The Myth of Defensive Medicine Costs


The standard refrain of opponents to comprehensive health care reform efforts, like Obamacare, is that one of the major drivers of escalating medical cost is defensive medicine practices caused by fear of lawsuits. Fix that and you’ll move a long way toward keeping health costs from escalating, or so the theory goes. The science to back up this claim has never been borne out.  Yet Red State legislatures — including Texas and Georgia — dutifully bought the wisdom of conservative think tanks in recent years and enacted tort reforms making it more difficult to file, as well as limiting the amount of damages plaintiffs can win in medical malpractice lawsuits. Now we have some additional studies that these news laws haven’t really made much of a difference in terms of controlling costs. Today’s New York Times Upshot reports about it.

When you talk about rising health care costs you have to deal with, among other things: an aging population in need and demanding care for chronic illnesses;  new, more sophisticated medical technologies that replace cheaper, less expensive diagnostic tools;  the high-cost of recovering research expenses by overcharging for new drugs to the market; a reimbursement system that pays physicians more for ordering tests and procedures than it does for keeping patients well; and the 20-25 cents on the premium dollar that goes to profit, marketing and administration of commercial health insurance plans. The fear of malpractice, no doubt, is another factor. But it is chump change. And when you hear it come up in serious policy discussions, it is more than likely just a way to distract you from the serious issues this country still faces in making health care affordable.

Mike King is a retired health policy reporter, editor and columnist for The Atlanta Journal-Constitution. He is the author of “Diversion,” a book about how large public hospitals have become the safety valve for the nation’s highly profitable $3 trillion a year health care economy. The book — as viewed through the experience of Atlanta’s Grady Memorial Hospital — is expected to be published next year.