Yesterday, I wrote a diary wondering aloud if it was OK to include more cost containment in a heath-care bill. As usual I was pillaged as a republican plant, uninformed, possibly unhinged. :-)
The diary touched on medical tort reform, and I decided to devote a whole diary today to that subject alone.
The sub-thesis of my diary is that the progressive agenda will be advanced the farthest when we include a couple of centrist tidbits in the legislation. Its not only politically smart, but as is the case here, the right thing to do. And that no country in the world that has universal care is without major cost containment including tort reform and some sort of rationing.
There is an interesting article this morning in the St. Petersburg times at http://www.tampabay.com/...
The central point is how well the Canadian system keeps malpractice costs fair and in check. While that is partly achieved through the wonders of universal care and single payer, awards for pain and suffering for example are capped at $300,000. I think the Canadians well understood that when you open the floodgates of universal care and government funding, the taxpayers are not going to stand for the sorts of shenanigans we have here in the US.
Here in Florida in 2006 a jury awarded a man $217 million in punitive damages, prompting state tort reform in the republican controlled legislature.
The last two paragraphs of the article are really central to my point:
While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts. So-called defensive medicine increases health care costs by up to 9 percent, Medicare's administrator told Congress in 2005.
"How much money is spent in this country to assure that every test known to man is done to avoid a lawsuit?" asks Yelverton of Women's Care Florida. "Defensive medicine is not talked about nearly enough, although the costs are huge."
I am just asking progressives to open their minds. Let me be clear. Yes, I favor universal coverage. Yes, I favor single payer, although I understand as a tactical matter that won't be happening real soon. So yes, in that absence I favor a strong public option. If that eventually crowds out private coverage thats fine with me.
But if you look around the world to countries we admire such as Canada that have much better medical delivery and payment systems than ours, you will find very strong costs containment and even what Americans call rationing. Simply extending health insurance to everyone without balancing the costs side is a recipe for disaster.
In Miami the average Neurosurgeon pays $237,000 in malpractice insurance. Does anyone really that that is wise or cost effective?
In my view progressives would be better served if they stopped demonizing everyone who wants to look at the costs side of the ledger as we pass universal health-care legislation. It doesn't mean that we don't favor universal health-care if we say we want to look at the costs.
To the contrary, it just means we want to follow more closely a model that has worked throughout the rest of the western world.