Mama said wonk you out

*Apologies to Ezra Klein for the blatant theft.

So over the last few weeks, health care has dominated the public discourse. Or I guess a more accurate representation would be that the health care debate has dominated the national discourse.

Acrimony and vituperation has categorized that discussion as of late. In general there seems to be little understanding of how our health care system actually works. So I decided to do some homework on the subject.

Today I decided to look into the subject of "tort reform".

A common refrain from right/GOP is that medical malpractice is a consequential driving force on the upward movement of health care costs. And if I was doing what is commonly done on the teevee machine, then I would not point out that all available information paints this statement in a bad light.

The CBO (Congressional Budget Office) a non-partisan organization, which has in it auspices the duty to score governmental spending, looked at the issue in some detail. And what they found was this.

Evidence from the states indicates that premiums for malpractice insurance are lower when tort liability is restricted than they would be otherwise. But even large savings in premiums can have only a small direct impact on health care spending--private or governmental--because malpractice costs account for less than 2 percent of that spending.⁽³⁾

Case closed right? Not really. Further they go on to state this.

Advocates or opponents cite other possible effects of limiting tort liability, such as reducing the extent to which physicians practice "defensive medicine" by conducting excessive procedures; preventing widespread problems of access to health care; or conversely, increasing medical injuries. However, evidence for those other effects is weak or inconclusive.

The problem with medical malpractice is that it is a complicated issue.

To society in general it is a valuable corrective. There must be some recourse of individuals done harm.

But at least, in regards to practicing doctors, their motivation can be equally persuasive. Even though the cases of malpractice litigation are rare, the fear and the personally deleterious effect on the physician are quite real. Even if there is a 1 in 10 chance of litigation the resulting suit may well cost the physician his practice or just be financially ruinous. These are real concerns and I do not want to minimize them.

The problem is more the perception of "tort reform". People believe, devoid of any statical evidence, that there is an epidemic of malpractice suit abuse. When in actuality the opposite is true.

"Thirty years of inflation-adjusted data show that medical malpractice premiums are the lowest they have been in this entire period. This is in no small part due to the fact that claims have fallen like a rock, down 45 percent since 2000. The periodic premium spikes we see in the data are not related to claims but to the economic cycle of insurers and to drops in investment income. Since prices have not declined as much as claims have, medical malpractice insurer profits are higher than the rest of the property casualty industry, which has been remarkably profitable over the last five years."

Now this is not to say that some reforms are not needed, but to state as is commonly done, that this is some sort of magic bullet is inaccurate.

A few more articles and charts on the issue can be found below.

American for Insurance Reform
American Association for Justice
Scott Maxwell-Orlando Sentinel
Townhall.com
The Dallas Morning News (and example where they capped damage awards)

-Cheers