President Bill Clinton revived his efforts for health-care reform by promising the American Association of Retired Persons additional benefits in long-term care and prescription coverage while he is trying to convince the American people that the plan will cut the deficit.
These contradictions are not by any standard the most outrageous points in the Clinton plan. What is really the most disappointing about the plan is the lack of effective liability reform.
On one hand, physicians support the concepts of universal coverage, community rating, eliminating the exclusion from coverage of pre-existing conditions, portability of coverage, patients' choice of physicians, and physicians' choice to participate in different plans.
On the other hand, the overwhelming majority of physicians rank effective liability reform as their top priority for health-care reform, and they will withdraw their support for the reform if the final bill does not include substantial changes from the current liability system. In a survey of the members of the American Medical Association, 95 percent of the members ranked effective liability reform as their top priority for reform. The same association's public polls indicated that 63 percent of U.S. adults think that there are more health-care liability claims than are justified and 53 percent think the amount of money paid to claimants is usually excessive.
Why is liability reform so important to American physicians?
(1) The liability explosion has reduced access to care for many patients in need. About 60 percent of family physicians stopped delivering babies in rural areas. Approximately 40 percent of obstetricians-gynecologists have changed their practice pattern, with 24.2 percent providing less high-risk care, 10.4 percent delivering fewer babies, and 12.5 percent not delivering babies at all.
(2) Uncontrollable liability inhibits medical research and development. The future of any business or profession relies heavily on development of new products. As a direct result of the liability explosion, for example, the number of pharmaceutical companies conducting research on fertility and conception went from 13 such companies in 1970 to only one in 1988.
(3) The wasteful cost of defensive medicine continues to climb as a direct result of excessive lawsuits. The American Medical Association estimates that defensive medicine adds $15 billion a year to the total health cost. Many other sources estimate that the real figure may even be twice as high.
(4) The lack of liability reform adds significantly to the cost of health care by driving up the cost of medical and product liability insurance for doctors, health-care personnel, hospitals and manufacturers of health-care products. Professional liability premiums for doctors, for example, has nearly tripled in 10 years, rising at four times the rate of inflation. The frequency of claims against doctors rose from two per 100 doctors in the '60s, to three in the 70s, to eight in the early 80s, to 16 in the late 80s. …