Monday, August 31, 2009

Cost of defensive medicine is indeed significant

Jay Hancock in his article regarding health care malpractice costs ("Health care myths obscure the much tougher decisions," Aug. 6) cites information from the Congressional Budget Office that "malpractice costs make up only 2 percent of health care spending" and WellPoint Insurance, which says litigation and defensive medicine "are not considered a significant recent significant factor in the overall growth of health care spending."

Well, I guess it depends on who you talk to.

In a Massachusetts Medical Society survey of 900 doctors published last November, 83 percent of Bay State physicians cited the fear of being sued in their decisions to practice defensive medicine. According to the doctors anonymously surveyed, on average, 18 percent to 28 percent of tests, procedures, referrals and consultations and 13 percent of hospitalizations were ordered to avoid lawsuits. All of this adds at least $1.4 billion to annual health care costs in Massachusetts alone, and national estimates range as high as $200 billion.

A 2006 Harvard School of Public Health study found that four out of every 10 medical malpractice lawsuits filed in America each year were "without merit." Nonetheless, defending against such lawsuits imposes costs on doctors, hospitals and insurers that invariably are passed on to health care consumers. Beyond the obvious costs of litigation, more subtle costs related to the practice of "defensive medicine" are contributing to runaway health care inflation.

Texas has joined 24 other states in enacting reforms that include a reasonable limit on noneconomic damages for pain and suffering of up to $750,000 per incident. This reform does not limit compensatory awards for calculable lost wages and medical expenses, but it does balance the interests of patients and care providers while helping to ensure access to necessary care. Now, according to Gov. Rick Perry, doctors' insurance rates have declined by an average of 27 percent while the "number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In ... just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time."

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