Proposition 46

If you’ve been tempted to skip this election cycle, do so at your own great peril. Regressive forces like the Koch brothers have been throwing wheel-barrows of money into elections all over the US–Over $700,000,000 so far. Buying this election is a top priority.

In California Prop 45, the insurance industry has spent $38,000,000 to defeat this measure. Most of this has come from Kaiser, Wellpoint and Blue Shield.

The opposition to Proposition 46 has spent $53.5 million almost all of it from the physician organizations and the insurance industry.

Both of these propositions are strongly pro-consumer and fair.

Medical providers do not want to be forced to compensate the victims when they gratuitously make gross errors. (Clearly, not every medical problem that ends poorly is the fault of the physicians.) That is why we have courts. If there is a suspicion, modern society has decided that the court system is the best place to discover the truth. Unfortunately bringing a lawsuit is expensive and with the present limit or cap on awards, few attorneys can afford to take malpractice lawsuits.

The opposition to both these ballot measures is almost entirely from those who would be regulated. Doctors who don’t want to be drug tested (It is well-documented that there are many errors made by doctors under the influence of alcohol, cocaine and other illegal drugs.)

Physician say that they need protection from malpractice suits. Otherwise they are forced to practice “defensive medicine” but the following article from Science Daily shows that this is not the case.

Please use this link to sign up for your own email feed. They summarize each story and provide a link to the full article. One of the best news sources I read.

Giving physicians immunity from malpractice claims does not reduce ‘defensive medicine’

October 15, 2014
RAND Corporation
Conventional wisdom says that a lot of medical care in the United States is ‘defensive medicine’ prescribed because doctors want to protect themselves from the risk of malpractice lawsuits. But a new study that examines three states where emergency room doctors were given immunity from malpractice claims finds that such protections do little to reduce the cost of medical care.
Changing laws to make it more difficult to sue physicians for medical malpractice may not reduce the amount of “defensive medicine” practiced by physicians, according to a new RAND Corporation study.

Studying the behavior of emergency physicians in three states that raised the standard for malpractice in the emergency room to gross negligence, researchers found that strong new legal protections did not translate into less-expensive care.

The findings are published in the Oct. 16 edition of the New England Journal of Medicine.

“Our findings suggest that malpractice reform may have less effect on costs than has been projected by conventional wisdom,” said Dr. Daniel A. Waxman, the study’s lead author and a researcher at RAND, a nonprofit research organization. “Physicians say they order unnecessary tests strictly out of fear of being sued, but our results suggest the story is more complicated.”

It is widely said that defensive medicine accounts for a substantial part of the hundreds of billions of dollars of unnecessary health care spending that is estimated to occur annually in the United States. Malpractice reform has been advocated by many experts as a key to reining in health care costs.

RAND researchers looked at three states — Georgia, Texas and South Carolina — that about a decade ago changed the legal malpractice standard for emergency care to gross negligence. Other states use the more common ordinary negligence standard, or a failure to exercise reasonable care.

The higher standard means that for physicians accused of malpractice in the three states examined, plaintiffs must prove that doctors consciously disregarded the need to use reasonable care, knowing full well that their actions were likely to cause serious injury.

“These malpractice reforms have been said to provide virtual immunity against lawsuits,” said Waxman, who also is an emergency medicine physician at the David Geffen School of Medicine at UCLA.

Researchers examined 3.8 million Medicare patient records from 1,166 hospital emergency departments from 1997 to 2011. They compared care in the three reform states, before and after the statutes took effect, to care in neighboring states that did not pass malpractice reform.

The study examined whether physicians ordered an advanced imaging study (CT or MRI scan), whether the patient was hospitalized after the emergency visit and total charges for the visit. Advanced imaging and hospitalization are among the most costly consequences of an emergency room visit, and physicians themselves have identified them as common defensive medicine practices.

The malpractice reform laws had no effect on the use of imaging or on the rate of hospitalization following emergency visits. For two of the states, Texas and South Carolina, the law did not appear to cause any reduction in charges. Relative to neighboring states, Georgia saw a small drop of 3.6 percent in average emergency room charges following its 2005 reform.

“This study suggests that even when the risk of being sued for malpractice decreases, the path of least resistance still may favor resource-intensive care, at least in hospital emergency departments,” Waxman said.



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