Thanks for having taken the time to read that (and to anyone else who followed that link but did not comment) – it’s a haul, especially if you follow the links back to the full study. Very few people are willing to make that sort of effort to educate themselves, which is one reason the quality of such discussion is usually so information-poor.
IMO, the direct and indirect costs of litigation are one of the most difficult costs to quantify, and since there have been very divergent study results, you can cherry-pick studies to support the position that it is a quite significant contributor (7-9%) or a very minor one (less than one percent).
One way of assessing the extent to which such litigation is a problem is to compare the US system and costs with similar systems in other countries which have an Anglo-Saxon based legal system, the most widely cited recent study of this sort is:
http://www.worldcongress.com/events/nw600/pdf/HealthSpendinginTheUnitedStates.pdf
My conclusion after extensive reading is that litigation is not one of the major cost drivers in the US system.
And even if you accept the higher estimate, and assume that such costs are 10% of total spending, and could arrange to somehow completely eliminate such costs (see below) and achieve a one-time savings, you are still left with the remaining cost (and rapidly increasing) cost differential.
You also have to keep in mind that to some extent litigation is a market mechanism – there is always going to have to be some sort of quality control external to the provider stream, and some means of financial compensation for mistakes made (if only to the extent of rectifying to the extent possible the medical results of such mistakes).
If you don’t like a “litigious society” in which seeking recompense is an individual responsibility, conducted on a case-by-case basis in the courts, then you have to specify some other mechanism, most of which are also unpalatable to conservatives (for example, cost-effectiveness regimes, where “best practice” is defined, and providers who comply with the recommendations have greater protection from sanctions for “malpractice”).
So it’s not as though a transition to some other mechanism is going to eliminate such costs, it will just be somewhat more or less efficient and “costly”.
I’m cutting and pasting; forgive me if I offend you, and ignore.
http://www.medicalnewstoday.com/releases/105599.php
“The authors believe this is caused by neurosurgeons restricting their practices to limit malpractice liability. This means that additional neurosurgeons are needed in the same geographic area to cover the spectrum of diseases and surgical needs of the population. In other words, two neurosurgeons are now needed to perform the job that used to be performed by one.”
>This would be expensive.<
http://overlawyered.com/2009/09/canada-keeps-malpractice-cost-in-check/:
Susan Taylor Martin in the St. Petersburg Times has some striking numbers:
“For neurosurgeons in Miami, the annual cost of medical malpractice insurance is astronomical — $237,000, far more than the median price of a house.
In Toronto, a neurosurgeon pays about $29,200 for coverage. It’s even less in Montreal ($20,600) and Vancouver ($10,650).
Among the reasons why: in 1978 the Canadian Supreme Court imposed (on its own) nationwide limits on pain-and-suffering recoveries, adjusted for inflation and now just over $300,000. A single mutual insurer covers most doctors and takes an aggressive approach to defending claims. Most cases are tried before judges. Billboard and TV advertising by lawyers is much less prevalent in Canada. And so forth — all aside from the loser-pays principle.”
>As we found out when that actress fell and bumped her head on the ski slope a couple years ago, the Canadian doctors probably aren’t expected to do as much either, as they are unlikely to have the tools like MRI at their beck and call, let alone medevac helicopters.<