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Rob Kailey is a working schmuck with no ties or affiliations to any governmental or political organizations, save those of sympathy.

The myth of malpractice caps

by: Jay Stevens

Wed Aug 13, 2008 at 13:13:07 PM MST


I saw the news that Roy Brown promises to convene a bipartisan commission to address the cost of health care for Montanans. Not a terrible idea; but the usual tactics of a politico, eh? We don't need commissions, we need affordable, universal health care.

Anyhow. Here's the paragraph from the report I want to talk about, emphasis mine:

Brown cited the skyrocketing cost of health insurance, the growing cost of malpractice insurance for health care providers and the increasing costs of keeping hospital doors open in Montana.

The highlighted portion - the "worry" over malpractice insurance - is often Republican code-speak for tort reform, and a desire to legislate caps on malpractice settlements. The theory is that caps mean lower malpractice insurance rates, which leads to lower health care and coverage costs.

Of course, in reality, there's no such correlation.  

Jay Stevens :: The myth of malpractice caps
Take this 2004 Consumer Affairs report (emphasis, again, mine):

Do caps or medical malpractice damage awards hold down doctors' liability insurance premiums? The nation's largest medical malpractice insurer says they don't.

GE Medical Protective's finding was made in a regulatory filing with the Texas Deparment of Insurance (TDI), in a document submitted by GE to explain why the insurer planned to raise physicians' premiums 19% a mere six months after Texas enacted caps on medical malpractice awards....

According to the Medical Protective filing: "Non-economic damages are a small percentage of total losses paid. Capping non-economic damages will show loss savings of 1.0%."

The company also notes that a provision in the Texas law allowing for periodic payments of awards would provide a savings of only 1.1%. The insurer did not even provide its doctors that relief and eventually imposed a rate hike on its physician policyholders.

Got that? Savings is about 1% -- pocketed by the insurer - which apparently is not only not enough to offer relief to doctors (and thereby patients), it's cause to jack up rates another nineteen percent!

Worse yet, according to the Drum Major Institute, the Texas malpractice cap has not passed on savings to consumers, results in lower quality care for Texas patients, and is a disincentive for attorneys to take on malpractice cases. Worse care...harder to sue bad doctors...all for the same, high, high price!

Let's face it, folks. The insurance industry is the main party to blame for the high cost of health insurance. Do they really need another handout, in the form of malpractice caps?

I've got a funny feeling that's the kind of health care "reform" Roy Brown and the Montana Republicans are going to advocate.

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RE: Brown and that anti-malpractice approach to lower healthcare (0.00 / 0)
Yeah, blame it on those lawyers.  The guys that are the last line of defense to uphold silly things like laws and rights.

It's a pro-corporate agenda - fueled by people like Rush Limbaugh and Michelle Malkin - and now, Roy Brown.

Wheee!!!


I think you're missing something (0.00 / 0)
Specifically, it's not just the price of the insurance that increases the cost of health care (though even that is ridiculous, but it's a rich doctor, so who cares, right?)  The drain that is more apparent in an everyday practice is he daily, hourly, dose of CYA.  The paperwork along with he unnecessary treatments are a huge (if anecdotal) drain on the health care system.  Even then, when you do all you can it's ridiculously easy to find an ambulance chaser who would love to try to take a bite out of one's wallet; then you get to waste a day or two at a hearing that proves that low and behold, you've done everything right.  The complainant loses nothing, the complainant attorney moves on to their next attempt, while the doctor and/or hospital gets to write another check for attorney fees, to say nothing of the lost time that can never be recovered.  Yeah, there's a myth here, but I don't think it's what you think it is.    

You misunderstand (0.00 / 0)
I'm not blaming doctors. In Texas a malpractice cap saw a 19 percent raise in insurance payments.

The biggest paperwork cost is associated with insurance companies. They deliberately create a Byzantine system of paperwork in order to justify denying claims. (Check out this Atul Gawande piece about the business of medical practice. And you wonder why most general practitioners are in favor of a single-payer system?)

You call them "ambulence chasers." I call them the last bastion between ordinary joe and huge corporations. Most often, these "ambulence chasers" are paid from the settlement, not hourly. That is, they have a market-created motivation to take cases that will win.

We could argue about this all night, but I posted actual stats based on studies done on this subject. And remember, the entity saying that caps don't affect insurance premiums was an insurer. So come back with some info showing I'm wrong.


[ Parent ]
I'm not saying your wrong (0.00 / 0)
I'm just saying your focus is wrong; the malpractice rates are a small part of the problem.  The time a doctor spends and the treatments a doctor orders to protect his or her butt is a much larger issue when it comes to malpractice considerations.  Bring you a study?  Go ask a doctor.  Finally, because those lawyers do get paid from the settlement, there are quite a lot out there who take the shotgun approach to litigation, and that sucks more time and more dollars out of the heath care system. If one can find an 'i' not dotted, they've hit the jackpot, which leads us back to where we started.

[ Parent ]
hm... (0.00 / 0)
I still don't buy it. Your claims don't show out in Texas.

First, given that actual cases of malpractice increased after the cap -- despite lawyers less interested in taking cases, because of the cap -- belies the claim that lawyers create malpractice cases. It would actually appear that no cap serves as an incentive for doctors not to make mistakes.

Second, in Texas costs didn't come down for patients or doctors after the cap was implemented. So all these other related costs you attribute to un-capped malpractice suits either don't exist, or caps don't address them.

It's all moot anyway -- at least for schmoes like us. Malpractice costs and insurance are an insignificant contributor to health care and insurance costs for patients. So even arguing for malpractice caps as a means to reduce health care costs is misguided at best.


[ Parent ]
health insurance is license to fraud (0.00 / 0)
what republicans don't understand about health insurance is that the majority of americans who are covered are mad as hell about the way they are treated by the insurers who try to defraud, shirk and obfuscate us to death.
every time we send a bill in to the insurance it comes back as not covered for some scurrilous reason. we send it back in with threats to legal action and as if by magic it suddenly is covered. what is going on is fraud and the insurance companies do it to increase their profits.

insurance executives know that every four people they deny coverage to will probably not have the time, the energy and the stubbornness to fight back. this is profit by fraudulent means and it happens to seniors, single patients too tired from treatments to respond and anyone too busy working to buy groceries, pay mortgages, and pay insurance bills to respond. lack of insurance is not the problem. fraudulent insurance practices are the real problem and until someone reins in these predators, all the false coverage in the world will not solve this.

United we stand, divided we fall.

power to the polite people!


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