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.

Tennessee Health Freedom Act Dies

The session of the Tennessee General Assembly has ended, and with it, the chance for Tennesseans to assert a claim for federalism and health care freedom.

The House and Senate had passed different versions of a bill, but failed to come to an agreement.

Story here.

Health Care Freedom Bill Stumbles in Tennessee House Committee

In Tennessee, a health-freedom measure carried by Rep. Mike Bell was defeated in a House committee, says the Tennessean. That’s an unfortunate setback, since the Senate has already passed a companion measure. The Tennessean doesn’t mention the number or even the title of the bill, but I think it’s HB 3433, which says, “This bill provides that it is the public policy of this state that every person within this state is and will be free to choose or decline to choose any mode of securing health care services without penalty or threat of penalty, and this bill provides that with this bill the state is exercising its sovereign power to declare this public policy.”

Another bill, HB 2622, “prohibits the legislature from requiring any person to participate in any health care system or plan.”

UPDATE: Knoxville News has much more, including the fact that the nominally Republican speaker cast the deciding vote against Bell’s measure.

Tennessee Plays the Medicaid Shell Game

It’s a tax. No, it’s a fee. Wait, it’s a way to play “scam your neighbors!” Yes, another state–this time, Tennessee–is enacting a tax on hospital beds, meant to bring money from taxpayers in other states into Tennessee, through federal Medicaid funds.

The vote in the House was 91-4.

Tennessee AG Gives OK to Freedom Act

Good news! The attorney general of Tennessee has given a positive review (legal view only, not substance) of the Health Care Freedom Act.

Will Tennessee Sue?

Put Tennessee in the camp of states with an attorney general who isn’t enthusiastic to sue the U.S. government over the recent health “reform” law.

“Even as he gears up for a Senate vote Monday urging the state’s top lawyer to sue over the new federal health care bill, Lt. Gov. Ron Ramsey has taken preliminary steps to investigate the use of a special counsel to take up the challenge should Tennessee Attorney General Robert Cooper ultimately refuse.”

The Tennessee Senate has passed the “Health Freedom Act,” but action in the House has stalled. Robert Cooper, the attorney general of the state and a Democrat, has raised several objections to the act. One of the Republicans vying for the nomination to be the next governor says the law passed by Congress is “going to cost the state over $1 billion over the first five years of it, and we’re in the hole we’re in already. I think it’s incumbent upon the governor to see what the alternatives are to prevent that.”

Freedom of Health Care Act Advances in Tennessee

Last week the Commerce committee of the Tennessee Senate approved SB3498, the Tennessee Health Freedom Act. The measure still has a long ways to go before it becomes law, but this is an important first step. The vote was 8-0, with one abstention.

According to the official summary, “This bill provides that it is the public policy of this state that every person within this state is and will be free to choose or decline to choose any mode of securing health care services without penalty or threat of penalty, and this bill provides that with this bill the state is exercising its sovereign power to declare this public policy.

Vulnerable to Government Budgets

Some people think that the mark of an advanced society is an extensive welfare state. A better alternative is to create laws and a climate such that few people need public assistance.

When you’re on the government dole, you’re vulnerable to the ups and downs of the political budget cycle. Tennessee, for example, has now stopped adding new people to its SCHIP program, even though most of the funds for it come courtesy of taxpayers in other states, via Congress.

Government Health Care Rationing in Tennessee

Tennessee is cooking up trouble for some of its residents by following a classic recipe:

1. Tell people that you’re giving away something (or at least at a deep discount), in unlimited quantities.

2. Discover that you can’t afford to keep giving that thing away.

3. Start limiting the freebies.

In this case, we’re talking about health care. TennCare, Tennessee’s health care miracle program of the 1990s, plunged the state into fiscal trouble before it got scaled back.

Turns out they may not have scaled back enough.

TennCare officials said that they could impose a new $10,000 annual cap on hospital coverage for the 1.2 milli20n state residents enrolled in the program.

They said they might also eliminate coverage for occupational, speech and physical therapy, and limit enrollees to no more than 15 outpatient procedures and 15 lab procedures in a year.

The limits, which would not apply to children and pregnant women, would reduce TennCare spending by $380 million, even as the cost of treatment is expected to rise and the number of enrollees is expected to increase by 63,000 during the next fiscal year.

When government can’t deliver what it promises–which is inevitable when it offers a free lunch–it resorts to rationing.

States Can Reform Health Care

While everyone is focused on Congress, there are some significant steps that states can take towards health reform. The Tennessee Center for Policy Research says that Tennessee shouldn’t wait for Washington. It should:

1)    Give individual Tennesseans control of their healthcare decisions by moving away from employer-based insurance.
2)    Allow Tennesseans to obtain health insurance from companies in other states.
3)    Eliminate unnecessary mandates that require individuals to purchase coverage for certain treatments, especially for young adults.
4)    Reform medical licensing laws to encourage greater competition among providers.
5)    Permit public employees and TennCare recipients to utilize health savings accounts
(HSAs) in lieu of conventional health insurance plans.

It’s all in a policy brief titled Implementing State-Based Healthcare Reform in Tennessee.