As Democrats hold their first debate today in the race for the White House, the fallout of the Affordable Care Act is certain to be a topic of discussion.
The Kaiser Family Foundation just issued a report that found that healthcare deductibles are outstripping any increase in pay for employees. In a survey of employer health benefits, it found that deductibles have risen six times faster than workers’ earnings.
Deductibles, insurance premiums, co-pays and out-of-pocket costs have all skyrocketed, partly because of the Affordable Care Act. It failed to address a major driver of healthcare costs — defensive medicine.
Physicians practice defensive medicine every day when they order more tests, procedures, physician referrals and prescription medications than are medically necessary to protect themselves from litigation.
In 2010, Gallup found that one in four healthcare dollars could be attributed to defensive medicine. The Official Journal of the Congress of Neurological Surgeons reports that more than 75 percent of neurosurgeons practice defensive medicine. The problem is clearly pervasive.
Hillary Clinton has proposed a healthcare tax credit to help citizens with large medical bills, but that would not affect healthcare spending, which is driving up costs for all of us. Bernie Sanders wants a universal healthcare plan, but that too won’t address expenditures.
If Clinton, Sanders and the other candidates want to contain healthcare costs they should look to the five states that are embracing a plan that would not only eliminate defensive medicine but improve patient safety, too.
Florida, Georgia, Tennessee, Montana and Maine are working to end defensive medicine through legislation that would create a Patients’ Compensation System (PCS). Under this proposal, states would eliminate the broken medical malpractice litigation system and replace it with a no-blame administrative model patterned after the workers’ compensation system.
Under the proposal, an injured patient would file a claim, which would be analyzed and resolved in a timely fashion by a panel of healthcare experts. Today, patients must file a lawsuit, which takes five-seven years to litigate with uncertain outcomes. If the panel of healthcare experts determined that a patient suffered a medical injury, the patient would be fairly, appropriately and quickly compensated based on traditional payouts in the legal system.
With no need to fear frivolous lawsuits, doctors would no longer need to practice defensive medicine. Healthcare costs would start to decrease, as would health insurance premiums. BioScience Valuation, a healthcare economics firm, estimates that a PCS would save an estimated $840 billion over 10 years in private and government-funded health insurance programs such as Medicaid and Medicare as physicians stop ordering unnecessary tests and procedures.
In addition, patient safety would increase. Doctors would feel more secure in the practice of medicine and not fear losing their personal wealth if they admit mistakes and work together toward best practices.
Nine years ago, U.S. Sens. Clinton and Barack Obama authored a policy paper in The New England Journal of Medicine that said the centerpiece of malpractice reform should be patient safety, open communication between medical professionals and patients, reducing liability premiums and ensuring fair compensation for medical injuries.
A PCS would do just that as doctors would work on patient safety. Patients who have been harmed would not have to endure the exhaustive litigation system. Doctors would be willing to discuss incidents with patients and other healthcare professionals as they would no longer be sued. And patients would have a near-term predictable remedy.
Health insurance costs are only going to increase as long as we continue to ignore the serious problem of defensive medicine.
As the candidates of both parties move forward with health care policy proposals leading to the 2016 election, it’s time to have an open dialogue about how we can truly make healthcare affordable, increase patient safety and improve our broken medical malpractice system.
Jeff Segal, a North Carolina neurosurgeon, is CEO of Medical Justice and a board member of the non-profit Patients for Fair Compensation. Wayne Oliver is the executive director of Patients for Fair Compensation. Thinking of submitting an op-ed to the Washington Examiner? Be sure to read our guidelines on submissions.
