Published CommPro.biz 2014.02.10

Legally But Not Medically Necessary

Depending on whose numbers you look at, somewhere between 5% and 40% of the cost of healthcare in America is spent on “Defensive Medicine.”  In 1994 the Congressional Office of Technology Assessment defined it: “Defensive medicine occurs when doctors order tests, procedures, or visits, or avoid high-risk patients or procedures, primarily (but not necessarily or solely) to reduce their exposure to malpractice liability.”

The body formally known as the Trial Lawyers Association, the barracuda bar that strikes fear into the hearts of all in the medical world, says that defensive medicine does not exist. They see it as a big scam that the medical types use as an excuse to ratchet up their income. And while we don’t buy that, there is a certain amount of truth in what they say. Testing facilities owned by doctors, hospitals and others in the game certainly benefit. As do those who consult to affirm the decisions made by their colleagues.

The leading solution is Tort Reform, restrictions on the legal profession. And/or limitations on the amount those harmed by the medical system can collect. Some of those reforms have been set up by state governments, however, and they don’t seem to help. That either means the lawyers are right, that unnecessary medical stuff reflects greed among medical providers, or that the practice is so ingrained that fear makes it near impossible for them to stop.

A totally different approach is now under consideration in Florida and Georgia, a concept that eliminates the possibility that any medical player could be sued. The Patients’ Compensation system would take medical errors out of our legal system entirely. Panels of experts would be tasked with evaluating claims and awarding the injured party funds to cover their losses. It would be quick and fair.

We spend more per-capita than other countries on healthcare but our outcomes rank below third world nations. We fail to make it into the top twenty-five in most cases. On the other hand our VA Health Care system provides excellent care at 40% less per patient than the national average. That’s an impressive number made even more impressive when you look at their patients. Mostly a bunch of beat up old folks, with some really beat up younger folks from our recent wars. Compare that to the national patient base; it includes all those folks under forty who are in relatively good health.

Oh yes, the VA enjoys a few other advantages. Their people don’t have to worry about lawsuits. And they don’t have to spend a lot of time filling out paperwork for insurers. They were among the first to go digital; any Vet can go into any VA facility in the world and they can pull up their records in seconds. All this allows them to focus on prevention. And the VA can negotiate to hold down drug costs, unlike Medicare that is prohibited by Big Pharma who has our Congress bought and paid for.

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