Tort reform must be factored in with healthcare reform

April 10, 2011

Medical malpractice reform, also called tort reform, needs to be on the front burner of healthcare reform.

It is ironic that the United States spends more in healthcare dollars than any other industrialized nation in the world. According to Medicare's actuaries, American healthcare spending in 2009 was a whopping $2.5 trillion-17.3% of the gross domestic product (GDP). Switzerland, the next most expensive health system, spends only 10% of its GDP on healthcare. Yet, according to a recent World Health Organization report, the United States ranks 37th in overall health system performance out of 191 member nations.

Healthcare dollars are not being spent efficiently and wisely.

In spite of the outcry about healthcare reform, an important issue has received far less attention. Medical malpractice reform, also called tort reform, needs to be on the front burner.

Nearly half of new physicians in Illinois relocated because of a tough medical liability climate, according to an American Medical Association news report. According to the report, medical malpractice premiums in Illinois are two to three times higher than neighboring states. Since Texas, Arizona, and California legislated tort reform laws, the physician population in those states has increased and continues to grow.

In addition, according to Medical Economics' 2010 Exclusive Survey on malpractice (November 19, 2010, page 26), ob/gyns pay an excessive annual median of $51,200 in medical malpractice premiums.

Defensive medicine is one of the biggest reasons for the escalation of healthcare costs in the United States and accounts for 30% of total healthcare dollars. Defensive medicine is a well-studied result of the liability pressure on physicians. A nationwide Gallop poll released in February 2010 found that 73% of physicians practice defensive medicine to shield themselves from malpractice attacks.

The American Medical News notes that, overall, 42.2% of physicians have been sued, with a fourth of them being sued more than once. Ob/gyns, neurosurgeons, and orthopedic surgeons are among the most likely to be sued, and a 2009 survey revealed that one-third of ob/gyns reported cutting back on high-risk pregnant patients. The cost of fighting claims is high.

Tort reform, also called medical liability reform, is a complex issue that needs to be addressed by both the executive and legislative branches of government at the state and federal levels. The reform should address:

This healthcare reform is the largest since Medicare, and it is disappointing to see that tort reform was not addressed. Progress cannot be made without it. I hope that a meaningful tort reform will be enacted to keep the torch glowing.

The author is a urologist at NorthWest Clinic. Send your feedback to medec@advanstar.com
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