The first rule of politics is “it’s always about the money.”  So let’s talk about the money in the medical malpractice “reform” debate.

The Republicans claim that many billions of dollars are wasted due to what they’ve dubbed “defensive medicine.”  Defensive medicine occurs when a doctor does something – usually ordering a test – only because he or she is afraid of being sued.  According to Republicans, if we “reform” the medical malpractice system, defensive medicine will stop (or at least slow) and billions will be saved.  This argument is both wrong, and a red herring.  Here’s why it’s wrong:

Each and every medical insurer (including Medicare & Medicaid) makes doctors sign a provider agreement.  The provider agreements differ in many ways, but are identical in one respect: all of them require doctors to certify that every procedure they order is “medically necessary.”  The penalties for ordering unnecessary tests include both monetary penalties, and jail time. The monetary penalties can be very large.  For example, if a doctor bills Medicare or Medicaid for a procedure he or she knows isn’t necessary, the doctor will be liable to the United States Government for a civil penalty of not less than $5,000 and not more than $10,000, plus 3 times the amount of the unnecessary procedure.  So if a doctor orders a $1,500 MRI that he or she knows isn’t necessary, the doctor will have to repay the government anywhere from $9,500 to $14,500 dollars.  It will also be the doctor making the repayment, and not his or her malpractice insurance carrier because insurers don’t cover fraud.  Oh, and there’s also the chance the doctor will be criminally tried and go to jail for ordering that unnecessary MRI. 

Now, getting sued in a medical malpractice suit isn’t much fun.  But do you really think it’s worse than paying huge criminal fines and going to jail?  Or do you think there’s more to the “defensive medicine” argument than Republicans are letting on?  The bottom line is that if a doctor orders an MRI and bills an insurer, the doctor is either admitting that the procedure is medically necessary, or the doctor is committing insurance fraud.  Either way, the Republican arguments about defensive medicine are wrong.

Those arguments are also a red herring.  What’s the first rule of politics?  “It’s always about the money.”  In this case, it’s about campaign money.

When Republicans bash trial lawyers, what’s the one thing they always point out?  They always point out how trial lawyers give so much money to political campaigns.  And to which campaigns?  Democratic campaigns.  Republicans tend to exaggerate just how much that trial lawyers give, but make no mistake, they do give a lot of money to Democrats.

Now put yourself in the shoes of a Republican.  If one of the biggest sources of campaign contributions for your opponent was a trial lawyer, what’s one thing you could to to reduce the amount of money your opponent has?  That’s right – you pass laws that make it harder for trial lawyers to make money.  The less money trial lawyers have, the less they can give to Democrats.

But for Republicans, passing tort “reform” doesn’t just cut down on the amount of money your Democratic challengers will have.  It will put more money in your campaign coffers.  Doctors and insurance companies both love tort “reform” because it will save them money.  So if you’re running on a platform of tort “reform,” you can count on both of those groups to give you plenty of campaign cash.

If you’re a Republican, passing medical malpractice “reform” is the ultimate win-win for you: It will cut your opponents’ funding, and increase yours.  But wait – it gets better.

Notice how Republicans are trying to force Democrats to pass tort “reform” in order to get universal healthcare?  Think about how twisted that is.  Republicans are telling Democrats, “Sure, we’ll give you universal healthcare to save countless lives.  But to get it, you’re going to have to commit political suicide.”  Talk about playing dirty!  Of course, the second rule of politics is “You don’t win by playing fair.”