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.  

UPDATE: The Wall Street Journal's Jacob Gershman reports that some of the supposed savings that Cuomo has proposed might not come to pass, or might be outweighed by spending increases tucked away in the legislation.  Concludes Gershman: 

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.