Bush's Tort Reform Will Kill People

[XT]

@pervert

This assertion needs some clarification. In the case brought up by the OP, it seems perfectly reasonable to me that both docotrs could have reasonably thought their course of treatment was the best possible option. I’ll add the caveat that we don’t have many details, and it is still possible that there was some obvious sign which they both missed. But without such evidence (hell even a claim that such a sign existed would be something) we really cannot make the claim you do here even for this case. It is much more difficult to make such a claim for all medical cases. Sometimes people get sick and die. Rarely, they do so very quickly. It is simply ludicrous to suggest that every time a person dies who might have been saved that someone committed a crime or that they must pay. It is just as possible (in fact, IMHO more likely) that the result (death) was simply an atypical occurance.

And I also don’t see how or why having no limits on lawsuits, or conversely putting caps on them will cause more or less deaths…and certainly the OP has done exactly zero to make his/her case that it would, despite repeatedly being asked to provide such facts. As you say, sometimes people get sick and die. More rarely, they get sick and die because of a real (as opposed to a perceived) fault by a doctor or hospital. But to me its ludicrous to think that doctors would allow patients to die more frequently if only they didn’t have the sword of unlimited lawsuits floating over their heads. Its going to take sometime more than hot air to convince ME that this is the case anyway…some of those fact things would be nice.

-XT

[Sam_Stone]

If a doctor has malpractice insurance, why would he care how high the liability cap is?

I’ve read that one of the reasons health care is so expensive in the U.S. is not just high malpractice insurance costs, but the fact that doctors have to do excessive amounts of diagnostic medicine just to cover their asses. i.e. will the result of this case now mean that doctors are going to have to screen every single person who complains of breathing difficulties for pneumonia, whether they fit the profile or not? If you go to the doctor complaining of a headache, is he going to have to send you for a CT scan, “just in case”?

Also, if the amount of liability is capped, wouldn’t that lead to fewer ambulance chasers? It seems to me that if there’s a potential 100 million dollar windfall, lawyers are more likely to file frivolous lawsuits. They can afford to lose 100 cases for every one they win, if the one they win is the jackpot. Put a cap on awards, and suddenly that economic model goes out the window. If a lawyer can only hope to earn half of a $250,000 award, and it costs him $50,000 to take the case to trial, then he’s not going to do it unless he’s got a better than 50% chance of winning (considering opportunity cost).

[Sam_Stone]

BTW, the Bush adminstration says that the malpractice cap could lower medical costs by 5-9%, and they base that on a peer-reviewed study from Stanford.

Here is that study. And here’s a quote from the conclusion:

We present four findings. First, physicians from states enacting liability reforms that directly reduce malpractice pressure experience lower growth over time in malpractice claims rates and in real malpractice insurance premiums. Second, physicians from reforming states report significant relative declines in the perceived impact of malpractice pressure on practice patterns. Third, individual physicians’ personal experiences with the malpractice system are a key determinant of the perceived importance of defensive medicine: Physicians who have had a malpractice claim filed against them, particularly a recent claim, are more likely to report changes in practices as a result of malpractice pressure than physicians who have not. Fourth, the impact of individual physicians’ claims experience on perceptions is smaller in reforming than in nonreforming states. Taken together, these results suggest that reforms in law affect physicians’ attitudes, both by reducing the probability of an encounter with the liability system, and by changing the nature of the experience of being sued for those physicians who defend against malpractice claims.

These results validate our previous research by illustrating how reforms change physician incentives. Our 1996 study showed that reforms changed physician behavior, but stopped short of investigating the mechanism by which reforms altered medical practices.57 Our current results, however, indicate that mechanisms commonly cited by physicians in anecdotal reports namely the frequency and severity of malpractice claims may play an important role in fostering defensive medical practices. Reforms appear to affect practices particularly through their impact on the attitudes of physicians who experience lawsuits. In this paper, we did not explicitly model why attitudes of physicians who are sued in states with reforms are less dramatically affected [*pg 106] than attitudes of physicians in states without reforms.58 However, the differences we find here suggest that malpractice claims are less onerous in states with reforms, providing a foundation for their differential impact on physician attitudes.

In addition, our results suggest that physician surveys do relate to actual behavior. The fact that state-level reforms both reduce measures of malpractice pressure and reduce physician perceptions of the impact of malpractice pressure suggest that survey methods provide valid measures of defensive practices. Nonetheless, further investigation of the extent of the validity of survey methods will be a fruitful topic of further research. Because the format of the 1984 and 1993 questions regarding the impact of malpractice pressure on practice patterns were not comparable,59 we needed to assume that impact of the change in the questions’ terms was uncorrelated with physicians’ personal characteristics and uncorrelated with geographic area in order to identify the impact of law reforms on relative changes in the rates of reported malpractice-pressure-induced changes in behavior. Future research might investigate the validity of our assumption, or might seek to replicate our results with comparable survey questions. In addition, our results suggest that physician surveys do, in part, measure negative feelings about the malpractice system, or unobserved differences across physicians, rather than the targeted issue of the impact of malpractice pressure on perceptions and practice patterns. Malpractice claims history has a strong positive correlation with perceived changes in malpractice-pressure-induced changes in practices, and more recent history is more strongly correlated with perceived changes than is less recent history. Future research might investigate the extent to which these findings represent actual changes in practices, rather than the well-studied problem of response bias.

On the other hand, the GAO points out that the Bush administration is extrapolating this study into all aspects of health care, when it only focused on heart patients in a hospital setting. So the numbers may not be accurate. But the study in question certainly shows that, at least in the case of heart patients in a hospital, liability caps do make a difference in health care costs.