One can hardly blame physicians for throwing up their hands in disgust at President Obama and his Democratic buddies on Capitol Hill.
The Health Reform Express after all, has roared right past Tort Reform, which is the stop many if not most of the Long Whites like to get off.
First, the Big O did little more than genuflect at the issue during his memorable “you lie” speech last month. Then, Max Baucus and Senate Finance released a health reform proposal with nary a word on the subject… making it the fifth (out of 5) Congressional proposals—all penned by Democrats—to squelch the subject.
And to think these diss jobs came after the Long Whites voted for Obama in droves, and the notoriously conservative AMA came out to support health reform when the chips were down!
Alas the issue seemed to have flatlined altogether until last week when, lo and behold, the Congressional Budget Office released a report saying the Express could save up to $54 billion over the next ten years if it capped payouts on medical malpractice lawsuits.
That was 10 times higher than previous estimates, and supported the long-held Republican position on the matter.
The CBO report said the simple move would cut malpractice premiums, sure, but more importantly, it would create an environment that permitted the Long Whites to stop all that silly test ordering they do in order to cover their butts in a court of law.
The heartening report came to light in the form of a letter written by CBO director Douglas Elmendorf to Utah Republican Senator Orrin Hatch, a long-time advocate of tort reform.
“These numbers show that this problem deserves more than lip service from policy-makers,” Hatch chortled. “Unfortunately, up to now, that has been all the President and his Democratic allies in Congress have been willing to provide.”
But the Big O—who once edited the Harvard Law Review let us not forget—remains staunchly opposed to caps on jury awards and as a result the Beltway odds makers remain steadfast: there’s little chance tort reform sees the light of day on this go ‘round.
In his letter, Elmendorf said that newly available evidence had prompted the CBO review. The review concluded that capping payouts at $250,000 for pain and suffering plus $500,000 for punitive damages “would reduce total national health care spending by about 0.5 percent.”
The Feds would recoup most of the savings via reduced Medicare costs, according to the CBO report.
Maybe the Big O should rethink his position on the matter. Tort reform is just the sort of tasty bone that would coax Republican attack dogs onto the Express, not to mention solidifying support among providers, whose recent obstreperousness threatens to derail his efforts completely.
Besides, Obama is smart enough to understand that the Feds can’t implement tort reform all by themselves anyway, so long as states maintain jurisdiction in malpractice litigation and set insurance premiums.
That means if he come outs in favor of the concept, all he’s really doing is punting the matter to the states, and last time we checked, most of them feature a legislature dominated by Democrats.
Glenn Laffel MD, PhD
Sr. Vice President, Clinical Affairs, Practice Fusion
