Wayne W. Oliver: Solution to address health care affordability

healthcare access (Large)

Health care continues to be at the center of debate across our nation and in Florida’s State Capitol. At the national level, House Speaker Paul Ryan and Representative Tom Price are vowing to make tort reform a key part of their replacement plan for the Affordable Care Act which is usually referred to as “Obamacare.” But while many focus on the number of Floridians covered by some form of health insurance, equal attention should be paid to the ever-increasing cost of health care.

The cost of health care affects everyone: the insured, the uninsured, employers and the State. If costs are reduced, by definition, health care becomes more accessible and more affordable for all Floridians. We must, therefore, look at spending on the front-end and develop effective mechanisms to contain costs while considering any State options for extending coverage to more people.

Currently, in Florida, the fear of medical litigation among physicians has manifested itself in the form of the practice of defensive medicine. By definition, defensive medicine is ordering unnecessary medical tests, medications, CT scans, referrals to specialists, procedures, and consultations with little clinical or no therapeutic value but may help physicians protect themselves against a potential malpractice lawsuit. In Florida alone, the practice of defensive medicine costs all Floridians more than $40 billion per year. Each year, billions of dollars are wasted on unnecessary health care expenses. And, defensive medicine is a hidden driver in the cost of health care. According to the Gallup Organization, wasteful, defensive medicine accounts for as much as 26 percent of overall health care spending.

The current dysfunctional and inefficient medical malpractice system is, therefore, imposing an avoidable and onerous burden on a wide swath of Florida’s economy, impacting Florida’s physicians, patients and businesses. A proposal called the Patients’ Compensation System is intended to transform the broken medical malpractice system in Florida and preserve the physician-patient relationship.

The proposal would remove medical malpractice from the inefficient court system and place it in a streamlined administrative system. Rather than flooding the courts with lawsuits which take years to resolve, the administrative model allows for a less contentious, more fair and timely determination of any compensation that should be paid to an injured patient.

Joanna Shepherd, Ph.D., Associate Professor of Law at Emory University School of Law, detailed in her article “Justice in Crisis” that the current system offers justice for 3 percent and no justice for 97 percent of medically injured patients. The vast majority of attorneys require minimum expected damages of $500,000 to accept a case. The high cost of medical malpractice litigation limits the plaintiff attorneys to take cases below this threshold.

This creates a major access to effective health justice issue for a significant number of injured patients in our state that have no access to a judge and jury. Yet, attorneys and insurers have created a profitable niche within the existing medical tort system.  We need a system that ensures access to legitimate health justice which fairly and appropriately compensates all medically injured patients.

The Patients’ Compensation System works to ensure costs savings to our state, private employers and citizens, eliminates frivolous lawsuits and ensures all legitimately medically injured patients receive fair compensation, especially those who are currently denied access under the existing system.

Affordability extends to everyone across the health care spectrum — whether utilizing private or public health insurance. The Patients Compensation System would make Florida a national model for how to protect the physician-patient relationship while bringing down health care spending in Florida.  The proposed Patients’ Compensation System will likely be considered in the 2017 Legislative Session by Florida’s legislators.

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Wayne W. Oliver is Executive Director of Patient for Fair Compensation.

Guest Author



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