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Sweeping Medical Reforms Lack Medical Liability Element

Focus is on cost control, with other issues not yet addressed

MONDAY, June 15 (HealthDay News) -- Three approaches to medical reform currently under discussion in the United States all have pros and cons, and questions remain over whether or not the reform package should include changes to the medical liability system, according to an article published online June 15 in the New England Journal of Medicine.

Michelle M. Mello, J.D., of the Harvard School of Public Health in Boston, and Troyen A. Brennan, M.D., of CVS Caremark in Woonsocket, R.I., describe the advantages and disadvantages of disclosure-and-offer programs, administrative or specialized tribunals, and 'safe harbors' for adherence to evidence-based practices, but point out that medical liability reform has received little attention.

Bundling liability reform into the overall health care reform package would tackle the issue of defensive medicine, counterbalance the changes in the payer mix that are unfavorable for top providers, and may attract support from congressional Republicans, the authors argue.

"At present few policymakers are openly discussing the pros and cons of bundling liability reform and health care reform," the authors write. "The overture to the exquisite oratorio of lawmaking calls for each player to press the key positions its constituents demand. But within a few months, we predict that many will be looking for compromises."

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