Globe Editorial

GOP can streamline health law, improve malpractice system

November 7, 2010

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PRESIDENT OBAMA threw down the gauntlet Wednesday on Republicans’ cries for dismantling the health reform law passed this year. Do the Republicans, he asked, want to go back to letting insurers deny coverage to anyone with a pre-existing condition? Do the Republicans want to end the new law’s aid for the elderly caught in the Medicare doughnut hole on drug reimbursements?

Of course, the Republicans won’t take on these popular features of the law. Nor will they do away with the mandate on individuals to get coverage — the insurers insist on it in order to have enough healthy people in the insured pool to make it affordable to cover the less-than-healthy with preexisting conditions. Some Republicans talk about cutting funding for the reform. But the big outlays will not come until 2014 when the law goes into full effect. In the meantime, does the GOP really want to block, for instance, the $5 billion set aside to fund a high-risk insurance pool for the uninsured with pre-existing conditions until 2014 when private insurers have to cover them?

Still, there is a way for the Republicans to improve on the law — by strengthening its anemic effort to reform this country’s dysfunctional medical-malpractice system. The current system fosters costly defensive medicine, provides benefits to too few deserving victims of physicians’ mistakes, forces doctors in many specialties to buy high-premium insurance policies, and discourages the open reporting of treatment errors, even though such information could lead to genuine improvements in medical care.

Congressional Democrats, many of them beholden to lawyers who like the tort system as it is, made only a token effort to fix the malpractice morass. The law calls for just $50 million to finance tort-reform demonstration projects, and places limits on what these projects can offer as alternatives to lawsuits. Republicans should propose a much more robust program of resolving medical errors in ways that make patients whole and help the health care system become as mistake-free as possible.

While they are at it, Republicans could also find Democratic allies to deep-six a revenue-raising mechanism in the new law that only an accountant could love: the requirement starting in 2012 that all businesses submit a form to the IRS for every purchase of more than $600. Yes, this whole new level of paperwork could head off some tax-dodging, but it is not worth the trouble.

The health reform law is by no means perfect. But it does extend coverage to millions of Americans who have lacked it and ends some of the most abusive practices of the insurance industry. Republicans should use their new-found political clout to improve the law, not undo it.