Don't blame malpractice suits

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Editorial: Don't blame malpractice suits

The des Moines Regester

 

Reforming health care takes a lot more than caps on liability awards.

 

By Register Editorial Board

 

02/20/2003

 

During President Bush's State of the Union address, he said one of the " prime

causes " of rising health-care costs is " the constant threat that physicians and

hospitals will be unfairly sued. " Because of excessive litigation, he said,

" everybody pays more for health care. . . . I urge the Congress to pass medical

liability reform. "

 

 

Would that really help?

 

Is the threat of lawsuits a " prime " factor in skyrocketing health-care costs?

Would capping the damages in lawsuits have a measurable effect on the cost of

health care?

 

It's unclear how this could be true.

 

The medical-malpractice premiums physicians pay are not as expensive as the

public is being led to believe. In 1990, the average physician's salary was

$164,300. The average malpractice premium was 8.8 percent of that salary. In

1997, the salary increased to $199,600, and the amount spent on malpractice

premiums dropped to 7.1 percent of the salary. Insurance got less expensive in

proportion to salary.

 

Between 1988 and 1998, total U.S. health-care costs increased 74.4 percent. The

costs for medical malpractice increased a mere 5.7 percent during the same

period.

 

And is there " excessive litigation " ?

 

It's unknown what the president would consider a " reasonable " number of

lawsuits, but this is known: The percentage of suits is dropping. The number of

malpractice claims per doctor dropped between 1998 and 2001. Claims per insured

hospital stayed the same during that period.

 

Granted, in the everyday world of the doctor's office, the threat of lawsuits

can affect how medicine is practiced. Physicians fear being sued, so they order

tests, prescribe medications and refer patients to specialists that may be

unnecessary. That fear can certainly drive the overuse and misuse of health-care

services, which can drive up costs. But the extent of the increase due to this

fear factor is impossible to measure.

 

There's little evidence to support the idea that the threat of lawsuits is a

major cause of the inflation in health-care costs. There's even less evidence

that federal legislation capping damages in lawsuits will measurably affect

those costs.

 

Malpractice awards belong far down the list of causes for spiraling health-care

costs. Debating them diverts attention from efforts to make real improvements to

the system.

 

 

 

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