Howard Argues for Reliable Medical Justice PBS
The News Hour with Jim Lehrer, October 22, 2004 You can view a video of the discussion here; an audio-only version is available here. (Howard appeared in the "Campaign Day: Discussion" segment.)
Soaring health care costs cannot be reigned in without "a reliable system of
justice," CG Chair Philip K. Howard said during a discussion aired Friday, October
22, on PBS's The News Hour with Jim Lehrer.
"The pervasive practice of defensive medicine is a reality." Howard said. "If
you visit any hospital and talk to administrators or doctors, you'll get a litany
of the ways they practice that drive up the cost of health care."
Unreliable medical justice also erodes the quality of care, Howard noted. "Studies
by the Institute of Medicine and by the Harvard School of Public Health and others have demonstrated that distrust of justice is causing thousands,
perhaps even more, unnecessary errors ... because doctors so distrust justice
that they're afraid to be candid with each other."(1)
The News Hour explored the medical liability issue with Howard and Frank Sloan, professor
of health policy and economics at Duke University, because it has become a big
issue on the Presidential campaign trail.
Howard said that soaring liability insurance premiums are driving some specialists--in
particular neurosurgeons and obstetricians--out of their practices.
But he emphasized that the consequences of excessive litigation and unreliable
medical justice extend far beyond higher premiums for some specialists, impacting
broader issues cost containment. "We [Common Good] commissioned a poll a couple of years ago where four out of five doctors said they regularly ordered
tests they did not think [were] necessary," Howard said.
Simply capping non-economic damages, he argued, "doesn't really address the systemic
problems" of costly defensive medicine or the culture of secrecy that impedes
patient safety.
Asked about the effectiveness of a proposed reform that would set up a panel
of "independent experts to make sure [a case is] reasonable" before it's filed,
Howard said:
The idea of having an authority which actually has expertise to make binding
decisions about what is a valid claim I think is critical to fixing the system.
The problem with the three panel experts is they don't have the authority. So
a number of states have these and the way they work is they do weed out some cases.
But in the tragic circumstances, the baby born with cerebral palsy, even though
the science says that the doctor could not have caused the harm, the lawyers just
ignore it and more often than not, the juries will award damages because it is
such a tragic situation. And it is those cases or cases like that that have infected
the system with distrust.
Learn more about CG's plan to create special health courts.
Footnote
(1.) "The culture of medicine creates an expectation of perfection and attributes
errors to carelessness or incompetence. Liability concerns discourage the surfacing
of errors and communication about how to correct them. ... Patient safety is also
hindered through the liability system and the threat of malpractice, which discourages
the disclosure of errors. The discoverability of data under legal proceedings
encourages silence about errors committed or observed. Most errors and safety
issues go undetected and unreported, both externally and within health care organizations."
Institute of Medicine, "To Err is Human: Building a Safer Health System," pp.
22, 43
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