Tuesday, September 15, 2009

• Health Care – What Are You NOT Hearing?

The lawyers and legal minds holding the joystick of politics in America’s White House and Congress, are afraid to make a move. The administration and legislature are staying away from confronting their friends, and former classmates, in the legal profession.

America is holding fast on its resistance to health care reform. The double talk and confusion from Washington is abundant, however the leadership is unwilling to implement changes that could dramatically reduce health care costs such as those that could easily be acted on pertaining to tort reform. We are provided claims such as those from the “nonpartisan” Congressional Budget Office report that malpractice litigation represents only 2% of health-care costs. This one is very “misleading,” since lawyers have always made up the majority of representatives sitting in Congress. It also purposely ignores the real costs burdened onto physicians, and the costly “actions” they take to protect themselves from being financially wiped out. Insurance premiums are just the beginning of the overhead. Defensive medicine has nothing to do with health care, but with doctors protecting themselves, and there is almost no viable measurement on the hundreds of millions that this truly mounts to.

You could extrapolate some numbers such as the 83% of doctors in Massachusetts who order tests they know are unnecessary in order to minimize their potential liabilities. When doctors already pay up to $250,000 per year in malpractice insurance, it is understandable that protecting themselves as much as they can, comes naturally. This is defensive medicine, … not the good kind, but the expensive kind. These tests are not preventive care defending patients against future illness. These defensive actions come from doctors protecting themselves against lawyers of the ambulance chasing kind. While some doctors can be accused of offensive medicine by ordering extra, not wholly necessary tests, don’t believe for a moment that there can be no agreement on what constitutes defensive medicine. You might also ask yourself on average, and in their general population, would you trust more of the doctor, or would you trust more of the lawyers?

Federal tort reform must be implemented, such as bringing under control the size of verdicts handed down by the courts, as well as placing serious caps on noneconomic and punitive damages. It is also critical that the fees taken by law firms in all such cases be reviewed and percentages controlled and capped. Let’s not submit to the bromide that lawyers are society’s first line of defense against private or civil wrongs. That claim is a virtuous and finespun abstraction on justice, no matter how much we wish it to be a truism. We have been witness to enough abuse of the legal system by lawyers over the past twenty years. It is time to close the open season trial lawyers have enjoyed on the medical profession, and bring the enormous judgments into the realm of reasonableness.

Obama refuses to support limits on liability. Does he really want reform of the medical care system? His words are delivered emphatically, but they are vacuous. He seems incapable of taking a specific stand against his friends and financial supporters in the legal profession. Congress is right behind him from both sides of the isle. Neither Democrats nor Republicans seem willing to launch a determined heads-on confrontation with the waste, although some of the reticence can be explained by the fact that the Democratic party took $47 million in contributions last year from the its benefactors in the legal profession. The lip service we are subjected to is easily dispensed, but accomplishes little. The White House and Congress would demonstrate more honesty if they would only pick a side, … address health care needs of taxpayers OR admit to supporting the very financially supportive legal profession.

There is much to be fixed before you ever get to a complete overhaul of the health care system. When there is a dearth of will to implement partial corrections, or controls, pertaining to waste and abuse in the existing system structure, there can be little hope for serious reform other than pursuit of ideological doctrine. Tort reform would be a start, though only a start, on the long road to an improved and sustainable system.

The American public is right to be suspicious of leadership that will not take immediate and specific action that would reduce an estimated $200 billion dollars from the Nation’s annual medical bill. How can taxpayers not be apprehensive of a program whose point person, Secretary Kathleen Sebelius, previously led the Kansas Trial Lawyers Association? This is more assurance that “change,” is not coming.

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