Jonathan Cohn suggests that Obama should embrace medical malpractice reform as part of health care overhaul.Â He’s right: real malpractice reform, such as the “Sorry Works” plan adopted by the University of Michigan health system, is a promising way to cut costs at the margin.Â It won’t have a major impact, but it might also foster compensation.Â Cohn’s other major suggestion — retooling medical malpractice into a third-party no-fault system resembling workers’ compensation — also has promise.Â Despite all of workers’ comp’s problems, and there are many, it still is better than the tort system; it’s 23% rate of administrative costs is less than half that of the tort system.
Cohn asks, at the end of the piece, whether Republicans would ever take yes for an answer, and the answer, of course, is no.Â But this is not simply because the GOP s dedicated to defeating the bill no matter what.
Instead, the answer in my view is a little more bizarre: the GOP needs malpractice reform so much that it will never enact it.Â Yes, you read that right.
The Republicans have a key problem concerning health care reform: they basically don’t believe in it.Â For truly principled conservatives, health insurance is like a widget: if you have the money you buy it, and if you don’t have the money you don’t.Â That’s what it really means to have the market sort things out.Â But they can’t say that, because that would be grotesquely unpopular.Â What to do?
Answer: hang onto seemingly appealing but actually impotent ideas like tort reform, or seemingly appealing but horribly dangerous ideas like removing state insurance regulations.Â But don’t ever enact them, because then it will become apparent that your idea don’t work.
Don’t believe me?Â Well, recall who ran all three branches of government for four years.Â Do you remember them enacting malpractice reform?Â Me, neither.
Importantly, the GOP Congress did enact legislation with the Orwellian name of the Class Action Fairness Act, which was designed to stifle class actions.Â When it wanted to pass legal reform, it did so.Â But it never passed malpractice reform because Republican leaders knew that that would rob it of a platform.
So don’t hold your breath on this one, either.Â Republicans are very principled: they believe in putting party over country, and nothing will stop them in that.