Tort reform doesn’t actually save much money

Remember how the conservative “answer” to rising healthcare costs was supposed to focus on tort reform? About that:

Tortt reform,” which is usually billed as the answer to “frivolous malpractice lawsuits,” has been a central plank in the Republican program for healthcare reform for decades. The notion has lived on despite copious evidence that that the so-called defensive medicine practiced by doctors merely to stave off lawsuits accounts for, at best, 2% to 3% of U.S. healthcare costs. As for “frivolous lawsuits,” they’re a problem that exists mostly in the minds of conservatives and the medical establishment.

A new study led by Michael B. Rothberg of the Cleveland Clinic and published in the Journal of the American Medical Association aimed to measure how much defensive medicine there is, really, and how much it costs. The researchers’ conclusion is that defensive medicine accounts for about 2.9% of healthcare spending. In other words, out of the estimated $2.7-trillion U.S. healthcare bill, defensive medicine accounts for $78 billion.

As Aaron Carroll observes at the AcademyHealth blog, $78 billion is “not chump change … but it’s still a very small component of overall health care spending.” Any “tort reform” stringent enough to make that go away would likely create other costs, such as a rise in medical mistakes generated by the elimination of the oversight exercised by the court system.

The most remarkable thing about the modern conservative policy apparatus is how divorced it is from objective reality. That’s a fairly new thing. It was at least theoretically possible back in the late 1970s to defend trickle-down economics, tort reform, and similar policies as potentially workable solution to the postulated liberal overreach of the Great Society. It wasn’t true then, either, but holding that ground was at least intellectually defensible.

These days, though, we know better. We know that supply-side economics is a failure. We know that tort reform doesn’t work. We know that abstinence education and other conservative social policies have abysmal outcomes. But there’s no acknowledgement of reality on the other side.

The reports on the near uselessness of tort reform to contain healthcare costs will come and go, and conservatives will continue to offer it as an answer, anyway. Objective reality need not apply.

David Atkins

David Atkins is a writer, activist and research professional living in Santa Barbara. He is a contributor to the Washington Monthly's Political Animal and president of The Pollux Group, a qualitative research firm.