Lawsuits Create Defensive Medicine

William M. Thomas (R-Bakersfield) is chairman of the House Ways and Means Committee

Let's pause for a moment in the debate over a patients' bill of rights and go back to the basic premise of health care. It's about helping people. It's about getting the best medical treatment. It's about you and your doctor making decisions that affect your health, your family and your life.

It's not about a lawyer making those decisions.

The most fundamental patients' right is access to the best possible care from the most qualified doctors. The greatest achievement that should emerge from the national focus on a patients' bill of rights is better, more accessible and affordable care.

So any plan adopted by Congress and signed by the president will have to address this core issue: Does it deliver better care?

Against a backdrop of significant agreement with the Democrats on many important patient protections such as access to emergency care, obstetrician-gynecologists and pediatricians, members of the House of Representatives have developed a common-sense proposal to protect patients that places medical considerations above legal ones. It balances the right to a fair hearing of grievances with a firm commitment to quality medical care, establishing a system of internal and external reviews by practicing physicians who must make decisions based on science and best clinical practices. Cardiologists must review cardiologists; dermatologists review dermatologists.

The heated policy arguments that have surrounded this issue for five years have so far failed to offer answers that make sense in the context of today's litigious society. Lawsuits have spun out of control. The answer to any grievance is to sue. Ask for some outrageous amount; you may even get it.

But frivolous lawsuits have victims: 1.2 million Americans stand at the brink of losing their health insurance under the Democrats' health care proposals. Higher insurance premiums passed on by employers when lawsuits threaten their financial viability ensure that coverage will be more expensive and further from the reach of some Americans. It is difficult to protect patients in managed care if they are uninsured.

Our proposal places medical decisions firmly in the hands of qualified physicians. HMOs will be motivated to accept the decisions of the independent review. Failure to do so would blatantly place their judgment above that of qualified, independent physicians and specialists. If they do choose to ignore the decision, patients can sue in either state or federal court.

Because it relies on provisions in different state laws, the competing bill provides no such option for some patients in some states, since many have not enacted legislation that allows lawsuits.

Lawsuits promote defensive medicine. They encourage doctors to make choices that are least likely to land them in court, even if a different treatment might be better medically. Our legislation's binding external review channels money into better training, research and equipment rather than legal settlements. Bottom line: The patient gets better care.

Successful legislation is always based on compromise, and patient protection has run the legislative gauntlet over the past five years without a bipartisan compromise emerging. Now a diverse group of House members from across the political spectrum--including family physician Ernie Fletcher (R-Ky.)--has crafted a compromise. Their proposal ensures accountability, improves the availability of quality health care, encourages best medical practices and deters frivolous lawsuits. It is a responsible approach to the legitimate and significant concerns of Americans about the future of their health care.

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