Defensive Medicine Becomes Part of Transformation Bill
July 14, 2011 -- Before Republicans signed off on major legislation transforming Oregon’s healthcare system – House Bill 3650 -- they insisted that the cost and impact of defensive medicine be looked into.
The Oregon Health Authority has been charged with hiring consultants to conduct such a study. The Legislature set aside $295,000, with half of those dollars coming from federal matching funds.
Felicia Hagins, political director for SEIU Local 49, isn’t convinced that’s money well spent. “A lot of resources have gone into this in the past, and the Legislature has been either unable to act or voters have turned this down on the ballot,” she told her colleagues on the Oregon Health Policy Board on July 12.
Those dollars should have gone toward bringing more people onto the Oregon Health Plan or studying issues such as global budgeting, or outcomes and metrics, she said.
But the impact of defensive medicine is a critical element to maintain an adequate work force in Oregon, countered Dr. Joe Robertson, president of Oregon Health & Science University.
“We’re competing with other states to see who can have an adequate work force,” he said, and evidence from other states indicates that the cost of defensive medicine definitely plays a role in whether physicians choose to work in certain areas. It’s not just training and loan forgiveness that makes a difference.
The Health Authority doesn’t intend to organize a work group on defensive medicine, said Dr. Bruce Goldberg, administrator. Once the consultants have finished their work, they’ll present their findings to the Health Policy Board, with recommendations readied for the February Legislature.
“We’ve had a number of work groups on this in the past,” he told the board. “Our goal is to carry out some analysis and work with expert consultants.” And, there’ll be sufficient time for stakeholders to share their expertise and opinions before those recommendations are finalized, he said.
The consultants are expected to look into the impact of malpractice caps on medical liability premiums; the benefits of binding and non-binding panels to examine malpractice claims; examine the exceptions and exemptions of the Stark laws, and placing a cap on damages to providers who participate in the Oregon Health Plan and other state-run programs.