insanity. Do you really wonder where all these lawyer jokes come from? Sanctioning a lawyer for a frivilous suit??? get real, I can't remember the last time it happened around me. That is a red herring and you damn well know it.
Personally, I am not a big fan of capping suits, but every reasonable change that is forwarded is fought tooth and nail by ATLA (I am sorry what do they call themselves now, the american association of justice and the american way, or some other kind of selfserving, doublethink, bullshit name). I am no friend of the insurance industry. I deal with them orders of magnitude more than you do. However, ATLA and friends will do nothing to alter the system in which there members are suckling at it's teets and we both know it.

Attorney Andy said...

Anonymous, it's nice to be corrected by someone with the wealth of knowledge obtained through multiple days sitting on jury duty. I'm sure after your experience you know all the in's and out's of the legal system, including jury selection. Despite what you might have "learned" from watching LA Law or The Practice, lawyers have very little effect on the makeup of a jury through the selection process. And the "lowest common denominators" you have such little resepct for actually render defense verdicts in the vast majority of med mal trials. If a doctor in your area was hit with a 10 million dollar verdict, particularly in this climate, I'm glad she won't be practicing medicine anymore, it means the system is working. I do agree with your impressions of ATLA, however the same charge can be made against any such professional group. I'm sure the AMA is vigorously supporting many bills proposed to cap damages, even though all of us seem to agree that this won't help doctors. The purpose of my comment was to encourage doctors to keep an open mind about legal reform, and to objectively think about how the proposals will or will not help them in their practice. A lot of the measures proposed are handouts to insurance companies disguised as "health care reform."