
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: SUNDAY, September 25, 1994                   TAG: 9411050001
SECTION: EDITORIAL                    PAGE: E3   EDITION: METRO 
SOURCE: JOAN CLAYBROOK
DATELINE:                                 LENGTH: Medium

HEALTH-CARE COSTS

BOB BROTHERS went into the hospital for surgery at age 49. While the anesthesiologist was out of the room, the surgeon failed to notice that his patient's oxygen supply had been cut off. Left in a profoundly vegetative state until his death 21 months later, Bob is survived by his wife and children.

Tragic stories like Bob's are rarely publicized because they contradict the financial interests and public-relations strategies of the powerful medical establishment.

For 15 years, the American Medical Association and the country's largest insurance companies have misinformed the public about medical malpractice lawsuits. Their public-relations and lobbying have created support for restrictions on the legal rights of health-care consumers.

They don't want us to know the horrifying frequency of malpractice: that 80,000 people die every year from substandard medicine, and hundreds of thousands more are injured. Only cigarettes and alcohol cause more preventable deaths. They don't want us to know that 1 or 2 percent of licensed doctors cause 25 percent or more of malpractice-insurance payments each year. And, they certainly don't want us to know that incompetent, negligent doctors add $60 billion a year to health-care costs alone.

Influenced by relentless propaganda and campaign contributions, Congress is blindly limiting citizens' rights under health-care reform. Instead of proposing to reduce the incidence of malpractice, the AMA and the insurance industry are pushing Congress to make it harder for victims and their families to receive fair compensation. Once again, the special interests are dangerously close to having their way.

How would these proposals harm consumers? They would limit the amount a jury can award to victims, no matter how grave their suffering. Victims would be restricted as to how much they could pay their attorneys, regardless of the intricacies of their cases. Defendants would have no such limitations on their legal options. And, unbelievably, some victims who win their lawsuits might have to pay the lawyers who opposed them.

Believing that such measures would lower health-care costs, California adopted some of them in 1975. But health-care costs there are higher and have increased more rapidly than in the rest of the country.

One of the favorite rationales for such flawed public policy is the fictional burden of ``defensive'' medicine: the claim that extra tests and procedures, ordered by doctors fearful of being sued, add $25 billion to the nation's health-care tab. This myth has been discredited by Congress' Office of Technology Assessment, which found that changes in liability law would not affect the frequency of defensive medicine.

The AMA and insurance companies say rising premiums are a major cause of spiraling health-care costs. The facts tell a different story: Malpractice insurance costs equal less than one-half of 1 percent of health-care expenses. They want the public to believe that courts regularly award outrageous sums to greedy plaintiffs for insignificant injuries. In truth, only one in eight malpractice victims ever files suit, and only one in 16 is compensated for his or her injury.

According to the General Accounting Office and Duke University researchers, the handful of victims who recover damages generally receive compensation consistent with the severity of their injuries. However, the most seriously injured victims are most often undercompensated.

The best approach to reducing the staggering toll of this epidemic lies in prevention. State medical boards, which regulate physician and hospital licensing, should be beefed up. Currently, there are only 3.44 serious disciplinary actions for every 1,000 doctors. This is well below the frequency of substandard care, and indicates that the boards lack funds, authority and determination.

Patients today have access to more information when shopping for a car than when choosing a doctor. Meanwhile, the federal government maintains a secret trove of disciplinary and litigation records about U.S. physicians in the National Practitioner Data Bank. The contents of the data bank should be available to taxpayers who pay for it, but it is kept under lock and key.

It's time for the public to recognize the medical lobby as just another entrenched special interest seeking self-protection, not good and fair public policy. It proposes a dangerous prescription, based on a misdiagnosis, that would do nothing to stem the death count or reduce health-care costs.

We should instead focus our efforts on the minority of doctors responsible for so much harm. After all, the real medical-malpractice crisis is occurring in operating rooms - not in courtrooms.

\ Joan Claybrook is president of Public Citizen in Washington, D.C.

by CNB