The national health care debate is far from over. Days
removed from his televised national health care forum, President
Obama is calling for an “up or down” vote on the measure within
the next few weeks.
In his recent State of the Union address, President Obama
asked if anyone had a better approach to holding the line of
health care spending. I do. Stay true to the original goals of
reform.
Adopt Medicare and Medicaid payment policies that reward
quality, efficiency, and care coordination across many medical
specialties. Incentivize the use of health information
technology, especially Electronic Medical Records systems which
promote information sharing. Minimize the need for doctors to
practice defensive medicine. And lastly, do not harm proven
state liability reforms, such as those enacted in Texas, that
have delivered thousands of new doctors and a record increase in
charity care. It is the latter point that has been absent from
the national health care debate.
House and Senate leaders on both sides of the aisle readily
admit that the practice of defensive medicine, the ordering of
procedures and tests to avoid a lawsuit, increases consumer
health care costs. The latest analysis from the non-partisan
Congressional Budget Office estimates that government health
care programs could save more than $54 billion over the next 10
years if Congress enacted nationwide limits on jury awards for
pain and suffering and other curbs similar to Texas law.
Unfortunately, proposed health care reform legislation
doesn’t include a shred of meaningful tort reform. Thus, the
CBO’s projected cost savings will not be realized.
Even more alarming, the current House and Senate bills
include ambiguous language that could create new opportunities
to sue doctors and hospitals. Amazingly, a bill that aims to
reduce total health care costs could do just the opposite.
Encouraging new and novel theories to sue doctors, hospitals,
and nurses will surely increase defensive medicine and drive up
the cost of medical care for the average American.
And there’s more bad news: the health care bill could
pre-empt the lawsuit reforms we passed in Texas, reforms that
have brought thousands of primary care doctors and high-risk
specialists to the Houston area alone. If Congress kills our
lawsuit reforms, they will discourage promising students from
becoming doctors, reduce patient access to doctors, drain
budgets for improving care delivery, and ultimately drive up
health care costs instead of curtailing them.
Six years ago, Texas lawmakers passed a series of medical
lawsuit reforms aimed at keeping doctors in practice and
treating high-risk patients. The evidence of those reforms can
be seen throughout Houston, not just in new doctor’s offices and
hospital expansions but in more doctors in the emergency room
and a $41 million expansion in the rendering of charity care
from Houston hospitals funded by liability savings.
Since the passage of reforms, Harris County has seen a 17
percent increase in family physicians, internists, and
pediatricians, and a near tripling of pediatric specialists.
Houston patients now have access to more than 1,700 new
physicians including 110 ER doctors and 556 high-risk
specialists. Physician growth in neighboring counties is off the
chart, as well.
Lawsuit reforms have directly benefited patient care at
Kelsey-Seybold Clinic. Our physicians care for more than 400,000
individuals every year. Many of those patients have complex
health problems. Because of Texas’ more reasonable liability
climate, Kelsey-Seybold has been able to recruit bright and
talented doctors from across the country to deliver care.
We took 100 percent of our medical lawsuit reforms savings
and invested those dollars in a state-of-the-art Electronic
Medical Record system to benefit our patients. This system
eliminates sources of medical error due to illegibility,
monitors for medication allergies and alerts the prescribing
physician about drug interactions. It gives physicians across
many medical specialties instantaneous access to comprehensive
patient information. Our patients can now schedule appointments
online and email their healthcare team. Our EMR system is
enhancing our ability to deliver coordinated care more
efficiently, and at a total lower medical cost.
Let’s hope that any national health care legislation builds
on these successes, allows more patients to get the quality care
they need, and does nothing to harm the reforms that have proven
so effective here in Houston.
Dr. Berthelsen is managing director and chairman of the board
of Kelsey-Seybold Clinic.