[quote author="EvaLSeraphim" date=1247657232][quote author="three sheets" date=1247620335]There is no doubt that malpractice risk mitigation is a significant cost affecting health care costs. I agree that it is a serious problem.
Another huge cost is R&D. I think someone already posted the outrageous cost and time associated with bringing a drug to the US market. I've read that 1 in 250 drugs actually make it to market. US drug prices are higher than any other country and US based private research companies are by far the largest innovators. It makes sense. The US has fostered the greatest incentive to invent new drugs (specifically because of our health care system and IP protections), therefore more drugs will be produced here.
I think if we have national health care, then we must acknowledge that every person cannot be afforded the most innovative technology. If we want the Cadillac of health care, then we can't complain about paying the Cadillac price. I envision low cost health insurance (or government provided health care) which buys lower grade health care. If you get sick and there is a new drug on the market that can cure you, you shouldn't get the benefit of the drug without paying for it. If you get sick and there is a specialist that demands a high price for his services, he shouldn't be compelled to perform without being paid what he wants.
If we want low cost health care, then we must be willing to accept that we can't sue a doctor for mere negligence.</blockquote>
Oh, three sheets, you are making my head hurt.
<a href="http://www.boston.com/business/globe/articles/2005/06/01/rising_doctors_premiums_not_due_to_lawsuit_awards/">Not all premium increases are due to lawsuit awards.</a> Here is <a href="http://www.kaiseredu.org/topics_im.asp?id=226&parentID=59&imID=1">another discussion</a> of same.
Of course, in California we have MICRA, which caps pain and suffering damages at $250K, and the limit has not been increased since MICRA was passed in 1975. And while in some instances that cap seems sufficient, imagine an instance where a surgeon amputates the wrong leg or screws up back surgery, especially on someone fairly young. In such an instance, $250K for a lifetime of ongoing pain isn't nearly enough. Yet, despite the cap, and the cap not being increased over the years, malpractice premiums in California have continued to climb. Fancy that.
Further, in med mal cases, it's not "mere negligence." The plaintiff must prove that the doctor (or nurse, or other medical professional) failed to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful doctor would use in the same or similar circumstances - and often in the same community, such that docs in Bakersfield cannot be compared with docs in La Jolla. That the doctor's acts which fell below the standard of care caused plaintiff's harm must be established with a degree of medical certainty. Both the standard of care and causation can only be proven by experts, which are usually expensive to hire.
Moreover, a doc is not considered negligent simply on the basis that the doc's efforts are unsuccessful or the doc makes an error that was reasonable under the circumstances, or because the doc chose one medically accepted treatment over another.
<a href="http://www.courtinfo.ca.gov/jury/civiljuryinstructions/documents/caci.pdf">Here</a> are the jury instructions. (Start at #500 - "Medical Negligence.")
I'll get to R&D later, and how patients in other countries are paying lower prices because patients, or rather, insurance companies in the US are basically footing the R&D bill.</blockquote>
Eval - I'm not quite sure what made your head hurt. I never suggested that medical malpractice was the sole or a main reason for increase in costs. Awards are a very small part of "malpractice risk mitigation" (i.e. the cost associated with litigation, insurance and, to a much lesser extent, actual damage awards). I'm not an expert and frankly too lazy to look up any proof but I would venture to guess that the increase in premiums are <em>partly</em> due to the increased cost of litigation. Also, as I am sure you know, the cap of $250,000 only applies to non-economic damages, so, for instance, in addition to any non-economic damages, a litigant will probably collect a significant amount of money from a malpracticing doctor for the medical bills incurred in connection with such negligence - so your example litigant may only have $250,000 to compensate him for a lifetime of pain and suffering but the defendant will be on the hook for the cost associated with treating the pain.
You caught a bit more of my laziness. I am aware of the standard of negligence for professionals. Regardless, my point had little to do with the actual negligence standard. My point was simply that granting a higher level of civil immunity (not unlike sovereign immunity) to the medical profession by increasing the level of negligence necessary to find malpractice would go a long way to decrease costs associated with medical malpractice litigation, which should in turn, decrease med mal insurance premiums and ultimately health care costs.
