The SanityPrompt

This blog represents some small and occasional efforts to add a note of sanity to discussions of politics and policy. This blog best viewed with Internet Explorer @ 1024x768

Thursday, July 21, 2005

A Democratic Response to The Malpractice Straw Man

One of my frustrations in the last election was with the failure of Democrats to counter Republican rhetoric implying that a solution to the health care crisis lay in malpractice reform. Whatever the merits of attending to friviolous lawsuits or protective (practice that protects against lawsuits) rather than preventive medicine, capping maltpractice claims is likely to help (some) doctors without helping patients much.

There is a lot of evidence that much of the run up in costs is attributable to practices of the insurance companies rather than of the patients and their lawyers. And evidence I have highlighted suggests malpractice damage caps will do little to cut overall spending in the system. Another argument against the idea though goes to the fact that the malpractice system essentialy represents the only effective mechanism patients have to punish bad medical practice and try to keep it in check. The review boards of the AMA are notoriously reluctant to punish fellow doctors. Given that an estimated 195,000 Americans die of medical errors in hospitals alone, the true policy issue facing Washington shouldn't be how to emasculate the malpractice system but how to craft a more effective mechanism for assuring high quality delivery of medical care.

"More than five years after the Institute of Medicine brought the issue of medical errors to the national agenda, House and Senate negotiators have agreed on legislation to create new voluntary reporting systems for errors and 'near misses' so that researchers will be able to analyze the data and recommend policy fixes," CongressDailyAM reports. "The deal -- struck before dawn Tuesday... resolves more than two years of on-again, off-again negotiations over relatively minor differences between measures passed by the chambers in the 108th Congress."

A Democratic agenda needs to address both health care reform and health care quality as a response to the malpractice ju-jitsu of the Republicans.

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