By Dr. Brian E. Hill and Wayne Oliver
During the next few weeks, many of Americans will receive some very bad news at work or in the mail: Health insurance premiums are expected to skyrocket for 2015 because of the Affordable Care Act (ACA).
The PwC Health Research Institute projects double-digit rate increases for health insurance plans in Florida, North Carolina and Iowa, for example.
With health insurance becoming so unaffordable, many will be wondering why the ACA didn’t take steps to reduce health care costs. One linchpin Washington politicians skipped in addressing the health care crisis was addressing medical malpractice reform.
ObamaCare did nothing to protect physicians and hospitals from frivolous lawsuits or to deter the costly practice of defensive medicine. Doctors routinely order expensive tests that have no clinical, diagnostic or therapeutic value to patients but are performed to reduce the likelihood of a medical malpractice suit. In Georgia, defensive medicine costs all of us up to $14 billion a year.
But Georgia has a solution that could change all of that: the Patients’ Compensation System (PCS). If implemented, it would save Georgia employers between $15 billion and $31 billion over 10 years in health insurance costs. Additionally, state taxpayers would see nearly $7 billion in savings over 10 years from insuring Medicaid patients and state employees, teachers and their dependents.
By reducing the necessity for physicians to practice defensive medicine, Georgians can save billions of dollars. Gallup estimates that one in four health care dollars in our country is wasted on defensive medicine in an effort for physicians to avoid lawsuits. If neither a doctor nor hospital could be sued again, physicians would no longer need to order these wasteful procedures that run up premiums.
A 2012 survey by Oppenheim Research found that 82 percent of Georgia physicians said they practice defensive medicine. They often order costly X-rays, blood work, CT scans, prescription medications, ultrasounds and MRIs, not because it’s good patient care, but out of fear of lawsuits.
If doctors and hospitals could no longer be sued for malpractice, Georgia would significantly reduce defensive medicine and lower health care costs – particularly as we replace the current system with a no-blame, administrative solution. Like the state workers’ compensation system, which has been around for more than a century, a PCS would allow an injured patient to file an application asking for an investigation by an independent panel of medical experts to determine whether a medical injury occurred. If the independent panel finds it has, the patient would be eligible for compensation.
The system would not require taxpayer funding and would be financed by health care professionals and facilities, just as the system is financed today. Patients who have been injured would be compensated in a matter of months instead of years, as happens in the current dysfunctional medical liability system.
The PCS, in essence, takes the same funds from the same funding mechanism, provides compensation more quickly to injured patients, and does so while removing the unintended consequence of defensive medicine that brings tremendous cost without any benefit to Georgians.
Billions of dollars are at stake for employers, Georgia taxpayers and consumers. There is no end in sight to how expensive health care will get. It’s time to start a serious discussion about a state-based solution that can actually reduce health care costs, return savings to Georgians and facilitate justice to patients who have been truly injured.
This commentary was written for the Georgia Public Policy Foundation by Brian Hill and Wayne Oliver. Hill is an Atlanta urologist, a member of the Board of Directors of the Medical Association of Atlanta and the Executive Board of the Emory Healthcare Network, and author of, “Stop the Noise: A Physician’s Quest to Silence the Politics of Health Care Reform.” The opinions expressed herein are his own. Oliver is executive director of Patients for Fair Compensation, a non-profit working in several states to replace medical malpractice laws with a no-blame, administrative system.