Re: The Power of the SCOTUS III: Roberts' Rules of Order
I'm sorry to bring old stuff back up, but I haven't been here for a while.
I think you're misunderstanding the problem. It's not that these cases are won by plaintiffs to the tunes of billions of dollars, driving up healthcare costs. It's that the THREAT that any random case against any one individual COULD win (decided by juries) that drives up malpractice insurance costs to the tunes of billions of dollars, which is actually what drives up healthcare costs. My bro-in-law has never been sued in near 20 years of practice, but his malpractice insurance premium is incredibly high - I think it costs him more than his take-home pay. That cost is there regardless if he is ever sued.
I don't misunderstand the problem at all. My belief is that medical malpractice insurance companies over-charge on premiums, playing on the fear that doctors have of financial ruin if they were successfully sued and didn't have coverage. It seems to me that insurance companies want each doctor to cover the cost, over his or her career, of a medmal suit. But that isn't what insurance does. My car insurance premiums, over my life, will not cover the cost of the worst possible scenario that could occur. Since most doctors will never be sued, each doctor's premiums should only need to cover a small portion of the risk of lawsuit. So what I'm saying is that I believe that they could, in the current system, charge a fraction of what they do, and still maintain a healthy profit margin. In other words, I don't think medical malpractice suits drive up the cost of medical care, I believe
unnecessarily high medical malpractice insurance costs drive up medical costs.
Whether or not they are difficult to win, it's the number of Med Mal cases that are in play. It still takes money to hire an attorney to receive a defence (extortion if you ask me; although it's possible to be appointed a public defence attorney, they aren't necessarily up to snuff on medical law), and even then, you have to protect yourself in case the prosecution wins.
It absolutely is extortion if the case is frivolous, and I could support a GOOD system for quickly identifying and eliminating frivolous cases. But the doctor doesn't have to hire an attorney. That's what the insurance is for. Or, that is what the insurance should be for. In any case, I believe that the insurance industry is extorting doctors by over-chargin g for their services. And by extension, they are extorting the general public by forcing doctors to raise fees to cover insurance premiums.
This. Just had a Canadian GP visiting us, and he put the blame squarely on med-mal. In Canada, there are no punitive damages in med-mal cases, so only actual damages can be awarded. His malpractice insurance is C$1500 per year. Equivalent coverage for a US GP is $50k+. Huge med-mal awards are not so common that they alone would cause such a huge increase in cost - but they're common enough that doctor's can't ignore the threat so they have to be insured. The sum total of the insurance premiums has to cover the cost of the awards plus operating costs and profit for the insurers, so the net total cost to the doctors (and therefore their patients) is much higher than the just the sum of the awards and settlements themselves. Eliminate punitive damages and the risk of going to trial would be greatly reduced, so not only would awards come down, every settlement would also come down, and med-mal premiums would sink like a rock.
I really do think that Canada's health care system has something to do with this being a workable solution, too. I personally believe that non-economic damages have their place. I absolutely do NOT support eliminating them altogether.
In any case, my original point was that the actual cost to medical malpractice insurance companies is nowhere near as high as the cost that they pass on to doctors, who pass it back on to us. An attorney who my company works with recently won the largest medmal arbitration award in American history, and it was something like $70 million. the thing is, the plaintiff is a 12-yr-old who will live her entire life with constant medical bills because of a hospital decision to use a medication off-label during child birth, rather than using a medication designed for the purpose, which would cost $125 more per patient. The reason punitive damages come in is that this hospital was by no means the only one doing this. The non-economic damages send a message to other hospitals that if they get in trouble for this, that $125 per patient they were saving was a bad investment.
I do realize that in the end, that money costs all of us, but the insurance industry loves to make it sound like every filing of medical malpractice result in a $100 million judgment. That just isn't true.