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August 26, 2008

Evidence of the Problem Is Not Always Proof of One's Solution

Justin Katz

I'm sure there are examples on the Right, as well, and taking my own biases into consideration, I wouldn't be confident declaring an imbalance. But it does seem as if the Left has a habit of assuming the soundness of its solutions and seeing any evidence of the initial problem as explicit proof for its assumption. Consider Ian Donnis:

Speaking of Carcieri, our governor has been an energetic supporter of what proponents call medical malpractice reform. Yet those who believe the medical system is plagued by unwarranted lawsuits might want to watch a segment aired last night on 60 Minutes, featuring actor Dennis Quaid.

The interview with Quaid is certainly chilling. In brief, his newborn twins were given adult dosages of a blood thinner, resulting in a thousandfold overdose that nearly killed them. The reason was that, at three steps between the receipt and administration of the drug, nobody read the label on the vials carefully enough, and the different shades of blue on the two versions' packaging were not sufficient to raise alarms.

A few details worth noting: According to 60 Minutes, there have been two similar incidents over a span of several years, one before and one after Quaid's experience. After the first, the pharmaceutical company that manufactures the drugs "issued a nationwide safety alert" and modified the packaging. Curiously, Quaid is suing the drug company (for failure to recall), but not the hospital, because:

"I'd like to see Cedar Sinai take the lead in doing something to change what's going on in what I consider to, in the end, a broken healthcare system in patient medical care."

All of which leads one back to Donnis's curious insertion of our governor into the story, which requires him to ignore the fact that the agent for dramatic change in the 60 Minutes report wasn't litigation, but the involvement of a wealthy and famous man. Moreover, of the five components of Carcieri's favored tort reform that Ian cites, only one — limits on non-economic damages and reimbursable attorneys' fees — would have any implications whatsoever for legitimate complaints in the service of rapid change. To insist on the necessity of eye-popping awards from lawsuits, one must imagine that some millions of dollars would add substantial motivation on top of the possibility of killing children to avoid the decisions and mistakes that ushered the wrong drug into Quaid's newborns. One must imagine, in other words, that the packaging designers, pharmacy technicians, nurses, and managers along the line understood, on some level, the possibility of being responsible for deaths and shattered lives and still took less care than they would have in the face of financial liability.

Keep in mind, too, that the financial liability is mostly borne by others: insurance companies, proximately, and policy holders and their clients, ultimately. Therein lies the cognitive dissonance of Donnis's juxtaposition. Malpractice insurance is driving up costs and driving out doctors, and as fewer medical providers are available — working in an environment of ever-tighter margins — mistakes will likely become more common, not less.

Then, true to form, the Left will up its rhetoric in the push for government healthcare... without questioning government workers' capacity for mistakes or government leaders' tolerance for high-profile, high-price-tag litigation, let alone taxpayers' ability to absorb new costs that come with the backing of police power.

Comments

Andrew, some supporters of med mal reform act as if medical errors are a non-issue. In fact, they are far more common than most people imagine. Although perhaps not articulated that well, that was the point I was trying to make.

Posted by: Ian Donnis at August 26, 2008 9:14 AM

My apologies, Justin. I obviously meant to address the preceding remark to you and have been thrown off track by the alarmingly good play of the Rays.

Posted by: Ian Donnis at August 26, 2008 9:27 AM

There are legitimate malpractice cases.

Unfortunately there's also an entire ambulance chasing industry built on a business model of suing, or threatening to sue, and relying on insurance carriers to cough up money to make it go away rather than incur the cost and expense of defending even facially dubious, if not frivolous, claims. With the ambulance chaser pocketing 1/3.

Just watch the schlocky lawyer advertising running during the 12:00 p.m. local news broadcasts.

The just answer would be to emulate the workers comp system for medical malpractice.

Establish medical-savvy courts to hear cases, and to the extent that there was medical malpractice issue an award based upon some established formula (ditto for attorney's fees - none of this 1/3 contingency nonsense). And if no malpractice, no award.

This alone would cut out a major portion (if not the bulk) of malpractice costs, for not only would it cut the attorneys' take, it would lower the other side of the equation with insurance companies paying shake down money and/or defending claims. It would also speed up the recovery for legitimate victims of medical malpractice, while greatly lessening (if not eliminating) the incentive to bring non-meritorious claims.

In turn, medical providers (like employers) would be required to procure "medical malpractice comp" insurance, and their rates would adjust based upon loss experience.

Posted by: Tom W at August 26, 2008 10:02 AM