Friday, March 13, 2009

Too big to fail: the malpractice industry?

“I will pursue tort reform in America until every state enjoys the same success as Texas,”  announced Texas Governor Rick Perry to a group of physicians gathered in Washington D.C.  In a speech eerily reminiscent of another Texas governor, Perry detailed the successes of the tort reform movement in Texas, stating, “We need tort reform, and we need it now!”  Unsurprisingly, the group of physicians gathered for the American Medical Association’s National Advocacy Conference greeted the remarks with a standing ovation. 


Since the passage of Proposition 12 in September 2003, Texas has transformed from one of America’s “judicial hell-holes” into the land-of-milk-and-honey for physicians.  Neurosurgeons, obstetricians, and emergency physicians flocked to the state, seeking shelter from the litigation wars in Florida, Ohio, and Mississippi.  Malpractice insurance rates have declined by 23% overall.  There is a 2,300 case backlog for the Texas State Board of Medical Examiners, struggling to provide licensure for the litigation refugees of other states.  Seventy-two counties in sparsely populated west Texas boast physicians where there were none 5 years ago. 


As the debate for health care reform heats up in Washington D.C., the focus is appropriately on accessible, affordable, high-quality medical care.  Policy-makers struggle to find an economic model that will pay for the kind of care that Americans want and deserve.  Physicians make up a very small percentage of those serving as elected officials in Washington.  Perhaps that explains why lawmakers, who overwhelmingly come from another line of work, fail to see the blunt truth that is right in front of them.


Americans could provide the highest quality medical care to everyone in the country, conveniently and affordably, by eliminating defensive medicine. 


Of course, the economic cost would be borne by those involved in the litigation industry, which includes far more people than the the much maligned plaintiff attorneys.  Also securing monetary gain from the pursuit of malpractice litigation are defense attorneys, malpractice insurance companies, professional (I mean, expert) witnesses, arbitrators of all types, professional and paraprofessional case reviewers, settlement structure analysts, actuarials , courthouse personnel, and purveyors of advertising.  In fact, perhaps tort reform is not a part of health care reform discussions because the entire malpractice industry is too big to fail?

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