Bipartisan health care reform must include tort reform
Now that his yearlong partisan push for government-run health care has so far failed to produce legislative results, President Barack Obama wants Republicans to join him for another White House summit to see if he can salvage his proposals. But unless the president and congressional Democrats address the need for tort reform as a critical component of cutting health care costs, a bipartisan solution seems unlikely.
The unsustainable path of rising costs is a serious national problem. Currently, health care spending exceeds $2.5 trillion per year. By 2019, it is expected to top $4.7 trillion per year. Any hope for cost containment would involve comprehensive medical malpractice reform to end the practice of defensive medicine, close the loopholes that allow frivolous lawsuits to clog up the system, and set reasonable limits on jury awards.
The president seems to think that eliminating wasteful spending alone would get Americans on track to more affordable coverage. But the government’s track record of recouping its losses from waste, fraud and abuse leaves something to be desired. In 2008, for example, the government recovered a meager $35 million from criminal prosecution of fraud once enforcement costs were factored in. Real savings would start when Congress tackles the billion-dollar problem of defensive medicine.
Defensive medicine — when doctors order unnecessary and usually expensive tests and procedures in order to avoid lawsuits — is a major contributor to skyrocketing health care costs. As much as $210 billion is spent on defensive medicine annually — equal to $700 for every U.S. man, woman and child. This helps drive up insurance premiums that are already too high for many Americans. And the excessive malpractice litigation inevitably leads to physician shortages — especially among obstetricians, neurosurgeons and emergency room physicians.
Fewer doctors mean reduced access to medical care for everybody. New Jersey, for example, will be short 2,800 family doctors and specialists by the year 2020, according to a recent report from the New Jersey Council of Teaching Hospitals. The reason for the shortage, council President Richard Goldstein says, is a “morale problem” because of the state’s “hostile” environment for doctors and the heightened threat of malpractice lawsuits.
As long as out-of-control malpractice premiums are built into medical costs, many will never be able to afford coverage. Shamefully, it is estimated that the cost of defensive medicine and the associated liability-based medical care costs account for at least 3.4 million uninsured Americans.
Moreover, the current system is studded with irresponsible lawyers’ fees associated with malpractice claims that do not involve injury or medical error. A large share of the awards goes to pad the pockets of plaintiffs’ attorneys. Recently, the Manhattan Institute concluded that approximately 10 cents of every dollar paid for health care services goes to cover malpractice premiums, defensive medicine and other costs associated with excessive litigation.
Tort reform that reduces frivolous lawsuits and caps outrageous jury awards is a critical component of any solution to bring the cost of health care within reach of every American. So far, however, the president has barely mentioned it.
If bipartisan support is what he’s after, the president needs to do more than host Republicans at the White House for a chat. He’s going to have to get serious about the damage being done to U.S. health care by frivolous lawsuits and the cost of defensive medicine, which real reforms could correct.
Rep. Darrell Issa (R-Calif.) is the ranking member of the Committee on Oversight and Government Reform.
Trial lawyers to Obama: Don’t deal on tort reform in healthcare neogtiations
- 02/14/10 04:56 PM ET
President Barack Obama wants a bipartisan deal on health reform, but trial lawyers don’t want him to deal on a top Republican priority: tort reform.
Trial lawyers defeated President George W. Bush’s push for medical liability reform and successfully lobbied to water down tort reform provisions in healthcare reform bills this Congress. But the battle is far from over.
And in an odd twist, a longtime ally of the trial lawyers could be the one to resurrect the idea -- President Barack Obama.
“I would hope this would be an area we just don’t go,” said Linda Lipsen, vice president for public affairs at the American Association for Justice, the trade group for trial attorneys.
Lipsen said. “The last thing Congress should be doing is eliminating people’s rights when the real issue is safety in hospitals.”
Obama’s hints that he is willing to make a deal with Republicans on medical malpractice reform has got physicians and trial lawyers scratching their heads.
As recently as Tuesday, Obama floated the possibility of offering an olive branch to Republicans on malpractice reform as a gesture of bipartisanship. “I've said from the beginning of this debate I'd be willing to work on that,” Obama remarked during a press briefing.
Retiring Sen. Judd Gregg (R-N.H.) has recently indicated he is open to a healthcare compromise, stressing the need for malpractice reform to be included.
The White House announced on Friday that it will post a detailed health reform proposal online before the Feb. 25 bipartisan health summit, which Gregg was not invited to. It is unclear if that plan will be Obama’s own proposal or a merged version of the House and Senate-passed bills.
In an interview on Federal News Radio on Friday, Democratic strategist Bob Weiner said Obama should strike a deal on tort reform. He noted that Gail Wilensky, head of the Medicare and Medicaid agency in the first Bush administration, recently said Democrats could have gotten Republican votes if they had compromised on medical liability.
Weiner, who worked in the Clinton White House, said, “Why don’t we give a little on that and put some limit on [caps] and then get all of this national health insurance coverage for people and protect them with it? It’s not that much of a price. That’s part of the sausage-making that I think we could done that actually might have made a difference.”
Although Obama has repeatedly cited medical malpractice reform as a possible area of compromise with the GOP, he has not explained where he sees the middle ground and, indeed, has rejected Republicans’ top priority in this area: the hard-dollar caps on lawsuit awards in malpractice cases long sought by the physician and business lobbies.
But officials from pro- and anti-malpractice reform camps agree that, beyond the modest measures already in the healthcare reform bills that passed Congress and some demonstration projects under way at the Department of Health and Human Services (HHS), Obama has not give a clear indication of what sort of offer he is willing to make.
Asked whether they were aware of any new malpractice reform proposals from the Obama administration, these officials professed they were aware of none.
“I haven’t heard anything like that,” Lipsen said.
“Not that I know of,” said Lisa Rickard, president of the U.S. Chamber Institute for Legal Reform, a proponent of limits on malpractice lawsuit awards.
“We haven’t seen any substantial proposal that supports his rhetoric,” said Kurt Bardella, a spokesman for Rep. Darrell Issa (R-Calif.), who has been a critic of the Obama administration’s stance on malpractice reform. “We have been waiting for his follow through and that’s what we have yet to see,” Bardella said.
Based on Obama’s oft-stated views on federal policy governing malpractice lawsuits, the trial lawyers likely have little to worry about. “I don’t think he’ll shock the world and come out and embrace caps,” Rickard said.
Obama indicated he could embrace malpractice proposals that “make my party a little bit uncomfortable.” Unlikely though it is that Obama would reverse positions on malpractice lawsuit caps or other proposals, it would not mark the first time he aggravated his liberal allies during the healthcare reform debate.
Despite campaigning against taxation of employer-sponsored health insurance, Obama put himself at odds with unions by endorsing a Senate-passed excise tax on high-cost insurance plans that organized labor and most House Democrats passed. The White House also struck a controversial deal to win the support of the pharmaceutical industry for healthcare reform, frustrating liberals who think Obama went too light on their long-time nemesis.
The House and Senate bills each contain provisions aiming to improve patient safety and offering grants to states that develop alternate ways to resolve disputes over medical errors. Proponents of broader malpractice reforms dismiss these proposals as inadequate while trial lawyers have rejected another possible compromise, the creation of special “health courts” that would hear cases and medical errors and malpractice.
Moving toward the middle on medical malpractice reform is no guarantee of winning GOP support, however. Any concession that Republicans would view as meaningful would prompt an outcry from Democratic lawmakers and the trial bar, a close ally of the party.
“I don’t see that as a credible place to go if the object is to pass the bill,” said Lipsen, noting that legislation to enact malpractice award caps could even not advance through the Republican-controlled Senate several times in the last decade.
Moreover, Republicans have stood so strongly opposed to the Democratic healthcare bills that even full capitulation on medical malpractice reform would not produce instant bipartisanship, Rickard noted. “There are so many issues that are in dispute in this bill,” she said, “that malpractice reform in and of itself isn’t going to overcome them.”
Bob Cusack contributed to this article
A comment I found interesting
Even before it was a Republican idea - The People have been calling for TORT REFORM! Did Obama and this org Hear THAT?These Frivolous (stupid) Lawsuits are killing Healthcare - IF someone is truly negligent it's these Lawyers trying to mae a fast buck on peoples misguided ways! IF a doctor is truly Negligent, then he should pay - but also pay with his license, but he isn't going to be negligent for every LITTLE thing, some is always with the patient and MORE is what these, so-called Lawyers, do and say. REFORM in this area is a definite need OR Healthcare cost's will continue to rise! The monetary % amount that these lawyers get should be cut way, way down and then see how many cases they do - more money should go to the patient - NOT to these lawyers, remember the damage was done to the patient, not the lawyer!
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