This issue is mainly centered on reform in the area of medical mal- practice. America’s health care system is hinged on the ability of physicians in the U.S. to practice medicine with the best interests of the patient in mind. In this day and age physicians are forced to limit their practices to low risk procedures. America’s physicians can no longer take on patients without a complete background check to see if they are sick or simply in the business of searching for their next lawsuit. Tort reform in the area of medical malpractice will drastically improve the quality of healthcare in the United States. President Bush has proposed setting a $250,000 cap on non-economic damages.
The fight over tort reform with respect to medical malpractice has been going on for over 30 years. It has been rekindled in the past ten years due to the tremendous spike in malpractice insurance premiums.
Physicians are currently paying anywhere from $30,000 to $200,000 annually for insurance. When one combines the out of control insurance premiums and the cost of practicing defensive medicine, it is easy to understand why there are such low incentives to enter the medical field. When people talk about doctors, they seem to harp on the amount of money physicians earn. And why shouldn’t they? After all, these men and women did nothing in the way of education or painstaking work to get to where they are; they simply pulled the doctor card out of a magical hat and are now on easy street.
Tort reform is a simple issue when one looks at it from a humanistic point of view: if doctors are forced to practice defensive medicine, patients lose. In Fairfield County, Connecticut, not only have more and more physicians stopped performing high risk and sometimes life saving procedures and removed themselves from HMO panels, but also are being forced to decline patients with Medicaid and/or Medicare insurance. They have also reduced the amount of free or charity care given to patients without insurance or for other reasons. If reform is not enacted soon, patients will likely find themselves with an even greater reduction of medical services, an ever increasing shortage of specialists and higher costs. Another important and sometimes overlooked issue is the recruitment of new physicians. Doctors say it is increasingly more difficult to recruit new physicians into their practices, keeping up with staffing requirements and upgrading their medical and business technology so that they are on par with the most advanced patient care.
The Bush administration is trying to model its proposal for medical liability reform on MICRA. MICRA (Medical Injury Compensation Reform Act) was enacted in California in 1975. It allows plaintiffs to win no more than $250,000 in non-economic damages or pain and suffering. Along with capping non-economic damages, MICRA limits attorney contingency fees, thus limiting the incentive for lawyers to push their clients to go to trial. Before MICRA was enacted in California, malpractice rates were climbing as much as 100% annually. After the act was passed by the state legislature, rates fell to nearly single digits.
The Bush administration can simply cite the success of MICRA in order to promote their own national proposal. Other states have also taken strides in the right direction towards reform. Florida, Texas and Pennsylvania are a few of the dozen states that have passed some form of medical liability tort reform. California’s MICRA is, however, the most stringent and most effective. Even in states with reform, insurance premiums are out of control. An obstetrician in Miami may find themselves paying $250,000 per year for malpractice insurance, whereas an obstetrician in Los Angeles may only be paying $69,000 per year for the exact same thing. The inequality in insurance premiums is not only unfair to the physician, but also to the patients, who are receiving limited care due to the astronomical premiums. Physicians in California say that MICRA has significantly helped their practices.
In this debate there are more ways than simply capping non-economic damages to help the problem. The first and most obvious way to help the problem is to limit the amount the lawyers can pocket from the patients. Another way to reduce jury payouts is to allow consideration of “collateral sources” in measuring damages. It is very important that juries are informed about any benefits injured patients have already received. These benefits are normally in the form of health or disability insurance policies.
The issue of tort reform in the area of medical malpractice is one of great contention. Those on both sides of the debate hold a tremendous deal of power and clout in government. Until the United States recognizes the seriousness of the problem and the Senate can move beyond partisan politics, our country’s health care system will continue to spiral downward.