July 27, 2009

Reforming Malpractice and Healthcare
By Jim Knaub
Radiology Today
Vol. 10 No. 14 P. 4

I certainly hope malpractice reform becomes part of healthcare reform. Here’s why: Everyone involved will have to give something for meaningful reform and cost control to become a reality. You just know that any cost-control plan will target provider reimbursement in some way. History won’t let me believe anything else.

Providers should get something in exchange. Radiologists and other doctors need malpractice relief. A stricter malpractice litigation environment could give physicians something valuable in return for taking that impending hit. That said, you have to wonder how President Obama plans to reduce malpractice suits. Obama doesn’t favor placing caps on malpractice awards like many physicians and Republicans (and presumably Republican physicians) desire.

We hear time and time again how doctors frequently order tests they really don’t believe the patient needs to protect themselves against malpractice suits. That behavior, in turn, drives up medical costs. In truth, such defensive medicine is just one component driving healthcare costs higher, but it will take efforts on many fronts to rein in healthcare spending in this country.

That realization—along with some understanding that we can’t put off addressing the healthcare problem much longer—may be settling in among healthcare stakeholders. The pharmaceutical industry recently touted its plan to save $80 billion in drug costs over 10 years. Insurers have raised the possibility of not denying coverage to those with preexisting health conditions in exchange for mandatory coverage laws. (Maybe they’ll just cancel the coverage later.) A coalition of healthcare companies, including insurers, doctors, hospitals, drug makers, medical device manufacturers, and a healthcare union, put forward a vague proposal to save $1 trillion to $1.7 trillion over 10 years. The cynical voice in my head says these organizations are coming to the table now because they fear the inertia and stalling tactics of the past may be overcome this time—they don’t want reform to happen while they’re mere bystanders. That is oddly encouraging to me.

Everyone is likely to take some hit (and hopefully gain something, too) from real change in healthcare. If reform means hitting physician reimbursement—and that is inevitable—doctors need to get something back, even if they really don’t see it as a fair trade.
Enjoy the issue.