We should all be for personal accountability

Most places you look these days, someone is blaming medical malpractice claims, and the “clever trial lawyers” that bring them, for the high cost of health care in the United States. This argument is unsupported by actual research performed by the Congressional Budget Office, who says that med-mal claims account for a mere 2% of health care costs. Furthermore, the actual practices of med-mal insurance carriers shows this argument to be untrue. For instance, Texas has strict tort reform and thus far fewer medical malpractice claim filings, but doctors practicing in Texas have malpractice premium rates double that of neighboring Arkansas in many practice areas.

The argument for tort reform also ignores the real problem underlying medical malpractice cases: some hospitals, doctors, and nurses are injuring the patients they are charged to protect. Medical malpractice laws are on the books to ensure that injured patients are made as whole as possible for the health provider’s errors. However, in many medical malpractice cases, it is impossible for patients to be made completely whole for the life-changing injuries they sustain.

That’s where medical malpractice claims step in. Civil law only provides one way for injured parties to make themselves as whole as possible:  money. That’s it. For example, consider a mother whose heart stops during labor due solely to the fault of her doctor and who has brain damage such that she will need assistance and care for the rest of her life. There are but two options for her care: either the responsible doctor pays for his mistake, or the mother receives some form of public assistance through Medicaid, Medicare, or the like.

Self-described conservatives and insurance companies would have you believe that caps on malpractice awards would reduce the cost of medical care in this country. That’s simply not true, because injured patients will require assistance and care no matter who pays for it. The health insurance lobby would rather taxpayers pay for these costs. It seems to me that pushing more injured patients onto the rolls of government health care is the opposite of the conservative movement’s stated objective.

Insurance companies accuse trial lawyers of being the scourge of the health care industry. Those same companies want to have their cake and eat it too. Notice that you don’t hear insurance companies talking about their profit margins, since that would expose the fact that insurance companies profit far more from the health care industry than do trial lawyers. For what? Taking money from one side and handing it to the other, albeit in as slowly and painstaking a fashion as possible.

Instead of providing the care patients need, insurance companies balk. Instead of paying doctors promptly, insurance companies ask that doctors negotiate an insurer discount. Instead of paying malpractice claims to injured patients, insurance companies make those same patients fight to recover through years of court proceedings while trying to recover at the same time. Industry insiders and trial lawyers call this unethical strategy “delay, deny, defend,” and it has added billions of dollars to insurance companies’ bottom lines at the expense of policyholders and taxpayers.

While some sort of tort reform may be justified, insurance reform is a more pressing issue for health care reform in this country. Conceptually, insurance is a good idea. It spreads risk throughout the population so normal people can have access to care and funds in times of need. However, insurance companies today aren’t living up to the traditional insurance laws, which require the insurance companies to put their insureds’ interests ahead of their own and to give insureds the benefit of the doubt.

In fact, insurance companies are lobbying to change these traditional rules so they can be even more aggressive in denying claims and withholding funds that properly belong to their clients. So far, the federal and state governments have turned a blind eye to this activity by giving antitrust exemptions to insurers and failing to enforce regulations that prevent insurers from abusing their clients.

A good start toward reforming health care would be to make the insurance market more competitive by strictly enforcing regulations requiring insurance companies to provide fair and prompt coverage to their policyholders. Until this happens, insurance companies will continue to take the money from our wallets and withhold it when we need it most. The only ones protecting the rights of policyholders and taxpayers from insurance companies are trial lawyers. Count us among those proud to carry that title.