STATE EYES BOLD HEALTH CARE PLAN

With the nation captivated by the presidential primaries, a new poll released by the Kaiser Family Foundation finds the cost of health care and health insurance rank among the top concerns of registered voters.

Falling behind only terrorism and the economy, the rising cost of health care is very much on the minds of voters. That’s certainly the case here in Tennessee as lawmakers are working on a bold approach to reduce costs by $30 million annually.

That proposal now before the state House and Senate would encourage the elimination of wasteful, defensive medicine. Gallup says one in four health care dollars can be attributed to such medicine. To make that happen, lawmakers have introduced legislation to repeal Tennessee’s broken medical malpractice system and replace it with a no-blame, administrative model.

(Defensive medicine is a common practice and occurs when physicians order unnecessary tests, procedures and medications to avoid being sued.)

Under the proposed Patients’ Compensation System (PCS), patients who have been injured by a physician would no longer take their case to court. Instead, they would file a claim before an administrative panel of health care experts and an administrative law judge. If the PCS found an avoidable harm had occurred, the patient would be quickly compensated, unlike our current legal system which takes years and compensates very few injured patients.

Patients would be compensated in an amount similar to what they would receive after years in the legal system. This no-blame, administrative model would eliminate the adversarial relationship between patient and doctor and allow physicians to acknowledge their errors without fear of litigation.

During my 40 years of leading hospitals, I can say the majority of physicians I met have been sued — many under frivolous circumstances. As a result, doctors have changed their behavior to practice defensive medicine to protect themselves.

Despite efforts at cost containment, hospital administrators have little impact in preventing this.

It is almost impossible to reduce costs when doctors believe they must protect themselves with expensive and unnecessary CT scans, blood work, X-rays or MRIs. We can encourage best practices and offer incentives to reduce spending, but when a physician’s net worth and life savings are on the line, they will continue to order wasteful medicine.

BioScience Valuation, a health care economics firm, reports defensive medicine cost $487 billion in the United States in 2015 and $13 billion annually in Tennessee.

A new survey by Beacon Research finds consensus for the new approach, with 85 percent of Tennessee doctors agreeing the proposed PCS would reduce costs and 89 percent saying they would support the proposal before the Tennessee assembly.

While other attempts at cost reduction have been attempted, this plan would save Tennessee significant dollars in health care — more than $30 billion in public and private health plans over a decade. Florida, Georgia, Maine and Montana are considering similar plans.

As we have seen in recent weeks, all the major insurance carriers in Tennessee report they will ask for significant increases over the next year to remain sustainable — some as much as 30 percent. Consumers can no longer afford those types of premiums, co-pays and out-of-pocket costs.

Adopting a PCS model in Tennessee would do more than any policy change I have seen in my career. It would make Tennessee a national leader in doing what Washington has failed to do: make health care affordable and its medical liability system expedient, predictable and healthier for taxpayers, patients and doctors.

Charles R. Evans is president of International Health Services and vice chairman of the nonprofit Patients for Fair Compensation.