TorteDeForm

Michael Townes Watson

Even the Best Doctors Know The Causes of Rising Healthcare Costs

This week’s New England Journal of Medicine contains an article (Nov. 8 issue) entitled “Addressing Rising Health Care Costs — A View from the Congressional Budget Office.” The article is interesting not only for what it states, but also for what it does not state. Let’s start with what it states.

It first addresses the serious and continuing rise in the cost of healthcare, concluding: “If costs per enrollee in Medicare and Medicaid continued to grow at the same rate as they have over the past four decades, federal spending on those two programs alone would increase from about 5% of the gross domestic product today to about 20% by 2050 — roughly the share of the economy now accounted for by the entire federal budget.” It then goes on to raise a solution to the problem—

“A variety of evidence, however, suggests that there are opportunities to constrain health care costs without incurring adverse health consequences. One approach that could reduce total health care spending (rather than simply reallocating it among different sectors of the economy) involves generating more information about the relative effectiveness of medical treatments and enhancing the incentives for providers to supply, and consumers to demand, effective care.”

Now let’s talk about what it does not state. Nowhere in the article is there a claim that any part of the solution for rising healthcare costs would be to have further tort reform (a view discussed and refuted by Kia Franklin in this blog on Nov. 1). The tort reform movement, and its claim that medical malpractice reform decreases healthcare costs, has already been thoroughly defeated by the Congressional Budget Office. (See this document from AmericasTunnelVision.com, showing the finding that the medical malpractice tort reforms instituted have had no significant statistical impact on healthcare costs).

According to the NEJM article, “the financial incentives for both providers and patients tend to encourage the adoption of more expensive treatments and procedures, even if evidence of their relative effectiveness is limited. For doctors and hospitals, these incentives stem from fee-for-service reimbursement, which encourages providers to deliver a given service efficiently but also creates an incentive to supply additional or more expensive services — as long as the payment exceeds the costs.” In other words, the profit motive of providers seems to be a much bigger problem than the “hungry trial lawyers” we hear so much about.

Even our country’s foremost physicians, writing in its foremost journal, do not seem to claim that the problem of rising healthcare costs can be remedied by tort reforms, so why do the tort reformers continue to blame the high cost on injured patients and lawyers?

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Michael Townes Watson, author of America’s Tunnel Vision—How Insurance Companies’ Propaganda Is Corrupting Medicine and Law. www.StopMedicalError.com.

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Posted at 10:46 AM, Nov 08, 2007 in Debates with Tort "Reformers" | Debunking Tort "Reform" | Health Care | Health Insurance
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Comments

This article brings out a major problem with healthcare in America. The problem of "evidence based medicine". In medical terms, "evidence based medicine" refers to an analysis of current diagnostic techniques, treatments and their results. A common "evidence based study" would be that mamograms in women over 40 can pick up 60% of occult breast cancers. MRI can pick up 60% but are extemely costly. You then look at other criteria and come up with the best compromise that will catch the most cancers with the lowest cost. Then, there is "tort evidence", where you say in hindsight that a MRI of the breast should have been done since this patient developed cancer and it should have been caught sooner. So, what do you make the standard of care? We can MRI every woman and an incredible cost and not have enough money for other medical problems or we can except the results of "evidence based medicine" but to do this means that there will be missed cancers.

This is the classic problem that is faced everyday in medicine. Just look at vaccines. In the early 1900's there were hospitals full of patients with polio. These patients had lifelong problems that resembled cerebal palsy. With the onset of vaccines, polio is all but unheard of, instead we have sued the vaccine makers for the known one in 100,000 side effects of the vaccines. Where do we want to draw the line? Save millions of people or be sued for millions of dollars. We can't have it both ways.

What would "tort reform due"? If done correctly, it would help us practice "evidence based medicine" instead of "tort based medicine". With evidence based medicine, we have real data that tell us how many patients we can treat for what cost and make some big decisions on healthcare. Without "tort reform", we will spend all our healthcare dollars preventing lawsuits instead of disease.

Posted by: throckmorton | November 8, 2007 11:39 AM

People may stop reading upon seeing the source, the New England Journal of Medicine. That left wing rag has the credibility of Soviet claims to inventing lipstick and Coca Cola. It is a Commie journal, pushing for central government, Commie control of the entire health budget, Commie Care. It allows no substantive rebuttal, nor balance, being a Commie propaganda rag.

If you are a patient (everyone over 30 is a patient), expect the limit of spending in Commie Care to be in the dozens of dollars. If a patient requires care in the $100's, they wait months. If they require care in the $1000's, they go home, die. The article makes that exact point, in lying, misleading words.

See the experience of Princess Diana, at the hands of Commie Care. If the same crash had taken place in the worst slum of the US, she would have had a good chance to survive. A helicopter would have flown her 4 miles to a trauma center. An experienced, Board-certified, thoracic surgeon would have been futzing with her torn aorta in a well equipped operating room, with good support. In France, under Commie care, no helicopter. No trauma center. No surgeon. An ambulance dude futzed at the scene 45 minutes. The ambulance dudes drove around for an hour. They stopped to do street resuscitation, with outdated equipment, and repeatedly. Commie Care assassinated Princess Diana by its gross inadequacies.

Imagine the effect of Commie Care on ordinary people.

Posted by: Supremacy Claus | November 9, 2007 8:41 AM

Medical Malpractice also starts with hectic-ness...I find it amazing that doctors/clinics still don't use technology that is available at their "finger tips" to help them organize their working environments more

Studies show that in most clinics, medical areas that have disorganization the increase of mal-practice is greater...I guess you could apply that theory to any business...take a restaurant for example if you have dis-organization you may have a overcooked or undercooked meal and a bad stomach ache!....not a serious injury or worse death!

Solutions like LOBBY MANAGER (www.lobbymanager.com ) are helping clinics/doctors/dentists, etc with increase efficiency and organization....take a look at this great tool

Thanks..www.lobbymanager.com

Posted by: Lobby Manager | November 9, 2007 12:34 PM

Being too busy and overwhelmed leads to disorganization. Those that see more patients, i.e. inner city ERs tend to see more lawsuits. Lobby Manager doesn't help the multiple gunshot victim coming to the ER by helicopter who will sue the trauma center for his neurologic injury on the basis that perhaps it was the delay getting from the helipad to the OR that caused his disability and not the gunshot.

Posted by: throckmorton | November 10, 2007 7:55 PM

Being too busy and overwhelmed leads to disorganization. Those that see more patients, i.e. inner city ERs tend to see more lawsuits. Lobby Manager doesn't help the multiple gunshot victim coming to the ER by helicopter who will sue the trauma center for his neurologic injury on the basis that perhaps it was the delay getting from the helipad to the OR that caused his disability and not the gunshot.

Posted by: throckmorton | November 10, 2007 7:56 PM