Bill's Notes

[Industrialblog, April 30, 2004]
Tort Reform
There's a discussion down in the comments below on medical malpractice costs.

My solution is not just hyperbole: We need an extreme solution. Immunize all professional and licensed occupations, as well as all public and quasi-public entities.

Malpractice will be dealt with on the peer-review level. Sure, a few people will be screwed over. But most people won't. In the current system, a combination of legislators, insurance companies and litigators are doing more to restrict our rights and our freedoms than any king of England. We're all getting massively screwed in the current system.

The goal is to create a culture of passivity and fear--look at public school teachers and principles who fear making decisions. Or doctors' ordering extra tests just to make extra sure. The insurance/tort has put tons of small businesses out of business — as they simply can't afford insurance, which legislators (lawyers themselves) in turn require.

Something's gotta give. Either end mandatory insurance, or end most tort lawsuits against public entities, quasi-public entities (such as hospitals) and professionals. The specific cases were people get hurt can be dealt with on a case-by-case basis. The department of health can always shut down a hospital. We don't need insurers and tort lawyers complicating matters.

BTW, this is an area where I was always conservative. Mandatory insurance is nothing more than a tax that ensures a massive pool of funds are available for the plaintiffs' bar — and of course the defendants' bar, too. It's a scam, it's always been a scam, and it will always be a scam.

Insurance should be for auto accidents, fire, theft, life — that sort of thing.

Just my two cents.

The objections: What about those who are victims of malpractice? I don't know. Maybe doctors themselves can agree to review these events on a case-by-case basis, and volunteer to provide extra care at no or low cost. Doctors are licensed so clods can have their licenses pulled by the state.

As far as other cases of negligence ... we can deal with that on a case by case basis. I'm not saying eliminate all tort lawsuits — but I'd eliminate them for all entities paid for with public funds: cops, judges, teachers, government officials. Public officials already enjoy broad immunities; let's finish the job. Do you know how much money New York City puts out a year just to settle legal cases — in many cases, just settling to make tort lawyers go away. It's hundreds of millions. Anytime someone in that city of eight million people slips and falls, a tort lawyer hands out his business card.

Of course everyone doesn't sue, but that's my point. Rare are the cases where you should have to take your conflicts before a judge. I would say virtually any doctor, immunized from malpractice, would gladly give free treatment to patients where he has made an error. If the patient is no longer comfortable, the doctor can easily send the patient to another doctor.

Trust me, if we get these insurance costs and legal costs out of the system, we'd see the economy explode, and our education and medical system costs plunge.

Just a starting place for a discussion ...

Super G:
IB Bill,

I doubt their is a perfect solution.

Peer review can be biased by the friendships and biases of the internal group. So, some external or independent option needs to be available most of the time. Absent of abuse, businesses and individuals ought to be responsible for their actions. For businesses, it certainly could be considered part of competitive survival which makes the economy stronger in the long run.

So, I would not be excited about immunity all around. But I'd rather have that than no medical care.





5.2.2004 11:21am
Andrew r:
You know that litigation and malpractice insurance account for less than 2% of all medical costs in this country?

Oh, and take a look at the WONDERFULY sucessful tort reform in Texas. You're are a joke.
5.2.2004 7:14pm
Super G:
I know that people claim it is 2% or 3%. I also know OB MDs that pay something like $250k/year in insurance which may ultimately lead at least some MDs to opt out. Thats why I'd like a solution that also opts out insurance companies hence they make profits regardless. Kind of like oil companies, I suspect their profits rise with ther rates.

No one bothered to make the argument that major damage settlements are a deterrent to unethical behavior that might be encouraged without that threat. But I'm not really a believer that the death penalty is a deterrent to crime. However, that argument exists.

Clearly we're not all the way to no MDs yet.

Medical costs resulting from drug price increases are an interesting discussion for the conservatives.



5.2.2004 8:22pm
Bill:
I'm not sure malpractice insurance and litigation costs are two percent. Not with the malpractice premiums doctors pay. I'd have to see how those numbers are crunched. If you want to add a source, I'd like to see, Andrew.

5.3.2004 6:19pm
Super G:
Bill/Andrew,

I think it is true that litigation is a smallish part of the cost of medical care. However the cost of malpractice insurance is often passed directly to MDs which means it is a large burden to them. Particularlry if you were in an individual practice. So, if you spread the cost of insurance across the system as a whole you could reduce the burden on individuals practioners. Hence my "big government" solution. I don't think one should take lighthly the suffering of people injured through malpractice.
5.4.2004 2:00pm

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