I’m back after having read your “discussion.” I have to say that I’m in the unusual (for me) position of thinking that many readers might be better off not reading it. While it is quite long, that is not the objection. Nor is the objection that your discussion is a comparison of the medical malpractice reform proposals of Bush and Kerry which, while containing common elements, is not directly tied to my discussion of the Republican medical malpractice legislation offered in Illinois. Rather, the constant fight over which “facts” are true and the rhetorical slights of hand in your discussion are so burdensome that rather than clarifying things they confuse them (and not at all in a good way).

As far as the argument goes, there are some points you seem to concede that trouble me as policy:

- I disagree with the view that the inability to offer consistent or perfect justice in non-economic damages means that caps are the right way to go, despite the injustice that caps offer to those truly and profoundly harmed in a negligent manner.

- The fact that while you suggest substantial savings in medical malpractice premiums from non-economic damage caps (in one case 1/3 of premiums) and while you describe malpractice insurance rates as “directly related to payouts on malpractice claims” (I note no mention of proportionality), you do not require insurers to actually reduce their rates in any way. This is the same criticism I have of the “Code Blue” bill I discuss in my blog entry above.

- Finally, in a point that you don’t directly address, but that I would guess we well may disagree, I do not view medical malpractice insurance as a “free market” situation given the paucity of insurers in many of the so-called markets (in some cases I believe the number is one or two). Even if this were to improve with caps on non-economic damages, a debatable point, it seems unlikely to expand beyond an oligopolistic market situation. So I’m not convinced that savings will be market-driven. Even without the normal business maximization of profits, it may well be that the processing costs and other associated business costs for private malpractice insurance are simply too high. Since I believe in national healthcare (a point we again may well disagree upon), I do not believe we should let private insurance costs erode the affordability of healthcare for all. I would be in favor of legislation to achieve this goal.

I appreciate the comment/reference. I do agree that the “liberal” argument in what I referred to seems to come out ahead, but I do not believe totally unscathed. I’d be interested in what you consider the “incorrect assertions” made.

I skimmed your referred link, and will read it tomorrow when I have a bit more time. I’ll reserve judgment until then.

Take care,

Hiram

Hiram Wurf absolutely nails the discussion on medmal reform in Illinois. Using the Cross game as a starting point, Hiram looks at the myriad issues that contribute to the medical malpractice crisis, and points to arguments on both sides of…