While testifying during a medical liability reform hearing before the House Judiciary Committee, American Medical Association Board Chair Dr. Ardis Hoven said the current legal environment (PDF) has become increasingly irrational, is unfair and costly to physicians and patients and has created a "culture of fear" that discounts doctors' clinical judgment and leads to defensive medicine practices that add between $70 billion and $126 billion to the nation's annual health bill.
Clash over malpractice reform at hearing
Similarly, Dr. Stuart Weinstein, a professor of pediatrics and orthopedic surgery at the University of Iowa, called defensive medicine the "antithesis of healthcare reform" and argued that it drives up costs while decreasing access to care, resulting in a situation in which half of the country's counties lack a practicing obstetrician.
Not all who testified echoed Hoven's and Weinstein's comments. Joanne Doroshow, executive director of the New York-based Center for Justice & Democracy, said caps on damages lower incentives to provide quality healthcare and that despite an "epidemic" of medical malpractice, malpractice claims are in steep decline.
Some Republican representatives took Doroshow to task for not disclosing where her organization's funding originates. Hoven was grilled by Rep. Bobby Scott (D-Va.) about whether the billions of dollars she cited as the cost of defensive medicine constituted fraud if the tests being ordered were, in fact, medically unnecessary. Hovan replied that the issue was that courts dismiss physicians' clinical judgments about whether the tests and procedures generating these costs are necessary.
Rep. J. Randy Forbes (R-Va) noted that the military uses modeling and simulations to predict the outcomes of assorted scenarios and said malpractice damage limits in place in California and Texas represent "two monstrous demonstration projects" showing the success of caps.
"I have never had a constituent come to me and say 'I cannot find a trial lawyer,'" Forbes said.
Rep. Hank Johnson (D-Ga.), however, cited cases of a woman suffering brain damage after undergoing a partial thyroidectomy and another who was infected with hepatitis C after kidney-stone surgery.
"Is that worth $250,000?" Johnson asked, citing California's cap on noneconomic damages. "No it's worth a whole lot more than that."
Representatives also brought up whether this issue should be left for individual states to settle and if a "loser-pays" provision might deter individuals from filing frivolous lawsuits.
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