Your whole post is an error wrapped in a misapprehension clothed in a lie.
You said 30% of health care costs can be attributed to defensive medicine, i.e. unnecessary care offered only to protect doctors from liability. You say tort reform has been successful in Texas because malpractice insurance premiums are down. Obviously shielding providers from liability will lower their malpractice insurance premiums. But unless you want to revise your post to say 30% of costs is attributable to malpractice insurance premiums, you have to show that the volume of unnecessary care has dropped. Otherwise the criteria you've laid out for defining success differ from the outcomes you've cited.
Do you have any personal explanatioon as to why tort reform was not included in the law? It may not decrease costs dramatically, but it is naive to think it would not decrease costs.
I don't have a personal explanation but I suspect the reality is simple: no one who views malpractice reform as a top priority ever realistically offered their vote in exchange for that provision. You don't get to shape legislation if you don't intend to support it. You can find anecdotes like
this one that illustrate the point:
When Barack Obama informed congressional Republicans last month that he would support a controversial parliamentary move to protect health-care reform from a filibuster in the Senate, they were furious. That meant the bill could pass with a simple majority of 51 votes, eliminating the need for any GOP support. Where, they demanded, was the bipartisanship the President had promised? So, right there in the Cabinet Room, the President put a proposal on the table, according to two people who were present. Obama said he was willing to curb malpractice awards, a move long sought by Republicans that is certain to bring strong opposition from the trial lawyers who fund the Democratic Party.
What, he wanted to know, did the Republicans have to offer in return?
Nothing, it turned out. Republicans were unprepared to make any concessions, if they had any to make. But the encounter did make some Democrats wish they could see more of that kind of presidential engagement on the issue that Obama says is his top legislative priority.
The reality is that Republicans could have gotten substantially more of whatever it is they want if they ever presented themselves as serious negotiating partners. The only Republican who bothered to do that was Olympia Snowe, who never ruled out voting for the Senate Finance Committee's bill in committee (in fact she ultimately did end up voting for it in committee). And she got lots of concessions on that legislation during the mark-up as a result. Funny how that works.
In the end, tort reform appears in the law only as seed money states could use to test out and experiment with their own state-based malpractice reform efforts.
Do you get a "Docfax" when you see a new DR?
Telling how many procedures he has performed and how man successes, etc?
Their professional history?
That's actually not too far off. For the past few years, doctors who treat Medicare patients have been able to get incentive payments if they participate in the
Physician Quality Reporting Initiative, reporting on various quality metrics. This program was extended by ACA and CMS will be
launching a website soon that will allow you to compare (participating) physicians along those quality metrics:
By Jan. 1, 2011, CMS will be required under the federal health reform law to launch a website that would allow consumers to compare physicians based on factors such as quality, performance and patient experiences, Government Health IT reports.
The Physician Compare website is expected to be modeled after CMS'
Hospital Compare website, which allows consumers to compare hospitals using similar criteria.
According to CMS, the website initially will include information about physicians who participate in the Medicare program and those who participate in the agency's Physician Quality Reporting System.
Regina Reymann Chell -- a health insurance specialist at the CMS Office of Clinical Standards and Quality -- said the agency will use data from its directory of Medicare providers as the foundation of the new Physician Compare website.
Beginning in January 2013, the Physician Compare site will include physician performance data based on quality reporting survey information gathered in 2012.