Jewish World Review Feb. 7, 2003 / 5 Adar I, 5763
How much is a solution for America's health care problems worth? How 'bout ten grand!
http://www.NewsAndOpinion.com | Suddenly, solving America's health care problem has become a tawdry matter of money.
In exchange for a solution, a health care consultant is offering - are you ready? - $10,000. That's right, baby. Ten grand. One hundred squared. A one with a whole lot of zeros - four of them.
Kathleen O'Connor, an author and consultant based out of Seattle, Wash., will award this prize for the best way to take the disconnected pieces of America's health care system - or, according to my expert medical diagnosis, the schizophrenically dissociated pieces - and make them all fit together like something that really, really fits together. A grapefruit, for example. Sure, if it helps you fix health care, think of a grapefruit. It'll do you about as much good as thinking about that $10,000.
For you see, the best thinking is done for free. Indeed, with medical malpractice insurance premiums becoming impossibly high, I am suddenly - mysteriously - surrounded by selfless people who are only trying to help.
And the problem, lobbyists tell me, is that plaintiffs and lawyers in malpractice suits are greedy. I'm hearing a strangely uniform opinion on this. I guess people are lining up for botched medical procedures - little kids switching their charts around, grown men asking for hysterectomies.
Want proof? Advocates point to California's caps on plaintiffs' awards. But let me explain what did happen in my home state, then tell you how our caring health care lobbyists are interpreting it for us, out of the goodness of their hearts.
In 1975, California passed the Medical Injury Compensation Reform Act. Among other things, MICRA placed a $250,000 cap on how much malpractice victims could receive for non-economic injuries.
Well, an amazing thing happened after that law passed: It made no difference. At all.
When malpractice premiums went down everywhere else in the country, they went down in California. When national premiums went up across the country in 1982, they went up in California. By the time that state's prices leveled off in 1986, the average premium had increased by 175 percent over the first decade after MICRA. (All my numbers come from the Foundation for Taxpayer and Consumer Rights, based in the lovely Santa Monica, Calif.)
Then in 1988, the state reformed all insurance, not just malpractice - and blame was cast onto the insurance companies rather than the patients. Proposition 103 rolled back and reduced property-casualty insurance rates, and insurers had to justify future increases.
Guess what happened. Come on, guess. Seriously, this will be fun. Guess. All right, I'll stop. The price of malpractice insurance dropped farther and faster in California than it did elsewhere. And when national prices went up in 1992, California's stayed down. That 175 percent rate increase after the meaningless MICRA has been shaved down to 167 percent.
What did trusted industry leaders conclude from this? Well, Dr. Robert Cline, president of the Florida Medical Association, looks at it this way: Since MICRA passed 1975, rates for professional liability insurance in California rose only 167 percent, while it increased fivefold everywhere else. Other medical groups are doing similarly nasty things with numbers that ignore the 1988 reforms - an argument that seems equivalent to saying the Dark Ages brought great medical advances because, since then, we've cured syphilis.
But hey, these advocates have medical degrees. Or maybe law degrees. Maybe just a bachelors in marketing. But that still qualifies them to cut open a guy, right?
My point is that you don't need to offer an award to get opinions. What might solve a lot of our problems instead is if you get all the people who torture numbers this way and stick them on a slow-moving barge to Ecuador.
Where's my $10,000?
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