Tort Reform is a pre-requisite to repairing our Health Care System
What is a “TORT” and why must it be reformed?
A tort is a non-criminal wrong where an injury exists (such as falling down the stairs at work). The recourse for such an incident is for the victim to sue for dollars to offset the cost of injury (loss of income, reimburse medical bills, plus pain & suffering).
Presently, American workers have access to WORKERS COMPENSATION through a majority of businesses. Workers Comp is actually an example of a TORT Reform. Originally, employees hurt on the job would sue for any amount they could conceive of. Naturally, this put the employer at risk for bankruptcy with each and every incident – whether by his neglect or not. Something had to be done to allow the employer to continue in business but meet the needs of the employee. Consequently, Workers Comp established regulated amounts (“fixed benefits”) for injuries. The “tables” for such financial settlements are utilized across the country to settle such situations.
In essence, Workers compensation is simply a set of laws that allow the Employer to avoid being sued for such injuries, and in exchange the employee receives certain financial benefits. They are:
- Replacement for loss of income (66% while recovering from a work related injury).
- A settlement to compensate in the event there is a permanent physical injury.
- Unlimited medical coverage for the injury.
Why is this important?
In medical practice, there are TORT injuries, too. There are any number of procedures that are performed throughout hospitals and clinics daily that could result in unintentional injury. The recourse for such an incident is for the victim to sue for dollars to offset the cost of injury (loss of income if unable to work, reimburse medical bills, plus pain & suffering).
Similarly, medical institutions face financial hardships if victims can sue for any “sky-is-the-limit” amount of money. Consequently, part of what forces constantly rising medical costs is purchasing insurance to cover against such incidents. And many physicians leave private practice because they simply cannot afford malpractice insurance and charge reasonable fees for basic services.
So why couldn’t a form of workers compensation be designed for medical practice tort and reduce the cost of healthcare without a negative effect on physicians or patients?
That is exactly what we suggest.
Apply Tort Reform to eliminate malpractice premiums for all providers of “outpatient services” and enable an independent commission to better police the medical industry.
The sort of TORT reform we envision would not have to be applied to all categories of healthcare. The risk level for some is already within a uniform table of costs, or has experienced reduced levels of risk due to stabilization of services.
- Inpatient Hospital Service for surgeries and major illnesses would not be affected
- Outpatient procedures would not be affected because many of these services have become commonplace, simplified and routine. However these are still surgical
Only Routine Care or Primary Care would be targeted for TORT reform in healthcare, primarily due to the fact that human error cannot be eliminated when diagnosing. Doctors are limited by their ability to explain the symptoms we alone experience, and are often further hampered by lacking experience to the variety of diseases and ailments that people are exposed to. Consequently, if medical malpractice premiums could be eliminated at this level – costs and bureaucracy would reduce significantly. This does not mean elimination of coverage for unintentional injury – just how the funds are generated to fund the program and what system of settlement is utilized, while providing for efficiencies in evaluation and compensation of claims. This is worth immediate consideration – as it can be claimed that medical malpractice premiums have been a significant factor in the decision to not open a primary care private practice – a reality to be reversed immediately.
As already stated, malpractice insurance is extremely expensive, and its costs are built into fees paid by patients for service. If it were not needed, the cost of healthcare would drop for two reasons:
#1 – a workers comp form of insurance would lower costs immediately as no
high premium for lawsuits would be necessary
#2 – physicians could charge less for daily care without the burden of
expensive malpractice insurance “baked into their pricing”
Since Americans are already familiar with Workers comp and its provisions, it would not be difficult to “retrofit” the workers comp model into a medical practice compensation plan. Fixed levels of benefits could be reworked to provide for procedures with a pre-determined negative outcome. We know this is possible because we have the workers comp model to follow.
So, rather than build more bureaucratic levels of paperwork and supervision to oversee such medical tort compensation, we propose that the “small independent commission for policing” be paid for by a tax equally applied to every outpatient service across all fifty states. It would provide the funds for compensation packages and eliminate malpractice premiums (as was done with workers comp).
We believe the effect would be more physicians returning to private practice. And with the elimination of insurance company involvement in “outpatient services,” we would see physicians establishing office visit rates at a price consumers can afford.
If this sort of TORT REFORM were crafted for the medical industry, the incentive to exploit every medical mishap for every dollar possible would be eliminated. We also believe that eliminating malpractice premiums could result in an immediate 20% reduction in the cost of health care.
With Workers Compensation as a model – this is worth exploring immediately.
Solutions are ideas that evolve. We are not an expert in any facet of government. Your ideas, comments, questions and experiences us develop these solutions. Please continue to submit your insights.