A survey by the Gallop organization this summer found that 26 percent of all healthcare spending here is on unnecessary tests.
Georgia doctors ring up $15 billion annually in avoidable costs when they practice so-called defensive medicine to create evidence in case they are sued. Just in the state's Medicaid program, that amounts to $4 billion yearly that taxpayers swallow on top of their own elevated premiums, according to BioScience Valuation in a study sponsored by the Atlanta-based advocacy Patients for Fair Compensation.
"This is massive savings, something to be taken very seriously," said Charles R. Evans, vice chairman of Patients. "Certainly it should draw the attention of every state lawmaker grappling with fiscal uncertainty."
The latest proposal calls for establishment of a no-fault, patient-compensation system similar to state workers-compensation plans.
One hundred years ago, Wisconsin enacted the first state workers-compensation law when employers agreed to pay medical bills and wages without a court finding them at fault, and workers agreed to give up their right to file suit. Employers were required to purchase insurance to make guarantee the payouts.
Such a tradeoff in the medical arena would require doctors and hospitals to compensate victims without going to court, and patients would give up the right to pain-and-suffering awards. Their compensation would be granted by an independent panel based on national standards for specific injuries.
"We think we can increase the number of victims that are compensated and get them the money faster," said Kelly McCutcheon, president of the market-oriented think tank Georgia Public Policy Foundation.
Victims could still sue for cases of gross negligence -- like if a surgeon operated while drunk -- but those have a higher burden of proof than the preponderance of the evidence standard used today for most medical-malpractice cases.
Georgia followed other states like Texas and California in enacting a legal cap on pain-and-suffering awards at $250,000. Unlike those states, it did not pass a constitutional amendment, and the Georgia Supreme Court voided the caps as unconstitutional.
McCutcheon said no constitutional amendment would be needed for a patient-compensation system although others disagree.
The Texas caps slowed the rise in premiums doctors pay for their liability coverage, but they didn't improve the bills their patients received. Instead, Medicare spending there rose faster than the national average, according to the advocacy group Public Citizen.
Those results don't surprise Tom Baker, a University of Connecticut professor and author of "The Medical Malpractice Myth."
"There is lots of talk about the heavy burden that 'defensive medicine' imposes on health costs, but the research shows this is not true," he wrote. Unreasonably large jury verdicts aren't the cause of high liability premiums, malpractice is, he says.
Pushing the idea of patient compensation is Rick Jackson, founder of a network of health companies based in Atlanta that include staffing, outpatient clinics and medical-office software. He founded the Patients group, put his employees like Evans into its leadership posts and reportedly pours his money into it.
The organization tried to convince the Florida legislature to pass the proposal last year without luck.
So far, according to McCutcheon, no Georgia lawmaker has committed to introducing it as a bill here. But it could win support from Gov. Nathan Deal who once chaired a key health subcommittee in Congress. As a candidate in 2010, Deal blasted the Supreme Court for overturning Georgia's lawsuit caps.
Deal appointed Jackson to the Community Health Board, and the board's chairman, Ross Mason, complimented Jackson on the concept at his first meeting in August.
Mason said he and Jackson would not comment for this report because their board positions would imply the Department of Community Health formally endorsed the concept.
Fueling support is a survey released last week by Emory University Law School Professor Joanna Shepherd-Bailey of trial lawyers who say they reject 90 percent of the patients who ask them to sue. Their reasons aren't because the cases are weak but because the rewards won't be big enough.
"In fact, over half of the attorneys responded that, even for a case they are almost certain to win on the merits, they will not accept the case unless expected damages are at least $250,000," she wrote. "For a case that they are only slightly likely to win, the vast majority of attorneys require minimum expected damages of $500,000 to accept the case."
As a result, only about 1 in 100 patients who suffered from an avoidable medical accident wound up compensated.
A fast, inexpensive system that patients could use without having to hire a lawyer is the answer, according to McCutcheon.
"I think it's really a social-justice issue," he said.