Cutting liability costs
Bill targets high insurance premiums for physicians

With financial projections for Massachusetts’ fledgling health insurance rising sharply — and communities and businesses across the state groaning under the burden of ever-growing premiums — efforts on Beacon Hill to keep a lid on health care costs have taken on a new urgency. Timely action on a proposal for reducing wasteful “defensive medicine,� now being studied by a legislative committee, would be a welcome step in that direction.

House bill 985, aggressively supported by the Massachusetts Medical Society, addresses factors that have made expenses related to medical liability suits a significant cost-driver in the state’s health care system.

One factor, of course, is huge “pain and suffering� awards, often for many millions of dollars, that drive up the cost of malpractice insurance in some fields sky-high.

Even more expensive is the cost of “defensive medicine.� Faced with the possibility of huge malpractice judgments, physicians may feel it necessary to order tests, treatments and procedures that are of negligible medical use — knowing that, if they are not ordered, the omission is apt to figure in some future lawsuit.

The cost of defensive medicine is hard to nail down, but the medical society estimates it is in the billions. That’s good for the owners of MRI clinics, testing laboratories, pharmaceutical companies and the like. But it is unlikely to improve the physical or mental well-being of overtested, overmedicated patients or the fiscal well-being of the health care system,

In addition, liability judgments may undermine access to health care in the state. The medical society’s research has tracked a 13-year decline in the “physician practice environment.� It is not surprising, then, that the society’s current work force study also shows continued “severe and critical physician shortages� in nine specialties, including family practice, internal medicine and cardiology.

The House bill, currently being studied by the Joint Committee on Financial Services, would end “joint and several� liability, making defendants pay only damages for which they are responsible. Among other provisions it also would limit interest charges related to malpractice judgments to four points above the interest rate of treasury bills and would require expert witnesses to be certified in the speciality of the defendant physician.

House bill 985, while only a partial solution to the double-digit inflation of health care costs, warrants prompt and favorable consideration by the Financial Services Committee and the full Legislature.
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