The Right And Tort Reform

The American Association for Justice, formerly the American Trial Lawyers Association, is getting ready to counter calls for tort reform. Daphne Eviatar reports:

The lawyers’ association opposes proposals to cap injured patients’ damages or to limit their right to sue proposals often favored by physicians’ groups and Republicans. In fact, as I’ve reported before, public health experts agree that medical malpractice defense costs constitute a tiny portion of the nation’s spending on health care, while medical errors can actually be very costly. Meanwhile, states that have passed severe tort reform laws limiting damages have not seen a corresponding drop in health care costs.

Still, the existing medical malpractice system that requires injured patients to hire a lawyer and costly experts and fight their cases out in court for years isn’t generally considered the most efficient system, either. But experts agree that a frequently-cited alternative a government-run panel of health experts that would hear and decide malpractice claims would cost far more than the current system, and likely wouldn’t garner significant support from either major political party.

The Dish hosted a reader discussion last month on tort reform. Readers arguments for and against reform can be read here and here. The discussion was continued by a Professional Liability Insurance Underwriter who made the most convincing case for reform (he is rebutted here). He wrote that, "there was a period in 2004 and 2005 where there were only 4 Neurosurgeons practicing in the entire state [of Illinois] because several fled to Indiana." He later wrote in to correct:

That was supposed to read "45," not 4. I would hope that it's obvious that I'm not such an idiot to think that there are only four neurosurgeons in IL. I did, however, make a genuine error in writing in company-speak. In insurance, the Chicago MSA is treated as a separate entity from Illinois for many risk-assessment purposes. I neglected to make that clear, and for that I apologize.

The number of non-Chicago MSA neurosurgeons has increased to about 57 over the last few years, mostly through new grads, but also a few who moved into the area. In per capita terms, during the period I referenced there was only about 1 neurosurgeon per 70k people, as opposed to 1 per 67K people in Chicago. That seems like a small difference, but given the very large area those 45 neurosurgeons had to cover, it is much more of a hardship for those people living downstate. Fortunately, there are now more neurosurgeons downstate per capita than in the Chicago MSA.

On an ironic note, the private practice group your reader referred to, the Chicago Institute of Neurosurgery and Neuroresearch, no longer exists. The entire hospital where it is located, the Neurologic and Orthopedic Hospital, is going out of business and will close its doors by the end of the year. All those physicians have been absorbed by a recently-formed large hospital network on the North Shore and they will no longer be in private practice. They will be employed physicians, and as such, they will no longer have the expense of malpractice insurance. The average med mal premium in the Chicago MSA for neurosurgeons is $200K, but this will now be borne by the network's self-insurance plan.

The CBO's 2004 analysis of tort reform is here. Whatever you think about the issue, tort reform being the crown jewel of Republican cost control on healthcare says a lot about the intellectual bankruptcy of the party.