It is the uncounted cost that is the Big one. The Doctors who all do more test than they would normally to cover their Ass and avoid a law suit in the first place. That is where the real cost of it is.
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.
An excellent
article published last year drives the point home:
“It’s really just a distraction,” said Tom Baker, a professor at the University of Pennsylvania Law School and author of “The Medical Malpractice Myth.” “If you were to eliminate medical malpractice liability, even forgetting the negative consequences that would have for safety, accountability, and responsiveness, maybe we’d be talking about 1.5 percent of health care costs. So we’re not talking about real money. It’s small relative to the out-of-control cost of health care.”
Insurance costs about $50-$60 billion a year, Baker estimates. As for what’s often called “defensive medicine,” “there’s really no good study that’s been able to put a number on that,” said Baker.
Krauthammer cited a study by the Massachusetts Medical Society that found that five out of six doctors said they ordered additional tests, procedures and referrals to protect themselves from lawsuits. He also relies on a much-criticized study from the libertarian Pacific Research Institute on the civil justice system to conclude that “defensive medicine” wastes more than $200 billion a year.
Baker is skeptical, and makes the point that “defensive medicine” is not the same thing as wasteful medicine. “Like defensive driving, some defensive medicine is good,” he said. “To change behavior. When you drill down those studies, you see that what it means is, doctors are more careful with patient records. They spend more time with the patient. They’re more careful to say hello and goodbye to the patient. That’s good.”
Other health economists agree that “defensive medicine” is not the main driver of costs, and malpractice liability reform is not a panacea.
“If you were to list the top five or ten things that you could do to bring down health care costs that would not be on the list,” said Michele Mello, a professor of Law and Public Health at Harvard.
Just to pile on one more
story from last year:
A major new study released today by Americans for Insurance Reform finds that premiums and claims for doctors both have dropped significantly in recent years while the medical malpractice insurance industry is enjoying remarkable profits in light of the global economic collapse. It concludes that further limiting the liability of negligent doctors and unsafe hospitals is not only unjustified, but also would have almost no impact lowering this country's overall health care expenditures.
AIR's report, True Risk: Medical Liability, Malpractice Insurance and Health Care, is by Gillian Cassell-Stiga and Joanne Doroshow of the Center for Justice & Democracy, and actuary J. Robert Hunter, who is Director of Insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas, and former Federal Insurance Administrator under Presidents Carter and Ford.
Do you have anything to back up what you're saying or are you just talking?
[...]It's no secret that $5 billion isn't enough to insure every uninsurable person in the country through the end of 2013...
You are ignoring the not so subtle implication that the 'program' might well not survive 2011, much less more implications in 2014. Still not fully functional then.
Explicitly noting that the high-risk pools are underfunded for a three-year run is ignoring it?
It sounds to me like you're confusing the high-risk pools with the exchanges. The high-risk pools aren't supposed to last (ideally they would make it through 2013 but then ideally they'd have three times the funding they do). There are no implications for them in 2014 because they won't exist in 2014.
Could you be more disingenuous maybe? The Rates are going up in anticipation of the Law going into Effect. Even the CBO now says it will result in Higher costs, NOT LOWER.
It's actually kind of cute that you think insurance rates started skyrocketing now (instead of, say, at the beginning of the recession-you know, when they actually did) "in anticipation" of something. You may have missed it but rates have been going up quite a bit the past few years:
In
Arizona and North Carolina:
The nonprofit Blue Cross Blue Shield of Arizona raised rates on individual-market policyholders every year between 2007 and 2009, while its surplus grew from $648 million to $717 million, the study shows. In North Carolina, Blue Cross Blue Shield raised rates by a total of 39 percent between 2008 and 2010, even though its surplus was $1.4 billion by 2009 — more than four times the regulatory minimum.
In
Maine in early 2009:
Maine's superintendent of insurance has rejected a set of rate increases proposed by Anthem Blue Cross and Blue Shield.
In a decision released Monday night, Superintendent Mila Kofman said the increases sought by Anthem would be excessive and unfairly discriminatory.
But Kofman said with some scaling back Anthem could win approval.
As a result of changes proposed by the superintendent, the total average rate increase proposed by Anthem of 18.5 percent would be reduced to 10.9 percent, according to Kofman.
Others in 2009:
Anthem of Connecticut requested an increase of 24 percent last year, which was rejected by the state. [...]
In 2009, Blue Cross/Blue Shield of Michigan requested approval for premium increases of 56 percent for plans sold on the individual market. Regency Blue Cross Blue Shield of Oregon requested a 20-percent premium increase. UnitedHealth, Tufts, and Blue Cross requested 13- to 16-percent rate increases in Rhode Island. And rates for some individual health plans in Washington increased by up to 40 percent until Washington State imposed stiffer premium regulations.
Yes, 2010 is truly the year of the health insurance premium increase. Well, until you remember that so was 2009. And 2008. And most of the years before that in fact.
In this economic climate, with people out of work and incomes taking a hit, insurance pools also take a hit. People who choose to remain in the individual market or continue their coverage through COBRA after losing their jobs are either 1) people who can afford to do so or 2) people who
can't afford not to do so (i.e the sick). That latter part is adverse selection, since healthy people who can choose to skip out on paying for insurance until the economic dust settles will do so, leaving pools sicker and more expensive.
The legislation itself carries penalties for unjustified rate increases in anticipation of the exchanges opening: exclusion from the new exchanges (i.e. the market in which everyone receiving a subsidy will be shopping)
(b) Continuing Premium Review Process-
`(1) INFORMING SECRETARY OF PREMIUM INCREASE PATTERNS- As a condition of receiving a grant under subsection (c)(1), a State, through its Commissioner of Insurance, shall--
`(A) provide the Secretary with information about trends in premium increases in health insurance coverage in premium rating areas in the State; and
`(B) make recommendations, as appropriate, to the State Exchange about whether particular health insurance issuers should be excluded from participation in the Exchange based on a pattern or practice of excessive or unjustified premium increases.
[...]
`(c) Grants in Support of Process-
`(1) PREMIUM REVIEW GRANTS DURING 2010 THROUGH 2014- The Secretary shall carry out a program to award grants to States during the 5-year period beginning with fiscal year 2010 to assist such States in carrying out subsection (a), including--
`(A) in reviewing and, if appropriate under State law, approving premium increases for health insurance coverage; and
`(B) in providing information and recommendations to the Secretary under subsection (b)(1).
Actually, it's working quite well in making premiums skyrocket, to the point that people will be dropping their coverage and businesses will no longer offer medical insurance as a benefit, subsquently forcing people onto the gubmint "insurance" pool.
What "government insurance pool" are you talking about? The health insurance exchanges containing
only private health plans?
Probably because I subscribe to K.I.S.S. method of problem solving. Keep It Simple, Stupid. Arguing the specifics of this graph assumes the premise that it's accurate and relevant. YOU are the one who first suggested it isn't (and you're probably right). This problem isn't so hard that it requires this new beauracracy here and that one there. The more government tries to 'fix' things the more it ***** them up. Here's an idea government; STAY THE **** OUT OF IT. De-regulate health care so that the insurance companies actually have to compete. Government doesn't need to fund and create some new database to help people shop for health care. People aren't so dumb that they don't know how to shop for a deal and what's best for them.
Here are some things for you to consider while you're keeping it simple:
1) What do you want insurers to compete on? Price? Risk (i.e. win by attracting the healthiest enrollees and rejecting everyone else)?
2) How does fragmenting the insurance market empower insurers to negotiate down reimbursements to providers, particularly in geographic regions where
certain providers have attained substantial market clout (driving up prices)?
3) The five large health insurance companies are already national operations--how would removing state restrictions on out-of-state companies ("deregulation") dent their market shares? Just as Cleveland is a hub for Continental Airlines, why wouldn't Maine remain a "hub" for Anthem Blue Cross Blue Shield? In fact, given that insurers form relationships with networks of providers, why wouldn't the large, nationally present insurers (i.e. those who already have relationships with providers in most states, including lower reimbursements--and ultimately lower premiums--than potential competition) have an immediate and likely insurmountable advantage over any sort of upstart insurance company?
4) Why is market transparency now a bad thing? You don't think prices should be publicly available to shoppers?
An interesting suspension of disbelief occurs with the dual debates on Health Care insurance being the worst in the world and the average life expectancy rising so high so fast that it will bankrupt Social Security. What's wrong with this picture?
Just for sake of argument, who is it that you think is providing health insurance for the elderly in this country? Blue Cross?
While we're at it pointing out elitist snobbery and all that, let's take a good gander at who's telling us that we're not asking the "right" questions about Obolshevikcare!
Just who died and left Pinkbeard in charge of what constitutes the "right" questions to ask, or not?
Who said anything about the "right" question? I agreed with Bern that the questions he was raising were good ones. How elitist!
