I don't get it: which number is bigger $600 billion or $54 million???

[healthmyths]

Tanning TAX 10%
At any rate, proponents of the tax estimated that shaking down the 25,000 stand-alone tanning salons across the country would produce $200 million for the 2011 fiscal year and $2.7 billion over 10 years.
Oops.
On Thursday, the Treasury Inspector General for Tax Administration issued a new report which found that just 10,300 tanning salons filed returns, generating only $54.4 million from July 1, 2010, through March 31.

That means revenues are running at a dismal 36 percent of projections.
Tanning tax - Opinion - ReviewJournal.com

SO only $54 million???

YET the biggest single controllable cost Driver $600 billion a year documented by physicians as a valid real number.. NOTHING!
NO tax on the lawyers that DRIVE defensive medicine costs out of FEAR of lawsuits!

 

[Euro]

Tanning TAX 10%
At any rate, proponents of the tax estimated that shaking down the 25,000 stand-alone tanning salons across the country would produce $200 million for the 2011 fiscal year and $2.7 billion over 10 years.
Oops.
On Thursday, the Treasury Inspector General for Tax Administration issued a new report which found that just 10,300 tanning salons filed returns, generating only $54.4 million from July 1, 2010, through March 31.

That means revenues are running at a dismal 36 percent of projections.
Tanning tax - Opinion - ReviewJournal.com

SO only $54 million???

YET the biggest single controllable cost Driver $600 billion a year documented by physicians as a valid real number.. NOTHING!
NO tax on the lawyers that DRIVE defensive medicine costs out of FEAR of lawsuits!

I agree with you it’s a good solution, or you could do something with the laws.
It’s corruption when lawyers is getting away with that amount of money because of defensive medicine.

 

[editec]

Taxing tanning salons.

The Masters have no shame at all.

 

[healthmyths]

actually what it shows the their total ignorance!
Really the total REASON for health care increases can be found in the opinions of the experts.. i.e health care providers!
They say 1 of ever 4 dollars is spent out of fear of being wrong and then sued!
$600 billion and NOT ONE effort to reduce by simple Tort Reform!
YET stupid taxing of tanning salons?

 

[Greenbeard]

Yeah, why hasn't anybody thought of doing tort reform?

If only more states had implemented some form of collateral source rule reform. If only the same was true of joint and several liability rule reform. If only states would cap damages which, aside from this map of state damage caps enacted since 1986, nobody seems to have done!

And yet here we find ourselves in this sad situation in which malpractice reform has never been attempted by anyone anywhere. Ever. I wonder how much this tragic situation is costing us?

National Costs of the Medical Liability System:

This article identifies the various components of liability system costs, generates national estimates for each component, and discusses the level of evidence available to support the estimates. Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending.

According to the CBO in 2004:

Proponents of limiting malpractice liability have argued that much greater savings in health care costs would be possible through reductions in the practice of defensive medicine. However, some so-called defensive medicine may be motivated less by liability concerns than by the income it generates for physicians or by the positive (albeit small) benefits to patients. On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small. [. . .]

However, when CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts. Still, the question of whether such limits reduce spending remains open, and CBO continues to explore it using other research methods.

Or CBO's more concrete estimates of how much tort reform would reduce spending from 2009:

CBO now estimates that implementing a typical package of tort reform proposals nationwide would reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009). That figure is the sum of a direct reduction in spending of 0.2 percent from lower medical liability premiums and an additional indirect reduction of 0.3 percent from slightly less utilization of health care services.

Does tort reform have zero effect on costs? No, but the claim that it's a silver bullet (with its ~0.5-2.5% reduction in cost growth annually) to controlling health care costs seriously overestimates the magnitude of its effects.

As for why tort reform wasn't included in last year's health reform package--well, actually it was. The ACA contains exactly the same approach to tort reform contained in Paul Ryan and Tom Coburn's comprehensive health reform bill from two years ago: federal money to encourage states to try implementing new approaches to tort law at the state level.

Ryan's bill:

`(a) In General- The Secretary may award grants to States for the development, implementation, and evaluation of alternatives to current tort litigation that comply with this section, for the resolution of disputes concerning injuries allegedly caused by health care providers or health care organizations.

`(b) Conditions for Demonstration Grants- ...

The ACA:

`(a) In General- The Secretary is authorized to award demonstration grants to States for the development, implementation, and evaluation of alternatives to current tort litigation for resolving disputes over injuries allegedly caused by health care providers or health care organizations.

Wow, it looks like they even lifted the language directly from Paul Ryan's legislation. Shocking stuff.

I have to say, I think you're definitely the frontrunner for having the mostly aptly chosen username of anyone on the forum. Well-done.

 

[healthmyths]

I am NOT saying the $600 billion number..
the people that create the $600 billion say so!

According to a 2010 survey of physicians by Gallup for Alpharetta-based Jackson Healthcare, one of every four dollars spent in health care goes to defensive medicine.
The Hidden Costs of Healthcare | HealthFlock
90% of physicians when POLLED said:

f 1,231 physicians...(90%) Ninety percent of physicians surveyed said
"doctors overtest and overtreat to protect themselves from malpractice lawsuits.
"Defensive medicine is when doctors order multiple tests, MRIs and other procedures, not because the patient needs them, but to protect against litigation based on allegations that something should have been done but wasn’t. according to the survey published Monday in Archives of Internal Medicine.
Doctors Practice Medicine in Fear, New Study Finds

As the emergency room physicians said:
According to a poll conducted by the American College of Emergency Physicians, nearly half of emergency physicians, 44 percent, say the biggest obstacle to cutting costs in emergency departments is overcoming the fear of lawsuits. The poll, made up of 1,800 emergency physicians, also found that more than half of physicians, 53 percent, state that the reason they conduct the number of tests they do is due to the fear of being sued.

Defensive Medicine - Fear of Medical Malpractice Lawsuits


So tell that to the thousands of physicians who unlike YOU have to contend with the fear every day of being sued many times frivolously!

 

[Greenbeard]

Maybe you're not getting my point here. Tort reform is not some untested concept that could have any effect we imagine because, hey, we just don't know (that stuff that opened my previous post? that was sarcasm). Numerous kinds of tort reform have been tried in numerous states, giving us some empirical evidence for its effects. For example,

Is there empirical evidence for "Defensive Medicine"? A reassessment.

Proponents of tort reform applied to medical malpractice argue for change partly on the premise that the threat of lawsuits has made medical care more costly. Using U.S. longitudinal data from the National Long-Term Care Survey merged with Medicare claims and other data for 1985-2000, this study assesses whether tort reforms have reduced Medicare payments made on behalf of beneficiaries and the survival probability following an index event. Direct reforms (caps on damages, abolition of punitive damages, eliminating mandatory prejudgment interest, and collateral source offset) did not significantly reduce payments for Medicare-covered services in any specification. Indirect reforms (limitations on contingency fees, mandatory periodic payments, joint-and-several liability reform, and patient compensation funds) significantly reduced Medicare payments only in a specification based on any hospitalization, but not in analysis of hospitalization for each of four common chronic conditions. Neither direct nor indirect reforms had a significant effect on the health outcomes, with one exception. The overall conclusion is that tort reforms do not significantly affect medical decisions, nor do they have a systematic effect on patient outcomes.

Low Costs Of Defensive Medicine, Small Savings From Tort Reform

In this paper we present the costs of defensive medicine in thirty-five clinical specialties to determine whether malpractice liability reforms would greatly reduce health care costs. Defensive medicine includes tests and procedures ordered by physicians principally to reduce perceived threats of medical malpractice liability. The practice is commonly assumed to increase health care costs. The results of studies of the costs of defensive medicine have been inconsistent. We found that estimated savings resulting from a 10 percent decline in medical malpractice premiums would be less than 1 percent of total medical care costs in every specialty. These savings are lower than most previous estimates, and they suggest that the presumed impact of tort reform on health care costs may be overstated.

Even the high-end estimates from those sympathetic to these arguments don't get anywhere near 25% of spending: Do Doctors Practice Defensive Medicine?

`Defensive medicine' is a potentially serious social problem: if fear of liability drives health care providers to administer treatments that do not have worthwhile medical benefits, then the current liability system may generate inefficiencies many times greater than the costs of compensating malpractice claimants. To obtain direct empirical evidence on this question, we analyze the effects of malpractice liability reforms using data on all elderly Medicare beneficiaries treated for serious heart disease in 1984, 1987, and 1990. We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices.

In other words, it's what I've already said: savings from tort reform are modest, not a silver bullet for lowering costs. And some forms would undoubtedly be a good idea. But the hesitance to institute some of the more common ideas nationally is due to the fact that tort laws actually do serve a purpose: to protect the consumer. If the reductions in patient outcomes from some variety of tort reform outweigh the spending reductions by physicians, that's not necessarily a good thing.

The Welfare Effects of Medical Malpractice Liability

Policymakers and the public are concerned about the role of medical malpractice liability in the rising cost of medical care. We use variation in the generosity of local juries to identify the causal impact of malpractice liability on medical costs, mortality, and social welfare. The effect of malpractice on medical costs is large relative to its share of medical expenditures, but relatively modest in absolute terms—growth in malpractice payments over the last decade and a half contributed at most 5.0% to the total real growth in medical expenditures, which topped 33% over this period. On the other side of the ledger, malpractice liability leads to modest reductions in patient mortality; the value of these more than likely exceeds the cost impacts of malpractice liability. Therefore, policies that reduce expected malpractice costs are unlikely to have a major impact on health care spending for the average patient, and are also unlikely to be cost-effective over conventionally accepted ranges for the value of a statistical life.

Encouraging state-level experimentation would be a fine way to start separating the wheat from the chaff.

And about doctors' opinions? I've got some bad news for you. Whatever defensive medicine they do practice out of paranoia over being suing may not be substantially reduced by implementing tort reform (at least the reforms that certain folks want to impose at the national level--i.e. those that have already been tried in many states).

Physicians’ Fears Of Malpractice Lawsuits Are Not Assuaged By Tort Reforms

This study of a nationally representative sample of physicians found high levels of concern about the risk of malpractice litigation among physicians across a range of specialties, practice settings, and geographic areas. Physicians in specialties generally considered to be at highest risk for costly malpractice claims, such as emergency medicine, expressed the greatest concern.

The relationship between physicians’ level of malpractice concern and some objective measures of the riskiness of the state liability environment, such as malpractice premium levels and the risk of incurring a paid malpractice claim, was statistically significant. But the magnitude of these associations was very modest. [...]

Malpractice concern was somewhat lower among physicians who practiced in states that had established caps on total damages or abolished joint-and-several liability. However, the presence of other types of tort reforms in the state, including caps on noneconomic damages, did not significantly reduce levels of physician concern, relative to states without such reforms.

The high level of malpractice concern among physicians in our sample, even those practicing in relatively low-risk environments, is striking. Although previous studies reflected conditions during a malpractice insurance “crisis” in 2001–5 marked by deteriorations in the availability and affordability of insurance, our results indicate high levels of concern even during a period of relative stability in malpractice insurance.

We don't need 50 more threads on this myth.

 

[healthmyths]

You wrote" Even the high-end estimates from those sympathetic to these arguments don't get anywhere near 25% of spending: Do Doctors Practice Defensive Medicine?

Who EVER SAID 25%???
The Daniel P. Kessler, Mark McClellan study
We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices. "
9% of $600 billion is over $50 billion! Directly reducing insurance claims has a direct a reduction in insurance premiums as average company pays 80% of premium in claims.

So you agree then in your last comment "The high level of malpractice concern among physicians in our sample, even those practicing in relatively low-risk environments, is striking." that "defensive medicine" is from physicians,i.e. the guys generating the claims is a concern.

It is then whether a $60 billion or $600 billion cost driver and the source i.e. fear of lawsuits agreed the motivation to CYA!

I am always of the opinion to follow the money!
And lawyers donated $300 million to Obama/Democrats.
There was ONLY a token "demonstration" study of Tort Reform in Obamacare.. nothing like what Illinois or Texas or FL have done to at least stabilize the rising defensive medicine costs!
So all your substantiation just confirms "defensive Medicine" is a bigger problem then the token "Tanning Tax" in Obamacare which is what was just one more idiocy illustration!