You've often heard that one reason health care costs are skyrocketing
in this country is because doctors pay so much for medical malpractice.
Your medical bill is huge because we doctors have to give half our
income to an insurance company to pay off all of those frivolous law
suits.
But what if I told you that your health insurance probably costs more
than your doctor's malpractice insurance? I'm serious. How do I know?
Well, to start with, I'm a doctor who pays for his own medical
malpractice insurance, and this is my bill.
That's right -- $3,549 is the total I'm paying for my malpractice
insurance for all of 2013! I bet some of you pay more than that for your
car insurance.
Am I unique among doctors in how little I pay for medical
malpractice? Not really, but before we discuss what other doctors pay,
I'd like to discuss national trends for medical malpractice. Believe it
or not, the cost of medical malpractice has been dropping, nationally,
for about a decade. That's right: dropping!
In 2003 there were nearly 17,000 paid medical malpractice claims in
the U.S. totaling nearly $4.5 billion (pages 9-10). By 2011, the number
of paid claims had dropped below 10,000 and the total amount paid was
less than $3.2 billion. That's a 40 percent drop in the number of paid
claims and a 29 percent drop in the total amount paid.
What about hospitals? Surely hospitals are still getting killed by
law suits, right? Well no. In a study of the financial records for 387 California hospitals,
the average that hospitals paid for malpractice in 2003 was just over
one percent of their total income (figure 10). Not much, but by 2011
that had dropped to just over six tenths of a percent (0.6 percent) of
their income which was less than one penny for every dollar they brought
in. Again, that's nearly a 40 percent drop.
My own malpractice insurance reflected this trend. In 2003 I paid
over $8,000 for medical malpractice but, by 2012, it had dropped to just
under $3,000 before rising slightly to just over $3,500 this year. Now,
not all malpractice rates in the US are as low as they are in
California. In fact, if you're a doctor in New York or
Pennsylvania, you
might have already punched your computer screen more than once by now.
Although medical malpractice rates have dropped considerably in the
U.S., not every State has felt the love evenly. In 2010, for example, six states accounted
for over half of all the money spent in medical malpractice law suits,
and one fifth of all the money spent on medical malpractice was spent on
suits in New York alone, a state with only about one-sixteenth of the
U.S. population.
Even so, if the cost of medical malpractice is falling nationally,
how can it contribute to rising health care costs? One reason that's
often given is the cost of defensive medicine: we doctors are so
terrified of being sued that we often order many unnecessary tests on
our patients just to avoid these law suits.
Okay, I admit I don't want to be sued either and it's hard to
quantify how many tests I, or any other doctor, might order out of fear
alone. But I can tell you that when I order an expensive test like a CT
scan, I normally have to contact my patient's insurance company to
explain why I want the test or they won't pay for it. I'm not the only
doctor who has to do that, so knee jerk defensive medicine isn't as easy
as you might think.
Also, if the cost of malpractice is going down because fewer doctors
are being sued each year, why would the cost of defensive medicine be
increasing? Am I the only doctor who's looked at his malpractice bill
lately? Speaking of other doctors, last year I took the opportunity to
survey many of the other doctors who practice near me by asking them how
much they paid for their medical malpractice insurance.
In my admittedly informal survey,
I found that other internists and family practitioners pay about what I
pay.
A cardiologist who does angioplasties pays about $5,500 a year. An
ophthalmologist might pay $7,000 a year; emergency room doctors pay
about $12,000 a year; anesthesiology: $14,000; general surgery: $18,000;
and orthopedic surgery: $20,000 a year.
For comparison, my family's health insurance (for a family of four
that has no medical problems) costs just over $20,300 this year. So my
family's health insurance cost almost six times what my medical
malpractice insurance costs me, and slightly more than what an
orthopedic surgeon in California pays for his malpractice insurance.
For a long time we've been in the middle of a great national debate
on controlling our crippling health care costs. The next time a
hospital, an insurance company or a politician says we can't control
these costs because malpractice is so expensive, why don't you ask them
if maybe they'd like to show you the real numbers and start looking at
the real problem. Because now you know: it ain't the lawyers.
For more by David Belk, click here.