EVANS: Georgia lawmakers consider bold move to reduce healthcare costs

Charles R. Evans

As we move through presidential primary season, a new poll released by the Kaiser Family Foundation finds that the cost of healthcare and health insurance among the top concerns of registered voters.

Falling only behind terrorism and the economy, the rising cost of healthcare is very much on the minds of voters across the country. That’s certainly the case here in Georgia as we approach the SEC Presidential primary on March 1.

Voters want solutions to one of most expensive items in the family budget and on the corporate balance sheet. While Washington may have failed to provide a solution with the Affordable Care Act, Georgia lawmakers are offering a bold plan to reduce healthcare costs during the 2016 legislative session.

A proposal before the Senate Health and Human Services Committee chaired by Sen. Renee Unterman (R-Buford) would repeal the state’s broken medical malpractice system and replace it with a streamlined, no-blame administrative model. A similar bill is anticipated in the Georgia House. Under this model, physicians would no longer need practice wasteful, defensive medicine.

After 40 years as a hospital administrator, I can say that one of the primary drivers of rising costs can be linked to a doctor’s pen.

Despite efforts at cost containment, wasteful defensive medicine is a common practice and occurs when physicians order unnecessary tests, procedures and medications to avoid being sued.

It is almost impossible to reduce costs when doctors believe they must protect themselves with expensive and unnecessary CT scans, blood work, referrals to specialists, X-rays or MRIs. In 2012, a survey of Georgia physicians conducted by Oppenhiem Research found 82 percent of doctors admitted to practicing defensive medicine.

BioScience Valuation, a healthcare economics firm, reports defensive medicine cost $487 billion in the United States in 2015. In Georgia, defensive medicine runs about $14 billion annually in wasted healthcare costs — something we all pay for in escalating premiums, co-pays and other out of pocket expenses.

While other attempts at healthcare cost reduction have chipped around the edges, this bold move would save our state significant dollars in health care – nearly $7 billion over a decade for taxpayers in state-funded health plans such as Medicaid and between $15 and $31 billion in private plans. Florida, Tennessee, Maine and Montana are considering similar proposals.

Under the proposed Patients’ Compensation System (PCS), patients who have been injured by a physician would no longer take their case to court. Instead, they would file a claim before an administrative panel of healthcare experts and an administrative law judge. If the PCS found that a medical injury had occurred, the patient would be quickly compensated which is unlike our current legal system that takes years and compensates very few injured patients.

Patients would be compensated in an amount similar to what they would receive after years in the legal system. This no-blame, administrative model would eliminate the adversarial relationship between patient and doctor and allow physicians to acknowledge their errors without fear of litigation.

During my 40 years of leading hospitals, I can say that the majority of physicians I met have been sued – many under frivolous circumstances. As a result, doctors have changed their behavior to practice wasteful defensive medicine to protect themselves.

Since the 1980s, we in the healthcare field have lamented soaring costs. In recent years as consumers have had to share more of the burden, they too have come to terms with the unsustainable price of healthcare with significant premium hikes, co-pays and deductibles.

Adopting a PCS model in Georgia would do more to reduce healthcare expenses than any policy change I have seen in my career. It would make Georgia a national leader in doing what Washington has failed to do: make healthcare affordable, its medical liability system expedient, predictable and healthier for taxpayers, patients and doctors.

Charles R. Evans is president of International Health Services Group and is vice chairman of the non-profit Patients for Fair Compensation. He retired President of Hospital Corporation of America (HCA), Eastern Group and held senior hospital executive positions in Indiana, Florida and North Carolina.

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