Why does tort reform keep getting mentioned in healthcare debates?

[Damuri_Ajashi]

@Fotheringay-Phipps

That’s a valid cite (though worth reading the study itself vs just the opinion column in the LAT).

But there’s room to quibble. There’s one big assumption in that study, which is that the only costs that result from defensive medicine are those which are completely due to defensive medicine concerns. I’m not sure that’s true (a lot would depend on how the surveyed doctors understood the question).

Also, it would make sense to me that a lot of doctors would convince themselves that what they’re doing has at least some value rather than being 100% useless and due only to defensive medicine. So it would make sense for the amount to be bigger than what’s self-reported by doctors (and especially on a non-anonymous survey).

All that said, it’s not like tort reform is some sort of magic cure all, and studies like this tend to undermine anyone who would claim it is that.

Almost ALL forms of tort reform comes in the form of caps on damages. Doctors will not decline to order tests to save the insurance company some money just because their liability is now capped at $500,000 for pain and suffering (unlimited for all actual economic damages).

There is no simple form of tort reform that solves this. You need to change burdens of proof and professional standards and all sorts of other shit (primarily get the jury out of the equation) in order to give doctors the confidence to follow best practices rather than “cover my ass” practices.

[Northern_Piper]

@lance_strongarm

Not weird. They are simply extensions of the state.

Difference between US and Canadian perspectives, then.

In Canada, only the federal government and the provincial governments can claim Crown immunity. Municipalities are not part of the Crown and cannot. (And in any event, the federal and provincial governments have by statute largely eliminated Crown immunity from suit.)

[Fotheringay-Phipps]

@Damuri_Ajashi

Almost ALL forms of tort reform comes in the form of caps on damages. Doctors will not decline to order tests to save the insurance company some money just because their liability is now capped at $500,000 for pain and suffering (unlimited for all actual economic damages).

There is no simple form of tort reform that solves this. You need to change burdens of proof and professional standards and all sorts of other shit (primarily get the jury out of the equation) in order to give doctors the confidence to follow best practices rather than “cover my ass” practices.

I’m not advocating for any particular form of tort reform, and it’s possible that there are better ways to deal with it. I’ve just been discussing the extent to which defensive medicine might impact overall healthcare costs.

But FWIW, I’m not sure I agree with your logic here. To the extent that the payoffs are capped then two things would follow. 1) Patients - and more importantly, lawyers working on contingency fees - would have less incentive to file long-shot lawsuits where the lower likelihood of prevailing is offset by the possibility of huge payoffs. And 2) insurance companies would have less incentive to settle cases which have little merit, since they’re not staring at huge payouts on the off chance that they lose.

But as it stands now, I think the unlimited p&s awards tend to incent cases that have little merit to be brought, and settled. [I’m aware that some of the more sensational amounts tend to be reduced by the judge, but nonetheless they can be pretty big, which is why the cap is a big deal for both sides.]

[Really_Not_All_That_Bright]

Here, everything under the state level is a subdivision of the state and more or less exists at the pleasure of the state. We have things called “charter counties” in Florida that enjoy more autonomy than other counties and more control over their constituent towns and cities. There are even state- or locally-chartered corporations that enjoy sovereign immunity.

[lance_strongarm]

@Damuri_Ajashi

Not entirely but its about as effective as reducing medical costs as an AWB would be at reducing gun deaths or a vaginal probe would be at reducing abortions.

It’ll make a difference around the edges.

Perhaps, but at what cost to those who deserve compensation for malpractice?

[Northern_Piper]

@Really_Not_All_That_Bright

Here, everything under the state level is a subdivision of the state and more or less exists at the pleasure of the state.

Same for municipalities here, but that doesn’t make them part of the Crown, so no immunity.

[Northern_Piper]

Still curious if there is any information about how high “pain and suffering” / “loss of enjoyment of life” non-pecuniary damages can be in the US?