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Eric T. Chaffin
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Tort Reform Fails to Reduce Health Care Costs—Or Improve Patient Safety

7 comments

In April 2013, Florida lawmakers approved medical malpractice reforms, in essence making it harder for patients to sue doctors and hospitals for medical negligence. Originating from the Judiciary Committee of the Florida Senate, the bill was approved by the House Representatives with a 77-38 margin.

Lawmakers at the time believed the bill would create an environmentally friendly atmosphere in Florida for physicians, potentially reducing malpractice insurance costs and easing healthcare costs in general. The reform is similar to the laws West Virginia passed in 2003. Studies since then, however, do not show the expected outcomes of the reform.

Results of Tort Reform Do Not Reduce Health Care Costs

Proponents of medical malpractice tort reform typically promise voters that new laws will help reduce health care costs. The fear of medical malpractice lawsuits, so the theory goes, pushes doctors to perform more tests than necessary, increasing costs. Reducing the fear of malpractice litigation, therefore, should reduce costs. Early studies, however, indicate this is not the case.

In Texas, tort reform passed in 2003 limited payouts in medical malpractice lawsuits. Researchers from the University of Texas examined Medicare spending in Texas counties between 2002 and 2009 to look at the results of the reform. They saw no reduction in doctor’s fees for seniors and disabled patients. In addition, results showed that Medicare payments to doctors rose 1-2 percent faster in Texas than in the rest of the country.

Those advocating tort reform also typically state that reform makes states more friendly for physicians, increasing patient access to the healthcare providers they need. The study found no evidence to support this claim either, noting that physician supply did not improve after reform.

Patients Don’t See Benefits

In October 2011, non-profit advocacy group Public Citizen released a report entitled “A Failed Experiment,” noting that health care in Texas has worsened in key respects since liability caps were put into effect in 2003.

Malpractice lawsuits have dropped dramatically since the caps were imposed, but patients have failed to see benefits. Medicare spending and private insurance premiums have both risen faster than the national average, while the percentage of Texans who lack health insurance has gone up. The per capita number of primary care physicians has remained flat, while the prevalence of those in non-metropolitan areas has declined.

Another study published in the Journal of Empirical Legal Studies in June 2012 noted similar trends, finding no evidence that tort reforms bent cost curves downward.

Does Not Improve Patient Safety

So far it seems that tort reform does not necessarily level out medical malpractice premiums.  A Medscape Medical News analysis in 2010 found that even in states that have enacted reform, annual premiums vary widely, with premiums in one region being two to three times higher than in other areas.

Looking again at Texas, the analysis reported that since reform was enacted in 2003, malpractice premium rates are uneven, and more than twice as high for general surgeons in Hidalgo County, for example, as they are in Potter County.

These results echoed those of a 2007 study published in Health Affairs, where researchers reported that the size and number of medical malpractice payments are affected by only some tort reforms, and the pattern differs between states with high versus low levels of claims or payments. The researchers noted, “tort reforms’ overall impact appears to be extremely limited.”

More concerning was the final conclusion of the study, which was that tort reform fails to address the most important thing: patient safety. “None of the tort provisions enacted to date addresses pervasive and troubling issues of patient safety,” the authors wrote. “Reducing the number of value of malpractice claims by tightening the rules for compensation through the tort system does nothing to foster quality improvement.”

7 Comments

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  1. Jay Menna says:
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    No self serving motive to this article…..

  2. david nova says:
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    @jay menna: u realize, i hope, that argument by innuendo is a fallacy.

    the article reports on 4 studies by researchers representing a wide variety of interests — university of texas, public citizen, journal of empirical legal studies, and medscape medical news — yet all reach similar conclusions.

    does your oblique allusion explain that, or do you need 4 more separate insinuations?

  3. jc says:
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    When a liberal rag like Public Citizen (which advocates single payer Medicare for all) does a study, you know that it is biased. The fact of the matter is that malpractice insurance is factored into the cost of doing business in a doctor’s office like rent and lights and billing. If malpractice rates go up then eventually doctors charges have to go up. It may not happen immediately, it may take a few years as older doctors retire and younger docs compare rates in various states, but it occurrs, because like all businesses, doctors are cost sensitive like computer and auto companies and yes even lawyers.

  4. jc says:
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    I want to give an example of the economic principle which I just explained. Two family physicians I know, stopped doing deliveries. They explained it to me this way. They only got $1800 for the delivery including all prenatal care and the eventual delivery of the baby. In 20 years, they never had a complication. They were doing 60 deliveries a year and enjoyed doing it. Yet they stopped, because their malpractice went up $60,000. Yep, for every delivery they did, it cost $1,000 for the malpractice insurance. That means they only got $800 for all the prenatal care and the delivery! Out of that $800 they had to pay office expenses including billing, nurses, lights, rent, phone etc, so at the end of the day they were not making enough to justify doing the delivers and they stopped doing it, even though they loved doing it! So Eric, think about this story before you site another goof ball liberal article.

  5. jc says:
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    So lets talk about one of the cost drivers of malpractice insurance costs. Incompetent plaintiff attorneys! For a doctor to do neurosurgery, he has to go thru medical school (4 years), thru a sugical residency (5 years) and a neurosurgical fellowship (2-3 years). Then he has to get licensed in the state he wants to practice and after all that he has to apply to a hospital and hope the medical staff grant him privileges to practice neurosurgery. O.K. medical malpractice is the hardest, most challenging law to practice. So what does a lawyer have to do before he can file a malpractice suit against a doctor? That’s right – -all he has to do is pass the state bar! He can sue a doctor as soon as he receives his bar certificate. What do you think happens when an inexperienced green lawyer files a malpractice suit against a doctor? He loses his butt, as 85% of medical malpractice claims that go to court are won by the defendant doctor! Eric wants to point a finger at bad doctors, but he doesn’t want to point a finger at incompetent plaintiff attorneys filing frivolous medical malpractice suits and driving up malpractice insurance costs and medical costs for all of us. Shame on you, Eric!

  6. mtbwalt says:
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    This article says that tort reform failed to drive down doctors fees in Texas.

    Why would it drive down doctors fees? Tort reform should drive down the number of medically unnecessary tests ordered (“defensive medicine”), not the fee a doctor is paid for an exam.

    Doctor pay makes up 7.4% of the medical dollar. Unnecessary labs, imaging exams, etc are a separate issue.

    Medicare fees may have gone up due to many factors including immigrant population, aging population, etc.

    EVERY doctor practices defensive medicine. Ones in malpractice hotbeds like Philly and NY all the more. Funny how every “study” challenging this is by a plaintiff law group.

  7. Kobi says:
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    This is too complex to debate in a paragraph. The documentary “Hot Coffee”‘, states the facts and gives examples of what has happend as a result of TORT.