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Bill Frist, Rick Santorum, and Judd Gregg: Playing Fast and Loose
With the Facts On Medical Malpractice
(Thursday, April 27, 2006 -Washington DC)—A handful of
senators appeared with a group of doctors today to tout chilling legislation
that would limit the ability of patients harmed by medical negligence
to hold the wrongdoers accountable.
The rally was staged in behalf of legislation pushed by Sen. Bill
Frist, R-TN, that would impose a $250,000 cap on non-economic damages
in medical malpractice cases.
“There were some politicians in suits and doctors, but why didn’t
they invite victims of medical malpractice to tell the public about
the horrors they experienced?’’ asked Ken Suggs, president
of the Association of Trial Lawyers of America. “They’re
the ones who were mistreated and no one was there to utter a word
in their behalf, letting people know the one-size-fits-all approach
that caps damages for people who are terribly harmed does them an
injustice.’’
Proponents of what is erroneously called medical malpractice reform
took the opportunity to misinform and mislead the public about the
issue. Here are some examples:
FRIST RHETORIC:
“The statistics really show skyrocketing costs of medical malpractice
premiums is driving us to defensive medicine, and that’s to a
tune of about $100-$125 billion a year.”
THE FACTS Frist Ignored:
- The Government Accountability Office: Malpractice Cases Have Not
Widely Affected Access to Health Care. The Government Accountability
Office (GAO, formerly the General Accounting Office) found that
“many of the reported provider actions taken in response to
malpractice pressures were not substantiated or did not widely affect
access to health care … some reports of physicians relocating
to other states, retiring, or closing practices were not accurate
or involved relatively few physicians.”[1]
- The Congressional Budget Office: Malpractice Costs Amount to Less
than 2 Percent of Health Care Spending. According to the Congressional
Budget Office, malpractice costs amount to “less than 2 percent
of overall health care spending. Thus, even a reduction of 25 percent
to 30 percent in malpractice costs would lower health care costs
by only about 0.4 percent to 0.5 percent, and the likely effect
on health insurance premiums would be comparably small.”[2]
- CBO: Savings from Reducing Defensive Medicine would be “Very
Small.” According to the Congressional Budget Office (CBO)
“… some so-called defensive medicine may be motivated
less by liability concerns than by the income it generates for physicians
or by the positive (albeit small) benefits to patients. On the basis
of existing studies and its own research, CBO believes that savings
from reducing defensive medicine would be very small.”[3]
- Insurance Industry Official: Premiums Increased, In Part, to Make
Up for Lost Investments. Lawrence Smarr, president of the Physician
Insurers Association of America, admitted to the Detroit News that
premiums are in part rising to make up for lost investment income.[4]
- AIA Suggested Prices Will Continue to Rise, Even with Tort “Reform.”
Dennis Kelly of the American Insurance Association has said, “We
have not promised price reductions with tort reform.”[5]
SANTORUM RHETORIC:
“One of the reasons I’m so passionate about this is because
Pennsylvania – if there’s a state in crisis in this country
more than Pennsylvania I want to find out where they are.”
The Facts Santorum Ignored:
- Pennsylvania Court Released Statistics Just this Week Showing
that the State has Seen a “Sustained Decline” in Medical
Malpractice. On April 25, 2006, the Administrative Office of Pennsylvania
Courts released data on medical malpractice case filings and verdicts
for 2005 that showed “a sustained decline in the number of
med mal lawsuits filed statewide.”[6] According to the data,
between 2000 and 2005, the number of medical malpractice case filings
dropped 35 percent – from 2,632 in 2000 to 1,698 in 2005.[7]
SANTORUM RHETORIC:
“We are in a situation that – we [Pennsylvania] are losing
physicians like we’ve never seen. There are 36,000 physicians
in the Commonwealth of Pennsylvania seven years ago last year we were
down to 32,000 physicians. … We have a CRISIS in Pennsylvania
when it comes to at any kind of high risk [subsectorous] case. You
simply cannot get care and people are dying. There not just getting
inadequate jury awards. There is no one to sue because they simply
cannot get care. So this is a crisis in Pennsylvania.”
The Facts Santorum Ignored:
- AMA Statistics Show that the Number of Doctors in the U.S. and
Pennsylvania is Actually Increasing. According to the most recent
statistics from the American Medical Association, the number of
physicians in the United States and Pennsylvania is increasing:
The Overall Number of Physicians in the United States and Pennsylvania
has Increased. According to data from the American Medical Association,
the number of physicians in the United States is up more than
40 percent since 1990 – from 615,421 to 884,974 in 2004.[8]
Over the same time period, the total U.S. population increased
by only 18 percent – from 248.7 million in 1990 to an estimate
of 293.9 million in 2004.[9] In Pennsylvania, the overall number
of physicians increased from 30,824 in 1990 to 40,832 in 2004.[10]
The Number of Emergency Physicians in United States and Pennsylvania
has Increased. The number of emergency room doctors has nearly
doubled from 14,243 in 1990 to 27,864 in 2004.[11] In Pennsylvania,
the number of emergency physicians has increased from 818 in 1990
to 1,277 in 2004 – an increase of 56 percent.[12]
The Number of Neurosurgeons in United States and Pennsylvania
has Increased. The number of neurosurgeons has increased by more
than 20 percent – from 4,358 in 1990 to 5,288 in 2004.[13]
In Pennsylvania, the number of neurosurgeons is up nearly 20 percent,
from 208 in 1990 to 246 in 2004.[14]
The Number of OB/GYNs in the United States and Pennsylvania has
Increased. The number of OB-GYNs has increased by nearly 25 percent
– from 33,697 in 1990 to 42,059 in 2004.[15] In Pennsylvania,
the number of OB/GYNs has increased nearly 10 percent, from 1,551
in 1990 to 1,694 in 2004.[16]
GREGG RHETORIC:
“But if you’re a young woman living in Northern New Hampshire
or a woman period you can’t see an Ob-gyn. You’re going
to have to probably drive an hour or two hours to see an Ob-gyn. And
that’s not right.”
The Facts Gregg Ignored:
- American College of Obstetricians and Gynecologists Lists OB-GYNs
in Northern New Hampshire. The website[17] for the American College
of Obstetricians lists 6 Northern New Hampshire towns or cities
with OB-GYNs:
Berlin, NH (pop 10,484): 2 OB-GYNs
Milan, NH (pop 1,379) : 1 OG-GYN
North Conway, NH (pop 2,069): 2 OB-GYNs
Lancaster, NH (pop 3,338): 1 OB-GYN
Littleton, NH (pop 6,116): 2 OB-GYN
Waterville Valley, NH (pop 268): 1 OB-GYN
- The Number of OB-GYNs in New Hampshire Has Increased, Even as
the Number of Births in the State Have Declined. According to statistics
from the American Medical Association, the number of OB-GYNs in
New Hampshire has increased by more than 50 percent – from
127 in 1990 to 197 in 2004.[18] This increase came as the number
of birth in New Hampshire declined. The most recent statistics from
the U.S. Department Health and Human Services show that the number
of birth in the state dropped from 17,569 in 1990 to 14,393 in 2003
– a decline of more than 3,100 births, or 18 percent.[19]
--------------------------------------------------------------------------------
[1] “Medical Malpractice: Implications of Rising
Premiums on Access to Health Care,” GAO, 9/29/03, www.gao.gov/cgi-bin/getrpt?GAO-03-836
[2] “Limiting Tort Liability for Medical Malpractice,”
Congressional Budget Office, 1/08/04
[3] Ibid
[4] The Detroit News, 7/8/05
[5] The Chicago Tribune, 1/3/05
[6] “Latest Medical Malpractice data shows sustained
decline in case filings,” Administrative Office of Pennsylvania
Courts press release, 4/25/06, http://www.courts.state.pa.us/Index/MedicalMalpractice/4-25-06%20Med%20Mal%20stats%20for%202005.pdf
[7] Administrative Office of Pennsylvania Courts data,
http://www.courts.state.pa.us/Index/MedicalMalpractice/2005StatewideFilings.pdf
[8] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.312
[9] U.S. Census Bureau data: http://factfinder.census.gov/servlet/SAFFPopulation?_submenuId=population_0&_sse=on;
http://factfinder.census.gov/servlet/DTTable?_bm=y&-geo_id=01000US&-ds_name=PEP_2005_EST&-mt_name=PEP_2005_EST_G2005_T001
[10] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 1992 edition, p.172;
“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 2006 edition, p.133
[11] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.312
[12] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.133;
“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 1992 edition, p.172
[13] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.312
[14] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.133;
“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 1992 edition, p.172
[15] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.312
[16] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.133;
“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 1992 edition, p.172
[17] “ACOG Physician Lookup,” American College
of Obstetricians, https://acog.org/member-lookup/statequery.cfm?stateid=nh
[18] “Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.124;
“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 1992 edition, p. 163.
[19] “Trends in Characteristics of Births by
State: United States, 1990, 1995, and 2000–2002,” U.S. Department
of Health and Human Services,
Volume 52, Number 19, 5/10/04, http://www.cdc.gov/nchs/data/nvsr/nvsr52/nvsr52_19acc.pdf;
“Births: Final Data for 2003,” U.S. Department of Health
and Human Services, Volume 54, Number 2, 9/8/05, p.45, http://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_02.pdf
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