Lion of the Blogosphere

Tort reform?

“gda” writes in a comment:

Krauthammer says tort reform alone would lower health costs 25%. But of course the lawyers work assiduously to make sure there is no real discussion, and certainly no implementation, of that.

Great idea, Republicans should work on tort reform instead of repealing Obamacare. Everybody would win except for lawyers.

Written by Lion of the Blogosphere

July 19, 2017 at 2:03 pm

55 Responses

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  1. Many (most?) States already have relatively strict liability caps in med mal cases so Krauthheimmer is pulling this out of the air.

    Two in the Bush

    July 19, 2017 at 2:06 pm

    • I’m not sure why anyone would cite krauthammer as an authority on anything. Who’s next? David Brooks? Tom Friedman?

      Magnavox

      July 19, 2017 at 5:02 pm

  2. I’m a pretty big fan of tort for physicians (and not just because I’m married to a doc), but that 25% figure is just crazy.

    trumwill

    July 19, 2017 at 2:07 pm

    • Agreed. I am against all those malpractice suits also, but they eat less than 1% of our health system.

      Schlafly

      July 19, 2017 at 9:34 pm

  3. Why not effectively regulate health care so that they stop killing hundreds of thousands of people every year?

    Magnavox

    July 19, 2017 at 2:15 pm

    • Because that would mean getting rid of vast numbers of incompetent doctors, nurses, etc. (I think Thomas Sowell had some stat on some minority of medical professionals doing most of the actions that got the malpractice suits.) And no one – bar no one – would like seeing the demographics of the people who were got rid of versus the ones kept on.

      Also, there is such a thing as inherent unhealthiness, and we’d have to have awkward discussions about how much medicine can actually achieve.

      Then, of course, there’s the famed doctor shortage. (Isn’t it fascinating that we had to let in all these doctors and nurses so they could serve people in rural isolated areas, and the newcomers promptly…went to the cities and suburbs, leaving the poorer people still without medical care and now even more priced out of the cities?)

      The problem with tort reform is that, without a LOT of uncomfortable decisions and structural changes, it would simply remove the financial penalty for bad or malicious medicine.

      Jesse

      July 19, 2017 at 4:49 pm

      • Yep. There is an enormously expensive diversity tax deeply embedded within our health care system. And it would only get much, much worse with any kind of single payer system.

        Andrew E.

        July 19, 2017 at 6:09 pm

      • I think we could increase the number of less competent doctors by, for instance, generating standardized air plane pilot checklists for as many of their activities as possible.

        It’s impractical to increase safety by further increasing the IQs of doctors and nurses rather than through procedural reforms.

        And I for one would like to see an across the board outlawing of affirmative action and would be happy to see all those fired black doctors, especially if it were instituted along side a repatriation that paid them to leave the country for good. So don’t say noone wants it but I hardly think it’s required to dramatically increase safety

        Magnavox

        July 19, 2017 at 7:53 pm

  4. I assume most of the savings would come from fewer medically unjustified, defensive-medicine tests and procedures and lower malpractice insurance rates for doctors and hospitals, which might pass on some of the cost-savings to patients. Still, Krauthammer probably exaggerates the savings by a factor of 10:

    “Savings from ‘tort reform’ are mythical”
    http://www.latimes.com/business/hiltzik/la-fi-mh-another-study-shows-why-tort-reform–20140919-column.html

    Mark Caplan

    July 19, 2017 at 2:21 pm

    • The crazy thing is that as full of shit and inflated as the 25% number is, the US could legitimately expect a 60% reduction by adopting a genuine first world style system.

      Magnavox

      July 19, 2017 at 7:56 pm

  5. America’s litigious legal system desperately needs to be remedied, but the underlying need to sue individuals or entities is now deeply embedded in the American psyche. Changing the legal system will need an underlying change in the way Americans see themselves and the world around them. To a large degree this will mean taking responsibility for your own well-being and not expecting the government or corporate entities to do that for you 120% of the time. Fingers crossed this can actually be done.

    Roli

    July 19, 2017 at 2:32 pm

  6. That percentage seems way high, and on a state by state basis, it’s not made that much of a difference; probably because doctor’s are not going to just suddenly stop practicing defensive medicine. That would take a generational switch. Still…it could reduce medical cost increases in the future, but that’s harder to measure.

    Mike Street Station

    July 19, 2017 at 3:12 pm

    • This “defensive medicine” line is bogus. Doctors pad the bill with unnecessary tests. It’s about money. Doctors also routinely hurt and kill people with unnecessary treatments and drugs, and are often criminally negligent in their failures to correctly diagnose. Iatrogenesis is a leading cause of death in America.

      bobbybobbob

      July 19, 2017 at 3:58 pm

      • Pretend cynics who claim that it’s “always about money” should at least demonstrate how physicians profit from sending patients to labs that have no connection to their physician’s practice.

        Mike Street Station

        July 20, 2017 at 6:13 am

      • There’s no downside for a physician recommending tests. (1) avoid lawsuits (2) maybe results in more billable work for the physician.

        Lion of the Blogosphere

        July 20, 2017 at 7:11 am

      • “This ‘defensive medicine’ line is bogus”

        I kinda agree. Of course doctors (and their apologists) are going to use fear of lawsuits to justify their wasteful self-interested behavior.

        fortaleza84

        July 20, 2017 at 10:23 am

      • ” labs that have no connection to their physician’s practice.”

        Those labs have representatives who are constantly wining and dining the doctors who are sources of referrals. Probably a lot of them are getting actual payoffs as well, but there’s no way to look up the frequency of this practice online.

        fortaleza84

        July 20, 2017 at 10:25 am

  7. This will not happen. Mates, please…. I’d spent 3 years in family court and 1 year in criminal court systems. They are beyond repair. On my next break gonna tell you a real riot of a story. Realy, mates, it’s a waste of time. Tort reform, lolz!

    I wanna see E-verify. When?

    Yakov

    July 19, 2017 at 3:54 pm

    • When Trump starts going after corporations for environmental damages, worker abuses, monopolist practices, financial crimes, etc. Which is to say never because Trump is corporatist scum

      Magnavox

      July 19, 2017 at 7:59 pm

  8. Probably the best results of tort reform would be reducing the flow of cash to attorneys, who are invariably major donors to the Democrats. Tort reform is a small part of starving the beast.

    Still, the odds of our current political class pushing tort reform are about as good as the odds of finding a black guy at a TED talk.

    peterike

    July 19, 2017 at 4:11 pm

  9. This is idiotic. Most of the inflation in medical care prices has been due to a lack of price transparency and insurance company reimbursement games (really a derivative of price transparency).

    No price transparency has resulted in health care providers (hospitals, insurance companies, doctors, etc) colluding to bill $2 syringes as $600 treatment devices. It is currently cheaper to fly to Japan and pay $300 for an MRI than it is to buy one outright for cash in the US ($3,000). It is a broken market because the government colludes with healthcare providers to maintain the status quo. Why do they do it you ask? Because healthcare is currently 20% of the economy (GDP). If healthcare costs fall even a modest 10% that would make growth negative for the year and economists would be forced to call a recession. What politician wants to be in the same headline as causing a recession?

    From this we can conclude two things:
    1) the US healthcare system is systematically broken to the point of being an outright fraud
    2) no politician will touch it because the short term pain is too significant and the lobbies against doing the right thing too strong

    Enjoy the last days of the republic before the roving hoards begin.

    OldTimer

    July 19, 2017 at 4:15 pm

    • That’s a very interesting point about causing a recession. But you have to acknowledge the limits of price transparency, because many patients are simply unable to shop around either because of their condition or location. For those services government needs to do what the insurance companies have tried (at least according to them) and failed which is to set fair prices. The government currently already does this for utilities like gas and water and health Care is regulated this way in every other developed country.

      Magnavox

      July 19, 2017 at 5:00 pm

      • It’s a bullshit canard that people can’t shop around. There are also ALREADY laws on the books about price gouging people under duress. Try charging someone $20 per gallon plus blowjobs for gas during a hurricane and see how long you avoid being taken away by men in black suits to federal pound me in the ass prison.

        Most sudden death illnesses like heart attacks can have prices posted ahead of time and people can explicitly will which hospital to go to in the event of an emergency.

        There is not a single contingency existing laws don’t cover. It is all a massive scam on the American public including intelligent people like yourself. If the posters at this blog can barely grok the magnitude of the fraud (and believe me it’s on the level of the food pyramid/global warming/race realism) then the general public will barely be able to comprehend the screwing they are currently taking.

        Insurance is still necessary but only for unpredictable catastrophic illnesses like cancer. Though with old age even cancer becomes predictable for many unfortunately.

        Insurance is for truly random events.

        Paul Ryan's Sickly Old Lapdog

        July 19, 2017 at 9:54 pm

      • the last thing a sick person wants to do is shop and haggle with his insurer. there are purely economic reasons for single payer. 1. inelasticity of demand (sick people will pay whatever it costs) 2. complexity (including how to tell a good doc from a bad one. how does a patient know what’s good for him?)

        Beverly Hills Ninja

        July 20, 2017 at 1:09 am

      • And no way to know the difference between a good health insurance plan and a bad one. They are too complicated for anyone to understand except the lawyers who work full-time writing the health-care plans.

        Lion of the Blogosphere

        July 20, 2017 at 7:07 am

      • Most sudden death illnesses like heart attacks can have prices posted ahead of time and people can explicitly will which hospital to go to in the event of an emergency.

        Now you're in libertarian la la land.

        Magnavox

        July 20, 2017 at 4:40 am

      • Really lion? You’ve never started a new job and had pick an insurance plan?

        Plus we are talking about shifting to an all cash market because prices will be low like in other countries, so no more haggling with insurers.

        You really telling me someone can’t come up with 10k for a heart operation (assuming prices return to historic norms instead of the 1000% mark up we have now)? They can do that with credit cards alone and pay the balance back over 4-5 years (3K per year ie 250 a month). It will be a financial strain but not ruinous for the median household.

        Heart attack stents etc are routine procedures now, there is no reason prices can’t be posted ahead of time. If any hospital refuses, the government can do its job and prosecute them under US 501C hundred year old monopoly law.

        Paul Ryan's Sickly Old Lapdog

        July 20, 2017 at 9:14 am

      • Beverly hills ninja: but it’s not single payer it’s price controls. Lots of other first world countries don’t have single layer as far as I can tell they all have price controls.

        Magnavox

        July 20, 2017 at 12:48 pm

    • Similar to the GDP and recession argument, healthcare is a major employer that is filled with make work positions. Just to ballpark figures from the Bureau of Labor Statistics, in the private sector between 2012 and 2016 the number of “health care and social assistance” employees in the US grew by 12.4% while all private sector jobs grew by 8.9% and healthcare workers are about 15% of the private sector labor force. If, hypothetically, the US could make the administrative part of health care like billing as efficient here as it is in Canada, then hundreds of thousands, if not millions, of people would be out of work.

      Lion’s post scarcity economy isn’t farming gold in WoW. It’s trying to make grandma live to 200.

      Aristippus

      July 19, 2017 at 6:48 pm

      • America is just a marketplace. Any smart reader here knows it. It’s all about money and frivolous consumption.

        Canada is a real country. It’s cleaner, safer, less bureaucratic, and the citizens are more civic minded. There is a less of a shopping culture, because people earn less/taxes are higher. Is this a bad thing? Not necessarily.

        Disposable monthly income in the New World, by country, state and province (for Canada).

        Just look at New York, and this is the reason why Yakov will stay put.

        JS

        July 19, 2017 at 7:53 pm

      • Anyone else surprised that Nunavut came out of nowhere?

        Lion o' the Turambar

        July 20, 2017 at 7:23 am

    • the same goes for the military industrial complex. this is late capitalism/post scarcity. most work isn’t really work. and even the fake work is hard to come by. all but 10% of the population could stay in bed and it would be hard to tell.

      Beverly Hills Ninja

      July 20, 2017 at 1:04 am

    • If you want to price an MRI, you can simply use an insurance company treatment calculator (available onlline) to find out what the actual insurance cost is for an MRI, or just ask your lab what the cost is. In almost all cases, you can just pay that amount rather than retail if you just ask beforehand.

      The prices are there, they’re just complicated because they vary per service and location.

      Mike Street Station

      July 20, 2017 at 6:19 am

      • This is a great theoretical proposition but how many people can actually do this? Show up at a professional MRI center and try to haggle. Unless you actually know all the ins and outs they don’t give a shit if they don’t get your $300 of business but can continue to price gouge everyone else.

        Paul Ryan's Sickly Old Lapdog

        July 21, 2017 at 12:40 pm

      • “This is a great theoretical proposition but how many people can actually do this? Show up at a professional MRI center and try to haggle.”

        Well you usually have to make appointments for these sort of things (unless emergency) so you should probably inquire about pricing then. However this is a strategy for people who don’t have insurance, and people who don’t have insurance are usually not the types to have the foresight to try to make arrangements…otherwise they would just have insurance and pricing is a moot point,

        Mike Street Station

        July 23, 2017 at 7:59 am

  10. So-called “tort reform,” insofar as it refers to medical malpractice is the single biggest phony issue in American life over the last 25 years. Even if you believe that physician/hospital pricing somehow follows malpractice insurance rates (highly doubtful) those rates in no way reflect the actual risks of malpractice litigation. It is almost impossible to get a lawyer to take a med-mal case, because the costs involved are so high in relation to the likely recoveries (the main reform – capping non-economic damages – was achieved long ago). That situation has only been exacerbated by the trend of the last 15 years or so, in which courtrooms in urban areas are effectively unavailable for ANY type of civil litigation. In short, linking availability of medical care to “tort reform” is like saying Mitch McConnell would be a more effective Senator if only he had a better choice of spots to have lunch.

    Sid

    July 19, 2017 at 4:38 pm

  11. i wonder where he got that 25% from. there are 2 expenses. the first is the expense of law suits and liability insurance, but this is like 1% iirc. so he must be guestimating that unnecessary thoroughness/covering the bases causes the remaining 24%.

    the dems will oppose tort reform because trial lawyers are among their biggest donors…not because tort reform isn’t needed. according to forbes the US spends more than any country on torts as a % of gdp. and liability insurance has loss ratios often < 50%. think of all the scammers involved. ambulance chasers, liability insurance companies and their salesmen, law schools producing far too many lawyers many of whom must therefore turn to ambulance chasing to make a living. #libertarianparadise.

    Beverly Hills Ninja

    July 19, 2017 at 4:40 pm

  12. 25% reduction from tort reform is too high a figure, although I am certain it would have some impact. One place to cut costs would be stopping reimbursement for procedures that lack evidence, like knee arthroscopy. Another place to remove waste would be stopping direct to consumer pharmaceutical advertising.

    R P

    July 19, 2017 at 5:15 pm

  13. The elephant in the room that no one ever brings up is that modern medical care is expensive because modern medicine uses a lot of expensive things.

    ICU care that did not even exist 50 years ago, takes up a huge proportion of health care dollars, on relatively few people.

    Surgeries use fancy technologies, we have many more, and more expensive drugs.
    Everything in medicine is fancy, new, and not cheap at all.

    Obviously, we see diminishing marginal returns on medical advances because things like penicillin were low hanging fruit. A newer, better antibiotic without huge amounts of bacterial resistance are hard and expensive to develop, and when they come out everyone wants to use it, because we’ve treated our way into a corner.

    Healthcare is only going to get more and more and more expensive. The end.

    Yes, administrators and insurance companies and bureaucrats and medical device cartels are skimming off the top. But even if we fixed this, health care costs are still a cancerous tumor that can only grow larger. The end.

    The only way to cut costs is to take a hard look at the marginal return on expensive treatments (aka death panels). Republicans will never go for this because it goes against the “free market” and is like abortion for old people, and democrats are only too willing to bankrupt us giving charity care to poor brown people.

    jjbees

    July 19, 2017 at 7:54 pm

    • MRI was invented thirty years ago. The cost of research has be recouped. Why is it $3000 for an MRI in the US and $300 in Japan?

      Because fraud and collusion that’s why. Your point is fair, medicine uses expensive things at the cutting edge, but anyone who points to anything other than monopolistic practices for the cost of most routine care is a bald faced liar.

      Paul Ryan's Sickly Old Lapdog

      July 19, 2017 at 10:00 pm

    • There is no incentive to fix healthcare in the US. If healthcare costs go down the economy undergoes a collapse worse than 2008 tomorrow.

      We aren’t talking about 30% correction the S&P we are talking S&P at 300 and the Dow at 3000.

      Paul Ryan's Sickly Old Lapdog

      July 19, 2017 at 10:01 pm

    • Trump will focus on consolidating power before popping the global debt bubble. You heard it here first.

      Immigration will be solved (whatever that means) long before any fiscal policy issues are addressed. Which is just well and dandy. Let’s use the global financial machine to our advantage for once and bleed the globalist a dry.

      We are going to rebuild nationalism and the globalists will pay for it.

      Paul Ryan's Sickly Old Lapdog

      July 19, 2017 at 10:04 pm

      • Consolidating power in the US? Where the establishments of both parties hate his guts and he has dismal approval ratings? Good luck with that

        Magnavox

        July 20, 2017 at 4:46 am

    • Healthcare is only going to get more and more and more expensive. The end.

      it is true that health care as % of gdp has gone up everywhere. but it is not true that it has gone up more in the US as a result of he US doing more for its patients. it doesn’t.

      Beverly Hills Ninja

      July 20, 2017 at 1:19 am

    • There already are insurance death panels. And how can you be so ignorant as to talk about the “only” way to reduce spending while ignoring how every other developed country manages to have superior health care at dramatically lower prices? Noone cares what you reckon will solve the problem.

      Magnavox

      July 20, 2017 at 4:44 am

      • Don’t worry your single payer solution won’t be implemented either because any reduction in healthcare as % of GDP means depression.

        Free market solutions with competition always lead to lower prices/efficiency relative to government organized ones.

        Paul Ryan's Sickly Old Lapdog

        July 20, 2017 at 9:17 am

      • That’s an article of faith of nitwit libertarians but it ain’t so. How about we introduce competition into electrical distribution next? Start running multiple sets of wires to each house so that we can get some competition…

        Magnavox

        July 20, 2017 at 12:53 pm

      • Every other western industrialized country has “better” healthcare only so far as you are comparing apples to oranges, demographically. The U.S. simply has a lot more non-whites compared to european countries, and non whites disproportionately skip doctor visits, show poor medication adherence, have unhealthier lifestyles, etc.

        The U.S. has much better care in many areas. For example, oncology.

        jjbees

        July 20, 2017 at 4:28 pm

      • The US just diagnoses more people with cancer and since it has more diagnoses marginal non lethal cases, statistically people are less likely to die from it (although still more likely in a true apples to apples comparison). And healthcare ain’t education where HBD nitwitery resolves away American dysfunction.

        Magnavox

        July 21, 2017 at 5:52 am

  14. Check this out. My company doesn’t hire illegals, so this guy shows up for work but doesn’t have his social security card with him. The manager is desperate for workers so he lets him start, but the guy keeps forgetting to bring the card. After schlepping for a week and a half this guy suddenly runs off the construction site. The next day his lawyer calls saying that his client got injured and is an illegal alien, whom the the company had no right to employ to begin with. He offers to ‘settle’. And the stupid company settles. Why, oh why didn’t they pay for a car service to take the guy home to pick up his social security card before letting him on a job site?

    What Tort reform, mates? Who’d dreamt of this baloney? Will never happen. Fugget about it. If there is no e-verify, no stop to immigration, no wall everything is nonsense. Will never happen. Mates, please…. Aren’t you the smart ones? I’m giving Trump four years to deliver, but not Tort reform. Just look at those imbeciles in Congress, just look at those mugs! They will deliver a Tort reform, a Healthcare reform, a tax reform…. Please….Mates, do you understand how crazy guys like McCain or Pelosi or Warren or Jeb realy are? Lion, seriously enjoy life. This is a total waste, man.

    Yakov

    July 19, 2017 at 9:54 pm

    • How much in taxes did you fraudulently avoid paying last year?

      Andrew E.

      July 19, 2017 at 10:46 pm

      • I dunno. Who cares? I’m not sure why whatever I do is any more ‘fraudulent’ or whatever then Bill collecting a tidy sum for his ‘charity’ for an hour of blah-blah-blah before a room full of wallstreeters or Russian bankers. What makes you ask the question? Like what difference does it make and to whom? Are you trying to give me an evil eye or something?

        Yakov

        July 19, 2017 at 11:01 pm

  15. https://www.youtube.com/watch?v=fQ22p_vX9BA (watch from around minute 34)

    Just to clarify (and correct) my earlier comment about the 25% figure. I went back and watched the segment again and what Krauthammer actually said was that 25% of all medical procedures are done to forestall legal challenges and NOT for medical reasons. That is, the present legal system causes doctors to practice defensive medicine, and thus is vastly wasteful. He suggests that even a rational tort reform might reduce that waste by HALF (of 25%).

    So my apologies for over-egging the pudding (so to speak) by suggesting that SAVINGS could be as high as 25%. Still, half of that would be, if indeed achievable, a significant cut in costs. And that is just the first step in bringing down costs.

    As to some who question the qualification of Krauthammer to opine knowledgeably on the subject, be reminded that, despite being a never-Trumper etc., he’s also a medical doctor who has actually experienced the system and also happens to be, undeniably, one of the most brilliant men around (IQ estimated at around 172 – see Pumkinperson).

    gda

    July 20, 2017 at 1:55 am

    • 25% of procedures is not the same thing as 25% of total costs. It could be the cheapest procedures.

      Magnavox

      July 20, 2017 at 12:55 pm

  16. Lion is normally so good at spotting right-wing/libertarian lies that really support the wealthy, I’m surprised he thinks there are too many frivolous med-mal cases driving up medical costs. The truth is, it is really hard to successfully sue for medical malpractice. There are caps on recovery. There are caps on lawyer’s fees. Expert witnesses, who are doctors themselves, are expensive. It takes a long time between filing a suit and getting a verdict. Most juries have been fed the same propaganda as the rest of us, and therefore hate plaintiff’s attorneys. In short, you need a really good case before a lawyer will agree to take it.

    Light Roast

    July 20, 2017 at 8:31 am


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