Reality-BasedTM Political Numbers from Nicholas Beaudrot
Electoral Math
Reality-BasedTM Political Numbers from Nicholas Beaudrot
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After all of this reading, what do I think the US should do about its malpractice system? Well, as with everything related to health care, it's a difficult question. But here are my initial ideas.
The costs of the medical malpractice system in the United States are definitely much higher than in other OECD nations. However, it's clear EU member nations are able to have a much cheaper malpractice systems because they have much more generous welfare states. Therefore any system which reduces the cost of the American tort system should be accompanied by changes that increase health insurance coverage for those currently uninsured, as well as changes to increase disability or workers' compensation benefits. Perhaps, however, the end result of such reforms would be a net decrease in overall costs of the health care/disability compensation system.
Assuming such welfare state improvements occurred, the Scandinavian system of no-fault compensation is very appealing, since it speeds the processing of claims and gets claims in the hands of more patients. Conservative critics will claim that this is simply more "big government", but my response is that having an agency that specializes in processing your claims is almost certainly better than waiting years while the trial lawyers, courts, and insurance companies haggle over how much you get paid, which can often take years. The Scandinavian system also separates compensation from doctor/nurse/hospital discipline, which probably improves the ability of the disciplinary agency to take its job seriously and mete out meaningful punishment to bad doctors. Separately, almost all countries seem to have problems indemnifying ob-gyns. Therefore, I think it's a good idea to provide a generous set of benefits to the parents of children with birth-defects, similar to the benefits package used in the United Kingdom, which can be received only in exchange for waiving the right to bring a malpractice claim against the doctor. Since many of the largest malpractice awards occur in cases of injury at birth, such a policy would at least provide some cost certainty to the insurance industry. Such an "Unlucky Mothers' Childcare Relief Act" would both be good policy and good pro-family politics -- it would be great to see a Republican Presidential candidate complain about how this idea hurts the economy.
In the end, I think that meaningful tort reform that puts some downward pressure on individual malpractice payouts could reasonably reduce health care costs by 2%, while still providing smaller, quicker compensation payments to a larger number of injured patients. It's unclear whether or not such reforms would further reduce health care spending by eliminating some "defensive medicine", but I am skeptical of such claims.
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updated by Nicholas Beaudrot on 11:13 05 May 2005
