Friday, October 05, 2007
It pays to lower the litigation tax
The front page of Friday's New York Times reports evidence from Texas that caps on the damages that may be won in lawsuits have a "supply side" impact similar to tax cuts:
Four years after Texas voters approved a constitutional amendment limiting awards in medical malpractice lawsuits, doctors are responding as supporters predicted, arriving from all parts of the country to swell the ranks of specialists at Texas hospitals and bring professional health care to some long-underserved rural areas.
The influx, raising the state’s abysmally low ranking in physicians per capita, has flooded the medical board’s offices in Austin with applications for licenses, close to 2,500 at last count.
“It was hard to believe at first; we thought it was a spike,” said Dr. Donald W. Patrick, executive director of the medical board and a neurosurgeon and lawyer. But Dr. Patrick said the trend — licenses up 18 percent since 2003, when the damage caps were enacted — has held, with an even sharper jump of 30 percent in the last fiscal year, compared with the year before.
“Doctors are coming to Texas because they sense a friendlier malpractice climate,” he said.
The damages cap influences the supply of doctors in two ways. First, it limits the damages that patients may recover, particularly speculative "non-economic" damages for pain and suffering. Since the damages cap lowers the risk for malpractice insurance carriers, Texas doctors are paying much less for insurance than a few years ago. That is an effective reduction in the cost of practicing medicine. Second, it reduces uncertainty for physicians. They know that they cannot be wiped out by a fluke jury award that exceeds their insurance policy. At the margin, that is going to make some doctors more willing to practice in Texas, and other doctors more willing to take on risky patients.
Now, since one can never derive "what ought" from "what is," none of this proves that other states should enact similar reforms. Perhaps Texas patients are at greater risk for medical negligence now that Texas doctors are less concerned about policy-busting jury verdicts. It does, however, add to the evidence that litigation damages do, in fact, operate like taxes: they diminish the supply of the thing that is taxed, in this case physician services delivered to risky patients.
The obvious next question is why should physicians be the only beneficiaries of these reforms? We all appreciate the services they provide, but there are other services and products that the tort system may be taxing to the point of inadequate supply. Why not cap non-economic damages for personal injury regardless of the defendant?
28 Comments:
By 
, at
Fri Oct 05, 11:21:00 PM:
Hey, shit for brains, how come juries need fixing only when they cost big insurance companies money?
How come juries don't need fixing when they send street niggers to jail, defended by don't know, don't care PDs, with no resources to mount a defense?
By , at
Fri Oct 05, 11:26:00 PM:
Please cite your evidence. Please list all the doctors you know about in Texas who have been "wiped out by a fluke jury award that exceeds their insurance policy."
Oops, turns out you just made that part up, huh?
By , at
Sat Oct 06, 02:32:00 AM:
Tigerhawk:
I cannot understand this. Everyone (The Lawyers, and their house Demonrats), assure us that the cost of litigation is such a small part the total medical costs as to be inconsequential.
I am sure they will find another reason that the supply of doctors is on the rise in Texas.
By , at
Sat Oct 06, 08:07:00 AM:
Dick the Butcher said it best in Henry IV: "The first thing we do is kill all the lawyers!"
By , at
Sat Oct 06, 08:47:00 AM:
Anonymous at 11:21 and 11:26 has all of the intellectual features of a Texas trial lawyer. And the connection in "listing all the doctors you know about in Texas wiped out"? The same intelligence behind Dem talking points. None. Zero. Except to the delusional. Take your meds, s for brains.
SEW
By , at
Sat Oct 06, 10:11:00 AM:
Hey, Shit Eating Wanker, answer the questions or go away.
But you CAN'T answer the questions, can you? The obvious answers give results you don't like.
By , at
Sat Oct 06, 10:17:00 AM:
Anonymous at 8:47
Where is your evidence TH has "shit for brains" and I am "Shit eating Wanker"? But, being a Texas physician, I can answer the question, but decline based on the absurdity of it.
By , at
Sat Oct 06, 10:25:00 AM:
LOL. You don't answer the questions becasue you CAN'T. The obvious answers give results you don't like.
By , at
Sat Oct 06, 10:25:00 AM:
Anonymous
For a more agreeable audience, you might try a Columbia, Harvard or Cal Berkeley blog.
Regards, SEW
By , at
Sat Oct 06, 10:33:00 AM:
So, first you had the answer. But you didn't give it.
Then you could easily give the answer ... if you wanted. But you didn't.
Now you claim the answer is somewhere in something someone else wrote somewhere.
You don't answer the questions because you CAN'T. The obvious answers give results you don't like.
By , at
Sat Oct 06, 10:45:00 AM:
By , at
Sat Oct 06, 10:56:00 AM:
LOL. Answer the questions or go away.
But you CAN'T answer the questions, can you? The obvious answers give results you don't like.
By , at
Sat Oct 06, 10:59:00 AM:
PROBLEM:
"An average of 195,000 people in the USA died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company.
The HealthGrades Patient Safety in American Hospitals study is the first to look at the mortality and economic impact of medical errors and injuries that occurred during Medicare hospital admissions nationwide from 2000 to 2002. The HealthGrades study applied the mortality and economic impact models developed by Dr. Chunliu Zhan and Dr. Marlene R. Miller in a research study published in the Journal of the American Medical Association (JAMA) in October of 2003. The Zhan and Miller study supported the Institute of Medicine's (IOM) 1999 report conclusion, which found that medical errors caused up to 98,000 deaths annually and should be considered a national epidemic."
SOLUTION:
Stop lawsuits against the killers.
By 
Dawnfire82, at
Sat Oct 06, 11:08:00 AM:
Why don't you put forth an idea on how to "fix juries for street niggers" so it can be debated, instead of just challenging others to come up with an answer and then insulting them? Or do you have shit for brains?
By , at
Sat Oct 06, 12:31:00 PM:
If doctors are killers then they need to be in jail, and be all means please NEVER seek medical treatment. Intresting how no one can put together the concept of group risk thru insurance, cost of doing business, and final cost of service all rising in the same time. Must be those greedy doctors. The only correct solution is to boycott all medical treatment.
By , at
Sat Oct 06, 12:34:00 PM:
"Why don't you put forth an idea on how to "fix juries for street niggers" so it can be debated, instead of just challenging others to come up with an answer and then insulting them? Or do you have shit for brains?"
Last I heard there were sentencing guidlines for criminal cases. Just no for civil. Or maybe your just to stupid to understand the difference. Sigh.
By , at
Sat Oct 06, 12:43:00 PM:
The point is not that criminal law procedures are deeply flawed, although they are. The point is that criminal law procedures are deeply flawed – but the people bleating about tort reform never ever ever mention that. They don't care.
Which leads logically to the observation that what they care about is not justice. What they care about is who is losing money.
They SAY they care about justice. They are lying. They care about money. Torts are about money. Tort reform is about money. Tort reform is about shifting costs from the people that provide sloppy medicine that kills, onto the people their sloppy medicine injures.
The AMA's own journal reports that sloppy, stupid medicine kill 98,000 people a year. And do these shit for brain's work to fix THAT problem? Not at all. Their solution is to stop lawsuits against the killers.
By Larry Sheldon, at
Sat Oct 06, 02:00:00 PM:
The interesting most interesting question here is "What in the world makes people who have the power to protect themselves from anonymous mindless attacks leave the forum open to these valueless lunatics?"
It is an interesting question, but I know the answer so let me use that fact to mention this:
I recently read (which article I can not now find although I sent pointers to several people) about a woman who went (or was taken>) to ER with chest pains. Pains subsided and available information (EKG, blood work) showed she probably had not had a heart attack.
In any case, she said she did not want _any_ invasive procedures and at here age (88 I think) she did not even want resuscitation.
Now is is the capper. In spite of the fact that further tests and procedures WOULD IN NO WAY ALTER THE TREATMENTS OFFERED some of the doctors wanted to admit her ($4000 vice $800 ER bill) for observation and tests.
Wat is wrong with this picture? (The reasons given as I recall had to do with building the defense case against a malpractice claim.)
Aha! Found it! http://www.rangelmd.com/2007/09/er-physician-logic.htm
I am surprised that ol' A up there is bright enough to handle the captcha.
Maybe she had help.
Oh. And (pardon the Latin butchery--I think this is right):
Illigitimit Non Carorundum
By , at
Sat Oct 06, 03:11:00 PM:
I can't speak for Texas, because my father practiced in California. He was a dedicated family doctor who was at the hospital way more than he was at home. Although he was a doctor, I had to pay for my own college education, because his insurance premiums went up $20,000. the year I graduated from high school. It is about time that the lawsuit industry was downsized in this country. John Edwards made $30 million a in four years suing doctors. Anyone who won't admit that that kind of wealth distribution hurts the medical profession, is uninformed, or lying.
By , at
Sat Oct 06, 03:13:00 PM:
Sorry, mistyped the amount. Edwards only made $20 million.
By tm, at
Sat Oct 06, 03:34:00 PM:
Yet, the article notes elsewhere that about 300 people (of 2500 on the wait list) are coming from the 3 biggest export states. So I'd imagine that the biggest increase is from a surge in newly minted TX med school grads. That kind of undercuts the notion that the cap is leading to an influx of doctors from elsewhere.
Kind of hard to tell w/o more data, but there's enough there to make me skeptical of the narrative put forward in the article.
By , at
Sat Oct 06, 04:00:00 PM:
How about good tort reform and put a end to frivolous lawsuits like personal responibilty
By , at
Sun Oct 07, 05:39:00 AM:
Imagine being a doctor. And in walks anonymous 11:21 from above with his ill grandmother. And she dies tomorrow, next month, in 2 months. Whose 'fault' is it this 90 year old finally died? Imagine the struggle to put in the time and effort and shit for brains walks in. Yes folks, every patient is viewed as a prospectice lawsuit, see the reason above.
Look at your yellow pages under 'attorneys'. Look at and count the full page ads by 'contingency personal injury' attorneys. View the full front, rear and inside pages. "Personal injury" attorneys.
Imagine how long you would want to practice medicine. The average doctor gets sued every 2 years in Texas. 90% are settled with no payment.Frivilous. Imagine being viewed as a potential anonymous from above every time you go visit your doctor. Headache you complain of? Should he advise aspirin, or is he forced to order an unnecessary MRI?
Or retire ASAP?
SEW
By , at
Sun Oct 07, 03:38:00 PM:
Imagine being a doctor. And in walks anonymous 11:21 from above with his ill grandmother. And she dies tomorrow, next month, in 2 months. Whose 'fault' is it this 90 year old finally died? Imagine the struggle to put in the time and effort and shit for brains walks in. Yes folks, every patient is viewed as a prospectice lawsuit, see the reason above.
You are lying. You know of no settlements in cases involving the death of 90 year olds with this history. Please stop making stuff up.
The AMA's own journal reports that stupid, sloppy medicine kills 98,000 people a year. And your solution is . . . to make up lies about imaginary cases.
Or: cite the case you have in mind.
The average doctor gets sued every 2 years in Texas.
Please stop lying.
By Georg Felis, at
Sun Oct 07, 04:09:00 PM:
Credibility: We have an Anonymous Troll who claims Doctors only attend years of college and highly expensive medical school just so they can carelessly screw up and mangle patients vs. these same Doctors who actually look at the real cost and risk factors of employing their trade against the probable rewards. Being a Republican, I will tend to believe the Doctors in this regard. I am also quite glad that I operate in an environment where I do not fear being sued for every penny I have ever earned or will earn past my death because of a mistake I may or may not have made.
My apologies to TH, who is not One Of Those Kinds of Lawyers.
By , at
Sun Oct 07, 04:57:00 PM:
Credibility: We have an Anonymous Troll who claims Doctors only attend years of college and highly expensive medical school just so they can carelessly screw up and mangle patients vs. these same Doctors who actually look at the real cost and risk factors of employing their trade against the probable rewards. Being a Republican, I will tend to believe the Doctors in this regard.
Hey stupid, don't believe ME, believe the AMA. The American Medical Association. I'll go real slow for you. Watch my lips move . . . The A m e r i c a n M e d i c a l A s s o c i a t i o n. The AMA says sloppy, stupid medicine kills 98,000 people a year. That’s a jumbo jet crashing every day, killing everyone on board. And your solution is "I'm a Republican. I believe the doctors." What an idiot.
If you, or shit eating wanker, had actual facts, you'd cite your sources. You don't. You can't. Your claims are lies. Well, you maybe believe the stupidity you spew – you're a clueless idiot.. SEW just makes stuff up; he's a liar.
I am also quite glad that I operate in an environment where I do not fear being sued for every penny I have ever earned or will earn past my death because of a mistake I may or may not have made.
Hey stupid, stop making stuff up. Please name one doctor who has been "sued for every penny he has ever earned or will earn". It doesn't happen. What a clueless pile of steaming dogshit you are.
By , at
Mon Oct 08, 10:03:00 AM:
"that's a jumbo jet crashing every day"
Sources please. Jumbo jets are not crashing every day.
By , at
Mon Oct 08, 10:42:00 AM:
And from the law firms of BUZZARD,VULTURE,SHARK,SLUG,SNAKE,HYNA,JACKLE comes more frivolous lawsuits
