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AAJ Statement on President Bush’s Attack on Civil Justice System
Bush’s Misleading Attacks Won’t Play in Peoria
Tuesday, January 30, 2007 (Washington, DC)—President
Bush continued his assault on America’s civil justice system
on Tuesday, disingenuously blaming lawsuits for high medical costs.
“Bush is misleading the American public all to make the case
for further padding the profits of his insurance industry friends,”
said Jon Haber, CEO of the American Association for Justice, formerly
the Association of Trial Lawyers of America. “Restricting the
rights of victims to hold wrongdoers accountable will do nothing to
lower health care costs and in turn, eliminate a key incentive for
hospitals and health care providers to decrease the 100,000 deaths
that occur each year from preventable medical errors.”
Appearing in Peoria, Illinois, Bush said: “I'm worried about
frivolous lawsuits running of the cost of health care. You know that
there’s about 1500 counties in America where the OB/GYN has left
because of frivolous lawsuits. And when somebody gets sued all the
time they practice more medicine than necessary and it runs up your
costs."
The president’s claim that a doctor drought exists in the specialized
area of obstetrician/gynecologists is objectively false. According
to the American Medical Association’s own figures, the number
of OB/GYNs in the United States increased by nearly 25 percent from
1990 to 2004 at a time when the U.S. birthrate actually declined.
There are more practicing OB/GYNs than ever before.
Expensive medical malpractice insurance premiums, meanwhile, are
the result of industry price-gouging, not pay-outs. A 2005 study conducted
for the Center for Justice and Democracy by former Missouri Insurance
Commissioner Jay Angoff found that insurance companies have been drastically
raising insurance premiums even though claims payments have been flat
or, in some cases, decreasing. Medical malpractice court filings have
steadily declined since 1998. Even insurance industry officials and
their allies admit that limiting medical malpractice rewards won’t
lead to lower insurance rates.
Here are the facts about medical negligence that you didn’t
hear from President Bush:
Medical Malpractice Cases Aren’t Threatening Health Care
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.” [“Medical Malpractice: Implications
of Rising Premiums on Access to Health Care,” GAO, 9/29/03, www.gao.gov/cgi-bin/getrpt?GAO-03-836]
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.”
[“Medical Malpractice: Implications of Rising Premiums on Access
to Health Care,” GAO, 9/29/03, www.gao.gov/cgi-bin/getrpt?GAO-03-836]
AMA Data: The Number of Physicians Up More than 40 Percent Since
1990. According to the most recent statistics from the American
Medical Association, the number of physicians in the United States
is increasing:
The Overall Number of Physicians in the United States 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. 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.
[“Physician Characteristics and Distribution in the U.S.,”
American Medical Association, 2006 edition, p.312; 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]
The Number of Emergency Physicians in United States has Increased.
The number of emergency room doctors has nearly doubled from 14,243
in 1990 to 27,864 in 2004. [“Physician Characteristics and Distribution
in the U.S.,” American Medical Association, 2006 edition, p.312]
The Number of Neurosurgeons in United States has Increased.
The number of neurosurgeons has increased by more than 20 percent
– from 4,358 in 1990 to 5,288 in 2004. [“Physician Characteristics
and Distribution in the U.S.,” American Medical Association,
2006 edition, p.312]
The Number of OB/GYNs has Increased in United States. The
number of OB-GYNs has increased by nearly 25 percent – from
33,697 in 1990 to 42,059 in 2004. [“Physician Characteristics
and Distribution in the U.S.,” American Medical Association,
2006 edition, p.312]
So-Called “Defensive Medicine” is a Myth
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.”
[“Medical Malpractice: Implications of Rising Premiums on Access
to Health Care,” GAO, 9/29/03, www.gao.gov/cgi-bin/getrpt?GAO-03-836]
The Methodology Used to Calculate the Cost of “Defensive
Medicine” Has Been Debunked by CBO, GAO. According to Congressional
Quarterly Weekly, the statistics used to cite the cost of so-called
“defensive medicine” are “[b]ased on an estimate from
the Department of Health and Human Services (HHS) in a report that
extrapolated from a narrower study of the costs of treating Medicare
heart patients before and after states approved certain caps on damages
and other changes. The Congressional Budget Office tried to apply
that study’s methodology to a broader set of ailments and reported
no evidence that restrictions on tort liability reduced medical costs.”
In 1999 the GAO wrote, “[b]ecause this study was focused on only
one condition and on a hospital setting, it cannot be extrapolated
to the larger practice of medicine. Given the limited evidence, reliable
cost savings estimates cannot be developed.” [“Tort Reform
Battle: A Simple Case of Complexity,” CQ Weekly, 1/31/05; “Medical
Malpractice: Effects of Varying Laws in the District of Columbia,
Maryland and Virginia,” GAO, 10/99, p.5]
Other key factors to note about the study include:
The study was published in 1996 and the data used was from 1984,
1987 and 1990;
The study only looked at one type of heart procedure performed only
on Medicare patients; and
HHS took the limited, out-dated data and extrapolated the results
to the entire health care industry. [“Do Doctors Practice Defensive
Medicine?” National Bureau of Economic Research, February 1996,
http://papers.nber.org/papers/w5466]
GAO: The “Prevalence” and “Costs” Associated
with “Defensive Medicine” Have Not Been “Reliably Measured.”
According to the Government Accountability Office, “[p]ysicians
reportedly practice defensive medicine in certain clinical situations,
thereby contributing to health care costs; however, the overall prevalence
and costs of such practices have not been reliably measured. Studies
designed to measure physicians’ defensive medicine practices
examined physician behavior in specific clinical situations, such
as treating elderly Medicare patients with certain heart conditions.
Given their limited scope, the study results cannot be generalized
to estimate the extent and cost of defensive medicine practices across
the health care system. … Recent surveys of physicians indicate
that many practice defensive medicine, but limitations to these surveys
suggest caution in interpreting and generalizing the results.”
[“Medical Malpractice: Implications of Rising Premiums on Access
to Health Care,” GAO, 9/29/03, www.gao.gov/cgi-bin/getrpt?GAO-03-836]
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As the world's largest trial bar, AAJ (formerly known as the Association of Trial Lawyers of America) promotes justice and fairness for injured persons, defends the constitutional right to trial by jury, and strengthens the civil justice system through education and disclosure of information critical to public health and safety. Serving members worldwide, AAJ provides attorneys with the information and professional assistance they need to serve clients successfully and protect the democratic values of the civil justice system. Visit http://www.justice.org
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