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Forest for the trees
Behind only the Iraq war and the economy, Americans are primarily concerned about the affordability of health care - but relatively unconcerned with regulating one of the primary drivers of the upwardly spiraling costs of modern medical treatment.
Such are the findings of a November Harvard School of Public Health affiliated survey of nearly 1400 respondents, according to a recent Associated Press article. The burgeoning costs of medical care and health insurance topped a list of 12 questions regarding health care priorities for the President and Congress.
What's peculiar is that one of the biggest keys to curbing the skyrocketing cost of modern mainstream health care - limiting both the frequency of malpractice suits and the amounts of their awards - scored NEXT TO LAST in order of priority. To summarize: 63% of respondents wanted more affordable health care, but only 26% made the connection between lower malpractice insurance costs for doctors and hospitals and lower insurance rates or out-of-pocket fees for medical care.
What does this tell me? That the rank and file American citizen is somewhat ignorant about what makes their health care cost so much. This is really no wonder, since the pachyderms and pack-mules on The Hill blame each other, while the two main industries that drive costs upward - the drug companies and the insurance giants - point the finger at one another while each escalating expenses in their own right.
Both sides of the argument have valid points…
The GOP argues that the trial lawyers' lobby - more or less the sole province of the political left - forces Congressional Democrats to nix any attempts at limiting lawsuits or malpractice awards, the trial lawyers' bread and butter. This, in turn, raises malpractice insurance premiums, which inflates doctors' fees, which trickles down to you in the form of higher health insurance premiums or a much bigger bite if you pay out-of-pocket.
The Democrats, on the other hand, squawk about the GOP's staunch opposition to allowing the purchase of cheap prescription drugs from Canada and other countries, and their traditional resistance to the legitimization of lower-cost natural or alternative therapies. This, in turn, forces insurance companies to pay more for drugs, and doctors to recommend only the most expensive courses of treatment. The end result is the same, however: Higher premiums or out-of-pocket costs for you. Quite the conundrum…
It's hard to pick one side over the other, but since I can't expect both parties to do the right thing by the public instead of by their coffers (isn't that what they swear an oath to do, though?), I'd have to say I wish the trial lawyers and the politicians in their pockets would consent to limits on malpractice suits and awards. All other things being equal, I think this is where the most money would come from.
As far as prescription drug prices go, I think there are some natural checks and balances in place (like the media, which loves a good drug scandal, but seems never to make a peep about obscene malpractice jackpots) that aren't there in the lawsuit world.
Besides, there's something fundamentally unfair about the notion that everyone should pay more for health insurance - even those who never use it - because of sky-high malpractice awards for a relatively small number of victims. At least the higher drug costs and co-pay fees that drive costs upward are borne in part by those who actually need (or are told by their misguided mainstream MDs that they need) medical treatment.
It's far from perfect logic (or a total solution), but it just seems fairer to me somehow. Perhaps if people understood the issue a little better, there'd be more pressure on ALL lawmakers to capitulate. Maybe not, though, if the latest news from Maryland is any indication…
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Adding weight to a legislative "Titanic"
Democrats in the Maryland state legislature have stayed true to their party's pandering to the trial lawyers and insurance giants, voting to override Republican Governor Bob Ehrlich's veto of a so-called "malpractice" bill originally promoted and passed by that state's overwhelmingly Democratic legislature.
The bill, which was sold to the public as a law designed to curb malpractice insurance costs, still allowed a 5% INCREASE in insurance rates this year!
According to a January AP report, the embattled, yet highly-rated-by-the-public Governor (the first in the overwhelmingly Democrat state from the GOP in more than 30 years), vetoed the initial bill on the grounds that it was "incomplete and inadequate" for real malpractice reform. The passage of the bill represents a shrewd move for Democrats: A paltry reduction in the maximum award allowed for a patient's death allows them to position the legislation as a "malpractice" bill that the Governor opposed - while still allowing their trial-lawyer and malpractice insurance cronies to collect big time.
One state-house Republican said the measure "rearranges the deck chairs on the Titanic."
Always thinking, never sinking,
William Campbell Douglass II, MD
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