NCPA - National Center for Policy Analysis


August 4, 2009

Health care reform is bogged down because none of the bills before Congress deals with the staggering waste of the current system, estimated to be $700 billion to $1 trillion annually.  The waste flows from a culture of health care in which every incentive is to do more; yet, congressional leadership has slammed the door on solutions to the one driver of waste that is relatively easy to fix: expensive and time-consuming malpractice system, says Philip Howard, chairman of Common Good, a nonprofit legal reform coalition.

What are they scared of?  The answer is inescapable -- such expert courts might succeed and undercut the special interest of an influential lobby, the trial lawyers.  An expeditious and reliable new system would compensate patients more quickly and at a fraction of the overhead of the current medical justice system, which spends nearly 60 cents of every dollar on lawyers' fees and administrative costs.

Even more compelling, expert health courts would eliminate the need for "defensive medicine," thereby helping save enough money for America to afford universal health coverage, says Howard:

  • A 2005 survey in the Journal of the American Medical Association related that 93 percent of high-risk specialists in Pennsylvania admitted to the practice, and 83 percent of Massachusetts physicians did the same in a 2008.
  • Defensive medicine is notoriously hard to quantify, but some estimates place the annual cost at $100 billion to $200 billion or more.
  • But containing costs requires overhauling the culture of health care delivery; therefore, incentives need to be realigned and a legal framework that encourages doctors to focus on is needed.

Furthermore, traditional tort reform is not sufficient to end defensive medicine, says Howard.  The key is reliability.  Reliable justice would protect doctors against unreasonable claims and would expeditiously compensate injured patients.

Source: Philip K. Howard, "A better model for malpractice system," Dallas Morning News, August 3, 2009.


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