Reducing malpractice means saving money

Today, Public Citizen joined with other consumer advocacy groups in a letter to the debt commission (PDF) condemning a dangerous proposal by Erskine Bowles and Alan Simpson, Co-chairs of the National Commission on Fiscal Responsibility and Reform, to use “comprehensive medical malpractice liability reform to cap non-economic and punitive damages and make other changes in tort law” as a way to reduce the national debt and urging the body to remove it from its final report.

Patients’ legal rights continue to be a scapegoat in the public debate on solutions to the country’s skyrocketing health care costs.  However, the proof is in the pudding. When Public Citizen examined Texas’ experience with strict liability limits (PDF) since their adoption in 2003, we found that injured patients in Texas lost their access to the courts but the restrictions did not translate into health or cost benefits. Instead, the opposite has occurred. In Texas: the uninsured rate has increased, remaining the highest in the country; health insurance cost has more than doubled; spending increases for diagnostic testing (measured by per-patient Medicare reimbursements) have far exceeded the national average; and the cost of diagnostic testing in Texas (measured by per-patient Medicare reimbursements) has grown 50 percent faster than the national average.

Clearly, tort reform will not cut the fat.

To blame high costs on medical malpractice litigation is to ignore the facts. In 2008, the cost of medical malpractice liability fell to less than 0.6 percent of the $2.1 trillion in total nation health care costs as measured in 2006. In fact, there are nearly 10 times as many injuries caused by medical negligence (PDF) as there are malpractice claims.

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Jon Stewart is right on many things, just not on so-called tort reform

By David Arkush and Christine Hines

Jon Stewart, the popular host of Comedy Central’s The Daily Show and “America’s most trusted newsman,”  regularly imparts an astute critique of American political affairs and media.

The comic’s recent two-part exchange with Fox News’ Bill O’Reilly, for instance, elicited – in between the funny jabs – thoughtful, nuanced discussion on policy, politics, and the president. As Daily Show fans though, we cringed a little during his chat with O’Reilly when they briefly discussed so-called “tort reform,” the phrase used by the health industry and big business to advocate taking away your access to the courts

O’Reilly first broached the issue when Stewart was a guest on Fox’s O’Reilly Factor. He complained that President Obama could have worked with Republicans during the health care reform debate by adding “tort reform” to the bill. Stewart shot back that the president said he was willing to compromise on the issue, a priority for Republicans, even though it wouldn’t save much in health care costs. In their second conversation, this time at the Daily Show. Stewart blasted the extent of corruption, in media and finances (financial services?), and then strangely expressed a willingness to offer “right wing tort reform,” as he called it. It wasn’t clear why he mentioned it. Perhaps to suggest he would bargain on the issue in exchange for measures that curb corruption.

We’re with him on the need to end corruption. Government and corporate accountability are at a serious low point; we’ve proposed

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New research refutes Boehner, Gingrich fear mongering on cost of medical malpractice lawsuits

Remember all the hand-wringing over medical malpractice litigation that opponents of health care reform brought to bear during last winter’s debate? This month’s Health Affairs includes three articles that empirically confirm what common sense told us all along: their claims had nothing to do with reality.

To recap, Republican House leader John Boehner last winter called “medical malpractice and the defensive medicine that doctors practice” the “biggest cost driver” of all in health care. Former House Speaker and 2012 presidential hopeful Newt Gingrich pegged the nation’s bill for “defensive medicine” at $625 billion a year, which is about 180 times the sum of actual medical malpractice payments.

Boehner and Gingrich were careful to tout “defensive medicine” – care rendered out of fear of litigation – because actual litigation costs are universally acknowledged to be tiny in relation to total health care spending – less than 0.6 of 1 percent by our estimate. Defensive medicine cannot be definitively measured. As in Gingrich’s wild estimate, the fear mongers usually rely on

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RAND study agrees: Improving patient safety will reduce malpractice claims

For decades, Public Citizen has urged Congress and regulators to address the patient safety crisis. We told them that reducing medical errors would also reduce the claims and the associated costs. Today, the RAND Corporation – an independent, non-profit research firm – released a report confirming our assertions. They write:

Our results showed a highly significant correlation between the frequency of adverse events and malpractice claims: On average, a county that shows a decrease of 10 adverse events in a given year would also see a decrease of 3.7 malpractice claims. Likewise, a county that shows an increase of 10 adverse events in a given year would also see, on average, an increase of 3.7 malpractice claims. According to the statistical analysis, nearly three-fourths of the variation in annual malpractice claims could be accounted for by the changes in patient safety outcomes. (Emphasis added)

In other words, the best way to reduce medical malpractice lawsuits is to increase patient safety. You can read the report for yourself here.

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Keep this out of health care reform

The President and Republicans sparred over health care in yesterday’s “bipartisan” meeting. One of Republicans’ favorite talking points is so-called “tort reform”- or restricting patients’ ability to hold negligent doctors and hospitals accountable for injuries they cause. They argue that liability limits will reduce health care costs.

The news out of Texas is that its comprehensive liability restrictions have not lowered costs at all. Despite its efforts to shield bad doctors, Texas health care costs have risen dramatically over the last six years.

Access to court is the only way that individuals can hold more powerful, sophisticated industries, such as doctors and hospitals accountable for wrongdoing.

Public Citizen sent a letter to Congress yesterday urging that it not include malpractice system changes in the health care bill, and to focus instead on the patient safety crisis facing the country.

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Cost of malpractice insurance steady or falling

New numbers from the Medical Liability Monitor show that 94 percent of medical malpractice insurance premiums have remained steady or dropped. Maggie Mertens over at NPR’s Shots Health Blog observes that the timing of this release is bad news for efforts to slip “tort reform” into the federal health care package.

No doubt it will be (and should be) tough to muster the political will to “rein in” costs that have remained constant or dropped for more than four years. Our recent report showed that the number of malpractice payments from medical providers to patients have fallen to a record low. If doctors’ liability insurance costs and medical malpractice payouts are both falling, Congress should be asking who the losers are in this system. Hint: It’s not the medical or insurance industries.

Between three and seven Americans die from medical errors for every one who receives a payment for any malpractice claim. The fact of the matter is it’s the medical errors that need to be reined in, not the claims. Congress should avoid the “tort reform” distractions and focus on real solutions to real problems, such as the decline of patient safety. Maybe if Congress sought to eliminate the epidemic of medical errors through simple important safety measures, then everyone would benefit.

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Medical malpractice victims to Congress: We are not frivolous!

Merlyna Adams of Louisiana sported a large round button on her lapel as she addressed reporters at a press conference yesterday. The button simply said: “I am not frivolous.”

Merlyna and eight families who have fallen victim to medical malpractice traveled to Washington, D.C., to ask their members of Congress to oppose proposals that would limit patients’ legal rights in the health care reform legislation.

Merlyna is a school principal whose medical treatment for a kidney stone in 2007 led to a lengthy stay in a hospital’s intensive care unit, congestive heart failure, renal failure, pulmonary failure and amputation of both her hands and her legs below the knee.

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Manhattan Institute still allergic to facts, reasoned debate

By David Arkush

Arguing with the likes of the Manhattan Institute about medical malpractice litigation isn’t much fun anymore. We’ve proved them wrong time and again, and it looks like they’re running out of gas. The Manhattan Institute’s latest piece misrepresents our analysis and accuses us of an odd mistake: responding to arguments about medical malpractice litigation in the terms in which they are made.

A little history: For years, enemies of the courts – doctors, liability insurance companies, and groups like the Manhattan Institute – have argued that a torrent of frivolous lawsuits against doctors have been driving up the costs of medical care. As everyone knows, medical costs have skyrocketed, with yearly spending increasing from $1.2 trillion to $2.5 trillion in the last ten years alone. The dream of these court deformers was to pin with the problem on lawsuits. But the math just doesn’t work. We’ve shown year after year that medical liability, even generously defined, is a tiny fraction of overall health care costs. Currently it’s at historic lows – just 0.58 percent of health care costs – while those costs are still skyrocketing.

With the evidence overwhelmingly against them, many deformers have changed the subject. They talk about so-called “defensive medicine,” which has extremely little empirical support – meaning that they can

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We wish we hadn’t been right about this

A few weeks ago, we warned you that Congress might become distracted by lobbyists seeking to shield negligent doctors and hospitals from accountability. Today, at least 23 amendments to the health care bill would do just that, weakening our right to hold negligent providers accountable when they cause severe permanent injuries or death.

In fact, the woefully inadequate health care bill introduced by Senator Max Baucus (D-Mont.) already endorses money for experiments with substitutes for the civil justice system.

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