OVERTREATMENT: IT’S THE LAWSUITS, STUPID!

When dealing with the problem of medical overtreatment, ”progressive” policy wonks always manage to tiptoe around the elephant in the room: malpactice abuse.

A typical example of this phenomenon can be found at Economist’s View. In a post about Shannon Brownlee’s book, Overtreated, Mark Thoma insinuates that the overtreatment problem is caused by greed:

Essentially, the argument is that profit maximization by health care providers does not coincide exactly with maximizing health outcomes.

He even manages to bring up incentives with no mention of defensive medicine:

The solution, then, is to change the incentives so that the incentives faced by health care providers are consistent with achieving the best health outcomes.

Well, here’s a clue for Thoma and other “progressive” commentators: any discussion of overtreatment that doesn’t mention malpractice abuse is a waste of bandwidth.

As Kevin, MD and many other practicing physicians have pointed out, everything they do is informed by the spectre of litigation. To paraphrase James Carville, it’s the lawsuits, stupid!

Comments 4

  1. Shannon Brownlee wrote:

    Malpractice worries are one reason for rising health care costs, but they aren’t the only reason, and they aren’t even the most significant reason. Read the book and find out how health care actually works, rather than how it seems to work.

    Posted 19 Dec 2007 at 4:50 pm
  2. Catron wrote:

    “Malpractice worries are one reason for rising health care costs, but they aren’t the only reason …”

    I hope you researched you book more carefully than you read my post. Its topic is overtreatment, not “rising health care costs.”

    “Read the book and find out how health care actually works …”

    Unlike you, I actually work in health care. So, I hardly need your second-hand observations to know “how it reallly works.”

    I haven’t read your book, but I have perused a couple of your articles. They read rather like discussions of sex from the perspective of a nun. Nonetheless, I will read it. And, in due course, I’ll offer some commentary … details at eleven.

    Posted 19 Dec 2007 at 6:26 pm
  3. drmatt wrote:

    and unlike you I actually provide health care, I suppose someone who sells band-aids can proclaim “I actually work in health care”. It is pretty clear by the your lack of depth in understanding the true issues that you are a paper pusher, nothing more, by the way, shannon worked in health care for quite some time before becomming a journalist, it was her experiences there that inspired her. Thanks for your meaningless and toothless input Sister Catron.

    Posted 20 Dec 2007 at 7:20 am
  4. Catron wrote:

    “It is pretty clear by the your lack of depth in understanding the true issues that you are a paper pusher, nothing more …”

    Your delusions of grandeur are showing again, drmatt. Perhaps if you listened to some “paper pusher? like me, your practice wouldn’t have gone belly up (as you describe in this comment from last week). My job, as the evil finance guy, is to prevent your brand of egotism and naiveté from bankrupting medical practices and hospitals.

    Posted 20 Dec 2007 at 7:47 am

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