[natalyarostova]

Spotting first order effects is relatively easy. It's not terribly hard to examine a system and point out some flaw or inefficiency. What's hard is coming up with a better solution that doesn't cost more in unintended consequences.

One unintended consequence of our malpractice law in the US is a tremendous amount of time and money spent by physicians purely to avoid lawsuits. Obviously medical malpractice is real, and should exist. But there are costs associated with ever increasing the scope and ability to medical practitioners to be sued.

[mandevil]

You can look at the Dartmouth Atlas of Health Care and see the costs of medical care, and medical malpractice reform just doesn't seem to have any effect on medical care costs.

https://www.dartmouthatlas.org/interactive-apps/medicare-rei... Price-adjusted total Medicare costs per enrollee, that belt of bright red along the Texas coast? Texas capped non-economic medical malpractice damages at 250,000, and still they have some of the highest Medicare spending in the country. Since this data is price adjusted this isn't so much a measure of how expensive a treatment is in the hospital, but of how many events a patient undergoes in a year. So Texas doctors continue to have very high utilization rates, even after malpractice reform. So it wasn't just "defensive medicine" that was driving that, but something else.

[Retric]

> purely to avoid lawsuits.

That time has real benefits. Medicine has a huge issue where people value their own lives vastly more than doctors do. Sure, 99+% of the time X is not the issue, but it’s rational to spend quite a bit to avoid fairly low odds of death.

For example, one of the US’s top killers is pulmonary embolism which presents as any number of other issues. Doctors not taking such symptoms seriously kills. “Pulmonary embolism is a common complication of hospitalization and contrib- utes to 5 to 10 percent of deaths in hospitalized patients.” “less than half of patients who die of pulmonary embolism were diagnosed with the problem prior to death“

[kgwgk]

> it’s rational to spend quite a bit to avoid fairly low odds of death

Then it’s not rational to be outraged when one finds out that healthcare costs are high.

[Retric]

Plenty of other things boost the US’s heathcare costs to get upset about. Texas capped malpractice liability and that seemed to have zero impact on heathcare costs.

[spacemanmatt]

There seems to be a presumption that "to avoid lawsuits" is a pure motivation. I don't think that it is.

Some of our laws actually come from just causes, such as protection patients from incompetence, malfeasance, etc. of their physicians, nurses, hospitalers, and insurance companies. A lawsuit is the necessary enforcement mechanism of such protections. Lawsuits can serve good purposes.

[bilbo0s]

Yeah, but I'd argue this really doesn't increase the scope. From my reading of the article, which is incomplete, we need a few more bits of info to make a call here, but I'm pretty sure these two organizations were operating in a grey area with respect to consults and referrals in this case. Personally, I think the policies they had, (maybe still have?), in place put certain care providers at enormous risk. But it really is on the doctors to make sure they are doing everything right. The greyness here, again, only my opinion, but I think the greyness led to confusion. But, yeah, confused or not, the doctors are on the hook for it.