Hey Doctors, Let's Make a Deal

[Blue State Blues]

Let me be clear, I respect you. I know you work hard. You have to churn through patients every 15 minutes to pay the rent and the billing staff and people to help you to keep track of the approved procedures and approved prescriptions for each insurance plan you have a contract with, and to pay huge premiums for malpractice insurance.

And maybe it's because you can see the system isn't working any better for you than it is for your patients that 70 percent of you support some form of public option (and 10 percent of you support single payer). I applaud you, at least 70 percent of you (and 10 percent of you with enthusiasm).

But here's the thing, what I keep hearing is that you need tort reform to bring down costs. That the key to reducing healthcare costs in this country is to limit the amount of money that can be awarded to someone who has proven in a court of law that they have been harmed by malpractice. And that's where I can't agree.

I mean sure, I hate lawyers, you hate lawyers, everybody hates lawyers -- ambulance chasers, vultures, whatever we want to call them. It's an acceptable prejudice. It's a historic prejudice -- even Shakespeare hated lawyers -- and it's a prejudice we don't feel guilty about, right?

But why would we hate victims? It just seems wrong to limit the right of someone who has been hurt to seek justice through the court system.

But I also can't agree, because I don't believe that the occasional award to someone who now has a malpractice-caused pre-exising condition, someone who has lost a limb or a loved one because of gross negligence ... I don't believe that really is why your malpractice insurance premiums are so high.

According to http://washingtonindependent.com/62646/medical-malpractice-insurers-profits-higher-than-nearly-all-fortune-500-companies">this article, medical malpractice insurance companies have higher profits than nearly all other companies and are even more profitable and less accountable than for-profit health insurance companies.

And according to http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=103x31577">this article, after Texas capped malpractice awards, malpractice insurance premiums did not go down.

I think your problem is the same as my problem. You're being gouged by for-profit malpractice insurance companies, just like I'm being gouged by for-profit health insurance companies.

So here's my idea. What if we help each other? What if any doctor who accepts patients from the Public Option would qualify for a non-profit malpractice insurance system?

Win-win. You help me escape the corporations that are gouging me, I'll help you escape the corporations that are gouging you, and we all get a system that works better.

And as for those doctors who don't merely make an understandable mistake, the ones who are grossly negligent and missed the class that taught, "first, do no harm," let's encourage them to pursue other careers, such as politics, perhaps (http://crooksandliars.com/susie-madrak/did-you-wonder-why-boustany-gave-repu">not naming any names).

So what do you say?

[area51]

1. Nice.

:thumbsup:

[Lydia Leftcoast]

2. This is something I've wondered about

A commentator on a newspaper website (NYT?) noted that if ob-gyns are charged $200,000 a year for malpractice insurance and there are 40,000 ob-gyns in America, that's eight billion dollars in income.

Are there anywhere NEAR eight billion dollars worth of ob-gyn malpractice cases in the U.S. each year?

[postulater]

3. Sometimes the doctor does the job perfectly

and there is still a disastrous outcome.

This is not malpractice. It is implicit in the procedure that bad things happen sometimes.

When this happens, who suffers? Not the doctor, he just moves on to the next patient. Not the insurance company, they just raise the premium and kick out the person.

The patient is the one who suffers when a properly performed surgery goes bad. They may be permanently disabled and in pain forever. No recourse and now maybe excluded from insurance coverage to boot.

Not that malpractice doesn't exist, but what about these cases?

It would be interesting to see how many disastrous outcomes could be avoided if all procedures were categorized by risk of disaster and each procedure performed was required to be insured against disaster with the proceeds going to the disabled patient. This would quickly weed out risky procedures done by excellent doctors and would re-focus our health care on more preventive efforts that bear less risk.

Yes, malpractice happens and should be dealt with. But we should also deal with the occassional disastrous outcomes of properly performed procedures done by excellent doctors with no malpractice involved.

(This was brought to mind by a man who told me yesterday about his wife who was recently hospitalized with new onset seizures. They figured out the seizures were caused by uncontrolled hypertension that she didn't know about. The hypertension was brought on by pain drugs she was taking on top of the pain pump she was on for chronic back pain. The back pain was the result of a back surgery that didn't work, another one to remove the metal implants, and then a third surgery to put the metal back in because the second surgeon thought the first surgeon messed up. That was twelve years ago, she has been suffering ever since, and now develops seizures. None of this is malpractice, it's just 'the way things go with surgery'. Good surgeon, surgery done 'by the book'. And she was the unlucky recipient with no recourse.)

I'm just not sure that medical malpractice is as big a problem as disability and complications caused by properly done procedures gone bad.

[Blue State Blues]

6. I have to wonder

if sometimes judgements are found against doctors in cases like you describe simply because the victim of the procedure is left uninsurable as well as hurt. And I have to wonder if guaranteed universal healthcare would remove that (hypothetical) incentive to assign blame when it might not be warranted. I have no evidence, it's just a suspicion.

I also agree that there needs to be some kind of "no fault" program to help people who are left disabled or otherwise harmed by such complications when there was no gross negligence.

As you say, some procedures are higher risk than others. Some of the best hospitals in the country don't have the best patient outcome statistics, until to account for the fact that they take on the hardest cases. Doctors who take on the hardest cases shouldn't be penalized.

So, I agree, malpractice is a complicated issue. Of course it's more complicated than my original post indicated. But it's also far more complicated than the people who say, "tort reform is all we need," would indicate.

[Overseas]

4. K&R. I didn't realize malpractice insurance was so predatory.

I'd love to see doctors come on board to demand nonprofit malpractice insurance and let the general public know how they have been gouged by the privatized insurance.

[Overseas]

5. K&R. I didn't realize malpractice insurance was so predatory.

I'd love to see doctors come on board to demand nonprofit malpractice insurance and let the general public know how they have been gouged by the privatized insurance.