Friday, February 11, 2011

NC and Tort Reform

I have been wanting Republican leaders in the NC General Assembly to make clear what they are for in the realm of health policy, and it looks like tort reform may be their first step. They appear interested in torts generally, but both Speaker Tillis and Sen. Berger have noted medical malpractice as areas of focus for this NC General Assembly Session. The John Locke Foundation, a Libertarian think tank has this proposal out today.

The medical malpractice system we have now does nothing well. It leads to frivolous suits, and misses most cases of true negligence, and that is just getting started with the problems. If you want a book length treatment of the (many) problems and realities of medical malpractice, this book by my Duke colleague Frank Sloan, and Lindsay Chepke (a lawyer) is excellent.

A few thoughts on tort reform and medical errors (this post has links to multiple primary sources on these and related topics; new one from AMA).
  • Medical errors are a huge problem, and tort reform would best be coupled with a patient safety approach that moved medical errors out of an adversarial system toward one that seeks to learn from mistakes.
  • One motivation of bringing a lawsuit on the basis of harm in the absence of negligence is the cost of medical care and the possibility that an injury could render someone uninsurable. Tort changes in the context of a guaranteed access to insurance for those injured is quite different from tort reform and nothing on the insurance side. In this way, tort is linked to the larger health reform discussion.
  • The Republicans in the General Assembly seem clearly opposed to the Affordable Care Act. It is easy to be opposed to something, but now they need to say what they are for in the way of expanding insurance coverage. I have noticed more persons willing to say privately (and some publicly) that they reject the notion that universal coverage is a worthy goal. I have no idea if this is the position of few/some/many Republicans in NC, but if it is their position it would be good to make that clear. If it is not their position, and universal coverage is something they want to work toward, they should say how they plan to do that.

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