Tuesday, February 23, 2010

Next card, med mal?

So, no Republican jumped up and said here is what we want on malpractice. The President should play the card they would play if they were going to negotiate: malpractice reforms. Cohn at New Republic writes this today, and I agree. Reforming malpractice won't save that much money for the system, but will save some money. Most importantly, the malpractice system is totally messed up, so it is good policy to reform it. As I tell folks when I am out talking up reform, no matter what you think is wrong with the malpractice system, it is worse than you think. To whit:

*about 40% of malpractice suits are filed when there is no injury, much less malpractice.
*when true negligence in care is present, only 4% (yes, 4 out of 100) result in any sort of suit.
*when negligence is present, a suit is filed, there is a finding for the injured, only 55% of the money goes to the victim.
*because insurance is an integrated business, some of the spikes in premiums are linked to losses in other sectors, like property.

So, there is a problem with too many suits, too few suits and inefficient compensation when there is an appropriate suit.

My hunch is the group most protected by the current system is actually bad doctors. The cats v. dogs nature of the current adversarial system mean they skate through on the systemic animosity.

If med mal reform was a step away from adversarial system toward a patient safety one, that would be good policy. And good politics to boot. Mr. President, you should play an Ace on Thursday. Either it leads to a deal, or you have the maximum cover to argue for reconciliation clean up after with House passing Senate bill.

Here is what I have written on med mal last summer, with a back up post here with lots of stuff.

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