Debunking a myth: an epidemic of medical malpractice, not of malpractice lawsuits

AS we reach for the dream of health care for all, we need to focus our reform energies on improving patient safety. Preventing medical errors will lower health-care costs, reduce doctors' insurance premiums and protect patients.

Taking away patients' rights does not improve the quality of our health-care system or produce cost savings. The myth that "reforming" our medical-malpractice system will somehow save money is particularly dangerous, as it asks us to give up a fundamental right in exchange for affordable and accessible health care. This so-called bargain would not benefit anyone except the insurance industry.

Instead, let's look at the real facts of medical malpractice and its cost implications and not take away the rights of innocent victims of medical malpractice and their families.

The true crisis in medical malpractice is negligent medical care. The Institute for Medicine estimates that more than 98,000 deaths a year are caused by preventable medical errors, making this our nation's sixth-leading cause of death. The cost to the system of these deaths alone is estimated at more than $29 billion dollars annually — twice the cost of the malpractice system as a whole.

Yet despite the numerous injuries and deaths from preventable medical injury, most injured people do not file lawsuits, according to the Harvard School of Public Health. Public Citizen found that malpractice litigation costs amount to less than 0.6 percent of overall health-care spending, and malpractice payouts are at an all-time low. In Washington state, medical-malpractice cases made up just 0.3 percent of all civil cases filed between 2002 and 2008, according to data from the Washington State Administrative Office of the Courts. As national expert and author Tom Baker said, "We have an epidemic of medical malpractice, not of malpractice lawsuits."

As a registered nurse and lawyer, I know that the so-called malpractice "reforms" offered by the insurance industry will not only increase the costs for injured families; they will result in breaking many families financially. When that happens, taxpayers pick up the continuing costs of these often-catastrophic injuries, the insurer gets a free ride, and the costs don't go away. This is no bargain or trade-off. It's robbery.

Another persistent myth is the wrong idea of "defensive medicine" and the costs that it purports to add to the health-care system. The idea that extra tests are ordered only to protect from fictitious lawsuits, and not because of our fee-for-service health-care system that rewards ordering extra tests and procedures, is defied by research and common sense. Insurance companies and Medicare will not pay for unnecessary costs, treatments and procedures.

No empirical evidence demonstrates that defensive medicine exists. On the contrary, a 2004 report by the nonpartisan Congressional Budget Office noted, "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."

The best way to save money in the health-care system is to prevent injuries from preventable errors in the first place.

Public and private organizations like the Centers for Medicare & Medicaid Services and HealthGrades are offering cutting-edge solutions for the prevention of the costs — and human misery — caused by these errors. Let's follow the example set by anesthesiologists, who looked at their own practices to increase patient safety by developing new guidelines to reduce errors. The safety changes they implemented make them among the safest practitioners in the U.S., with malpractice insurance rates that have fallen.

It is by curing the epidemic of preventable medical errors that we can achieve reduced costs for patients and families, but also for the whole system. Let's focus on what has been proven to reduce costs and improve lives — eliminating preventable errors — rather than giving up fundamental rights as a bargaining chip.