Orszag To Democrats: You Should Have Included Malpractice Reform In Affordable Care Act

Peter Orszag laments in the New York Times today about the Democrats’ failure to include more robust malpractice reform in the Affordable Care Act, noting that “what’s needed is a much more aggressive national effort to protect doctors who follow evidence-based guidelines“:

The health care reform act that Congress passed earlier this year included a modest set of state pilot projects, including one in Oregon that is intended to experiment with this approach. But these pilots are small; the project in Oregon, for example, has only $300,000 in financing.

What’s needed is a much more aggressive national effort to protect doctors who follow evidence-based guidelines. That’s the only way that malpractice reform could broadly promote the adoption of best practices. [...]

The health care reform act that Congress passed earlier this year included a modest set of state pilot projects, including one in Oregon that is intended to experiment with this approach. But these pilots are small; the project in Oregon, for example, has only $300,000 in financing.

What’s needed is a much more aggressive national effort to protect doctors who follow evidence-based guidelines. That’s the only way that malpractice reform could broadly promote the adoption of best practices.

Indeed, when I spoke to former Sen. Tom Daschle (D-SD) several weeks ago, he too indicated that malpractice reform was probably a missed opportunity that would have been politically difficult to incorporate into this effort. “I’m actually not surprised, I’m disappointed that we’ve failed to go further on some of these issues. I think the President is a realist, he’s a pragmatist, he needed to ensure that we could bring a bill, maybe not with everything he/we wanted across the line,” Daschle told me. “I think he felt it would be hard to hold Democratic caucuses together moving a bill that went further. Ultimately, I’m confident that it’s going to happen….it was probably a bridge too far in this legislative effort.”

To be clear, malpractice costs make up only a small percentage of national health care expenditures and malpractice reform does not significantly decrease physicians’ anxiety of being sued. But it’s an issue worth tackling, since developing sensible solutions could improve quality and increase the number of physicians. The good news is, as I’ve been chronicling here, HHS is already funding some promising pilot projects that could provide a template for any future legislative efforts.