Barbara O’Brien of the Mahablog today wrote this great piece about the AMA and President Obama
Last week the American Medical Association came out against the most important part of President Obama’s health care reform proposal — public health insurance that would compete with private insurance plans. Now there are reports that President Obama is considering “reducing malpractice lawsuits” as a bargaining chip to get the AMA on board with the public plan.
The AMA has a decades-long history of protecting the interests of the private medical industry and opposing all public programs. In the 1960s, for example, the AMA fought hard to defeat Medicare. As I wrote last week, the AMA’s primary function is to protect the profit margins of the health care industry.
Health care reform and tort law are both issues critical to people suffering asbestos-related diseases, such as mesothelioma. Most likely the AMA’s primary concern in this matter is reducing the cost of physicians’ malpractice insurance.
Sheryl Gay Stolberg and Robert Pear report for the New York Times that President Obama “views addressing medical liability issues as a ‘credibility builder’ — in effect, a bargaining chip that might keep doctors and, more important, Republicans, at the negotiating table.”
As of this writing it is not clear how the President might reduce malpractice lawsuits. He does not have a history of supporting caps on jury awards, as did his predecessor, George W. Bush. However, in 2005 Senator Obama voted for the Class Action Fairness Act (CAFA), which among other things placed limitations on attorneys’ fees in coupon settlements.
Also in 2005, senators Obama and Hillary Clinton co-sponsored a National Medical Error Disclosure and Compensation Act (MEDIC), which did not become law. MEDIC would have created a program to seek early compensation for patients and offer liability protections to doctors in exchange for acknowledgment of their errors. According to Stolberg and Pear, the President has been talking about “offering some liability protection to doctors who follow standard guidelines for medical practice.”
Dr. J. James Rohack, the incoming president of the AMA, that he is encouraged by the President’s “recognition that defensive medicine contributes to unnecessary health costs.” Whether so-called “defensive medicine” is a factor in health care costs at all is questionable, however. As I’ve written here before, there is no empirical evidence that physicians change their practices in any way when the threat of malpractice litigation is reduced.
It’s also important to understand that reducing physicians’ malpractice insurance rates, while certainly a welcome benefit for physicians, has no impact whatsoever on the overall costs of health care. We see this in states such as Texas, in which significant decreases in malpractice insurance rates have been accompanied by significant increases in health care costs and health insurance rates.
However, getting the AMA on board with the health care reform proposals probably would make passage of a meaningful health care reform bill a lot easier. Let’s hope President Obama can find a way to soothe the AMA without bargaining away the rights of citizens to sue for damages in court.