Jay,
I agree completely with your sentiment. There is no single remedy for improving the efficiency of the health insurance and health delivery markets. No one can say for certain what will work, what won't or worse, what changes will compound the problems. What is needed is an attitude of market experimentation. Rather than mandating new regulations Congress and the president should be encouraging innovation both in the marketing and delivery of health care and health care insurance.

All well and good, Jay; buy try to get legislation, which limits the potential earnings of lawyers, past a legislative body made up of....lawyers

Jay,

Finally, someone who touts "tort reform" without just saying it and not giving us a real plan for the reform. I question whether a majority of the 535 lawyers in DC would approve it, but it is a great idea for experimentation. Why aren't Republicans saying this stuff instead of shouting party mantra, death panels and fearmongering?

I appreciate the article and was pleased to read that other countries have come up with a workable system (medical panels) to both protect the public and hold down medical costs. There are studies in the United States that show that the much touted tort reform would at best save less than 5% in costs.

A lot of our existing problems are systemic. Doctors are human, and thus mistakes are made, but just try and find one that will admit to them, or comment on another doctors shortcomings. Everyone in the medical profession knows of individuals that are just plain incompetent, but the medical profession seems unwilling or unable to police it's own ranks (Try actually reading the Hippocratic oath sometime).

Lawyers take cases based on fees being paid on a percentage basis. Try finding one that will take a case on an hourly basis. This only encourages abuse, yet I see no reform being proposed on this issue.

Insurance companies deny legitimate claims to improve their bottom lines. This is commonly done by requiring the victim to undergo an independent medical evaluation. I can find not a single state that requires that these tests be blind and therefore truly independent. They are paid for by the insurance companies, and unfortunately there are doctors willing to write whatever the insurance writers request in exchange for that payment.

The end result is that we have doctors, lawyers, and big businesses, all making extravagant profits on the misfortunes of the sick and injured. What a system.

Excellent thoughts. There is no need to tie tort reform to health care reform. The New Zealand model seems reasonable. Neither is there a need to tie eliminating Medicare waste and fraud to health care reform. Both issues have significant merit without redesigning the American health care system entirely, as does requiring insurance companies to cover pre-existing conditions and eliminate coverage caps.

New Zealand also has universal health care. I like the idea of this system for compensating patients, but I wonder how much the system depends on universal health care.

President Obama’s heath care promises won’t be kept. Costs will rise exponentially, NOT fall. Therefore, our taxes will be the ones to pay for it. We need to support the goal of covering all individuals through private health insurance. We are NOT prepared to turn our health system over to the government.
http://www.friendsoftheuschamber.com/issues/index.cfm?ID=300 .

Now I've done some more research on this.

It would never fly in this country, IMHO. What Mr. Hancock's blog entry doesn't point out is that the claims are paid by the government -- i.e., the taxpayers. (Maybe the reference to "no-fault" made this clear to others, but it was not clear to me.)

The awards are considered very generous, sometimes including years and years of "lost income" for patients who are injured. I can't imagine how we'd pay for it.

An interesting idea, though.

Lorn: Good point about the fact that the New Zealand system is tax-financed. But the cost to NZ taxpayers is more than compensated for by the much-lower cost of medicine in that country. Partly because the compensation system for malpractice is so much cheaper (and I admit this is probably only one of several factors), medical spending per person in NZ was $1,886 in 2003 vs. $5,635 in the United States, said the Health Affairs piece. What they pay in taxes for malpractice we pay even more in health premiums, doc fees and other charges that pass along the cost of malpractice litigation. On the whole NZ pays much less.

But does New Zealand's constitution guarantee its citizens the right to trial by jury for civil redress?

Ours does. Moreover, how would it be possible for Congress to implement reform in what are, essentially, state tort law claims without violating the Seventh Amendment?

The current medmal system is woefully inefficient, with only 39 cents on the dollar going to claimants. Find out more at www.healthcaretownhall.com/?p=1599

Great solution. Why don't we put this in practice in Maryland and act as the demonstration project. Defensive medicine does cost us all and if Democrats are blind to that then they cannot rail against the realities the Republicans are equally blind to. As it is now, doctors have to practice perfect medicine versus good medicine as lawyers are quite adept in finding the proverbial expert that will determine that some obscure test was not performed thus causing harm and liability. Take lawyers and juries out of the equation and let true professionals sit in judgement.

One part of the solution is to make the losing party pay the winning party's attorneys fees and litigation expenses. This would discourage frivolous claims as well as frivolous defenses, both of which drive up the costs. As for defensive medicine, as long as we have a system in which the consumer of services (the patient) does not bear the cost of the services consumed (because of insurance, medicare or medicaid), unnecessary tests and treatments are inevitable.

As anyone who has ever tried to bring a malpractice suit will attest, the odds are already stacked against the injured patient. Making it more difficult to hold dangerous doctors to account will only increase the danger to patients. Google "Adventures in Cardiology"

AdventuresinCardiology.com

Jay it's a great solution. Unfortunately the trial lawyers wirld far too much power over the Democratic Party. This kind of system will never see the light of day in this country.

Who would sit on this panel of "medical experts?" - other doctors who would likely be biased in determining whether their fellow doctors were at fault. This is why our system of jurisprudence has lay juries - so ordinary citizens can participate in important decisions regarding civil wrongdoing.

The GOP trusts the government to define a frivolous malpractice suit but NOT to standardize best practices in treatment of common illness.

Its easy to defend against most malpractice lawsuits - just say "I followed the standardized testing/treatment plan"

Instead we have a system where even the common cold gets different tests/treaments from different doctors at the same hospital.

The key is universal health care which New Zealand has. One reason for the big settlements in all sorts of tort lawsuits in the US is that the injured parties, no matter who is at fault, face a lifetime of medical bills. The jury knows -- and lawyers emphasize -- that this case is the only shot they get at being compensated for that. So, not surprisingly, even if the facts of who is at fault are not that clear, juries often want to help out these people who otherwise would be saddled with huge debts. Put in place universal health care and those debts vanish. So a no-fault solution -- much like lawyers have agreed to in auto insurance -- is much more palatable.