-Caveat Lector- Bush on health care—the epitome of fuzzy logic
By Regina Varolli Online Journal Contributing Writer http://www.onlinejournal.com/Commentary/Varolli012303/varolli012303.html January 23, 2003—The cost of health insurance in the US continues to rise. The cost of my own individual PPO has gone from $58 per month to $179 per month over the past two years. This increase led me to decide to tag myself onto my boyfriend's company health plan, as they fortunately cover "domestic partners." Ironically, on the day when I placed the call to my PPO provider to cancel my coverage, Bush was in Scranton, Pa., making a speech about the rising cost of health care and his plan to curb it. As I listened to his speech on C-SPAN radio, it seemed to me to be unusually illogical, even for Bush. So after a bit of time I logged onto whitehouse.gov and retrieved the text of the speech. After having a chuckle at such a display of nonsense, I set about analyzing his argument. The Bush fix for the rising cost of health care and insurance premiums for Americans is rooted in the notion that frivolous malpractice suits are the main cause of rising costs and premiums. Hence, his legislation focuses on caps for malpractice awards. The argument presented in the Scranton speech, roughly broken down, can be summed up in the following. Broken liability laws in the US lead to frivolous lawsuits. 2- Broken liability laws coupled with "lousy juries" lead to excessive judgments. 3- "Lousy juries" and excessive judgments lead to large settlements out of court, in essence, turning malpractice suits into a "lottery." 4- This "lottery" leads to hikes in malpractice insurance premiums for doctors. 5- Hikes in malpractice insurance premiums for doctors can force a doctor to move to a state where malpractice insurance is more affordable. 6- When doctors migrate for more affordable malpractice insurance, this leads to a lack of doctors in your area. 7- A lack of doctors in your area equates to a lack of accessible health care for you and yours. 8- Therefore: Placing caps on the amount of non-economic settlements will lead to doctors staying put and to better access to health care for you and yours. Problem solved? Not quite. The issue facing many Americans is the rising cost of health care for individuals, not a lack of doctors, but at no point in his sloppy argument does he make any logical connection, however contrived, between caps on liability insurance and the skyrocketing cost of health insurance for you and me. Bush does offer one example as proof of the effectiveness of his plan to cap liability awards. He mentions California: "More than 25 years ago, they passed a law that caps damages from malpractice suits. And the law has worked. Let me tell you a startling statistic. Reports from Philadelphia say that juries there have awarded more in malpractice damages than the entire state of California did over the last three years." Here Bush has attempted to show that capping settlements will lead to less costly malpractice insurance. However, regarding the link between the cost of health insurance in California and the caps on malpractice awards, perhaps he should have checked his facts first. As it happens, despite these caps, the cost of health insurance in California is rising at an alarming rate. CalPERS HMO plan costs jumped 25 percent from 2002 to 2003. And back in 1998, a study by Peat Marwick showed that while the national cost of health care benefits had risen by 3.3 percent, in California it had risen by 4.2 percent. In another vague attempt to make the connection between migrating doctors and 45 million Americans who can't afford health insurance, he states the following about his proposed legislation: "It's a law that will recognize that an affordable and accessible health care system can best be had if we limit the caps—put caps on non-economic and punitive damages. That's what I understands." (The 's' is not a typo.) Counter to Bush's assumption that the malpractice "lottery" is the main cause of rising health costs, Kaiser Permanente CEO Dr. David Lawrence has made the claim that the reason why they must raise their premiums is because of the rising cost of "pharmaceuticals and technology"—no mention of malpractice insurance. Additionally, Department of Health and Human Services Secretary Tommy Thompson more recently made an issue of the fact that in the US we pay more for our prescription drugs even though these drugs are coming from US companies. At the Biotechnology Industry Organization's convention in Toronto, he urged the pharmaceutical industry to lower the cost of drugs in the US, because "People are going to start questioning why drugs are so much more expensive in the United States than in Canada, Mexico and Europe. That is going to add to the regulatory fervor." Of course, he noted his lack of support for a legislative solution and urged "voluntary" lowering of prices. I am as much in dismay about Bush's fix as I am in dismay about his speech. Perhaps he made no logical connection between caps and 45 million uninsured because there is no connection to make? Yet in his fallacious attempt to associate the two, he states the following: "And that problem is the fact that our medical liability system is broken, and therefore, a lot of Americans don't have access to affordable health care." Yes, he says "therefore," but in his argument above outlined one does not, and cannot, arrive at this conclusion from the premises given. All one can conclude is that individuals will have better access to doctors, not that they will be able to afford them. Personally, I believe that the argument, "If caps on non-economic awards, then affordable health care," cannot be derived unless there is an assumption—a legislative guarantee—that the savings in malpractice insurance will be passed on to the individual by way of lowering monthly premiums. That notion, of course, is not even alluded to in the Scranton speech. Nor, might I add, did this "passing on of savings" ever take place in California. To make matters worse, he wraps up his speech with the following statement: "In my mind, there is no doubt that we won't solve these problems." Here he clearly states that he does not doubt, that it is the case, that we will not solve these problems. Wouldn't he rather have said that he does not doubt, that it is the case, that we will solve these problems? As a speech writer and former student of symbolic logic, I'm appalled at his intelligence-insulting argument. As an individual who has personally felt the squeeze of jacked up insurance premiums, I'm nauseated . . . though not at all surprised. Contact Regina Varolli at [EMAIL PROTECTED] <A HREF="http://www.ctrl.org/";>www.ctrl.org</A> DECLARATION & DISCLAIMER ========== CTRL is a discussion & informational exchange list. Proselytizing propagandic screeds are unwelcomed. 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