What’s missing from the Democrats’ health plans

Despite the importance of health care (and particularly health care costs) in this U.S. election cycle, neither of the Democrats include any mention of tort reform or health courts in their health plans (Obama’s; Clinton’s). This has traditionally been a partisan issue, with Republicans for reforms to limit malpractice awards and Democrats against.

If newsbatch.com is to be believed, Democrats don’t support tort reform because trial lawyer associations are big donors. Opensecrets.org gives a good rundown: Clinton has received over $13 million from lawyers and law firms (her top sector); Obama has received over $11 million (his top sector); McCain has received over $3 million (his second top sector after retirees). It’s not that surprising that lawyers are the biggest sector for campaign donations, considering that they are wealthy and have more direct interest in politics and laws than any comparable profession. But without breaking those totals down more, it’s hard to say that is specifically the reason why Dems oppose tort reform (since surely many lawyers support it, in addition to many many doctors).

Clinton does not mention malpractice or tort reform in her health plan at all. Obama, supposedly free of lobbyist influence and mostly free of big money special interest influence, mentions malpractice obliquely: “Obama will also promote new models for addressing physician errors that improve patient safety, strengthen the doctor-patient relationship, and reduce the need for malpractice suits.” (p. 8) McCain’s outline of a health care plan includes tort reform as one of its planks.

Hopefully more will come of that once the nomination is settled; if Obama is the Democratic nominee, that may be likely. Short of a single-payer system that eliminates the huge overhead of commercial insurance or doctors factoring cost into treatment decisions in a more serious and systematic way (both long shots for the near future), tort reform and/or health courts are the only things likely to make a serious impact on reducing the cost of health services. (Inflated pharmaceutical costs are another matter, the dynamics of which I’m still trying to figure out.)