Opinion ID: 1787098
Heading Depth: 1
Heading Rank: 14

Heading: The Cap Reduces the Practice of Defensive Medicine

Text: ś 302. The issue of whether doctors are less likely to practice defensive medicine is related to medical migration. Majority op., ś 172. The majority admits that an `accurate measurement of the extent of this phenomenon is virtually impossible,' then holds this difficulty against the legislature. Id., ś 173. ś 303. The majority cites three studies, all concluding that defensive medicine is difficult to measure because [f]indings about defensive medicine must be based on surveys of health care providers.... Majority op., ś 174. ś 304. It is true that physician surveys provide ample evidence of the existence of the practice of defensive medicine. However, the majority's assertion that such surveys are the only evidence of the practice is simply not correct. On the contrary, [a] large body of research has accumulated showing that medical malpractice liability causes doctors to practice defensive medicine. [73] Of course, the majority repudiates or ignores physician surveys attesting to the fact that more than three out of four (76 percent) doctors report that they practice defensive medicine. [74] However, scientific studies arrive at the same conclusion. ś 305. In 1996, a study jointly undertaken by Stanford University and the National Bureau on Economic Research employed mathematical models and statistical research over the years 1984-1990 to study the effect of medical malpractice reformâ particularly noneconomic damage capsâ on the practice of defensive medicine. Daniel Kessler and Mark McClellan, Do Doctors Practice Defensive Medicine?, 111 Quarterly J. of Econ. 353 (1996). The conclusion: Our analysis indicates that reforms that directly limit liabilityâ caps on damage awards, [75] abolition of punitive damages, [76] abolition of mandatory prejudgment interest, and collateral-source-rule reforms [77] â reduce hospital expenditures by 5 to 9 percent within three to five years of adoption, with the full effects of reforms requiring several years to appear. Id. at 386. [78] The study further found that if reforms directly limiting malpractice liability had been applied throughout the United States [between 1984 and 1990] expenditures on cardiac disease would have been around $450 million per year lower for each of the first two years after adoption and close to $600 million per year lower for each of years three through five after adoption, compared with nonadoption of direct reforms. Id. at 387. ś 306. Another recent study concluded that tort reform, including the imposition of damage caps, would result in between $9.3 billion and $16.7 billion in additional budgetary savings in 2013 from reduced defensive medicine. [79] The Joint Economic Committee estimates that the reduced cost of health insurance resulting from the reduction in defensive medicine practices would contribute to allowing an additional 1.6 million to 2.6 million Americans to afford health insurance. [80] ś 307. Similar studies are in accord. [81] ś 308. These conclusions, based on statistical analysis, obliterate the majority's vague assertions that the effects of defensive medicine either cannot be measured or do not affect health care costs. Majority op., ś 174. The legislature unquestionably had a rational basis to conclude that its enactment of the noneconomic damage cap would both keep physicians in Wisconsin and reduce the practice of defensive medicine.