Obama Open to Reining in Medical Suits
By SHERYL GAY STOLBERG and ROBERT PEARWASHINGTON — The American Medical Association has long battled Democrats who oppose protecting doctors from malpractice lawsuits. But during a private meeting at the White House last month, association officials said, they found one Democrat willing to entertain the idea: President Obama.
In closed-door talks, Mr. Obama has been making the case that reducing malpractice lawsuits — a goal of many doctors and Republicans — can help drive down health care costs, and should be considered as part of any health care overhaul, according to lawmakers of both parties, as well as A.M.A. officials.
It is a position that could hurt Mr. Obama with the left wing of his party and with trial lawyers who are major donors to Democratic campaigns. But one Democrat close to the president said Mr. Obama, who wants health legislation to have broad support, views addressing medical liability issues as a “credibility builder” — in effect, a bargaining chip that might keep doctors and, more important, Republicans, at the negotiating table.
Seriously, though…this should have come out of Friday, the traditional day for releasing avoidable stupidity. Because I HATE having to pull all this together at 6 AM.
Malpractice Costs Up 150% Since 1999, Hospitals Say
By THOMAS J. LUECKThe cost of medical malpractice insurance in New York City, Westchester County and on Long Island has risen by nearly 150 percent since 1999, creating severe financial strains that have limited patients’ access to such specialties as obstetrics and gynecology and made New York a "crisis state" for doctors, according to a report released yesterday by a hospital trade group.
The trade group, the Greater New York Hospital Association, which represents medical institutions in New York, New Jersey, Connecticut and Rhode Island, said its analysis had focused on 34 hospitals in and around New York City. On average, it said, the hospitals have been billed for malpractice premium increases of 27 percent a year for five years.
"The increasing cost of malpractice insurance has become a pressing burden for New York’s financially fragile hospitals," said Kenneth E. Raske, the association’s president.
Now, here’s the thing.
We need to remember the economic rationale behind law suits. You sue when someone fails and the cost of their failure doesn’t fall on them. A law suit shifts the burden to the responsible party. Punitive damages is for egregious failure, avoidable failure or intentional failure.
Now, how do you set a limit on the cost of failure before the failure occurs? How to you even set a value on the damage cause by, say, a child dying of brain damage?
There are cases that are purely punitive, and should be. Humans being human, of course, you have folks trying to game the system and I suppose folks feel limiting the amount to can receive in any settlement removes an economic incentive to do so. But if you’re actually concerned about health care rather than people who didn’t deliver the health care properly, the incentives are applied in the wrong place.
Since 2000, the number of insurers providing malpractice insurance to New York area hospitals has fallen to four from six, the association said. It said the New York insurers, compared with those in other states, had had some of the worst financial results, paying out $1.44 in claims for each dollar collected in premiums. And it said many of the nation’s largest malpractice awards, some exceeding $90 million, had occurred in New York City. Although such awards are routinely reduced before the cases are settled, the study listed huge settlements reached in recent years, including one for $50.1 million in Manhattan in 2002 and another for $10.6 million in Brooklyn in 2000.
If there’s so many failures you can’t afford to pay for them, you can pay less…or fail less. Insurance companies advertise about programs to improve your driving or fire safety you can implement in exchange for lower insurance rates. Why not do the same thing for hospitals? Give them the incentives to eliminate the factors that cause error (primary of which, in NYC anyway, is a critical understaffing of hospitals…talk to the union reps, they’ll have the figures at their fingertips). That way we get lower premiums AND better health care.
And that is what we want, right?





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I wonder why doctors are required to purchase malpractice insurance in the first place. Consider the fact that doctors (and nurses) cannot practice in any given state unless they are certified by that state. The state, by certifying them in the first place, is vouching for their competence. Why, then, does not the state in question deal with claims of malpractice DIRECTLY by having an oversight committee (of disinterested consumers, NOT fellow doctors) investigate, and take punitive action if necessary? Seems to me that the malpractice insurance company is just a way to outsource the responsibility to a for-profit corporation. Sort of like hiring Haliburton to feed and supply our troops in Iraq.
Here’s another point. In countries which have universal, single-payer healthcare, there does not appear to be any tort law regarding bad birth outcomes (as far as I can find. If someone has better info on this, please contact me, I really want to know!). But then, if a kid is born with a medical problem (and most often, this has nothing to do with the attending practitioner’s competence…it’s just a case of Nature screwing up, which Nature does from time to time), the parents don’t have to SUE someone in order to get the cash to cope with the problem, which is about what they MUST do here in our charming protection-racket for-profit system of health “care.” They GET the care they need, period. Of course, there’s a lot of tort lawyers they’re not employing. Right? This is a major reason for universal, single-payer healthcare. Think how much cheaper health care would be if all we had to pay for was comfy salaries for doctors to just do their jobs with 40-hour weeks. Furthermore, this country has WAY too many OBs in the first place; we could train armies of midwives for a fraction of the cost and get better outcomes too, which would net us additional cost savings. We would be much better off–our c-section rate would be less than half of what it now is–if we just kept OBs and anaesthesiologists for obstetrical cases which actually warranted surgical intervention, and let independent midwives be the primary maternity care clinicians, as they ARE in many countries which have much better birth outcomes than the U.S. does. (In the Netherlands, for example, independent midwives are primary maternity care clinicians, their services are free, and at least 30% of births take place in homes; their c-sec rate is a third of ours and their birth outcomes are MUCH better than ours. If you elect to birth in a hospital without a medical indication for doing so, you have to pay out-of-pocket. Oh yes, and moms get a week of FREE “home-help” for the first week after the birth.) Part of this NY malpractice insurance cost problem is that independent midwifery is a felony in NY right now, so unless moms can find midwives working “under the table” or have the gumption to give birth at home unattended, they HAVE to go to OBs, whom the hospitals pressure to do as many c-secs as possible (because it pays so much more than vaginal birth, you see), which creates a lot of (unnecessary) morbidity and mortality (as c-sec DOES when it’s over 15%–and right now it’s well over 30%), which creates a lot of disgruntled clients, as well it should. All of which would be eliminated by having a universal, single-payer healthcare system, if only because once the POINT of health care is to produce and/or maintain health (rather than to rake in cash), once health care dollars become LIMITED, then the people in charge have to actually look at how much they’re spending, and what they’re spending it ON, and decide whether or not that’s the best, most productive, cheapest way of allocating those dollars. Under our current system, the insurance companies charge whatever they feel like for premiums, and then when a lot of people can’t afford those premiums, they scream “LOOK, nobody can afford health CARE!” as if health CARE and health INSURANCE were the same thing (which it isn’t, which you well know if you’ve ever tried to get insurance to pay for anything). Then the politicans scramble and pull strings and raise our taxes to pay for health INSURANCE to get a few more spot-lit groups “covered,” and pat themselves on the back for improving health CARE, but all they really did was soak us some more to improve the bottom dollar for health INSURANCE companies… even if you CAN afford health insurance in this country, your premium is inflated to pay for all those medically-unnecessary c-sections which the OBs are doing to increase their hospitals’ bottom line.