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Tort reform alone won’t cut health costs
Ruqaiijah Yearby studies the effect of health care laws on disenfranchised people. Photo: DOUGLAS LEVERE
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“Instead of adopting the IOM’s recommendations to prevent such medical errors, however, federal and state governments have elected to focus on tort reform.”
Tort reform—legislation that aims to reduce medical malpractice suits—will not cut medical costs and improve health care unless the government addresses the proliferation of unnecessary medical errors that victimize hundreds of thousands of patients every year, says Ruqaiijah Yearby, associate professor in the UB Law School.
Yearby’s research considers how laws enacted to grant equal access to quality health care can actually pose barriers to the disenfranchised, and she is critical of health care reform efforts that do not address the far-reaching problem of medical errors.
Finding ways to curb what she calls the “alarming rate of these medical errors,” will not only reduce medical malpractice suits but save lives and reduce the misery of innocent victims, she says.
Yearby, who directs the joint JD/Master of Public Health Program at UB, cites data from the Institute of Medicine (IOM), the health arm of the National Academy of Sciences, regarding medical errors and their consequences.
“The IOM concludes that about 98,000 Americans died from unnecessary medical errors in 2000,” she says, “deaths that cost the nation approximately $39 billion.” In August of this year, she adds, additional data showed that deaths from unnecessary medical errors have increased to about 200,000, making medical error the third-leading cause of death in the United States.
“Instead of adopting the IOM’s recommendations to prevent such medical errors, however, federal and state governments have elected to focus on tort reform,” Yearby points out.
While such reform has led to minimal reductions in the costs of health insurance and a reduction in medical malpractice suits, Yearby says the underlying problem of poor-quality health care persists.
In 2003, for instance, she says Texas voters approved a plan that capped non-economic damages in medical malpractice lawsuits at $250,000.
“The result,” she says, “was that the number of malpractice lawsuits was cut in half, malpractice premiums declined by 30 percent and there has been a 30 percent increase in newly licensed physicians.”
“Despite this, however,” Yearby says, “one in four Texans remains without health insurance—the highest percentage of uninsured in the country—and health care spending in Texas is growing faster than in any state.
“Obviously, tort reform alone is not the answer,” she says, “because it does not address the root cause of malpractice lawsuits: the continuation of unnecessary medical errors.”
Instead of spending all this effort on tort reform, Yearby calls for federal and state governments to do something to discourage the errors themselves. She recommends measures that would lay the foundation for tracking and preventing medical errors, thereby making malpractice lawsuits unnecessary.
“We need to create a mandatory national medical-error-reporting system and adopt initiatives that mandate the disclosure of medical errors,” she says. She also strongly urges states to require health care facilities and health care practitioners to apologize for errors and compensate patients or families for harm.
“State initiatives like those in Michigan and other states that require the disclosure of medical errors are the best models for health care reform because everyone gets what they want: reasonable insurance rates, a fair partnership between the medical profession and government, and, perhaps most important, better care for patients, who need a system they can trust,” Yearby says.
New York is another state that has addressed the problem, but in an inadequate way, she notes, pointing out that while New York requires mandatory reporting of medical errors, it does not use this information to regulate health care facilities or health care practitioners, and it does not disclose the information to patients.
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