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curious2 says

The "tort reform" myth is a red herring, actual malpractice liability amounts to only 2% of spending, and tort reform has caused disastrous consequences in Texas and California. But, no doctor should ever be required to carry malpractice insurance.

That's a good point about lawsuits amounting to only 2% of spending, and my research confirms that. I'm not sure about letting doctors carry no malpractice insurance though, as how would a victim get emergency corrective treatment and some kind of compensation if the doctor doesn't have assets.

However, the requirement for malpractice insurance is definitely expensive in itself. Here are a few good articles on it.

Medical Malpractice System Breeds More Waste

The direct costs of malpractice lawsuits — jury awards, settlements and the like — are such a minuscule part of health spending that they barely merit discussion, economists say. But that doesn’t mean the malpractice system is working.

The fear of lawsuits among doctors does seem to lead to a noticeable amount of wasteful treatment. Amitabh Chandra — a Harvard economist whose research is cited by both the American Medical Association and the trial lawyers’ association — says $60 billion a year, or about 3 percent of overall medical spending, is a reasonable upper-end estimate.

The problem is that just about every incentive in our medical system is to do more. Most patients have no idea how much their care costs. Doctors are generally paid more when they do more. And, indeed, extra tests and procedures can help protect them from lawsuits.

An excerpt from
The Medical Malpractice Myth

[T]he real problem is too much medical malpractice, not too much litigation. Most people do not sue, which means that victims—not doctors, hospitals, or liability insurance companies—bear the lion’s share of the costs of medical malpractice.

Second, because of those same studies, we know that the real costs of medical malpractice have little to do with litigation. The real costs of medical malpractice are the lost lives, extra medical expenses, time out of work, and pain and suffering of tens of thousands of people every year, the vast majority of whom do not sue. There is lots of talk about the heavy burden that “defensive medicine” imposes on health costs, but the research shows this is not true.

Third, we know that medical malpractice insurance premiums are cyclical, and that it is not frivolous litigation or runaway juries that drive that cycle.

Rural Health News, Vol. 9, No. 1
Spring-Summer 2002, High Insurance Premiums Jeopardize Rural OBs

Malpractice insurance rates are on the rise, particularly in high-risk specialties like obstetrics, and that is creating a crisis in some rural communities.

The American College of Obstetricians and Gynecologists (ACOG) concurs with Jenkins’s dire assessment. At a May 6 press conference, ACOG named nine "Red Alert" States where the medical liability insurance situation threatens the availability of physicians to deliver babies.

"Across the country, liability insurance for obstetrician-gynecologists is becoming unaffordable or even unavailable," said ACOG President Thomas Purdon, MD.

The situation is particularly worrisome for rural areas, where physicians and care are often already in short supply. "Hospitals, public health clinics, and medical facilities in medically underserved areas begin to lose prenatal and delivery care. The impact on rural women and Medicaid patients is most acute," said Dr. Purdon.

Dan8267 says

I'm not sure about letting doctors carry no malpractice insurance though, as how would a victim get emergency corrective treatment and some kind of compensation if the doctor doesn't have assets.

That's an argument for single payer emergency care, or for carrying true emergency medical insurance (which ObamneyCare prohibits), or for saving for a rainy day, or for choosing doctors who have sufficient insurance or assets, or avoiding doctors whenever possible. It isn't an argument for requiring malpractice insurance though, especially because the insurers' greatest expertise is in not paying. Ron Paul delivered thousands of babies in his career as a doctor, never got sued. As far as I know he never dropped a kid, but a malpractice insurer would charge him the same premium as butterfingers across the hall.

curious2 says

That's an argument for single payer emergency care, or for carrying true emergency medical insurance (which ObamneyCare prohibits)

True. I agree that implementing a single payer system could eliminate the need for doctors to carry any malpractice insurance. The single payer system could have a malpractice repair and compensation policy built into it.

Lazy incompetence can still be deterred by banning workers from the medical field if they screw up, for instance, by mixing up the blood types as in the Jesica Santillan case sited in the second article above. All medical workers, not just doctors, could be held to this standard. It would also encourage double-checking of work.

Dan8267 says

Lazy incompetence can still be deterred by banning workers from the medical field if they screw up...

But the opposite happens because it's much more lucrative. Hospitals profit from their mistakes, insurers use "runaway jury" stories to scare doctors into paying for more insurance, etc. As Noam Chomsky would say, it isn't a deliberate conspiracy in the usual sense of that word, it's only the inevitable result of executives in large organizations pursuing their own self interest.

curious2 says

But the opposite happens because it's much more lucrative. Hospitals profit from their mistakes, insurers use "runaway jury" stories to scare doctors into paying for more insurance, etc.

A properly implemented single payer system would eliminate both those problems and provide the transparency necessary to detect and correct mistakes.

I suspect 90% of those that have been Okeydoking Obamacare the most, running around calling it a Healthcare SYSTEM, will be the most vocal critics when that mandate kicks in. People are confusing this with some government stewardship of the Nations citizens and their well being. This is only a measure to make sure that all of the people investing in medicine, hospitals, insurance all gets paid.

My Mom 72 just informed me this week she no longer has Insurance since this passed. Well she does, but for the health problems she may have at this stage in life, she might as well not have. The out of pocket prices and expenses have never been higher, and no Doctor will see her now, with out her paying her part up front first. And this is a disabled little old lady. Do these people really think they will fare better under Obamacare.

CaptainShuddup says

I suspect 90% of those that have been Okeydoking Obamacare the most, running around calling it a Healthcare SYSTEM, will be the most vocal critics when that mandate kicks in.

I'd have no problem with the individual mandate if we got single payer, a public option, and a divorce of health insurance from employment in exchange. Otherwise it's a giveaway to already too-powerful insurance companies and it's going to backfire.

Of course, I'd have sponsored a real health care reform bill like the one I described above if I were in the Senate.

CaptainShuddup says

Do these people really think they will fare better under Obamacare.

Most people see through it and know they won't fare better, but partisans believe whatever their party tells them. For example, Homeboy refuses to acknowledge that insurers are buying hospitals, which enables them to sidestep the MLR rules by shifting profit from the insurance side to the hospital side within the same parent company. Most people, on both sides, just want to believe.

Dan8267 says

Of course, I'd have sponsored a real health care reform bill like the one I described above if I were in the Senate.

...which is why you aren't. Legislation isn't drafted by public spirited engineers. It is drafted by self-interested politicians and lobbyists whose patronage networks demand payback and offer opportunities, for example Billy Tauzin and Max Baucus. When you look at how a legislative body actually works, and the product that emerges when the inputs have been digested all the way through the system, it becomes a powerful argument for limited government.