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Johns Hopkins Bloomberg School of Public Health Study Downplays Impact of Medical Malpractice

Posted on: Wednesday, 13 July 2005, 21:00 CDT

Medical malpractice litigation is not to blame for the relatively high cost of health care in the United States, according to a Johns Hopkins Bloomberg School of Public Health study published yesterday in the journal Health Affairs.

The debate over malpractice insurance's impact on health care costs has gotten so heated in Maryland of late, Gov. Robert L. Ehrlich Jr. last December convened an emergency special legislative session to look at the problem. Doctors said an announced 33 percent increase in their malpractice premiums threatened their livelihoods, before emergency legislation softened the blow.

But according to the study, which compared health care spending and malpractice suits in 30 countries, such litigation is not to blame for higher U.S. costs. The study's authors conclude it represents less than half a percentage point of the nation's health care spending.

We were very surprised at the findings, said Dr. Peter S. Hussey, a recent graduate of the Bloomberg school's Department of Health Policy and Management, and co-author of the study with lead author Gerard Anderson, a professor in the department.

On the other hand, T. Michael Preston, executive director of the state's medical society, MedChi, insisted the study's findings don't disprove the gravity of the malpractice problem.

It's an international comparison, he said. It doesn't have much impact on our internal scene. It certainly doesn't have a whole lot of impact on the debate about the problems that malpractice costs create for us.

The study examined 2003 health care spending data in 30 countries from the Organization for Economic Cooperation and Development, a group of democratic governments worldwide. It looked at two possible causes for spending increases - the level of malpractice litigation and waiting lists for medical procedures.

The authors found that Americans spent $5,267 per capita on health care in 2003. That's 53 percent more than Switzerland, the next highest country at $2,193 per capita, and 140 percent above the median industrialized country.

The U.S. also logged 50 percent more malpractice claims per 1,000 people, at 0.18, than the United Kingdom and Australia, and 350 percent more than Canada.

But the study's authors found malpractice payments in America are lower on average than in Canada and the U.K. The U.S. average as $265,103 per settlement or judgment to Canada's $309,417 and the U.K.'s $411,171. The U.S. average was higher than Australia's $97,014.

Those dollar amounts were adjusted to account for cost of living differences between the countries.

It also found procedures that would be wait-listed in other countries represent only 3 percent of American health spending.

Defensive medicine - in which doctors order unnecessary tests to protect against lawsuits - accounted for 9 percent of health care spending in America, according to the study.

While the study's authors discount the 9 percent impact of defensive medicine on total health care spending, Preston seized on the figure. With health care spending representing about 15 percent of the nation's gross domestic product, he said, nine percent is a lot of money.

But Maryland Trial Lawyers Association spokesman Dennis O'Brien said the Hopkins study validated what his group has maintained throughout the debate. Malpractice insurance carriers, he said, are to blame for the artificially high rates they have imposed on physicians.

This is a manufactured crisis to get tort reform when insurance rates are weighted by carriers, he said. Rates are up incredibly high because carriers can get away with it. They can just blame the lawyers or the victims.

Source: The Daily Record (Baltimore)

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