Sunday, January 09, 2005

Hail to the Chief....
Excerpts from President Bush's' speech last week in Illinois:President Discusses Medical Liability Reform. Starts off with the list of local dignitaries, move on to discussion of medical savings accounts, medical informatics, and tsunami relief. Then to the meat of the speech:
Many of the costs that we're talking about don't start in an examining room or an operating room. They start in a courtroom. (Applause.) What's happening all across this country is that lawyers are filing baseless suits against hospitals and doctors. That's just a plain fact. (Applause.) And they're doing it for a simple reason. They know the medical liability system is tilted in their favor. (Applause.) Jury awards in medical liability cases have skyrocketed in recent years. That means every claim filed by a personal injury lawyer brings the chance of a huge payoff or a profitable settlement out of court. That's what that means. Doctors and hospitals realize this. They know it's expensive to fight a lawsuit, even if it doesn't have any merit. And because the system is so unpredictable, there is a constant risk of being hit by a massive jury award. So doctors end up paying tens of thousands, or even hundreds of thousands of dollars to settle claims out of court, even when they know they have done nothing wrong.

That's what's happening in the system today. It's a system that's just not fair. It's costly for the doctors; it's costly for small businesses; it's costly for hospitals; it is really costly for patients. (Applause.)

When those providing insurance have to pay the bills for enormous jury verdicts or out-of-court settlements, they have to raise premiums on physicians they cover. Specialists in high-risk practices like OB/GYN or neurosurgery are particularly vulnerable to lawsuits. So their premiums rise the fastest. You're about to hear a couple of stories of folks in this area who can testify to that fact.

Because junk lawsuits are so unpredictable, they drive up insurance costs for all doctors, even for those who have never been sued; even for those who have never had a claim against them. When insurance premiums rise, doctors have no choice but to pass some of the costs on to their patients. That means you're paying for junk lawsuits every time you go to see your doctor. That's the effect of all the lawsuits. It affects your wallet. If you're a patient, it means you're paying a higher cost to go see your doctor. If part of the national strategy has got to be to make sure health care is available and affordable, health care becomes less affordable because of junk lawsuits.
I'm sorry Mr. President that's not quite true. Many times physicians are in a situation where they cannot pass on their increased costs to patients. I believe that if a "premium surcharge" was allowed that the populace at large would not passively sit by. Since the crisis would affect them directly, they would take more notice.
In 2003, almost half of all American hospitals lost physicians or reduced services because of medical liability concerns. Think about that. One-half of all American hospitals lost physicians. Over the past two years, the liability crisis has forced out about 160 physicians in Madison and St. Clair Counties alone. When doctors move or close their practices, guess who suffers. The patients; the people who live in these good town in this part of the world. Pregnant women have to travel longer distances for checkups. Accident victims lose critical minutes in transit to faraway emergency rooms. New residents, people you're trying to get to come and live in your communities have a hard time finding doctors willing to accept extra patients. And that causes the quality of life in your community to deteriorate. It's a problem that we must address.

America's health care professionals should be focused on fighting illnesses, not on fighting lawsuits. (Applause.) Junk lawsuits change the way docs do their job. Instead of trying to heal the patients, doctors try not to get sued. Makes sense, doesn't it? If you're worried about getting sued, you're going to do everything you can to make sure you don't get sued. That's why doctors practice what's called defensive medicine. That means they're writing prescriptions or ordering tests that really aren't necessary, just to reduce the potential of a future lawsuit.

They have specialists who stop taking emergency room calls. Doctors turn away patients with complicated, life-threatening conditions because they carry the highest risk for a lawsuit. Defensive medicine drives a wedge between the doctors and the patients, and defensive medicine is incredibly costly for our society. Altogether, defensive medicine drains some $60 billion to $100 billion from the economy. Defensive medicine raises medical bills for patients and increases insurance costs for employers and it takes money away that small businesses could use to invest and expand.
The President then points out several physicians, patients, and hospital administrators out of the audience and tells their stories. Stories of physicians and hospitals cutting back on services, and patients feeling the effects of those cutbacks. All due to liability insurance premium increases.
But the other thing I discovered is that because of medical liability problems and lawsuits and increasing premiums and the defensive practice of medicine, your federal budget spends $28 billion a year extra money. See, we have to pay for Medicaid and Medicare and veterans' benefits. The rising cost of health care, the number of lawsuits, the defensive practice of medicine is driving up the cost to our taxpayers. Medical liability reform is a national issue and it requires a national solution. (Applause.)

So I went to Congress with some proposals that I think are fair, proposals that will build confidence in the judicial system. Nobody likes to come to a part of the world that says the judicial system is out of control and people lose confidence in it. We've got to have confidence in the fairness of our system. We want people who are harmed to be able to get -- have their day in court and get fair treatment in the courts of law. But we want -- we don't want a system that's so tilted the other way that it runs good doctors out of business and makes it hard for hospitals to deliver care.

I believe a victim of a legitimate medical error should be allowed to collect full economic damages, 100 percent of the cost of their medical care and recovery, plus economic losses for the rest of their life. Seems to be fair, if you get hurt. (Applause.) And when appropriate, injured people should be allowed to collect reasonable non-economic damages. And in the case of truly egregious wrongdoing, patients should be entitled to punitive damages. But there needs to be some reason, when it comes to non-economic damages in the system, and that's why I proposed a hard cap of $250,000 on non-economic damages. (Applause.)

Interestingly enough, the state of California has a cap on non-economic damages that was enacted in 1975. Patients in that state see their claims settled a third faster than states without those limits. In other words, patients are treated more fairly where there's a cap. And since 1975, insurance premiums for California doctors have become much more affordable premiums than anywhere else in the country -- than in most states. Caps on non-economic damages work. It's a good idea and the Congress ought to adopt them. (Applause.)

We have another problem with our legal system, and that is trial lawyers sometimes sue all the doctors involved in the patient's case even if most of the doctors have nothing to do with the patient's injuries. It's simply unfair to punish doctors who have done nothing wrong. (Applause.) And so, to make sure doctors and hospitals are treated fairly, Congress needs to pass joint and several liability reform. (Applause.)

Joint and several liability reform may have more of a long-term impact than caps would. Hopefully it will be a good year for tort reform at the state and federal level.
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