Bad Medicine

David Leonhardt discusses an interesting study on medical malpractice, showing that most malpractice claims don't result in any payment to a patient. This doesn't stop "defensive medicine" though, because the money is not really an issue for doctors, who are covered by malpractice insurance. What they do fear is the process of getting sued, which is stressful and unpleasant, even if the insurance company is going to be the one paying if you lose.

Leonhardt posts an interesting chart showing the rate of lawsuits and payments for different specialties, and the differences are dramatic. The top is neurosurgeons, almost 20 percent of whom may get sued in a given year, down to psychiatrists, who get sued around one-tenth as often. Why? I have a good friend who's a neurologist, and he explains the brutal answer for his specialty: By the time you come to him, you've probably suffered a catastrophic event in your most important and tender organ, and there's a good chance you'll either be dead or a vegetable before long. Neurologists get sued because so many of their patients have bad outcomes.

The conservative answer to this problem is simple: make it impossible for people to sue, aka "tort reform." The most common form is damage caps: set a low enough cap on the damages that can be won for medical malpractice, and it won't be worth anyone's while to sue. As Kevin Drum explains here, caps on damages are just about the worst way to address the problem, and in Texas, as in many other places, they've succeeded only in improving insurance companies' profits, while ensuring that people who have been genuinely wronged can't get redress. You'll hear people like Rick Perry tout tort reform as the answer to every health care problem, but the evidence shows that it doesn't bring down health care costs or improve care.

The real solution is to attack not malpractice suits, but malpractice itself. Reduce medical errors and everyone wins. There are also ways to quickly separate and address the legitimate claims so that lengthy lawsuits aren't necessary (I discussed some of them in this column). But don't let anyone tell you that medical tort reform solves anything.