Healthcare Tuesday

Rekindling the debate over medical malpractice: A group of researchers this week estimated that the annual cost related to medical liability is $55.6 billion — or 2.4 percent of the nation's healthcare spending. 

The figure includes payouts to patients who sue for malpractice; costs racked up as doctors practice defensive medicine to avoid lawsuits; administrative costs, including lawyer fees; and the costs related to lost work time.

The report, published Tuesday in Health Affairs, is certain to catch the eyes of Capitol Hill Republicans, who have long pushed for Congress to take up malpractice reform, including a cap on "pain and suffering" awards surrounding malpractice cases.

Democrats have countered that malpractice is a vital recourse for injured patients which, anyways, isn't contributing much to the nation's skyrocketing healthcare tab. The authors of the study said both sides are exaggerating their case.

“Physician and insurer groups like to collapse all conversations about cost growth in health care to malpractice reform, while their opponents trivialize the role of defensive medicine,” Amitabh Chandra, a co-author of the study and professor of public policy at Harvard’s Kennedy School of Government, said in a statement. "Our study demonstrates that both these simplifications are wrong — the amount of defensive medicine is not trivial, but it’s unlikely to be a source of significant savings."

The researchers are quick to concede that their cost estimate for defensive medicine — which they peg at $45.6 billion per year — is shrouded in "considerable uncertainty."

Still, they also note the value of having hard numbers to inform lawmakers as they continue their struggle to rein in the nation's astronomical healthcare spending.

“We cannot debate the potential for medical liability reform to bring down health care costs in any meaningful way without realistic cost estimates,” said Michelle Mello, the lead author and professor of law and public health at the Harvard School of Public Health.

"Some of the numbers bandied about in policy discussions were quite imaginative and we wanted a more defensible estimate."

Still plagued by a lack of primary care docs: More and more patients are rushing to the emergency room — not to their primary care doctor — for acute care—treatment, according to yet another Health Affairs report published this month. 

Twenty-eight percent of patients suffering acute symptoms — including fever, chest pain and stomach pain — went to the ER between 2001 and 2004, the researchers found. The trend is due largely to the dearth of available primary care doctors, combined with a lack of patient access to those physicians after-hours. 

"Primary care doctors have packed schedules and their offices are typically closed in the evenings and on weekends," Stephen R. Pitts, the lead author and an associate medical professor at Emory University School of Medicine, said in a statement. "Too often, patients can’t get the care they need, when they need it, from their family doctor."

How will the Mental Health Parity Act affect your benefits? It depends on any number of things, the Los Angeles Times reports.

"People who will see the most benefit are those who previously had high copays and deductibles on mental health services," the Times writes. "The impact will be far less for people who already have good mental health benefits, who have mild depression or have an acute life crisis where only a small amount of treatment is needed." http://bit.ly/cVYtGC

Healthcare costs in India are also skyrocketing: Health costs in India are projected to rise 14 percent annually over the next decade, reaching $280 billion in 2020, India's Economic Times reports. 

"Increase in personal income, government healthcare outlays and private domestic investments, combined with longer life expectancy should lead to annual average growth in healthcare spending of around 14 per cent in the forecast period," according to an industry report, the Times said. http://bit.ly/9s74Wd

Maryland's community health centers gearing up for influx of new patients: The Democrats' new health reform law includes roughly $11 billion to expand and improve community health centers, which cater to some of the nation's most vulnerable patients. Maryland is preparing.

"Our goal is to handle what the market gives to us," Jay Wolvovsky, president of the Baltimore Medical System, told the Baltimore Sun. "We're planning for growth."  http://bit.ly/ar8j4J

In Oregon, calls for a public insurance option on the state exchange: Oregon health officials touring the state this weekend to get input as they create an insurance exchange "got an earful" from local residents, the Corvallis Gazette Times reports.

"In short, what they heard was this: Give us a simplified health insurance marketplace with a public option and a range of private plans that go beyond federal coverage requirements." http://bit.ly/aPTDbp

While in West Virginia, state lawmakers have other concerns: Namely, that there simply aren't enough health officials to implement the new reform law. 

"It's D-Day, and they're hitting the beach, and they just don't have enough troops," said House Health and Human Resources Committee Chairman Don Perdue, (D) according to the Charleston Gazette. "That's a recipe for failure." http://bit.ly/brkOiu