Tort Reform is not Key to Health Care Reform

I’m turning into a one trick pony with my writing about health care reform. I have no qualifications in the field. I’m a retired electronics technician trying to start a farm. But I’ve been doing some reading on the subject, I think it’s important, and since nothing else is coming to me, here’s another post about health care reform.

High awards for malpractice suits are only part of health care costs. Tort reform may lower costs, but not enough to give coverage to the thousands of people who don’t have any or are at risk of loosing it. Medical tort reform may have a role in health care reform, but is not the “key” to health reform, as the notoriously inaccurate Investor’s Business Daily recently reported (the same publication that said Steven Hawking wouldn’t have a chance in the United Kingdom). People who call for tort reform instead of real health care reform are being unrealistic.

A post, from a law student (not even a real lawyer), does a good job explaining why tort reform, when it involves the misdeeds of major corporations, is bad for us and also explains one of the most famous misunderstood civil cases in U.S. history, the Liebeck/McDonald’s case. The big corporations have done a good job vilifying victims of corporate malpractice in order to turn the public against those who challenge their purity and righteousness. I’ve read a few articles about the the McDonald’s case and each time I do, I get enraged about how we’ve ridiculed a victim who suffered painful injuries as a result of known and deliberate malpractice by a major corporation, and who initially only wanted to settle for medical costs. You may disagree with me about the verdict, but please do me one favor: read the details about the case.

Opponents of real health care reform are advising us to cut consumer protection from doctors in order to lower health care costs. While scaring us with the idea of government bureaucrats being involved in our health care choices, opponents of real reform offer, as a solution, government bureaucrats deciding how much our lives, limbs and organs are worth when we loose them because a doctor made a mistake.

Health care costs are influenced, in part, by large sums of money awarded to patients or families of patients who have been injured, or killed by misdiagnoses or inept treatment. These awards compel doctors to perform “defensive medicine”, which includes excessive treatment and testing in an effort to avoid malpractice suits, and drive up premiums for malpractice insurance.

As we call for tort reform, we should be careful what we ask for. Fear of litigation saves lives because it compels doctors to eliminate possibilities that they might not otherwise bother with. It’s hard to call any of these efforts “unnecessary” or “excessive” because doctors don’t agree with each other. What one doctor considers excessive may be routine to another. All of those outrageous awards don’t happen because juries of regular Joe’s and Jane’s decide on their own that a doctor didn’t know what he was doing. They happen because another doctor takes the stand and tells them so. So, to avoid malpractice suits, doctors order tests and treatments that another doctor might think is necessary. One of those procedures might save your life, or might be the one that would have saved your life if we didn’t find a way to keep doctors from performing all those unnecessary tests.

Fear of lawsuits also causes extra diligence. We know, through revelations about car makers and tobacco companies, that benefits of cutting corners are weighed against costs of payments for damages, and the higher the costs, the more careful a company will be. And it’s not just “evil corporations” that are kept in line by fear of lawsuits. I know that fear of being sued plays a part, even if just small part, in making me drive more carefully. Fear works. It’s not that I’ll happily plow over a group of children playing in the street as long as I won’t get sued for it (teenagers, maybe, but not children); but a little self interest raises my attention level just a little bit. In some cases, that little bit might make a big difference. Certainly doctors are just a little bit more careful with the specter of a lawsuit looming in the distance.

Capping awards won’t save as much money as many people claim. There are many different reports out there each claiming different amounts that “could be” saved by capping awards. Phrases like “could save” sound like diet ads claiming how much you “could loose.” I’m sure we could save a lot of money in medical costs if we completely absolve all medical professionals for any liability. Less drastic measures would save less money. Beware of claims about how much money we “could save”.

Still, I’m not against reforms that protect good doctors from being punished. Medicine is complicated and we can’t expect that a doctor will never make a mistake. We shouldn’t ruin anyone’s life or scare good, competent people away from the field of medicine by awarding excessive sums in frivolous lawsuits. There are ideas for tort reform other than capping awards, which are more likely to actually make it into law. These have various advantages and disadvantages and are covered pretty well in this New England Journal of Medicine article. Capping awards will probably will not make it into law. But it will be a source of contention and blaming, and people will try to derail real reform by offering this unrealistic alternative.

Tort reform has it’s place, but we should not let it distract us from real health care reform.

Should be Show-Stoppers

I would like someone to explain to me why Glenn Beck’s astounding reversal of opinion on the health care system isn’t a show-stopper. Why hasn’t he been laughed off the air? And what about O’Reilly for claiming that life expectancy is lower in the United States than in Canada because our higher population provides more opportunities to die? We all make gaffs, of course, and I’ve made some doozy’s in my life. But rarely have they gone unpunished. The fact that these two idiots can stay on air after all the just plain wrong things that they’ve said breaks my heart. The good news is advertisers are starting to notice, and a slowly growing movement may help remove at least the most obvious liars and idiots from the airwaves. I came across this link, which is a petition site asking Walmart to drop advertising on Glenn Beck’s show. I’m sure there are more. These shows survive because corporations believe that running ads while people are watching them will bring them new customers. By convincing them that they’re wrong we can shut up these dopes.

I let people tell me how to think.

I’m proud to say that among the responses to one of Congressman Forbes’s blog posts against health care reform, mine was the only one that rated a personal attack from another commenter. That person disagreed with my interpretation that the government option on health care would not kill the health insurance industry, and he accused me of either being a pawn of the Obama administration or not having read the bill. Of course, that was before the CBO came out with a statement saying that the government option would not kill the health insurance industry. Still, I only read parts of the bill, and I’ve read a lot of of other people’s interpretations.

I admit it. Despite what I have read directly from the bill, If a nobel prize winning economist was against the bill, I might change my mind. Perhaps if the AMA and the ANA, not always in agreement, were not aligned in support of this bill, along with several other medical professional organizations, I would reconsider my position. But instead, all of these highly respected economists and medical professionals support the bill, and I defer to their opinion.

Meanwhile, if the opponents of reform didn’t keep refusing to acknowledge that the primary source of their statistics, the Lewin Group, is wholly owned by an insurance company, I might give them more credit.

Both leftys and rightys lob insults accusing each other of ignorance because they didn’t study a bill or read a report. And I agree, you should study what you can, but you often need the guidance of someone you trust.

So yes, I let people tell me what to think. In fact, that’s what I pay them for. I often pay a mechanic to tell me what’s wrong with my car. I do what I can on my own. I troubleshoot, listen to the engine, and develop some ideas. That helps me understand what the mechanic tells me and sometimes allows me to decide if the mechanic knows what he’s talking about. But if I have no reason to mistrust the mechanic, then I’ll defer to his diagnosis. Sometimes you just have to trust the experts. It only makes sense.

We are Not Debating a Government Takeover!

I just took a look at Randy’s Blog, because I was looking for info on last night’s teleconference, and saw that on the 24th he made a post titled, “What is your #1 reason that you either support or oppose a government take-over of health care?”. This is an example of what we call “framing”, but it’s also an example of what we call “lying”, or at least “misleading”. Mr. Forbes is deliberately confusing people by pretending that a “take-over” is what the health care debate is about. This might not be lying, but it’s about as honest as me asking why you’re cheating on your spouse and then claiming that I didn’t accuse you of anything, I just asked “why?”.

The argument that a government option, despite being a bloated and inefficient disaster, will have such an unfair competitive advantage over private health care that it will destroy the industry is just an argument. In my opinion, it’s a bad argument. Those who support health care reform don’t believe it. It’s dishonest and insulting to pretend otherwise, and to pretend that the health care debate is between people who want to kill the health care industry and people who don’t.


Missed Most of Randy Forbes’s Health Care Teleconference

My wife signed up for a teleconference with Randy Forbes about health care reform. When it was time for the teleconference to start, we waited for the call. And waited. I went on line trying to find out what was going on. Congressman Forbes’s website wouldn’t load but I found his Twitter page, and his last tweet, which was was sent before the start time, said he was getting ready to start. I actually joined Twitter just then so I can see if other people were having issues, and I found one tweet from someone who was also waiting for the call.

By the time the call came there was about thirty minutes left. We were on the phone line long enough to hear four questions, two of them from yakkers who were more interested in telling stories than asking anything. The last question was asked by a retired woman who said, in a sweet Southern accent, ( and I’m paraphrasing here ), “My health care is fine so fuck everyone else. I’m just worried about all them foreigners coming in with their dirty children spreading diseases around”.

We didn’t get to ask our questions during the conference but when it ended we were able to leave a message. Of course, we can call the governor’s office and leave a message any time, so I don’t know if the message that we left at the end of this conference will carry any more weight.

Sasha’s question was: “How will you address the rising costs of health care which will eventually force people to give it up?” and mine was “With so many services, like education, that are offered by business but also have a government provided option, why do you think health care is the one industry that will be destroyed, or taken over, by a government option?”.

I don’t know how the congressman will address our questions or those of others who didn’t get to ask. If I find anything I’ll update.


Examples of Public / Private Competition

I’ve been trying to think of a product or service that has a government option as well as private options, and am looking to my readers (all two or three of them) to tell me if these examples are good:

Example 1:
If you’re on trial, you can hire a lawyer or the state can appoint one for you. As much as state attorneys have been vilified in media and literature, the truth is, they offer an option to people who otherwise have none, and they do occasionally succeed in proving that their client is the wrong guy (or at least that there is no valid evidence to prove he’s the right guy).

Example 2:
As I wrote previously, meteorological forecasting companies tried to block NOAA’s website because it would offer unfair competition. But NOAA has a useful website which some people use, and there are still plenty of private weather sites out there.

Example 3:
There are public beaches and private beaches. People who have the money for a private beach can enjoy the exclusivity. The rest of us plebes at least have the public beaches.

Example 4:
We have public transportation. I wish we had more. I rode the express bus when I worked in Norfolk and can honestly say that the express bus is nice, but the ridership isn’t the cause of the automobile industry’s problems. And while people may complain about taxes going to a system they don’t use, it’s the only way a lot of people can get to work. I’d rather pay for the buses than keep an obstacle in place between people and their jobs.

Opponents to the health care plan make the contradicting arguments that the health care plan will be terrible, because it’s run by the government and everything the government does is terrible, but that it will offer unfair competition to the private industry. But there examples of products and services provided by private industry and also provided by the government. In cases where the government version is good, it succeeds in making the private versions better. In cases where the government version is not so good, it at least offers a choice to those who would be left without one. And, in many cases, we all benefit from letting those people have a choice, even if we choose not to use it for ourselves.


In Support of the Health Care Plan

Jim DeMint shined a light on an ugly side of the health care debate; that a big part of the battle is not about what’s good for Americans, but rather about what’s good for Democrats or Republicans. I don’t believe that President Obama entered this fray and opened himself up to a wave of attacks without believing that this is good for America. And while some of his opponents must honestly believe that this is a bad plan, we have seen that much of the opposition is fighting this because they see it as his “Waterloo”.

One common argument against President Obama’s health care reform plan is that it will eliminate your current health care plan. Obama denies this. Who’s lying? As Bobby Jindal eloquently explains, the government will offer an option that is so good, many people will leave their current plan in favor of the government’s. This will force private insurers to improve their plans in order to compete. For that reason, Obama is lying when he says government won’t take away your current plan. I appreciate Governor Jindal’s efforts to clear that up, but his writing doesn’t persuade me to his point of view.

Another accusation is the common “Government does everything wrong” argument. To that argument I offer these:
->I previously posted about my long and frustrating hours dealing with Verizon, and I’ll soon write about the $70 internet charge on my wife’s cell phone, when she only used it once for less than a half hour.
->My daughter’s hard disk just failed after she had it for about a month.
->The private company that my electric provider hires for cutting trees around electric lines just knocked down a young tree that we liked, outside of their easement.
->It takes about a half hour to go through the express line at Walmart even when there are only four people in front of you.
->In 2005, Private weather forecasting companies like Accuweather, tried to block NOAA from becoming too good at reporting the weather, for fear of competition.
->I believe, from personal experience, that the most dedicated and hardworking people work for the government, both military members and civilians.
.. and about medical care..
->We’ve often had to wait months to see a doctor. This is true for a lot of people, even those who say “If we have ‘socialized medicine’, we’ll have to wait months to see a doctor!”.
->Dealing with billing from private health insurers is no less a hassle than dealing with the government.
->I’ve been lucky enough to have a government provided health care plan for the past 26 years, and it hasn’t been perfect, but I’ve been happy with it.
It’s not that I believe that we should turn everything over to the government, I’m just saying that “Government sucks at everything” is a false argument.

But the mostly I admit that there are huge details hidden in pages of text, and I can’t decipher it all, so I have to look at who’s supporting or opposing this plan and why. And I see a lot people supporting this plan because they believe it’s good for the American people and I see a lot of people opposing it for ideology and political gain.