What are the factors driving the rising costs of healthcare?

[member 5645]

Kerry picked Edwards...

Sorry Democrats, but I think that has just about made up my mind for this election year. No 'dark side' ticket for this poster.

Is there any third parties, besided nader, that I can vote for in disgust of my election options?

 

[russ_watters]

Is there any third parties, besided nader, that I can vote for in disgust of my election options?

How about a write-in for Howard Stern? Seriously.

 

[wasteofo2]

Or a write in for Howard Dean :rofl:

 

[Ivan Seeking]

Kerry picked Edwards.

That was predictable. I was hoping for a surprise.

 

[Ivan Seeking]

Okay, I'm writing in Jesse Ventura and Jesse Jackson.

 

[Gokul43201]

The folks over at the New York Post were surprised to hear that it was Edwards. The Post had just named Gephardt as the running mate in a front page exclusive.

http://www.smh.com.au/articles/2004/07/07/1089000163898.html?oneclick=true

 

[loseyourname]

You can always write in Gray Davis. He's got nothing better to do.

 

[check]

Well, of the realistic choices I think Edwards was the best... But I'm still disappointed that it's not a Kerry/McCain ticket. Oh well.

 

[GENIERE]

Yeah! A McCain-Kerry duo is a strong ticket. It would be much stronger if Kerry weren’t on it. Strange people these liberals who have no qualms about casting a vote for a lifelong conservative such as McCain. He’s not a moderate Republican; he’s not a liberal in disguise. He’s a real-life, walking, talking, conservative. On the key liberal issues, he has a 0% voting record. The ACLU despises him. I can certainly see why a conservative might vote for McCain, but a Democrat would violate his most basic values. Oh, I get it. There are no values to violate.

Perhaps we all should take McCain’s advice and vote for Bush.

 

[revelator]

I can certainly see why a conservative might vote for McCain,but a Democrat would violate his most basic values. Oh, I get it. There are no values to violate

Isn't that similar to Michael Moore saying that you can't argue with conservatives on moral grounds as they have none, you must appeal to their greed.

In your case and Moore's case, it's a pretty ignorant thing to say.

 

[member 5645]

Okay, I'm writing in Jesse Ventura and Jesse Jackson.

I would sooner vote that pair over almost anything with Edwards on it.

 

[revelator]

I don't know very much about Edwards. What's wrong with him?

 

[member 5645]

I don't know very much about Edwards. What's wrong with him?

My main problem is that he made his millions suing OBGYN's for problems with babies that weren't the doctors' fault. In one case an award of ~$20million was issued. He went through several dozen 'expert witnesses' before he could find one to corraborate his case.
He's against tort reform and is in bed with the trial lawyer unions.
This is not even mentioning his lack of experience.

This is the epitome of what I DON'T want in a leader.

 

[Njorl]

Edwards is significantly more experienced than Bush was 4 years ago.

Arguing against Edwards for being a successful lawyer is nonsense. Would you be happier if those injured by doctors had no recourse? Would you be happier if he was bad at his job? John Edwards never decided a single court case. He never established a single monetary settlement. If you don't like the jury awards, or the judgements, your problem should be with them. If he won a case that was not meritorious, your problem should be with the other lawyer. If you don't believe in the adversarial justice system, your problem is with the United States of America.

Medical malpractice kills almost 100,000 Americans a year. It injures many times that number. Injuries at birth require a lifetime of care, often costing tens of thousands of dollars per year. There is no punishment for medical incompetence other than private lawsuits. For that reason, punitive damages are the only means to stop insurance companies from insuring (and so stop hospitals from hiring) incompetent doctors. Tort reform is a sham designed to make it economical to employ incompetent doctors.

If the AMA does not want juries incorrectly finding against competent doctors, they should reverse their policy of protecting incompetent doctors at all costs.

Njorl

 

[member 5645]

Edwards is significantly more experienced than Bush was 4 years ago.

Arguing against Edwards for being a successful lawyer is nonsense. Would you be happier if those injured by doctors had no recourse? Would you be happier if he was bad at his job? John Edwards never decided a single court case. He never established a single monetary settlement. If you don't like the jury awards, or the judgements, your problem should be with them. If he won a case that was not meritorious, your problem should be with the other lawyer. If you don't believe in the adversarial justice system, your problem is with the United States of America.

Medical malpractice kills almost 100,000 Americans a year. It injures many times that number. Injuries at birth require a lifetime of care, often costing tens of thousands of dollars per year. There is no punishment for medical incompetence other than private lawsuits. For that reason, punitive damages are the only means to stop insurance companies from insuring (and so stop hospitals from hiring) incompetent doctors. Tort reform is a sham designed to make it economical to employ incompetent doctors.

If the AMA does not want juries incorrectly finding against competent doctors, they should reverse their policy of protecting incompetent doctors at all costs.

Njorl

blah blah blah... the other lawyer didn't go through his dozens of expert witnesses trying to find one to support this claim. This is a great character story IMO. It shows Edwards true colors.
The system IS screwed up, and Edwards is against tort reform, and for protectionism. ATLA is his best friend.

Protecting incompetent doctors? Perhaps I am more sensitive to this all since I am in Texas, but in 2001, 52% of Texas physicians were sued for malpractice. You're telling me that is right? that is what is supposed to be happening?? That is a lawyer problem, not a doctor problem.


EDIT - and let's not forget that he is also against tort safety for doctors who donate their time to do free procedures. A doctor goes to help for a day at an inner city area, short of doctors from huge tort, and in exchange he gets sued for his FREE assistance.

 

[member 5645]

And I guess with the idea that it's the jury's fault, not edward's case, then this won't matter:

Yes yes, I can see that it's a conservative domain name...
http://www.cnsnews.com//ViewPolitics.asp?Page=\Politics\archive\200401\POL20040120a.html

Wallstreet journal story on edward's favorite, 'baby brain damage' cases:
http://www.manhattan-institute.org/html/_wsj-delivering_justice.htm

Tons more where this comes from www.google.com
Edwards cases were built on sifting through tons of witnesses and flaky science. Despite this, he still supports no tort reform.

 

[selfAdjoint]

Perhaps I am more sensitive to this all since I am in Texas, but in 2001, 52% of Texas physicians were sued for malpractice. You're telling me that is right? that is what is supposed to be happening?? That is a lawyer problem, not a doctor problem.

Sounds like a Texas problem.

and let's not forget that he is also against tort safety for doctors who donate their time to do free procedures. A doctor goes to help for a day at an inner city area, short of doctors from huge tort, and in exchange he gets sued for his FREE assistance.

So incompetent doctors who practice on poor people for free should not be attacked? What about the poor victims of the incompetence, should they be told "Tough luck, but remember you got damaged for FREE!".

 

[Njorl]

blah blah blah... the other lawyer didn't go through his dozens of expert witnesses trying to find one to support this claim.

So the other lawyer was an incompetent dunce. How is this a problem with John Edwards?

This is a great character story IMO. It shows Edwards true colors.

I'm glad you realize that. He believes that you should do your job well. If all Americans were as vigilant and hard working I'm sure our country would be greatly improved.

The system IS screwed up, and Edwards is against tort reform, and for protectionism. ATLA is his best friend.

Good for Edwards. "The system" is still skewed toward large corporations. There is no state mechanism in place to force them to pay you just damages, even if they commited a crime in injuring you. A trial lawyer working for a contingency fee is the only recourse for ordinary people injured by any corporate entity. Large corporations don't like that. It is in their economic interest to injure people with impunity.

Protecting incompetent doctors? Perhaps I am more sensitive to this all since I am in Texas, but in 2001, 52% of Texas physicians were sued for malpractice. You're telling me that is right? that is what is supposed to be happening?? That is a lawyer problem, not a doctor problem.

No, that is a doctor problem. Because it is known that incompetent doctors are free to practice, it makes it likely that a medical mishap was caused by incompetence. If doctors don't want to be sued, they should make it unprofitable for lawyers to sue. The only way to do that, is to strip incompetent doctors of their right to practice. If the AMA would eliminate 90% of the incompetent doctors, lawyers would find that they were losing a disturbingly large number of cases. After losing cases, they would hesitate to sue. Instead, the AMA fights every medical incompetence finding tooth and nail. There are no incompetent doctors, according to the AMA.

For forty years there have been stories of wrong limbs being amputated, left instead of right. There is a simple solution. Every medical school in the country should adopt exactly the same regime to denote which side of the body a limb should be amputated from. Very simple. In one generation the problem will vanish. It still has not been done. It can not be done. It can not be done because the AMA would have to admit that its past practices were flawed in an obvious manner. Since no doctor has ever made a mistake, that just can't be.

EDIT - and let's not forget that he is also against tort safety for doctors who donate their time to do free procedures. A doctor goes to help for a day at an inner city area, short of doctors from huge tort, and in exchange he gets sued for his FREE assistance.

Perhaps we should also issue liscences to philanthropists allowing them to hunt and kill a few poor people, depending on how much they give.

So, because the victim of incompetence is poor, they should be allowed to be mutilated and killed with impunity? Say some doctor doesn't bother washing his hands between patients and spreads a lethal resistant strep infection to 20 people whom he treated for free. He should be forgiven? And you know who are the biggest violators of hospital policies about handwashing are - not orderlies not nurses, it's doctors.

The biggest problems in medical malpractice law would be most effectively alleviated by eliminating a significant number of incompetent doctors.

No inner city area in this country is short of doctors because of torts. Poor areas are short of doctors because they are short of people with health insurance. Any effect of torts would be at a state level.

Njorl

 

[member 5645]

1>Sounds like a Texas problem.




2>So incompetent doctors who practice on poor people for free should not be attacked? What about the poor victims of the incompetence, should they be told "Tough luck, but remember you got damaged for FREE!".

1>For now...
2>As I have posted, this isn't just incompetent doctors being sued. But Yes. I know I would not be willing to risk a lawsuit, my livliehood. I would be thinking "I'd love to donate my time, but **** the risk!" You ARE aware that many other groups of people are protected from prosecution. Good samartin laws in my area keep that from happening, so that you can't be charged with HELPING. Malpractice and gross negligence are not one in the same.

 

[member 5645]

Njorl, with an argument like "all the lawsuits are just happening because they are witch hunting the really bad ones, and it's okay", I think we shall discontinue this.

Kerry canceled my vote with this move. Done and done.

 

[Njorl]

Just one little note about "Texas medicine".

No doctor in Texas has had his liscense revoked for incompetence since 1997.

Now, either there is something about Texas that makes medical incompetence impossible, or it doesn't matter how badly you screw up, you can't get your license revoked.

All I have to say is, "Hi eveybody!"

http://www.simpsonscollectors.com/wospdb/figure.asp?fig=f0112

Njorl

 

[member 5645]

Just one little note about "Texas medicine".

No doctor in Texas has had his liscense revoked for incompetence since 1997.

Now, either there is something about Texas that makes medical incompetence impossible, or it doesn't matter how badly you screw up, you can't get your license revoked.

All I have to say is, "Hi eveybody!"

http://www.simpsonscollectors.com/wospdb/figure.asp?fig=f0112

Njorl

Claims against Texas physicians doubled from approximately 16 per 100 physicians in 1996 to more than 30 in 2000. In the Lower Rio Grande Valley, the number of claims filed is growing at 60 percent a year. (Texas Department of Insurance)

I guess the doctors here are getting 'doubley' bad every 5 years! It can't be that the lawyers are hopping on the bandwagon. Malpractice is not the same as the gross negligence that Edwards and his pals claim caps would target.

Secondly, your statement is highly misleading. Since 1997 no doctor has had their license revoked for medical malpractice. They have been revoked for gross negligence, drug abuse, and prescription misuse.

 

[check]

Anyone else think that a universal healthcare system would significantly reduce the number of (frivolous) lawsuits brought against doctors and hospitals?

 

[Njorl]

Claims against Texas physicians doubled from approximately 16 per 100 physicians in 1996 to more than 30 in 2000. In the Lower Rio Grande Valley, the number of claims filed is growing at 60 percent a year. (Texas Department of Insurance)

I guess the doctors here are getting 'doubley' bad every 5 years! It can't be that the lawyers are hopping on the bandwagon. Malpractice is not the same as the gross negligence that Edwards and his pals claim caps would target.

Secondly, your statement is highly misleading. Since 1997 no doctor has had their license revoked for medical malpractice. They have been revoked for gross negligence, drug abuse, and prescription misuse.

I saw none for gross negligence.

Just drug abuse and sexual misconduct. That was as of May 11, 2004.

Njorl

 

[Njorl]

Anyone else think that a universal healthcare system would significantly reduce the number of (frivolous) lawsuits brought against doctors and hospitals?

Well, it would reduce them to zero if we had universal health care like Britain. You can't sue in that system. If you are injured in a way requiring medical care, that is already free. If you lose the ability to earn, you are put on welfare.

Even I wouldn't go that far.

It isn't really a big issue. There is not that much money involved, on a percentage basis.

You can find lots of statistics that show how much individual specialties pay, or how big some settlements are, or how much premiums change on a percentage basis.

Numbers you never see are total premiums paid, total lawsuit reimbursements and total physician earnings. New Jersey state law requires premiums be tallied. That is the only state for which I could find this info. It turns out that in New Jersey, doctors pay 3.2% of their salary on average for malpractice insurance. Specialists like anaestesiologists, neurosurgeons and ob/gyn's have higher premiums, but also make more.

It is also a myth that payouts affect premiums in the manner that we've seen recently. All insurance companies make money by playing the stock market. It is assumed that an insurance company will gauge the risk of insuring a physician well enough to make a profit by investing premiums in a broad array of stocks. During the 90's, stocks were rising so fast that the competition to get insurance premiums was fierce. Premiums were artificially supressed by an overperforming market. With the plunge in stock values, all insurance companies lost money. Many went bankrupt. This reduced competition. Malpractice insurance became a sellers market. To make up losses, those companies that stayed in business were free to raise their rates drastically without fear of losing business. The amounts of money involved in malpracticed suits is laughably small in comparisson to the money lost by insurance companies in the stock market.

Njorl

 

[russ_watters]

Sounds like a Texas problem.

Its a Pennsylvania problem too - a lawyers in PA problem, to be more specific.

Anyone else think that a universal healthcare system would significantly reduce the number of (frivolous) lawsuits brought against doctors and hospitals?

If coupled with tort reform, certainly - but then, why not just do tort reform on its own?

 

[check]

but then, why not just do tort reform on its own?

Because a universal healthcare system would serve the populous better than just tort reform.

 

[Njorl]

The AMA has staged some propaganda events in Pennsylvania to bring attention to the flight of doctors to other states. The problem is, it just isn't happening. Pennsylvania has increased its per capita physician level every year recently.

Doctors want more money. Insurance companies want more money. Trial lawyers want more money. That's all it is. There is no tort crisis; no malpractice award crisis. There is a medical malpractice crisis. Roughly one out of forty deaths is due to an avoidable medical error. That's well over double either drunk driving or homicide.

Njorl

 

[member 5645]

Because a universal healthcare system would serve the populous better than just tort reform.

DO NOT open that can of worms. I will vote for ANY politician that opposed a politician supporting a Socialized healthcare system. IT is the single biggest issue that trumps all others in my eyes for an election.

 

[member 5645]

Numbers you never see are total premiums paid, total lawsuit reimbursements and total physician earnings. New Jersey state law requires premiums be tallied. That is the only state for which I could find this info. It turns out that in New Jersey, doctors pay 3.2% of their salary on average for malpractice insurance. Specialists like anaestesiologists, neurosurgeons and ob/gyn's have higher premiums, but also make more.

l

How interesting, since New Jersey inacted malpractice tort reform laws, including a 78 million dollar pot to subsidize the doctors malpractice insurance costs.
Nice example...

 

[adrenaline]

As someone who many times is forced to vote as a democrat, it was smart of Kerry to choose someone who can harvest some Southern votes. I also like Edward's position on the persistent racial problems that still simmer in our nation. However,if Edwards hopes to be Vice President someday then I would suggest that he learn three important lessons:

#1. Manipulating the system for the benefit of a hand picked few does not mean that you are a defender of the poor and downtrodden.

#2. Attacking and exploiting important sectors of our society such as health care and insurance for the benefit of a small subset of the population is bound to have bad, unintended consequences that will affect everyone.

#3. Being Vice President of the United States means that you are a leader to all Americans not just victims of Cerebral Palsey or the poor or the unemployed


There are exceptions to this generalization, however, but as a trial lawyer, He/her will often put the client’s interest above the greater good. That is the nature of the lawyer/client relationship and of trial law in this country.

I believe that lawyers like John Edwards undermine our legal system. They can ignore data, science and greater good, and they do regularly. They are doing their job - and Edwards does that job well.

I admire his skill, but I disdain what his cases do to our legal system. I do not blame him, but I do not want someone with his attitude about the law as my vice president and potentially, president. If I needed a good trial lawyer, I'd hire him.

We need tort reform, and not just in medicine. Our legal system in so many aspects of society bog down and hinder production. Small business owners can't even survive some insurance premiums and protection umbrella systems that is now necessary. With Edwards in second in command, any hopes of reform will probably vanish. The court system, as used in this country, does not protect the public good.

We need a change from Bush but since Edwards represents the current sorry state of affairs, he scares me




And to add a further rant, Edwards made his money suing doctors who 'didn't perform C-sections soon enough' and thus 'condemned the children to suffer cerebral palsy.' The argument makes the science surrounding global warming seem like Gospel Truth. As a result of such lawsuits, there are now more than four times as many Caesarean sections as there were in 1970. But curiously, there has been no change in the rate of babies born with cerebral palsy. As The New York Times reported: "Studies indicate that in most cases, the disorder is caused by fetal brain injury long before labor begins." All those Caesareans have, however, increased the mother's risk of death, hemorrhage, infection, pulmonary embolism and Mendelson's syndrome.

How charming that Edwards cares about cerebral palsy babies...look at his legislative record in North Carolina: Edwards was one of the leading opponents of a bill in the North Carolina Legislature that would have established a fund for all babies born with cerebral palsy. So instead of all disabled babies in North Carolina being compensated equitably, only a few will win the jury lottery -- one-third of which will go to trial lawyers like Edwards, who insists he doesn't care about the money.

 

[adrenaline]

Let me introduce facts regarding the general misconception of tort reform.

People have a misconception of the AMA. For instance, the AMA, is mainly for nationalized insurance or health care of some kind...something the general population does not realize.

Just to be clear, the AMA does not oppose compensating an injured patient for medical expenses and lost wages. If there's been a wrong, they want it made right.

And the AMA also want accountability for all -- for attorneys and physicians -- and that includes those who give false testimony using junk science to perpetuate a meritless claim that should not have been brought in the first place. They still want bad doctors to get out of practicing medicine.

Reform based on actuarial evidence and not political expediency. National reform that does not undermine the effective state reforms already in place.
Their quest is to maintain access for patients in their hour of need. The current system is destroying access.



Right now, the medical liability insurance companies are a convenient scapegoat, but they are required by law to make conservative investments. They typically place about 80% of their investments in the bond market -- not the stock market. According to A.M. Best Co., the investment yields of medical liability insurers have been stable and positive for the last five years.

Thus, the issue on focusing on them detracts from the larger issue.... Errors can involve nurses, pharmacists, health technicians, aides -- in short, anyone who is working in the complex system of health care delivery. This word -- " system" -- is key to understanding how medical errors happen and how we can prevent them.

If you think the AMA is a "pawn," you are mistaken. Visit the Litigation Center on the AMA's Web site (www.ama-assn.org/go/litigationcenter). There you will find ample evidence that the AMA takes on insurers when we document that they have done harm to patients and physicians.

The Institute of Medicine and the Health and Human Services Dept. say most medical errors are not failures of physicians, but failures of the system. Even when doctors do their jobs correctly, most errors would still occur.

A better approach to fixing the problem of system errors would be to dispel the fear of physicians, hospitals and nurses that open discussion on adverse events would be discoverable in lawsuits. To stop errors, we need to prevent them through improved systems of safety, just as it has been done in the nuclear and aviation industries. The fear of being sued obviously discourages health care professionals from reporting problems when they happen. It hampers efforts to determine what went wrong and how to prevent it.


To truly protect patients, the AMA supports the Patient Safety and Quality Improvement Act or HR 663 -- legislation recently passed by the House of Representatives -- that would help create a voluntary, confidential error reporting system that allows review by experts, who report back to those involved on how to fix the system. The fix is then shared with all.

That is how the aviation safety reporting system works. Similar legislation, S 720, has been approved by the Senate Health, Education, Labor and Pensions Committee -- unanimously. In both chambers, the AMA has been immersed in bipartisan negotiations.
That's why the AMA support the Patient Safety and Quality Improvement Act (S 720), a proposed federal law that would allow the voluntary, confidential reporting of errors to patient safety experts. The result would be advice on how to improve the system and therefore patient safety. This system fix would be shared with all in a de-identified manner. This model works for the Aviation Safety Reporting System. It would work in the health care field, too. Right now, the current system does not help with an open discussion of errors.

The AMA continue to challenge the Assn. of Trial Lawyers of America to match our donations to the National Patient Safety Foundation. To date, they haven't offered one thin dime. Is this a hint that the trial lawyers are more interested in suing physicians than in saving patients?


Regardless of whose views prevail as to how to change the system, there will, ultimately, be change -- because patients will lose access to care as doctors retire early, limit their practice such as no longer delivering babies, or move to one of the six states that have more stable liability climates. Athens, on the third largest city in georgia just lost almost all its obstetricians. They were not asking for a raise, but when malpractice premiums are 1 1/2 times your salary, you can't survive. I don't know who is going to deliver my daughter's baby when she grows up, it will probably be a nurse midwife whose insurance coverage offers less reward value for the jury. (By the way, Edwards has limmited cases for a botched delivery preformed by a midwife or nurse practioner for this very reason.)

I disagree with the AMA on some things but their idea that we have to move away from a culture of shame and blame and towards a culture of prevention and safety is right on.


And for the record, the best doctors are the ones being sued. The average academic physician has 5 lawsuits vs. one in private practice at any given time. The qualifications and dedication of academic physicians are generally regarded as above those in private practice. (Work for less money and are on the cutting edge of information and research). This is because of the volume and complexity of the patients seen. 88% of those that go to trial are won in defense of the doctor. (The jury sees that the doctor did not commit negligence, the others may or may not have been negligence and may have been won with jury sympathy, like the cerebral palsey cases...and anyone can do some literature research to see how c sections don't affect the rate of cerebal palsey as this is a scientific forum and all.)

 

[member 5645]

To truly protect patients, the AMA supports the Patient Safety and Quality Improvement Act or HR 663 -- legislation recently passed by the House of Representatives -- that would help create a voluntary, confidential error reporting system that allows review by experts, who report back to those involved on how to fix the system. The fix is then shared with all.

Im glad you brough this up. I couldn't find the bill. I can't say how much I support this! It's fantastic idea.

 

[Njorl]

How interesting, since New Jersey inacted malpractice tort reform laws, including a 78 million dollar pot to subsidize the doctors malpractice insurance costs.
Nice example...

Oooh

If you add in that 78 million, the percentage rises from 3.2% to 4%. Still very far from a problem.

Damage caps have been shown to have no statistically noticeable effect on insurance premiums in any state.

New Jersey enacted "reform" because their rates were higher than average. So 4% of income for malpractice insurance is higher than average. There is no problem.

Njorl

 

[adrenaline]

Oooh

If you add in that 78 million, the percentage rises from 3.2% to 4%. Still very far from a problem.

Damage caps have been shown to have no statistically noticeable effect on insurance premiums in any state.

New Jersey enacted "reform" because their rates were higher than average. So 4% of income for malpractice insurance is higher than average. There is no problem.

Njorl

You are right, tort reform is more than limiting jury awards, although that is what makes the news and evokes little sympathy.

(However, I will tell you when they did limit noneconomic damages to 250,000 in Texas, state wide premiums went down... so the article is not accurate in its assessment about it not affecting premiums.)


First of all, we all want grieviously injured patients to be reimbursed and adequetly treated. Tort reform is not going to take that away.

But let's look at numbers before we say the insurance companies are all to blame: 10 years ago Georgia had over 30 malpractice insurers. We are down to five. It ain't that profitable and most know it. St. Paul our largest Nation wide insurerer quit basically because of this.

It is estimated that malpractice insurers will pay out approximately $1.40 in claims losses and direct expenses for every dollar of premium collected in 2001 and 2002 Even with significant rate increases, it is projected that insurers will be forced to expend $1.35 in claims costs and expenses for each premium dollar received in 2003.3 These figures are independent of investment gains or losses.


Mutual or reciprocal insurance companies, companies that are owned by the physician policyholders themselves, not outside shareholders, insure more than 60% of America’s practicing physicians. The primary mission of these companies is to provide insurance protection for practicing physicians. nonetheless, no company can long sustain losses of this magnitude and remain solvent, so premium rates have been forced sharply upward. MAG mutual, my insurance carrier has lost 1.12 for every dollar invested and at this rate will probably pull out of the whole business in 5 years.


Since 2000, mean rates across the country have increased between 10% and 20% annually. So our overhead increases automatically by 20% on a yearly basis while other reimbursement sectors continue to cut their payment. For instance, after 2006, Medicare will start cutting back payments for a total of 11% cut over five years (not even enough to keep up with inflation) and more docs will be leaving private sector or not treating Medicare patients. (The latter is becoming a reality...can't treat someone for essentially free and still make enough to pay exploding overhead payments that include liability .)

These averages obscure increases of 100% or more in some venues with unlimited liability in contrast to average increases of 5% to 10% in states that have passed effective tort reform statues In the states most severely affected, which include Pennsylvania, Nevada, West Virginia, Mississippi, Texas, and Florida, some physicians have been unable to find coverage at any price, or have been forced into state-run plans.

Despite the trial lawyers trying to blame malpractice rate increases on investments, the data argue that the problem is a cost problem. Trial lawyers speak persuasively, regardless of the data. That is their job! But the data prove them just sophists.

Though frequency has changed little over the past few years, it has stabilized at extraordinarily high levels. On any given day, there are more than 120, 000 malpractice actions pending against the physicians of the United States. One sixth of America’s physicians report a claim every year (The Doctors Company, unpublished data, 2002). For high-risk specialties, the numbers are even larger. The average neurosurgeon reports a claim every other year (The Doctors Company, unpublished data, 2002). Expressed differently, 50% of America’s neurosurgeons are sued every year. More than 30% of orthopedists, obstetricians, trauma surgeons, emergency department physicians, and plastic and reconstructive surgeons are sued every year (The Doctors Company, unpublished data, 2002).

And the number of lawsuits has nothing to do with competance. To say he/she is less compentant because they have more lawsuits is fallacious.

Approximately 70% of all these claims are closed with no payment to the plaintiff, but each one costs an average of $22,967 to defend adding an enormous expense that must be calculated into the cost of insurance.

This last sentence is the one that most opponents of tort reform ignore. We cannot just look at settlements and judgements; we have huge costs even in frivolous claims.


Wrongful death is abhorent. No monetary settlement can really right that wrong. However, huge payments add a second injury to the first. Physicians do not pay the $5.7 million.

Society pays.

Society pays through decreased access to the benefits of medical care.

Society pays through increased defensive medicine. Society pays as the doctor patient relationship becomes eroded. Physicians feel under siege. Many view each patient as a potential litigant.

In this atmosphere, California has the best track record.


A $250,000 cap on non-economic, not economic damages. Thus, a person can win millions of dollars in economic damages, lost wages, potential earned income etc. and this is not included in the award decision. The non-economic damages are what drives most of the frivilous lawsuits. As for pain and suffering, no one can put a price of that.


2nd, initiate the collateral source rule. This prevents double collection for the same damages. For example, if an injured patient has already had lost wages or medical costs covered by disability or medical insurance, recovery is not duplicated in a malpractice award.

We also need a provision for periodic payments. This allows damage awards to be paid over the period they are intended to cover.


3rd... limit attorneys’ contingency fees. MICRA provides for a sliding scale; a plaintiff’s attorney keeps 40% of the first $50 000 of an award but “only” $221, 000 (plus expenses) of a $1 000 000 judgment. This allows more of an award to actually reach the injured patient. The difference is significant. A patient with a $1 000 000 award in a state with a contingency fee of 40% must give $400 000 (plus expenses) to his or her attorney.


88% of trials that go to jury in Georgia are won by the doctors. Any other profession (tort lawyers) with such an 88% failure rate would be out of business. What this shows is the lawyers are bringing to trial many cases that don't have much of a leg to stand on. Perhaps, an independant body of reviewers who can review the case for legitimicy would be a good start. It is these 88% that really tax the system! not the remaining 12% which are probably valid cases and the victims need to be reimbursed. I spent $50,000 extracting myself from a lawsuit just because I treated the person for asthma 2 weeks before she got a severe infection from her spinal implants from her spinal surgery. They just threw out a net and roped anyone and anything that had contact with her before her severe illness. However, there is no valid mechanism of such innocent bystanders throwing off the net without expensive and timely legal proceedings just to say...oh yeah, you didn't need to be named in the suit.

The problem is much larger than jury settlements.

The Pennsylvania example is fallacious. There exists almost no specialties in certain fields since they have fled the state (almost no gastroenterologists who were hit especially hard for some inexplicable reason) and an influx of primary care physicians skewed the numbers to show there are more doctors. West Virginia has almost no cardiologists. If you have a heart attack, pray for a good internist who can retevase (thrombolyse) you, stabilise you and transfer you out of state for life saving angioplasty or open heart. This can take days to find a hospital willing to accept you.