Defensive Medicine and Increasing Health-Care Costs—A Phantom Association

Some policymakers spend so much time tilting at windmills you have to wonder if they do it just for exercise.

As noted on, the civil justice website sponsored by the Center for Justice & Democracy, yet another academic research report confirms that so-called “defensive medicine,” is not responsible for driving up health-care costs.

Defensive medicine, as we’ve explained, reflects a fear of being sued; it’s the practice of doctors performing unnecessary tests so that they can’t be accused of missing something. People pushing for “tort reform”-the imposition of capped amounts a harmed patient may recover in a malpractice lawsuit-want us to believe it does. Because if a correlation can’t be shown, limiting the money someone may receive for suffering medical malpractice isn’t the solution to a problem, it’s a pass for doctors who make serious mistakes and a deprivation of rights for their patients.

The Journal of Patient Safety examined the theory that the hidden cost of defensive medicine is a significant driving force in the increase of our nation’s health-care costs. If it is, you’d expect that states with higher levels of tort reform would show decreased use of Medicare, decreased use generally of medical services and lower overall health-care costs.

The researchers analyzed state medical reimbursements from 1999 to 2010 and correlated the data with how each state used medical services. Data for three states-Mississippi, Nevada and Texas-were available to enable comparisons between this use before and after tort reform was enacted.

The number-crunching showed no significant correlation. In six categories of Medicare use-total Medicare, hospital and skilled nursing facility, physician, home-health agency, hospice and durable medical equipment-a negative trend was observed.

According to the report, it “does not support the hypothesis that defensive medicine is a major driver of health-care expenditures. Tracking expenditures in the states of Texas, Nevada, and Mississippi, before and after passage of comprehensive medical tort reform gave inconsistent results and did not demonstrate substantial or meaningful total Medicare savings. In Mississippi, there was a trend of decreased expenditures after medical tort reform was passed. However, in Texas, where 80% of the analyzed enrollees resided, there was a trend of progressive increasing expenditures after tort reform was passed.”

So cost increased in one state after it supposedly solve a problem that apparently didn’t exist. “[T] hese data,” according to the report, “indicate that medical tort reform seems to have little to no effect on overall Medicare cost savings.”

Will supporters of tort reform ever find another form of exercise?

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