With the rising costs of prescriptions and medical coverage, the number of uninsured Americans is on the rise, and leaving people desperate for answers. But, what exactly is driving up the health care costs? What is inevitably forcing people to have to choose between having medical insurance and putting food on their kitchen table? Is it the number of medical malpractice claims? The number of medical lawsuits?
A new study shows that although many believe health care costs are largely affected by medical malpractice claims, there are other factors causing this increase.
According to Science Daily, “Efforts to lower health care costs in the United States have focused on demands to reform the medical malpractice system, with some researchers asserting that large, headline-grabbing and “frivolous” payouts are among the heaviest drains on health care resources.”
However, a new review of malpractice claims by Johns Hopkins researchers suggests such assertions are wrong. In all actuality, in their review of malpractice payouts more than $1 million, the researchers say those payments added up to roughly $1.4 billion a year, making up far less than the 1 percent of the medical expenditures each year in the United States.
“The notion that frivolous claims are routinely resulting in $100 million payouts is not true,” says study leader Marty Makary, M.D., M.P.H., an associate professor of surgery and health policy at the Johns Hopkins University School of Medicine.
Called catastrophic claims, payouts more than $1 million are more likely to occur when a patient is killed or injured, is under the age of 1, develops quadriplegia, brain damage, needs life long care as a result of the malpractice, or when the claim results from a problem related to anesthesia the researchers found.
Makary and his colleagues reviewed nationwide medical malpractice claims using the National Practitioner Data Bank, an electronic repository of all malpractice settlements or judgments since 1986. They looked at data from 2004 to 2010, choosing a 2004 start date because that is when data regarding the age and gender of patients and severity of injury became available for the first time. The information includes only payments made on behalf of individual providers, not hospitals or other corporations, meaning the number of payouts may be underestimated by 20 percent, Makary says.
Over that period, 77,621 claims were paid, and catastrophic claims made up 7.9 percent (6,130 payouts). The seven-year nationwide total of catastrophic payouts was $9.8 billion, representing 36.2 percent of the $27 billion worth of total claims paid over that time period.
Makary says the data suggests that the focus of legal reform efforts should be on doctor protections aimed at reducing defensive medicine rather than the creation of malpractice caps.
The Real Issue Behind Rising Health Care Costs
“The real problem is that far too many tests and procedures are being performed in the name of defensive medicine, as physicians fear they could be sued if they don’t order them. That costs upwards of $60 billion a year. It is not the payouts that are bankrupting the system — it’s the fear of them.”
He says his findings argue for more research to determine what interventions might prevent the type of errors that result in catastrophic payouts, with the overall goal of improving patient safety and reducing costs at the same time.
But real cost reductions, he says, will come from reducing the overuse of diagnostic tests and procedures.
This study was published online in the Journal for Healthcare Quality.