Health care costs rise with medical liability lawsuits

By Brian Lockhart
Columnist
http://orient.bowdoin.edu/

As December rolls around, I thought I might break the seal on campaign issues. I would like to discuss a consequence of medical liability lawsuits on health care that is not very well known. Most people know that doctors’ insurance has inflated dramatically as there have been increasing incidences of lawsuits brought against physicians. The rising insurance is often blamed for the skyrocketing health care costs. However, insurance is only a fraction of the problem.

A greater issue at hand is how physicians are forced to practice. Before America was faced with such a high number of lawsuits, doctors were able to practice at certain confidence level. Consider a patient who entered a hospital with chest pain.

Hypothetically speaking, a doctor could attain a 95 percent confidence level regarding the nature of the problem by performing diagnostic tests A, B, and C on the patient. Due to the current risk of medical liability lawsuits, the doctor must be more careful. In addition to tests A, B, and C, the physician also performs diagnostic tests D, E, F, G, H, and I, just to be certain nothing is missed in an effort to avoid a possible law suit. The additional tests are used to attain a hypothetical 99 percent confidence level about the patient’s illness.

Is there a problem with this methodology? In a perfect world, no. However, the world we live in has to deal with time and money as limited resources. If tests D, E, F, G, H, and I each run around $200, consider how much that hypothetical 4 percent extra confidence level costs our society’s health care system. The cost is significant. I present the question, could we better allocate our nation’s health care resources?

One could argue that the extra confidence level is necessary to prevent unfortunate outcomes of a small percentage of patients. I fully agree that practicing at a 95 percent instead of a 99 percent confidence level will lead to a small percentage of misdiagnosis and unfortunate outcomes. However, when the argument is taken reductio ad absurdum, we come to the realization that our country does not have enough money to attain that high of a confidence level.

Hypothetically speaking, consider a diagnostic test that costs $1,000 to perform. This particular test is the only way to detect a rare form of a common cold. One out of every 10 million people with the cold’s symptoms has the rare form of the illness. If all 10 million people receive the test, finding that one person would eat up a huge portion of our health care budget. If the cost of the test is increased to $5,000, and 100 million people get the illness, we simply run out of money. I know this may sound cold, but it is an unfortunate aspect of living in a non-ideal world with limited resources. As a country, we simply cannot afford to make sure that everyone is healthy 100 percent of the time.

Perhaps the medical community could devise a consensus about what tests should be performed when specific symptoms are present. As long as a physician performs the necessary procedures, they are protected from a malpractice suit. Such a consensus might help limit the number of unnecessary diagnostic tests that doctors perform solely for the purpose of covering their backs.

Another problem with medical malpractice suits stems from the methodology of our current system. I find it odd how we expect a jury to determine whether or not a physician with minimum seven years training made the right decision after hearing a few expert witnesses. This remark was not meant to be elitist. I would have as little confidence in a group of doctors determining whether or not a mechanic correctly fixed a car than I would a group of electricians, lawyers, plumbers, or any other occupation to make a decision about a medical procedure. When a lawyer is accused of an ethical breach, his fault is determined by a group of those trained in the law, not a jury of outsiders.

Perhaps the same logic should be applied to the medical field, and a group trained in the medical profession should hear the physician’s case. I lost almost all of my faith in the system when I heard of a case in New Hampshire where the wrong doctor was sued. That is to say, a physician who did not prescribe a patient medicine was on trial because an eighty-year-old patient had a stroke. The physician therefore had to defend himself as if he were the other doctor. The defense brought in a group of physicians from prominent institutions in Boston, while the prosecution flew in a single hired gun from outside the region. The doctor, who never dealt with the patient, was found guilty for the other physician’s proper actions and lost a million dollar lawsuit. Clearly the system needs improvement.

Regardless of how inadequate any potential solution I present may be, please understand that the constant threat of medical liability lawsuits costs our country’s health care system an enormous amount of money that could be far better allocated. If one finds the increase in health care costs troublesome and is concerned about malpractice suits driving the costs, or if one is considering medical school and worried about the manner in which one would be forced to practice medicine, be aware that John Edwards made his fortune as a personal injury lawyer. The North Carolina Senator has reported a net worth between $12.8 million to $60 million.

Please do not misunderstand me: personal injury lawyers are a necessary part of our system of checks and balances. However, medical liability needs reform, and Edwards may not be the most amenable candidate to changing the present situation.
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