Health Care Part 3 Tort Reform

Tort Reform

I would be remiss in this blueprint not to mention one surefire way to help reduce medical costs.  It is clear if we are going to reign in the cost of health care that we must implement nationwide tort reform. If President Obama is going to credible about reigning in health care costs, then we need to implement comprehensive tort reform and reduction of medical malpractice insurance. It is difficult for the President to argue that health care is inefficient in one breath and then argue that tort reform is not necessary. If the President is going to be credible on reigning in health care costs then he must show the country that he is willing to stand up to the trial lawyers for the greater good of the country. An example of rare government pragmatism on this issue is the GM bankruptcy case, where despite heavy lobbying the government did not carve out personal injury suits from the bankruptcy estate and left all suits to be paid from “Old GM” bankruptcy estate. Thirty states, including California and Texas, currently have some form of tort reform. According to the Wall Street Journal, although economists disagree about the exact burden of legal risk, some argue that it exceeds $100 billion a year.

Doctors are forced to practice defensive medicine and order additional tests in order to insulate themselves from the constant threat of lawsuit jackpots sought by patients. Malpractice lawsuits are exacerbating our health care issues by forcing doctors out of high risk professions and raising the costs for the provision of care. We suffer shortages of obstetricians and gynecologists because some doctors have to pay over $200,000 a year in malpractice insurance.  Even though trial lawyers are some of Obama’s biggest supporters, if he is serious about revamping health care, then he needs to implement tort reform. Although arguments have been made that tort reform, including caps on pain and suffering awards, severely impact the ability of poor and moderate income people to obtain counsel in malpractice cases, this is just not accurate. As the laws in California and Texas illustrate, it is possible to have a cap on pain and suffering and still have a mechanism for plaintiffs to have redress in the event of an injury. If the administration is asking all Americans to make sacrifices in order to provide universal health care, then individuals will need to live with a cap on pain and suffering awards to allow us as a country to reduce our health care costs.

I feel strongly that it is un-American to stifle the free market and impose government-run health insurance for its citizens. While I do believe that dealing with uninsured Americans is an important issue, it should not be addressed at the cost of rationing care, long waits to see a doctor and government bureaucrats deciding what treatments are appropriate. The problems of socialized medicine in Canada are well documented. Ironically, one of the fastest growing business in Canada is the establishment of private medical clinics. It is well known that in certain areas of Canada, local governments expect that its citizens will come to the United States to have procedures done.  While our American health care system may not be perfect, it is certainly far better than the other options out there and one that has served the American public well.

Healthcare Reform Plan Part 2

Catastrophic Care Insurance

Individuals who cannot or chose not to purchase a robust insurance plan could instead choose catastrophic care insurance. This insurance would cover required medical procedures performed in hospitals. It is precisely these major events that have caused uninsured individuals to file for bankruptcy. While policyholders would have to pay for their doctors’ visits, any major surgeries or illnesses that require hospitalization, would be covered by insurance. This option, which would be less than the statewide insurance pool plan, would enable those who cannot afford a full insurance plan to have protection against catastrophic events. It is my belief that multiple private insurance companies will be able and willing to provide this type of plan and thus enable individuals to purchase insurance on a pooled basis regardless of whether they are employed. Additionally, this can be an option provided by employers to their workers.

The one scenario when a public plan may be appropriate is in the event private insurers are unwilling to provide statewide catastrophic insurance, which I do not believe would be the case in light of the fact that this type of insurance currently exists in the market. While I am loath to see a government-run plan for a variety of reasons, including inefficiencies, wide-scale bureaucracy and challenges of implementation, I believe the following scenario could work if we do have a government-funded public option. Under my proposed government-funded plan, payments to doctors would be provided at the Medicare-approved rate. In the event that there are not enough physicians willing to participate or accept Medicare rates for this group of catastrophic care insureds, I propose the following.

The government should create a program to provide free medical education to doctors similar to what is currently offered to armed forces recruits. In return, doctors would have to work 4-6 years in hospitals or clinics that treat insureds that are members of a government run catastrophic plan or Medicaid. This program would serve multiple goals. One, it would ensure that there are enough trained medical professionals available to treat the government insured plan members and provide a greater pool of doctors to treat Medicaid patients. The costs of providing this care should be sharply reduced, because salaries for doctors during this four to six years of service would be commensurate with what doctors are paid during their required time in the armed forces after they graduate. This should dramatically reduce the amount of the cost of care as well as create a reliable source of practitioners to treat this patient base. By implementing this plan, the government would be able to ensure that there would be enough doctors to service a growing patient populace and control the cost of medical care provided to this group of patients.

The implementation of these two proposals should lead to more insurance options being available to individuals, small and large employers, and people with pre-existing conditions.  The benefit of this plan is that the costs of implementation are spread across the populace equally. Employers (both large and small), individuals and private health insurers will all contribute in a more equal fashion to help reduce costs. Small businesses gain by being able to provide insurance to their employees at a price in line with larger employers, individuals and freelancers will be able to purchase insurance not contingent on employment status and private insurers gain by not having to compete with a government funded entity.

Tomorrow:  Part 3 Tort Reform