Tort Reform: Money, Evidence, And Trust

Research studies are done in order to provide evidence to either confirm or refute theories or best practices. But a rather significant question comes to light. Why bother doing them in the first place if we don’t want to hear the results and are not going to utilize those results if they are counter to our beliefs or agendas?

It would appear that political agendas are winning out over evidence more and more these days. Case in point: tort reform in Texas.

The consumer has repeatedly been told that tort reform will help to decrease health care costs – or something along similar lines. Now, we have yet another study that reveals that no, actually, it doesn’t.

Score: Evidence – 0, Political Agenda – 1. The loser? The consumer, of course.

Consider a different scenario for a moment. Imagine you are a prosecuting attorney in a homicide investigation. You have witnesses that confirm the suspect’s involvement. You have evidence that links the victim’s blood and DNA to that found on the killer’s hands and clothing. Beyond a reasonable doubt, and then some. Open and shut case, right?

Now imagine the jury deciding that no, we just don’t believe it to be so. Nope, no way, just don’t believe it. By the way, the defense paid us to not believe it. We would all be mortified if this took place in our legal system.

But the health care equivalent occurs frequently. Evidence against tort reform? Ah no worries, the lobbyists will take care of the spin, so forge ahead anyways. Remember that this is taking place in a field of study that advocates for “evidence-based” approaches to health care.

When the research is ignored simply to promote an agenda or belief – tort reform, prostate screening, and mammography being three examples - then it is time for us to demand some accountability.

Just don’t expect that accountability to appear any time soon in Texas. In a recent editorial in the Austin American-Statesman, the author of the study (Charles Silver) noted …

“… he was "very pessimistic" policymakers will heed the study. His pessimism is justified. The Texas Legislature will not revisit tort reform anytime soon, and Gov. Rick Perry's office brushed off Silver's study by calling tort reform "a huge success."

So who should we trust in this mess? Science? Legislators? Physicians?

In 2009, when the Kaiser Family Foundation asked Americans whom they trusted …

“… 78 percent said they believed that their doctors put patients’ interests ahead of their own.”

Yet who are the beneficiaries of the tort reform legislation in Texas? Texas physicians, of course. Malpractice insurance premiums have dropped 50%. And let’s not forget the insurance carriers who are making some extra cash with the new law as well.

The long-term goal of research in health care is to improve it with better quality or making it more cost effective. We trust our legislators, physicians, and the researchers to find better solutions to the mess that is health care reform. But has our trust been betrayed after all these years? Are the hidden economic and political agendas just making the matter worse? And is the patient ultimately paying the price for it?

Photo credits: jared