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December 24, 2003

Dean on MalPractice: Then and Now

Dean no doubt has changed his positions on some issues, but there's a bit of a media/conservative drumbeat to argue that he has somehow betrayed "centrist" positions for leftwing ones now. But the reality is that then and now, he's actually maintained pretty nuanced positions that only selective focus and quoting makes to seem extreme one way or the other.

Take medical malpractice: I saw this 1988 Dean letter to the editor back when he was a doctor complaining about medical malpractice:

I have long maintained that until the legal profession and the news media are also afflicted with the increasingly severe consequences of a tort system that benefits few people outside the legal profession, there will be no return to a fair and reasonable system of justice.

The trends toward lawyers suing one another for malpractice and toward outrageous-size punitive damages in libel cases give me hope that the crisis in our tort system may finally come to the attention of those who can make this a public issue and improve the situation for all of us who require liability insurance to do business.

Complaining about stupidities in the court tort system has never been the exclusive preserve of conservatives. Only their solution of terminating the rights of those injured is exclusive to conservatives dancing to the tune of insurance companies and medical corporations.

So what is Dean's position now? From his blog:

I understand the concerns doctors have with medical malpractice system. Faced with rapidly increasing insurance premiums, doctors are avoiding certain specialties, and many are leaving the medical profession altogether. This isn’t good for patients or for the American health care system generally.
So not much change in his concern about the problem.

But where he (and most progressives) differ from conservatives is on the solution:

access to the courts is a fundamental civil right for all Americans, and many patients receive compensation for their injuries through the justice system.

We need a medical malpractice system that works for both doctors and patients. Patients and their families should have recourse to legal remedies if they suffer injuries and are wronged. Doctors shouldn’t be run out of business by soaring premiums or spend countless hours defending frivolous lawsuits...

support state efforts to discourage frivolous lawsuits while still holding the health care system accountable for its mistakes. For example, I believe that many malpractice actions can be resolved through mediation or pre-trial expert panels. Maine has enacted a sensible reform under which malpractice litigants must submit to a non-binding pre-litigation review. The review weeds out frivolous lawsuits without depriving real malpractice victims of the right to be compensated.

Look at that example-- the focus is on knocking frivolous lawsuits out of the system while allowing real victims full access to the courts.

What's the conservative solution? Capping the compensation for ALL lawsuits, whatever the injury or fault of the doctor or hospital or HMO involved. Such attacks on malpractice lawsuits has nothing to do with reform and everything to do with increasing profits for corporate medicine.

Dean will get quoted on all sorts of positions-- complaining about the runaway costs of Medicare in the past, medical malpractice, whatever. And usually in every case, his diagnosis of the problem then was accurate and his position is probably not that different. On Medicare in the past, he argued that given the choice between slashing federal money for the poor and adjusting medical benefits for the well-off elderly, he'd choose the latter.

The real question in evaluating his politics is what solution he promoted or promotes to solve the problem. Then and now, whether you agreed with his specific position, Dean usually took and takes a pretty reasonable position, neither the caricature of deviant conservative or wild-eyed liberal.

Posted by Nathan at December 24, 2003 01:55 PM