Medical-Tort Law: Ranking the States

How much do a state’s laws governing medical malpractice and other torts relevant to health care affect the availability of care?  Plenty!

Lawrence J. McQuillan’s & Hovannes Abramyan’s 2010 edition of the U.S. Tort Liability Index, which has a number of measurements included in the U.S. Index of Health Ownership, ranks states according to 42 variables.

Eight of the measurements in the U.S. Tort Liability Index are relevant to the U.S Index of Health Ownership: One output and seven inputs. The previous edition of the U.S Index of Health Ownership included six measurements of medical tort, but McQuillan & Abramyan have discovered more variables for their 2010 edition of the Tort Liability Index, allowing more detailed measurement.

As a partial update of the U.S. Index of Health Ownership, this brief analysis calculates a medical-tort index from a simple average of the eight relevant variables.  Mississippi, Nevada, Michigan, Colorado, and Louisiana lead the pack; while Vermont, Rhode Island, Kentucky, Pennsylvania, and Iowa bring up the rear. Even the leaders, however, lag in some measurements.

Mississippi, for example, leads on procedural rules: Pre-trial screening or arbitration and conditions on the use of expert witnesses. However, it does not limit lawyers’ ability to abuse their privilege by limiting their share of awards. Colorado and Louisiana also fail to impose limits. Unfortunately, the laggards do not show a similar pattern: The bottom five states perform poorly in all eight measurements.

Reducing the burden of medical tort is critical to increasing Americans’ health ownership and reducing medical costs that curtail our access to care. Some progress is evident, but states aiming to improve their medical-tort laws still have a long way to go.

No Disagreements, Please

A committee of the North Dakota Legislature had scheduled a hearing on implementing ObamaCare. There was just one problem: Many of the scheduled witnesses don’t like it.

That, in turn, bothered Kenton Onstad, one of the Democratic Party leaders in the House. He called some of the witnesses “partisan” and the Bismarck Tribune noted that “one [speaker] is a representative of the Cato Institute, which is critical of government entitlement programs.”

Speaking of the good folks at Cato, Michael Tanner will participate in a forum in Bismarck this afternoon, titled, “Reform passed, now what?”

Today’s edition of the Tribune contains a thread-bare mention of the legislative hearing, quoting both Tanner and a representative of the National Conference of State Legislators. The headline does a decent job of capturing the spirit of the age. It reads, “Analysts: Health care bill’s impact uncertain.”

North Dakota Rejects ObamaCare

Brett Narloch offers a view of the health care debate from North Dakota, where he serves as the leader of the North Dakota Policy Council.

According to a survey taken in December, 64% of North Dakota’s residents were opposed to the congressional health reform proposals. “Furthermore,” says Narloch, “Senator Byron Dorgan’s retirement announcement may have had to do with his unpopular support of the health care reform proposal. Earl Pomeroy’s electoral trouble may also have to do with his vote for the health care plan. Clearly, Obamacare is not popular in North Dakota.”

Last year, the Legislature considered but rejected putting the Freedom of Choice in Health Care Act into the state constitution. It did, however, endorse a resolution affirming the Tenth Amendment to the U.S. Constitution.

Health Freedom and Medical Marijuana in North Dakota

Medical marijuana will be coming to North Dakota, if one of the state’s residents gets his way. Del Snavely, who used to used medical marijuana while living in the state of Washington, is working on securing a ballot measure to enact a similar law in North Dakota.

I’ve never smoked a joint in my life and have no desire to do so, yet I find the med-marijuana campaign–which has succeeded in “more than dozen states,” according to the article–encouraging. First, it’s simply a pro-freedom move. It also expands the scope of health care options by a tiny bit.

Finally, the enactment of state laws is a strike back against the “Congress knows best” attitude that has held sway since the 1930s. “The federal Justice Department has said it won’t target medical marijuana dispensaries if they’re complying with state law,” says the AP article, printed in the Grand Forks Herald. Such a stance gives hope that the Freedom of Choice in Health Care Act will have legal as well as political legs.

Breast Implants and a North Dakota Divorce

How much did those breast implants cost? A North Dakota couple is going through a nasty divorce, and the husband wants to advance his financial outcome through counting his wife’s breast implants (presumably paid for out of joint funds) as a marital asset.

A justice on the state’s high court sees trouble ahead: “Do we have any lines to be drawn? Is dental work a marital asset? Is a hip replacement a marital asset?”

North Dakota Collects Unused Prescription Drugs

In what is one of the more benign uses of government power when it comes to health care, the Grand Forks, North Dakota police department will let members of the public drop off unused prescription drugs. Presumably the drugs will be incinerated or otherwise disposed of in a way that doesn’t let them enter the groundwater. Officials are touting it as a way of preventing teens from getting unauthorized access to drugs.

Will Takeover Artists Get Off?

North Dakota’s three-person congressional delegation has voted against the wishes of their constituents.

Will they pay a political price for voting for a government takeover of health care? A NoDak blogger surveys the scene and isn’t encouraged.

Want More Insured? Don’t Tax Insurance

It’s an axiom of economics that if you want to reduce the consumption of something, you tax it. Reduce the number of people who smoke cigarettes? Enact a tax, and then raise it. Reduce alcohol consumption? Tax booze.

Reduce the number of people with health insurance? Tax …. Oh wait. I thought that the High Moral Purpose of the moment is to increase the number of people with health insurance.

In North Dakota, State Sen. Tracy Potter (D-Bismarck) suggests eliminating the state tax on health insurance premiums. Potter wants to make the cut only for policies sold by non-profit companies (read: BlueCross BlueShield), but it’s a start.

Increased Competition Could Cut Insurance Costs in Half

In pursuit of “doing something” about the high cost of health insurance, Congress is set to force millions of Americans to hand over more money to insurance companies, and to government as well. A simpler way would be not to extend favoritism to insurance companies but to make them compete with each other.

Brett Narloch of the North Dakota Policy Council says that consumers could cut their costs by half, or more. The key is to open up the market within a state to more companies, and reduce the influence that politicians have on what insurance looks like. When people buy, one by one, what works for them, lower prices result.

Health Policy Alternatives in North Dakota

With two senators and a population of just 641,000, North Dakota is one of those states with an outsized influence on health care policy at the Federal level. The North Dakota Policy Council will host a public meeting on health care policy, current proposals, and patient-friendly alternatives. This video gives the pitch.