January 22, 2003 -- more on malpractice

 

 

More in medial malpractice

Bush is preparing his State of the Union speech to be delivered
January 28th.  Along with defense of the
Iraq invasion and not taxing
corporate dividends, the speech will also call for an initiative
capping medical malpractice awards.
http://www.ktul.com/news/stories/0103/70525.html

Bush opened the current attack on medical malpractice suits in a
highly publicized speech at a hospital in
Scranton PA, last week, in
which he blamed excessive awards and frivolous malpractice suits for
increasing cost and decreasing accessibility of healthcare.  Bush
played to a receptive audience of administrators, since the hospital
had recently been sued by the widow of a man who died following
placement of a breathing tube in his esophagus rather than his
windpipe, and not making the routine checks to insure correct
placement.  His medical records were then altered to hide the facts.
http://www.centerjd.org/press/release/030115.pdf


The issue is coming to a head now because malpractice insurance
companies are raising their premiums at an alarming rate, particularly
for obstetricians and neurosurgeons.  Malpractice insurance companies
are losing money, not because claims are increasing, but because their
stock investments have gone bad.  The increased premiums have driven
some doctors out of practice, but for big sections of business and
government
this is not a problem, since they say there's an oversupply
of docs anyway.

"Tort reform," severely capping medical malpractice suits, especially
punitive awards, has long been a high priority for all of the medical
establishment
, from conservatives (Bush, the health insurance
industry) to mid-roaders (the AMA) to liberals (the
Institute of
Medicine
, Robert Wood Johnson Foundation.)  Is something wrong with
malpractice suits?

Just on the face of it, one realizes that everyone, even good doctors,
makes mistakes sometimes, and it seems unfair to sue on that basis.
And it's also true that there are very bad doctors who are extremely
difficult to get rid of, or even find out about, who are undeterred by
malpractice suits.

But we need to look at a bigger picture.  There are up to 98,000
deaths per year from medical mistakes.  A large percentage of these
mistakes are caused by hospital policy decisions such as speedup,
understaffing, 100-hour work weeks for docs in training, too few beds,
and use of under-trained workers in direct patient care or important
behind-the-scenes tasks.

Other mistakes result from the fragmented structure of healthcare,
such as the  fragmentation of a patient's care between different
institutions, or between health workers whose duties have been
narrowed down to permit using cheaper workers, or between different
private doctors who function largely as independent operators.
Patient's information gets spread out over different locations,
providers are too rushed for adequate charting, and hospitals
under-staff medical records.

There are a multitude of reasons mistakes get made, but most of them
are profit-driven, either by reducing costs, or by sending patients
through a maze of different channels, each of which takes its cut.
Given all this, it's hardly surprising that many mistakes occur.  Yet
rather than fix healthcare to make it safe, the system exchanges money
for lost health or lost lives. And now the President of the
United
States
blames US for being greedy and litigious.

Forgetting bad outcomes where no mistake is involved, only one in
eight cases of mistakes even make it to court, and only one in 16 get
awards.  Malpractice claims have not risen; if anything, they have
decreased.  Most importantly, malpractice claims account for only one
half
of one percent of health costs.  The healthcare system saves
billions by tolerating dangerous conditions and absorbing relatively
few malpractice claims  rather than revamping the system to make it
safe.  http://www.centerjd.org/MediaGuide.pdf


Why then, if malpractice claims are such a small part of healthcare
costs, is the medical industry and government so desperate  to get
"tort reform?"

I believe the reason "tort reform" is being pushed is NOT to limit
lawsuits against the present levels of medical injuries and deaths.

I believe that in the future, because of rising health costs, reduced
health benefits for workers, rising budget deficits, rising
unemployment, the aging population, and continuing warfare, business
and government plan huge health cuts, that would cause many more
injuries and deaths.  It is this flood of  future malpractice suits
that they want to protect themselves from.