When Dr. Jonathan Crane prescribes a certain medication for athlete’s foot he also orders an expensive battery of liver tests. It’s a precaution, the dermatologist says, and is considered the standard of care. The tests are also completely unnecessary, Crane says, but he orders them anyway because the risk of a lawsuit makes it necessary.

It’s an example of “defensive medicine,” and a result of too many malpractice suits. So when people talk about changing health care they need to also consider tort reform, he said.

Thursday night, Crane opened up his office, Atlantic Dermatology in Wilmington, to several local politicians and an audience of a few dozen people to discuss possible health care changes.

New Hanover County Commissioner Jason Thompson, state Rep. Daniel McComas,, R-Wilmington, and Will Breazeale, a Republican who plans to run as for the U.S. House of Representatives in 2010 attended.

The point, Crane said, was to discuss alternatives to current health care reforms and also encourage people to go online and study the proposed reforms.

“We don’t need to go in and wreck everything,” McComas said. “This is too complicated a problem, we need to take it step by step.”

Thompson said New Hanover County spends millions of dollars each year on health care. They pay for everything from transportation costs for taking Medicaid patients to doctors’ offices, and dental care for uninsured children, he said.

On the national level, Breazeale proposed a Fair Health plan in which health insurance companies would compete for government contracts to cover the uninsured. The costs would be through a sales tax on people without insurance.

Crane said tort reform and changes to the Food and Drug Administration are needed to drive down medical and drug costs.

Several doctors who attended said they worry some changes aren’t part of current proposals.

Dr. Victor Abraham, a urologist, said giving tax breaks to doctors who treat the uninsured might be a good start.

Dr. Hormoze A. Goudarzi, a local surgeon who favors a basic Medicare-type plan for everyone, said politicians need to sit down with insurance companies and come up with ideas.

“This is everybody’s problem,” he said. “This system will collapse unless we do something about it.”

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