Obama Takes the Lead on Malpractice Reform

Obama's call for medical malpractice reform is being met with skepticism by the left and right. But this time the president's right.

During his State of the Union address, President Obama announced that he was willing to consider the possibility of medical malpractice reform as part of his willingness to consider modifications to Obamacare. Predictably, the right believes this idea won’t go very far and will only delay real reform, while the left opposes any malpractice reform until incompetent physicians are rooted out of the system and medical errors were eliminated. These views though are both off the mark.

There are far more patients who experience medical errors than actually sue their physicians so patients do need to have the opportunity to be compensated when they experience real injury. If the system compensated all patients who were injured rather than the few who actually sue but sometimes collect absurd sums, the overall cost of the payouts would likely not be that different.

On the other hand, the medical profession has made real strides in improving care, particularly in hospitals. One Philadelphia hospital has reduced the incidence of blood stream infections from about 15 to 20 per month to some months where no infections occur. This is the result of quality improvement efforts.  There will always be some errors in a complex setting like a hospital intensive care unit. But the current climate where physicians are under the gun and practice very defensive medicine or even avoid some high risk cases because of malpractice litigation fears is also very problematic. If the nation accepts that fact that the cost of medical care has become a national emergency that requires an aggressive response, then we must confront the costs associated with medical malpractice.

Several studies have suggested that malpractice reform would lead to savings of about $50 billion dollars per year. Some have called this a trivial amount and hardly an important component of runaway health care costs. On the other hand, describe it as half a trillion dollars over a decade and the savings suddenly sound important. Luckily, several solutions are at hand. Medical courts where the validity of lawsuits could be ascertained by expert panels is a good start. No fault payments with limits on pain and suffering payments is another. Freeing physicians from the burden of defending malpractice cases in court with all the expense and time associated with that activity would also reduce costs. Finally and perhaps most importantly, the costs of practicing defensive medicine would be dramatically reduced.

If we think health care costs are a national risk, we must act accordingly. Malpractice reform poses problems for some injured patients, no doubt. But combined with comprehensive health care delivery reform, it is a key part of the required approach to avoid financial calamity.

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