June 17, 2009
Medical Tort Reform
President Obama was booed this week at the annual meeting of the American Medical Association in Chicago. He was booed by an audience that included America's leading medical experts for declaring he was "not advocating caps on malpractice awards." Many the experts know something that Obama doesn't.
It costs a great deal of money, and as great or greater an amount of valuable time, for a medical practitioner to protect himself or herself against malpractice lawsuits. The amount of money involved may run as high as $100 billion a year. The president himself referred to the cost of "unnecessary tests and procedures as part of a ‘defensive' medicine culture created in part by the risk of medical malpractice lawsuits." He called the cost of health care "a threat to our economy" and "a ticking time-bomb." Strange then that a president who declares the nation is sitting atop a ticking time-bomb should declare off limits the most obvious solution.
That solution is medical malpractice reform. One would think that a president who has been pressuring the medical industry to save $300 billion over ten years would jump at the chance to save over three times this amount simply by passing reasonable caps on malpractice suits. Yet having declared himself "willing to listen" to all and sundry -- and having just moments before proclaimed the "need to explore a range of ideas" -- Obama simply slammed the door on any discussion of tort reform. Could this have something to do with the fact that the tort bar has been the largest single contributor to the Democratic Party in recent years?
In his speech to the AMA, as reported by CNN, "Obama urged all players ... to contribute to a workable system that would provide coverage for 46 million uninsured Americans [and children of illegal aliens] while reducing costs and increasing efficiency." These are fine words, except for the deceptive omission of coverage for illegal aliens and except for the fact that Obama's fine words do not mean what they say. He is calling on doctors, insurers, and drug companies to make great sacrifices to bring about universal coverage. The truth is that a government-run, universal health care system, based on a "public option" insurance plan running private plans out of business, would have the ability to do just that. It would cut reimbursements to hospitals, doctors, and drug companies, and as a result all who work in the medical field, from nurses and nurse practitioners to therapists and technicians, would see their incomes decline. Meanwhile, the president says nothing about workers in another sector of the medical field and one that is more highly compensated than physicians or hospital administrators. He says nothing about the abuses of trial lawyers, not in this speech or in any other statement during his entire political career.
It is remarkably disingenuous for Mr. Obama to declare, in the high-sounding but hollow rhetoric in which he excels, the need for shared responsibility, when that responsibility excludes every one of his political backers. "We look out for one another," he declaimed. "That's what makes us the United States of America." Have you ever run across a trial lawyer who "looked after" the interests of the decent, hard-working physicians whom he has sued? I may be mistaken, but I do not believe that John Edwards, who made a great deal of money suing the medical industry, has announced his intention to distribute his vast personal fortune to the public for the purpose of looking out for others. Nor has Michelle Obama, so far as I know, donated to the collective good the hundreds of thousands of dollars in salary and bonuses that she was awarded at approximately the same time that the Senate, in which her husband then served, passed a bill favorable to her employer, University of Chicago Medical Center.
Instead of collective sacrifice, Obama seems to have in mind another wealth transfer scheme that would favor his contributors and political supporters. In a speech in which he railed against more government bureaucracy, Obama affirmed his intention to set up a government-run, public option health care plan. I am beginning to think that the president has some sort of right brain-left brain problem that makes it possible for him to engage in the most astonishing non sequiturs. In the course of one 50-minute speech Obama assured doctors that the government would leave them alone "to be healers," not "bean-counters and paper-pushers." He then urged them to support the creation of the largest government bureaucracy in our nation's history. He referred to "dire warnings about socialized medicine and government takeovers," and then proceeded to lay out a plan for socialized medicine and government takeovers. He followed this up with an even more amazing disconnect: malpractice lawsuits are a threat to our nation's future, a time-bomb, a shadow cast over the very survival of our country, so I will continue to oppose medical tort reform.
One again in this speech, the president made use of what seems to be his favorite word: "fix." "My view is that health care reform should be guided by a simple principle," he concluded. "Fix what's broken and build on what works."
If the president were really intent on "fixing what's broken," one of the first places he would look is the abusive filings of medical malpractice lawsuits. The fact that he has ruled this out suggests that he is not entirely forthright about "fixing what's broken." Instead, it suggests that he is using the term "fix" in quite another sense. The president is not going to touch tort reform as long as trial lawyers remain the largest contributor to the Democratic Party. The fix is in. This is not the new politics of change but the very old politics of pay and play. The trial bar is paying, and Obama is playing along.
The only conclusion one can reach from the president's AMA speech is that he is not really serious about "fixing" health care. He is not serious when he calls on "all players" to make sacrifices. He is not serious about saving $300 billion on health care expenses. He is not really serious about fixing anything. But he is really serious about politics.
Dr. Jeffrey Folks taught for thirty years in universities in Europe, America, and Japan. He has published nine books and over a hundred articles