A recent study in the journal Health Affairs draws attention to the dollars medical malpractice lawsuits and defensive medicine are adding to America’s health care bill. The study shows that medical liability has a far smaller cost on the system than previously believed.
The study, written by three Harvard professors and a colleague at the University of Melbourne in Australia, estimates that medical liability spending totaled $55.6 billion in 2008. This equates to 2.4 percent of total health care spending. Additionally, $8 out of every $10 dollars – or $45.6 billion – went directly to defensive medicine by physicians who ordered more comprehensive testing than in the past to avoid a misdiagnosis and potential lawsuit.
The study stands apart for its rigorous attempts to quantify individual costs of the medical liability system, including payments to medical malpractice plaintiffs, defensive medicine and administrative costs. Past studies have lacked this detail and without it, there can be no meaningful discussion.
The study shows the costs of medical malpractice and defensive medicine are not draining the health care system, especially given the majority of the money spent in these areas went directly to testing aimed at ensuring patients walked out of the hospital safe.
The study’s authors made a similar comment, saying the dollar amount is “not trivial,” but, “is less than some imaginative estimates put forward in the health reform debate.”
The study gains relevance several months after President Barack Obama signed the Patient Protection and Affordable Care Act into law. The comprehensive reform bill expands insurance coverage and awards state grants to investigate areas of the health care system, such as alternatives to medical malpractice lawsuits.
A Republican movement has sought to go further by restricting medical malpractice claims. But the study supports the opinion that restricting claims is not the answer. Providing patients who have been harmed the ability to file a lawsuit remains a critical check on the health care system.
Lawmakers would be best served to leave medical malpractice reform alone and focus on another area of the federal health care law: quality control and cost savings. The law’s National Quality Strategy section calls on the country to develop a national strategy identifying priorities such as patient health outcomes and a measurement system.
While there are many areas to explore, quality can be improved and savings achieved by reducing use of the emergency room for non-critical needs. An ER visit is costly and doctors and staff have neither the time nor the resources to provide the care each patient needs. Most of the time, patients who are treated and sent home still need to follow up with their primary care doctor.
To read a New York Times article about the study, click here.