House Republicans see tort reform in ACA overhaul

Dive Brief:

  • GOP leaders in the House claim there is a medical malpractice crisis and are determined to make tort reform a cornerstone of their ACA overhaul, according to a report from The Washington Post.
  • Despite evidence to the contrary, top Republicans say trivial lawsuits are pushing malpractice insurance premiums over the limit and driving doctors out of business, the report adds. 
  • Their proposals would shift the burden of proof in malpractices cases from the physician to the patient.

Dive Insight:

HHS Secretary-designate Tom Price (R-GA) has long been a proponent of “lawsuit abuse reform,” according to the Post. “We waste hundreds of dollars to lawsuit abuse in this country and the practice of defensive medicine,” he told reporters in June. “Instead of just putting a Band-Aid on it, we propose a bold and robust solution.”

That solution includes caps on malpractice damages and compliance with clinical practice guidelines as a defense in malpractice claims. Price has also floated the idea of state-run tribunals to weed out frivolous cases and rule on personal injury claims — putting the onus on patients to prove doctors were negligent.

Costs of malpractice insurance have dropped since the early 2000s, as has the rate of claims.

However, more than half of U.S. physicians have been named in a malpractice suit at least once in their careers, according to a 2015 Medscape poll. Worry about being sued contributes to physician burnout, which in turn can lead to more medical errors and malpractice suits.

A 2016 report by CRICO Strategies shows miscommunications involving electronic health records cost the U.S. healthcare system $1.7 billion in malpractice claims and close to 2,000 lives between 2009 and 2013. Issues that were commonly reported include having the wrong information about a patient’s condition, failing to obtain informed consent, and ignoring a patient’s complaint.

Opponents of major tort reform point out that tipping the burden of proof in favor of doctors could harm patient safety. The BMJ reported last year more than 250,000 people die each year as a result of medical errors, making it the third leading cause of death in the U.S. after heart disease and cancer though some hospitals like Johns Hopkins have begun attempting to tackle the issue. While malpractice cases and defensive medicine comprise about 3% of the nation’s $3.2 trillion healthcare bill, tougher tort laws don’t guarantee more affordable care, the Post notes.

Moreover, caps such as California’s $250,000 limit on payouts for pain and suffering, imposed in 1975, are particularly hard on women and the elderly who tend to be lower wage earners and thus not as likely to win large economic damages. Such caps also tend not to keep up with inflation. 

Filed Under: Health Law Finance Policy & Regulation