The Defining Moment

“…[E]veryone in the political class — by which I mean politicians, people in the news media, and so on, basically whoever is in a position to influence the final stage of this legislative marathon — now has to make a choice. The seemingly impossible dream of fundamental health reform is just a few steps away from becoming reality, and each player has to decide whether he or she is going to help it across the finish line or stand in its way.” — Paul Krugman (New York Times op-ed via laurie)

“I’m a doctor. So sue me. No, really”

The doctors’ lobby says capping malpractice suits will make healthcare cheaper. I’m an M.D. and I don’t believe it.

Defensive medicine is just one of the supposed systemic ills that doctors, doctors' lobbies and doctors' insurers invoke when they shill for what they call malpractice reform. Proponents of reform say that defensive medicine, frivolous lawsuits and high premiums are behind the surge in healthcare expenses. They insist that malpractice costs are forcing doctors to close their doors and depriving patients of care. Recently, three past presidents of the American Medical Association coauthored an opinion piece for the Wall Street Journal that bundled all of these arguments into an attack on the public option. Their piece attempted to shift the blame for America's healthcare crisis away from private insurers and onto a supposed scourge of ambulance chasers. “The nation needs comprehensive medical malpractice reform,” they wrote. “It is the surest and quickest way to slow down the rising cost of healthcare.”Their refrain is familiar to anybody following the healthcare reform debate. The only problem is that it's not true. There's nothing “sure or quick” about changing medical liability laws that will improve healthcare or its costs. Defensive medicine adds very little to healthcare's price tag, and rising malpractice premiums have had very little impact on access to care.Let's look at the numbers.” — Rahul Parikh MD (Salon)

As an MD, I heartily agree with Parikh.The arguments for capping malpractice awards have seemed duplicitous, self-serving and, ummm, very Republican. On the other hand, an effective mechanism for discouraging frivolous suits would benefit everyone.

Bad medicine in New Orleans

The Katrina-ravaged health care system is ‘critically ill’: “Eighteen months after Hurricane Katrina, the healthcare system in New Orleans remains in such disarray that patients with heart disease and cancer are getting inadequate care, local medical authorities told Congress on Tuesday. By one estimate, they said, the number of deaths may have increased by more than 40% from pre-Katrina figures.

The federal government has pumped in millions of dollars in aid, but hospitals and clinics that care for the poor — already strained before the storm — have not recovered. Behind the failure to improve healthcare in New Orleans is a squabble between state and federal officials with competing visions.” (Los Angeles Times)