Eric Novack, MD is host of “The Eric Novack Show,” a weekly radio program dedicated to examining healthcare policy and politics. It airs Sundays on KKNT960 AM Phoenix. Today, he writes on why he thinks docs must continue to fight the good fight.
The issue of medical liability reform appears to have lost some of its front-page appeal to doctors and the media over the last several months. The big question is why? Is the ‘crisis’ over? Did it ever really exist in the first place? Have the efforts of the pro-reform forces succeeded, allowing the grassroots to—as they say—move on? Or has the defeat by anti-reform forces been so profound that proponents of tort reform have retreated? Or is it none of the above?
Answers: If we define ‘over’ as no longer having double digit—or triple digit—increases in premiums year over year, then perhaps it is over. The issue of total medical liability costs as compared to the whole system is a red herring. The fact is that costs increases have far outstripped the rate of even medical inflation and exploded compared to increases in revenue for physicians. So, that’s not it.
Of course a crisis exists. Efforts of the absurdly named Center for Justice and Democracy (AKA national trial lawyers assn.) notwithstanding, when obstetricians pay upward of $200,000 per year in certain locations for coverage, and entire segments of states have no OB docs at all—it is safe to say that the system is in critical condition. Not it.
I laugh at the prospect of a pro-reform complete victory – not when a large proportion of our elected officials are beholden to the trial lawyers guild, or even work as one. Not it.
Anti-reform forces on the national level have been remarkably successful—certainly a source of defeatism among pro-MICRA style reforms coming out of Congress. But, on the state level, efforts have been ongoing, and in some cases, successful.
The real issue is that physicians are coming to realize that the greater threat to them is the prospect of going out of business due to the double whammy of decreasing reimbursement combined with greater regulation and diminished bargaining clout with the private insurance oligarchy. So, while the battle for medical liability reform remains an essential front in the war on medicine, the focus has shifted to the real battleground: physician autonomy and reimbursement.
Physician groups need to continue to be vigilant about not being portrayed as ‘tilting at windmills’ when it comes to medical liability reform. But, we must recognize that the issue of tort reform would be a pyrrhic victory indeed if autonomy and reimbursement go the way of the Alamo.