Saturday, February 26, 2011

New York Governor Andrew Cuomo joins the fight for Serious Medical reform--UPDATED

New York Governor Andrew Cuomo obviously means business when it comes to reducing his state's budget deficit, and its overall expenses.   As part of that effort, he is pushing to reduce Medicaid spending, and of course, any comprehensive review of such spending will have to include a targeting of costly malpractice litigation.   As explained in many places by many experts, including Walter Olson of the Cato Institute, much or most of the money being siphoned out of the healthcare system by trial lawyers spells no good for the healthcare system--it only damages the system and enriches trial lawyers.

So yes, Cuomo is absolutely right to seek to cap pain-and-suffering damages at $250,000, which could save $209 million a year--and every little bit, or not so little bit--of savings will help the newly inaugurated chief executive reduce a deficit estimated to be $11 billion.

And yet as the New York Daily News' Kenneth Lovett explains, Cuomo's meritorious effort is certain to be opposed by the Speaker of the New York State Assembly, Sheldon Silver.   Silver, who has led the Assembly since 1994, is a longstanding opponent of any kind of tort reform, for reasons not limited to his lucrative association with the buccaneering law firm of Weitz & Luxenberg, one of those law firms you see advertising on TV, angling for clients.    Here's a look at Silver in his legal oeuvre:

If the screengrab above, the words "ACT NOW!" are prominent--here's a closer look, at a blatant pitch for business:
So let's wish Cuomo luck in this effort--and take note of his courage, taking on a powerful constituency, not only in New York State, but within his own party.   After all, the tort bar is a linchpin of the Democratic Party's political and financial structure.   Yes, it's strange that the self-styled party of working people has also made room for millionaire and billionaire trial lawyers, but that makes it all the more impressive that Cuomo is doing what he is doing. 

If Cuomo succeeds, we might add, the effect could be to inspire similar efforts in other political jurisdictions.   And the result would be both lower healthcare costs and better medicine. Estimates of the cost of medical malpractice range from $55 billion to $200 billion.   Yet as noted here at Serious Medicine many times, the real cost of trial lawyers is not the cost of paying malpractice bills, it's the damage done to R&D.  

A big unanswered question is where the Cuomo administration will aim the scalpel if its savings projections fall short, which they are expected to do. Unless providers shrink costs on their own, Mr. Cuomo would have freedom to change rates, levy surcharges, and eliminate services—and choose which sectors would shoulder the burden.  

A reminder that the fiscal devil is always in the legislative details.  More than one politician has declared a target, and gotten credit for that target in the political here and now, and then arranged to be somewhere else when the reckoning for an unmet target came to be paid.  

Yet even so, Cuomo's malpractice reforms, which are the most relevant to the cause of advancing Serious Medicine, do seem to be real--real proposals, that is.   Now we must see whether Cuomo can prevail over Silver.

Thanks to Fred Siegel for this update. 


  1. There is no doubt that tort reform would elevate the level and quality of R&D as more funds would be directed to a more beneficial direction. I am a little incredulous of many legislative efforts that have never been passed. It might be the lobbyists, they are ultra savvy.

  2. It's not just the lobbyist, but the politicians themselves. Some are carrying water for the trial lawyers. Others, are so myopic and truly believe that the system only needs some tweaking. This is absurd. Even the president gave a weak not to tort reform in January's State of the Union Address. For a 'Ground Zero' view on medical malpractice abuse, see under Legal Quality. If your mind is open, and you read a few posts, you won't be supporting the status quo afterwards. Thanks for your post, James.

  3. “After all, the tort bar is a linchpin of the Democratic Party's political and financial structure. “
    Ah, James you almost got it all right! You forgot to mention the other linchpin: the Public Employees Unions. You know the ones FDR said should never exist and George Meany agreed with him.
    I’m a NYer.
    Sadly Serious Medicine loses in NY; Silver wins! He knows where all the bodies are buried, i.e. Donald R. Manes. He's J. Edgar Hoover incarnate in my view!

  4. Oh the poor physicians of the State of New York with their homes in Scarsdale, Great Neck and the Hamptons. Surely, we have to protect these people from pesky "trial lawyers" who represent ungrateful patients who suffer because negligent physicians take off the wrong limb, puncture their organs and tell them not to worry about that little lump on their breasts. Seriously folks $250,000 maximum for pain and suffering! For a young unmarried woman who will have to get a mastectomy because of a doctor who failed to diagnose breast cancer? For the construction worker with four kids who suffered for 8 months in the hospital fighting a sepsis infection? For the former marathon runner whose orthopedic surgeon cut off the wrong foot? That is ludicrous. This bill will do nothing to advance quality healthcare in this State. This is not a cost saving tool it is merely a ruse by the health care lobby to insulate themselves from carelessness. Don't believe the hype! If this law is passed the New Yorkers will be worse off.