The unspoken booms in some reform debate

Bob Tippee
Editor

The secret of aggressive reform is often just that: off-message information that reformist politicians don't want anyone to know.

Energy reform pushed by the administration of US President Barack Obama, for example, thunders with silence on the grotesque disproportion of cost relative to supply for "green energy," toward which public money now flows without restriction.

Then there's health care. Some observers think the overhaul Obama proposes in this area would crush the economy and lead to rationing of medical services. Administration officials dispute those claims.

This writer has no expertise in health care beyond his life-long strategy of avoiding, to the extent possible, patient-provider interaction with doctors.

But warnings about crushed economies and waiting lists for—heaven forbid—essential surgery get a person's attention. So who's right?

Two inexpert observations seem pertinent.

One is what the administration assiduously avoids in its discussions about health care costs: medical malpractice litigation.

Theodore H. Frank, director of the American Enterprise Institute's Legal Center for the Public Interest, says the cost of "defensive medicine"—prescribed by doctors as an antidote for malpractice litigation—may be $30-180 billion/year.

He made that estimate in a March presentation to the Senate Republican Conference, noting also that malpractice liability lowers the supply of medical service and thereby results in the loss of "hundreds of lives a year and perhaps even as high as 1,000 deaths and many more exacerbated injuries a year."

Those are indirect costs. Medical malpractice is a big part of the direct costs of excess tort liability, which Frank estimates, from analyses by Tillinghast-Towers Perrin, at $128 billion/year.

Costs like these deserve attention in the health-care debate. Yet tort reform appears nowhere on the Obama agenda.

Hence the other observation: Obama and other Democrats are politically indebted to the tort bar.

According to the Center for Responsive Politics, the category "Lawyers/Law Firms" appears second behind "Retired" in a ranking of industry contributors to Obama's presidential campaign.

Rankings were the same for contributions to congressional campaigns in the last election cycle. The lawyers favored Democrats 78% to 22% and Obama most of all.

(Online May 15, 2009; author's e-mail: bobt@ogjonline.com)

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