Obama Offers To Consider Malpractice Reform To Obtain Support From AMA

Obama is looking like a smart politician, in the occasional good sense of the word, as he tries to obtain the support of the American Medical Association for health care reform. The New York Times reports that Obama discussed malpractice reform:

The American Medical Association has long battled Democrats who oppose protecting doctors from malpractice lawsuits. But during a private meeting at the White House last month, association officials said, they found one Democrat willing to entertain the idea: President Obama.

In closed-door talks, Mr. Obama has been making the case that reducing malpractice lawsuits — a goal of many doctors and Republicans — can help drive down health care costs, and should be considered as part of any health care overhaul, according to lawmakers of both parties, as well as A.M.A. officials.

It is a position that could hurt Mr. Obama with the left wing of his party and with trial lawyers who are major donors to Democratic campaigns. But one Democrat close to the president said Mr. Obama, who wants health legislation to have broad support, views addressing medical liability issues as a “credibility builder” — in effect, a bargaining chip that might keep doctors and, more important, Republicans, at the negotiating table.

On Monday, Mr. Obama will go to the annual medical association meeting to face a group that has come out against a central component of his broader health care proposal — his call for a new public insurance program that would compete with the private plans. The White House says he will make the case that “reform is the single most important thing we can do for America’s long-term fiscal health,” and how important it is to have the cooperation of doctors.

But whether he can get them on board is an open question. The speech comes as the president’s ideas on health reform are facing mounting criticism — not only from the A.M.A. and Republicans, who also vehemently oppose a new public plan, but also from the hospital industry, which is up in arms over a proposal Mr. Obama announced on Saturday to pay for his health care overhaul in part by cutting certain hospital reimbursements.

Medical liability is an important component of the debate, but that, too, is controversial. White House officials said Mr. Obama was likely to refer to the issue in his speech to the medical association, but would not offer any specific proposal.

Mr. Obama has not endorsed capping malpractice jury awards, as did his predecessor, President George W. Bush. But as a senator, he advanced legislation aimed at reducing malpractice suits. And Dr. J. James Rohack, the incoming president of the medical association, said Mr. Obama told him at a meeting last month that he was open to offering some liability protection to doctors who follow standard guidelines for medical practice.

“If everyone is focused on saying, ‘How do we get rid of unnecessary costs,’ ” Dr. Rohack said, recounting the conversation, “if we as physicians are going to say, ‘Here’s our guidelines, we will follow them,’ then we need to have some protections. He listened and he said, ‘Clearly, that concept is worthy of discussion.’ ”

Health care experts estimate that preventable medical errors kill more than 100,000 Americans each year, yet doctors and hospitals, fearing lawsuits, do not openly discuss their mistakes — an impediment to improving quality of care. At the same time, doctors complain that “defensive medicine” — ordering tests and procedures out of fear of being sued — drives up health costs.

Many liberal bloggers are protesting any action by Obama to limit malpractice suits, but limiting frivolous suits and ultimately reducing money wasted on defensive medicine should be in the interest of those supporting malpractice reform. Steve Benen isn’t as upset about this as some other liberal bloggers (such as here), seeing room for compromise which can be beneficial, but also points out that Republican claims of a “lawsuit crisis” are “patently ridiculous.”

Steve is right that many conservatives have exaggerated the role of malpractice suits, greatly exaggerating the potential savings if malpractice suits were to be eliminated. While their impact is exaggerated, frivolous lawsuits do remain a real problem and this is a concern to the American Medical Association. The more the claims of a “lawsuit crisis” are “patently ridiculous,” the easier it will be to take actions to reduce malpractice suits without such actions being harmful. Obama is doing the smart thing in trying to seek the support of the American Medical Association by offering support for a reasonable goal which is supported by physicians. Compromise is possible as many physicians do support changes to provide greater access to health care and reduce unnecessary costs.

Obama does not go along with capping malpractice awards which many physicians want. While I can see where some liberal bloggers would object to caps which limit the awards of those who are truly injured, there is no reason not to take other actions which will reduce frivolous suits (unless one’s primary goal here is preservation of income for trial lawyers). Personally I’ve always seen more benefit from actions to make it more difficult to file frivolous suits than to cap awards. Certainly the potential for tremendous awards will motivate some trial lawyers, but lawyers also file many suits knowing they will not receive a huge award, and are just rolling the dice hoping they can con a jury into paying out more than what it costs them to take a case.

While conservatives often exaggerate the costs of malpractice suits, defensive medicine does add to medical costs and it is to the benefit of supporters of health care reform to reduce such unnecessary expenses. Health care reform can also be of benefit to physicians who are concerned about malpractice suits. Patients who suffer adverse results, which may or may not be due to actual malpractice, often see a law suit as the only way to ensure they will have coverage of their medical expenses in the future. Universal health care would eliminate the need for malpractice awards to be able to afford future health care. Ideally we should separate payment for medical problems, whether or not due to malpractice, from the court system. Compensation to patients who suffer adverse outcomes should be more based upon their legitimate needs as opposed to whether they can prove malpractice and win a court battle, and evaluation of the quality of medical care should be handled separately from malpractice suits which do a poor job of evaluating the quality of medical care.

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