Posted by Bill Sandweg on 10 September 2018.
John and I have written about defensive medicine on many occasions in the past. Here is a link and here is another. It is our belief that claims by the medical profession about the amount of defensive medicine and its cost are overblown.
Doctors and their backers in the fight to limit your rights in the event of medical malpractice argue that much of what doctors do is in the nature of defensive medicine. They claim that these are tests and procedures that they would not order were they not afraid that they might get sued for failing to order them. One of the medical industry’s top allies in Congress has gone on record claiming that the annual cost of defensive medicine is $650 billion. This amount is 26% of the cost of all health care delivered in the United States in a year. That claim is outlandish and clearly false.
Claims by the medical profession that it is being forced to practice defensive medicine are suspect for a number of reasons. In the first place, doctors and hospitals get paid for ordering and interpreting the tests and performing the procedures they claim are unnecessary. Secondly, it is unethical for a doctor to order a test the patient does not need and to do so for the benefit of the doctor and not the patient. Until now, there have been claims of massive amounts of defensive medicine with no proof to support them. The problem has been how to determine if a test was ordered for fear of suit or because the patient needed it. A recent study found a novel way of addressing that issue.
Researchers from Duke and M.I.T. looked at medical care provided to active duty service members who are precluded from suing for malpractice. They compared the care provided to the service members with the care provided to their families, who do have the right to sue. They also compared the cost of the care provided to the service members in the military care system with the costs the service members incurred when a base hospital closed and the service members were forced to seek care in the civilian system. In both situations, they found that there was less care provided to the service members when they could not sue and that the additional care they received when they transitioned to the civilian world did not seem to make much difference.
While the study did finally provide some objective evidence of the existence of defensive medicine, it did little to assist those in the medical profession who claim that this is a huge problem which can only be solved by limiting the rights of patients. In the first place, the researchers concluded that what they believed was defensive medicine only increased health care costs by about 5%, a far cry from the 26% claimed by Rep. Tom Price in Congress. Secondly, the researchers quite properly concluded that any laws limiting patient rights in an attempt to prevent defensive medicine would only recoup some percentage of the increased amount of the bills. In other words, limiting patient rights in a major way might result in a 1-2% reduction in overall health spending. I respectfully submit that limiting patient rights to sue is a huge price to pay for such a small benefit.
There is much to complain about in terms of the amount of medical malpractice and how patients are treated when they try to get compensated for injuries caused by medical malpractice. One thing we should not waste a lot of time or energy complaining about is defensive medicine. It is a minor problem at best.
