Purple People Vote

The rhetoric on health care on health care is hitting a fevered pitch.  One bill has passed committee while other bills are in process, yet on hold for August recess.  The clash that is occurring between the two sides is likely being made worse by a genuine confusion about what is in and what is out of the bill.   Yet clearly there are a couple big health care money drains that are not being addressed, or not being addressed adequately - Fraud and Tort Reform.

CNN reports how burdersome fraud is to the health care system, and how the bill that passed committee does little to address it.

Health care reform: forgetting fraud

“We don’t actually know the dollar amount being lost but we know the order of magnitude. It’s hundreds of billions of dollars. We just don’t know how many hundreds of billions of dollars,” said Harvard Professor Malcolm Sparrow, author of License to Steal: How Fraud Bleeds Americas Health Care System.

President Obama warns health care reform is necessary to get medical costs under control.

“If we do not reform health care, your premiums and out-of-pocket costs will continue to skyrocket,” the president said July 22 during a press conference to promote his health reform initiative.

But one of the key factors driving higher costs – fraud – is getting little mention in Washington’s reform effort.

“They are certainly aware of this problem. They don’t seem to know the magnitude or the seriousness. They don’t seem to be acting with the kind of urgency that I would like,” said Professor Sparrow.

The health reform bill approved in the House, “America’s Affordable Health Choices Act of 2009″ – 1018 pages long – devotes only 40 pages to the issue of fraud. This and other bills still under discussion in the Senate would allocate just $100 million dollars a year to combat fraud, waste and abuse. That’s the amount of health care fraud occurring in this country every 12 hours, using the most conservative estimates.

Americans for Tax Reform takes on the need for tort reform, and explain why it is needed to keep health care costs under control.

Trial Lawyers Thwart Meaningful Healthcare Reform

Doctors combat impending lawsuits in two ways, both of which unnecessarily inflate the cost of healthcare. Most doctors purchase malpractice or asset protection insurance as safeguards against lawsuits. These insurance plans are expensive and raise overhead costs for hospitals. Secondly, doctors are forced to practice defensive medicine. Defensive medicine takes place when doctors order needless tests or procedures to protect themselves against future lawsuits. A 2008 survey found that 83% of Massachusetts doctors practice defensive medicine and that 25% of all imaging tests were ordered for defensive purposes.

 

Medical tort reform drives down insurance premiums by reducing the amount of tests insurance companies cover each year. This would reduce healthcare costs by as much as $200 billion a year. So why are no Democrats talking about eliminating defensive medicine as an easy way to save billions of taxpayer dollars? Trial lawyers, the only opponents to medical tort reform, happen to be in bed with Democrats, consistently raising millions for the Democratic Party.

SAN FRANCISCO (Legal Newsline)- President Barack Obama’s push for an overhaul of the nation’s health care system could be stymied by Senate lawmakers, particularly moderate Democrats, the lobbyist for trial lawyers said.

Linda Lipsen, American Association for Justice (AAJ) senior vice president of public affairs, told her organization’s members that among moderate Senate Democrats who could possibly pose a threat to the Obama health care push are Senate Finance Committee Chairman Max Baucus, D-Mont., and Sens. Blanche Lincoln of Arkansas and Tom Carper of Delaware.

Lipsen told trial lawyers in the AAJ’s Birth Trauma Litigation Group meeting this week that the lawmakers are “business Democrats that aren’t necessarily that great for us,” referring to plaintiffs’ lawyers.

Cost isn’t the only reason tort reform is needed.  Certain specialties like OBGYN’s are facing outrageous fees for malpractice insurance, and in some states like New York OBGYN’s are leaving as the cost of doing business is too high.

From Long Island Business News Ob/gyns on Long Island dropping deliveries, leaving state

Opatich, a solo practitioner in Bethpage, is one of a growing number of ob/gyns in New York State who, faced with malpractice premiums topping $100,000 and declining reimbursement rates for services, are making the often heart-wrenching decision to stop delivering babies. Others are dropping gynecological surgery, or simply retiring earlier than they had planned.

In a recent survey by the American College of Obstetricians and Gynecologists, 212 ob/gyns in New York State, or 16 percent of those surveyed, indicated that they have stopped practicing obstetrics. That’s left seven of the state’s 62 counties with no ob/gyns.

One of the consistent complaints about the health care debate is that legislation is being rushed through, that more time needs to be spent to ‘get it right.’  The lack of attention being paid to these two issues supports that theory.  Who could possibly be opposed to fraud prevention?  While there may be resistence to tort reform, if it is not addressed money is being left on the table, and more importantly quality of care will likely diminish if specialists feel they can no longer afford to practice.