Blog — Health Care

Posted 10/15/11 by Common Good

Philip K. Howard Argues for Health Courts

Common Good Chair Philip K. Howard recently spoke at the Union League Club in Chicago on the topic of healthcare, defensive medicine, and health courts. Modern Physician reported that according to Howard:

[P]eople [are] feeling powerless to oppose nonsensical legal or bureaucratic rules imposed on them by well-meaning politicians—many of them now dead—who sought through the rules to keep anything bad from ever happening. And now legislators lack the will to amend rules to fit current circumstances, he said. Howard urged the students to question and make fun of the rules and "write about this with clear eyes."

Howard made the common sense point that legal fear should not define how doctors practice medicine. Instead of traditional tort reform, which has proven to have limited effecitveness, Howard advocated health courts, a Common Good solution that "would not have juries but would be led by full-time health judges with a budget to hire neutral experts to testify on the merits of a malpractice case."

Read the full report from Modern Physician here.

Posted 8/12/11 by Common Good

Providence Journal Editorial: Join Start Over

In a Friday editorial, the Providence Journal endorses the Start Over campaign and encourages its readers to join the effort. A snippet:

The initiative promotes such reforms as (our favorite!) ‘sunset sessions’ of legislatures to get rid of outdated laws; making laws briefer and easier to read; and creating health courts to bring more medical science and rationality to medical disputes now dominated by trial lawyers.

Voters and candidates in this election cycle should pay close attention to Start Over for proposals on how to create a more efficient, more rational, more courteous and less costly society. Again, see www.startover.org and join the campaign. (The site has some hilarious examples of legal overreach. And you can send your own.)

This is not a right vs. left issue. It’s about common sense.

Read the editorial in full and leave your feedback in the comments section below.

Posted 7/27/11 by Common Good

Today’s Read II: Dr. Amy Tuteur on Defensive Medicine and America’s Aversion to Risk

In a blog entry at KevinMD, Dr. Amy Tuteur points to defensive medicine as the reason for “the explosion in the rate of C-sections and inductions” and reduction in number of VBACs (vaginal births after C-section). She goes on, however, to make a larger point about how defensive medicine fits into American society, writing:

There’s an important subtext that undergirds defensive medicine that often goes unrecognized and therefore unanalyzed. Defensive medicine is driven by the fact that we live in a ‘risk society,’ a society that is organized around a new understanding of risk.

There have always been risks, of course, but they have traditionally been viewed as outside the control of human beings. The risk society has arisen because of new beliefs that we can and (especially) that we should control every aspect of risk.

In our risk society, we are obsessed with the risk of auto accidents and outfit our cars with ever more airbags and safety features. We are obsessed with risks to our children, and restrict their play outdoors and their independence, and we are obsessed with illness and death, literally passing laws to control personal habits like smoking.

Dr. Tuteur goes on to point out that having doctors practice defensively poses its own risks—as does American’s efforts to eliminate risks from other areas of society:

So what’s wrong with defensive medicine? Defensive medicine rests on the premise that we must do things to reduce risk. It completely ignores the risks posed by doing things. But that’s not only a feature of defensive medicine, it is a feature of every aspect of a risk society.

Yes, we make cars safer by putting in more safety features, but we increase the price of cars. Yes, we reduce the risk of kidnapping if we don’t let our children play outdoors, but it’s not good for children to grow up cowering inside their houses. Yes, we reduce the risk of illness when we pass laws regulating private habits, but we also reduce freedom. And when we do more inductions for postdates we lower the risk of postdates stillbirth, but raise the risk of C-section.

Dr. Tuteur concludes by stating what must be done to combat defensive medicine and risk aversion in general—it’s an argument with which Start Over agrees, particularly the idea that realistic boundaries of acceptable risk (for doctors in particular) need to be defined. 

Read the entire blog entry and share your thoughts in the comments section below.

Posted 7/20/11 by Common Good

“Gang of Six” Deficit-Reduction Plan Calls for Medical Liability Reform

Included in the deficit-reduction plan released yesterday by the “Gang of Six”—which is comprised of U.S. Senators Chambliss, Coburn, Conrad, Crapo, Durbin, and Warner—is a call for Congress to find cost savings through medical liability reform.

The senators’ overall plan resembles that of the National Commission on Fiscal Responsibility and Reform’s, which was released in December 2010 and of which Senators Coburn, Conrad, Crapo, and Durbin were members. The Commission’s plan specifically calls for “creating specialized ‘health courts’ for medical malpractice lawsuits.”

Start Over argues that health courts hold the best promise for bringing reliability, efficiency, and fairness to medical liability disputes—and for limiting the costly practice of defensive medicine. Contact Congress and tell them that you support the renewed call for liability reform, and for health courts specifically. 

Posted 6/20/11 by Common Good

Today’s Read: Philip K. Howard’s Letter to the Editor

Common Good Chair Philip K. Howard has a letter to the editor in today’s New York Times in which he comments on a recent Times article on judge-directed negotiations of medical malpractice disputes. “Avoiding [the waste created by defensive medicine] requires more than better judicial management,” Howard argues in the letter. “It requires a reliable decision maker who can be trusted to sort good care from bad.” This requirement, Howard concludes, is why a broad coalition has called for the creation of special health courts. 

Read Howard’s letter—and the underlying article—and tell us your thoughts on which approach to medical liability cases is better—health courts or judge-directed negotiation?

Posted 6/6/11 by Common Good

Legal Idiocy #15: Warning: Reading All Potential Side Effects Might Cause Drowsiness

The New York Times reports on a May 2011 paper in the Archives of Internal Medicine which reveals that “the average drug label lists 70 possible side effects and some drugs list more than 500”—including those that are minor, uncommon, or could occur in the absence of taking the drug. Indiana University’s Dr. Jon Duke, one of the paper’s authors, states that drug companies’ fear of lawsuits is responsible for this frequent “overwarning.” The Times article relates: “Listing every inkling of an adverse reaction can help drug companies in lawsuits, Dr. Duke said. If someone sues about a side effect that is listed in the drug’s package insert, the company can say patients had been warned.”

Posted 5/25/11

Let’s Talk: The Role of ‘Defensive Medicine’ in Rising Healthcare Costs

Wayne Oliver of the Center for Health Transformation writes on the Atlanta Journal-Constitution’s HealthFlock blog that “there is a hidden cost of healthcare that no one wants to talk about”—defensive medicine. Defensive medicine—the practice where doctors order unnecessary tests and procedures to protect themselves from potential lawsuits—contributes anywhere from $45B to over $200B of waste to the cost of healthcare every year.