I tend to be independent, and somewhat libertarian. I tend not to be associated with a political party. However, this issue seems to be divided along party lines.
Victims' award limits killed
We have double-digit inflation in health care in a nearly deflationary economy. Physician malpractice premiums have gone up so much that some specialties (such as obstetrics) are in crisis mode (yearly premiums in multiple hundreds of thousands per MD per year). Many doctors are leaving the profession. Some areas are losing their physicians altogether. Malpractice insurance premiums get passed on down to the consumer, so we all pay for this. Devices that cost x amount for animals will cost 10x for humans because of the "liability" costs that manufacturers must build into the total price.
In a functional quality improvement/assurance process, all errors are documented and the system responds. In today's litigeous environment, any documentation of a medial "problem" is fodder for ambulance-chasing lawyers. If it's quality people want, you will not get it when hospitals, doctors, pharmaceutical companies, and medical device makers are hiding their mistakes.
The only winners here are the trial lawyers. We have no shortage of lawyers... We have too many of them in government - protecting their interests. And the trial lawyers have too much influence in government. This isn't about helping Mrs. Jones - it's about money. It's Sutton's law - you rob the banks (or healthcare system) because that's where the money is. Mrs. Jones would be better off in a system where errors are prevented in the first place.
Please, find a way to express your anger to your local representative. Any and all good ideas would be appreciated by those who represent you.
- Bill
Political opinion - medical malpractice
Moderator: Available
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
-
Gene DeMambro
- Posts: 1684
- Joined: Sat Dec 12, 1998 6:01 am
- Location: Weymouth, MA US of A
-
Le Haggard
- Posts: 116
- Joined: Fri May 02, 2003 3:38 am
- Location: Ballard area of Seattle, Washington State
While I'm outraged at the cost of medical care, I also don't share the "protect the doctors" attitude. My focus is and has always been on getting health care for all the citizens rather than allowing medicine to continue as a profit industry. I'm definately against libertarianism. (And it's my right to lobby against it as an American. No particular political party stance is promoted or protected by the Constitution.)
I just think there is a huge problem when the NBC news reported this morning the cost of $4BILLION per month (or was it week?) to maintain an occupation in Iraq (where I don't think we should be) for the next 2-4 YEARS at a minimum when we have people in the US going hungry, without medical care, without housing... All while the government rapes the education system's funding too in order to pay for their war machine.
No flames please...Just my objection to helping the rich get richer while letting the rest starve. My Solution? Find a way to make Socialized Medicine work and stop spending U.S. Dollars on others before our own citizens.
Le'
I just think there is a huge problem when the NBC news reported this morning the cost of $4BILLION per month (or was it week?) to maintain an occupation in Iraq (where I don't think we should be) for the next 2-4 YEARS at a minimum when we have people in the US going hungry, without medical care, without housing... All while the government rapes the education system's funding too in order to pay for their war machine.
No flames please...Just my objection to helping the rich get richer while letting the rest starve. My Solution? Find a way to make Socialized Medicine work and stop spending U.S. Dollars on others before our own citizens.
Le'
-
Dana Sheets
- Posts: 2715
- Joined: Mon Feb 25, 2002 6:01 am
There are short-term and long-term fixes.
Efficiencies in the current medical system must be found in the short-term. There is simply no way for the costs to keep increasing at the rate they are increasing. Socializing medicine represents a process that ain't all that easy and has huge potential problems. Have the federal government decide what health care should look like for all Americans may not be a good idea. Different states have very different health needs and messages -- the bigger the manager of a plan, the harder it is to tailor to the needs of the unique users.
Additionally, if we did socialize healthcare we could accelerate immigration into this country. We have some of the most advanced health care practices in the world which are therefore some of the most costly...add an extra few million people a year and who's going to pay???
The national budget is already almost 85% fixed on entitlement spending (medicare, medicaid, and social security) there isn't that much left over. Yes the current war cost the equivalent of our current deficit, but we can't leave the Iraqi people hanging now that we've gone in an turned their conuntry upside down -- we owe them one.
Bill isn't exaggerating that the cost of liability drives up the cost of medical care. Actually, it drives up the cost of everything we buy - from cars to toothpaste. So liability costs need to also be managed.
What I'm trying to say is that there isn't a simply quick fix answer like "socialize healthcare" or "privatize" out there. Anything we do is going to have to be phased in over time and careful attention must be paid to how much cost burden we want to place with the federal government and how much control.
Worst case scenario in my mind: the extreme conservatives get control of the federal gov't after socialized medicine and all abortions are outlawed, contraception is made illegal, and you don't get to choose your doctor. The US Fed becomes one big HMO where preventive care declines so that everyone has access to a lower standard of care.
While is idea won't be welcome by many -- I think it's important to start requiring businesses to cover all their employees - part-time or full-time with health care benefits. The pressure from the business community would force the health care industry to lower their costs. Yes - it would be a huge burden to small business owners - but that is where the Fed could step in and subsidize the healthcare for the employees of small businesses.
The pro of the law suit award caps is that big health companies would be able to track and predict their pay-outs on an annual basis. They wouldn't need as much liability insurance because, based on averages, they would know how many mistakes would be made by people giving care each year. It's silly to think we can eliminate error in medicine - but a key way to drive down cost would be to make those costs predictable for the companies that incur them.
There is no "just one right answer" to this question. The solution must be a process of incremental change that is constantly evaluated and updated based on the outcomes.
...end of rant...
Dana
Efficiencies in the current medical system must be found in the short-term. There is simply no way for the costs to keep increasing at the rate they are increasing. Socializing medicine represents a process that ain't all that easy and has huge potential problems. Have the federal government decide what health care should look like for all Americans may not be a good idea. Different states have very different health needs and messages -- the bigger the manager of a plan, the harder it is to tailor to the needs of the unique users.
Additionally, if we did socialize healthcare we could accelerate immigration into this country. We have some of the most advanced health care practices in the world which are therefore some of the most costly...add an extra few million people a year and who's going to pay???
The national budget is already almost 85% fixed on entitlement spending (medicare, medicaid, and social security) there isn't that much left over. Yes the current war cost the equivalent of our current deficit, but we can't leave the Iraqi people hanging now that we've gone in an turned their conuntry upside down -- we owe them one.
Bill isn't exaggerating that the cost of liability drives up the cost of medical care. Actually, it drives up the cost of everything we buy - from cars to toothpaste. So liability costs need to also be managed.
What I'm trying to say is that there isn't a simply quick fix answer like "socialize healthcare" or "privatize" out there. Anything we do is going to have to be phased in over time and careful attention must be paid to how much cost burden we want to place with the federal government and how much control.
Worst case scenario in my mind: the extreme conservatives get control of the federal gov't after socialized medicine and all abortions are outlawed, contraception is made illegal, and you don't get to choose your doctor. The US Fed becomes one big HMO where preventive care declines so that everyone has access to a lower standard of care.
While is idea won't be welcome by many -- I think it's important to start requiring businesses to cover all their employees - part-time or full-time with health care benefits. The pressure from the business community would force the health care industry to lower their costs. Yes - it would be a huge burden to small business owners - but that is where the Fed could step in and subsidize the healthcare for the employees of small businesses.
The pro of the law suit award caps is that big health companies would be able to track and predict their pay-outs on an annual basis. They wouldn't need as much liability insurance because, based on averages, they would know how many mistakes would be made by people giving care each year. It's silly to think we can eliminate error in medicine - but a key way to drive down cost would be to make those costs predictable for the companies that incur them.
There is no "just one right answer" to this question. The solution must be a process of incremental change that is constantly evaluated and updated based on the outcomes.
...end of rant...
Dana
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Interesting...
Before going further, please read the following well-researched publication from the Department of Health and Human Services.
Addressing the medical malpractice insurance crisis.
Health Policy Studies Division
Contact: Emily V. Cornell...
December 5, 2002
Worth quoting...
Before going further, please read the following well-researched publication from the Department of Health and Human Services.
Addressing the medical malpractice insurance crisis.
Health Policy Studies Division
Contact: Emily V. Cornell...
December 5, 2002
Worth quoting...
...and...Jury awards in medical malpractice claims jumped 43% in one year - from $700,000 in 1999 to $1 million in 2000.
Hmmm... so where did all that money go?In theory, the tort system is designed to compensate those who have been injured, and prevent further injury to others. However, whether the tort system does either is arguable. In reality, medical malpractice claims are expensive to pursue, can take years to resolve, and can result in the injured party receiving little of the settlement.
- BillIn some states, medical liability insurance carriers are getting out of the market, leaving a few carriers with very high rates, or no carriers at all. The insurance carriers that remain are quoting physicians rates double or triple those of the previous year. ... The loss of affordable medical malpractice insurance for providers could eventually turn into a loss of affordable, accessible healthcare, especially for high risk medical specialties such as obstetrics or neurosurgery, or in communities that are considered medically underserved.
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
I was in virginia at UVA when that baby swapping case came thru. One woman got in a paternity dispute with her man and they found out the kid wasn't either of theirs; it had been inadvertantly switched* with another baby who was in the nursery at the same time. She went on something of a rampage whining that having found out the kid she liked just fine wasn't hers, and learning there was a biological kid of hers being raised by someone else, was such a huge trauma she needed a multimillion dollar settlement. Well boo f**king hoo... She gets to take part in the raising of two kids now. She was at one point having her custody of the nonbiologic kid being questioned, and was on camera outside the courthouse laughing her butt off about something. Then she demanded to have custody of both, although she didn't seem to be that invested in the first. I just cannot fathom how this error and the relatively minor trauma it caused her is worth a million, much less many millions. Simply put, this was a woman from little means sucking way too hard at our society's teat of entitlement. It makes NO sense to claim she was a couple million dollars harmed by this occurance, and it makes NO sense to punish a nonprofit organization whose goal is to help people by making it provide this nincompoop with a mansion.
Also there, heard of a patient who was uninsured who got a VERY good cardiac surgeon to do his case for FREE and then had a less than optimal outcome (this is what you risk when you have your chest opened, fees paid or no) and then SUED the charitable soul.
Since, I've seen authentic medical disasters unfold. A routine procedure (thoracentesis, needle in the chest to drain off fluid) leading to, in various cases, a ruptured lung requiring a chest tube (guy thought it was the best thing that had happened to him, had never breathed better), or a lacerated spleen (required emergent surgery; lost some of her immune system to it but accepted the sincere apologies offered her by everyone involved and understood the risk going in) or lacerated liver (lead to a disastrous 4 month hospital course with cardiac arrests, brain damage, multiple infections, etc--same thing--family knew the risk going in and accepted apologies).
Then there's the little girl who snuck into our country for the medical care, got the wrong organs at Duke, got sick, got more organs when she shouldn't have, and will likely end up having earned her parents millions even though she would have died at home. I'm not saying no settlement is in order, but I smell vengeance in some of these larger ssettlements. Does that help the girl? The hospital? The family? The other patients? No.
Fact is people get sick and people die--mortality is stuck at 1 per person. Life is tough. Having bad luck or a bad outcome does not entitle you to unearned wealth!! I am revolted by the idea that people have a right to a good outcome and by people who have used threats of lawsuits, for example, to have many-thousand dollar procedures done on patients for no good reason (no benefit expected or delivered) who were almost unconscious due to their terminal brain cancer.
That said, it's astonishing how much slop there is in medical work. There was a recent study where charts were reviewed and people weren't getting an indicated treatment about half the time. There are often reasons, ranging from cost to patient noncompliance to other concerns being prioritized. But the safety standards are poor. If airplane mechanics had our standards, planes would be dropping from the sky left and right.
There needs to be a system of checks and reviews on the care people receive including MD reminders and treatment protocols. For example, if you come in with a heart attack, a physician should, in my mind, be required to either provide an aspirin, a betablocker, an ace inhibitor, a cholesterol lowering drug, and in some cases other medications, or specifically list contraindications, as these are established and proven lifesaving therapies. I would love to see this done but the reality is nothing will ever be truly required... MD's will gripe about their autonomy.
The trouble is if that autonomy is based on inaccurate perceptions or out of date learning, patients suffer. Prescribing those betablockers, for example, correlates directly with year of graduation from med school--the younger doctors have heard it emphasized more, they do it more. Meanwhile I knew a physician who didn't read or didn't "like" the research on heart failure and was still treating it with drugs that were clearly and definitively WRONG for the condition--he "liked" to use them for it. That is not an autonomy I could ever support. I myself have lost a handful of patients who INSIST on anitibiotics for viral conditions even though they don't help, have costs, have side effects, and cause antibiotic resistance. Other doctors are HAPPY to please the individual patients and spoil these drugs and raise costs for all of us. Still other doctors insist on using one of the world's most heavily advertised drugs, Norvasc, for high blood pressure, despite findings and recommendations that repeat OVER and OVER and OVER that an unadvertised, very cheap ($1 vs $60) drug called hydrochlorothiazide does a BETTER job.
If physicians can't autonomously do their jobs properly I say we should not be allowed to function autonomously. Standards should be set and enforced, with flexibility for doctors to alter the usual for special circumstances. Incidentally, switching people to cheaper generics against the impulses of their phsyicians would go a long way towards helping to lower costs.
Anyone who concentrates on protecting patients by supporting gazillion dollar settlements for a miniscule population without doing concrete things like standard setting... well, it's like kicking 20 homeless kids on the way to a rally to prevent very infrequent late term abortions. They've been watching too much television. We need to sit down as a country and set some sane limits about what we're going to do for people. Treating pneumonia after pneumonia after kidney failure is not really helping our demented elders, and it's fabulously expensive. Flailing away at rapidly terminal late stage cancers for another month of suffering is just not worth it. We need to make honest decisions about how we can help our patients the most with the resources we have.
On reread, this is a harsh post with a lot of unadorned opinions... but I haven't seen platitudes solve our healthcare mess yet. For perspective I've stayed up many nights studying or working when I didn't have to, and I spend far more time answering questions and discussing things with people than most, and I've fought hard for people that everyone else had given up on, when I thought it was in the patient's best interests. I have a distaste for the way these issues are sometimes warped by politicos because of my involvement at the bedside and practical level.
*the local word was that evidence emerged that the two families knew each other before the babies got "swapped" by the "hospital;" this wasn't played up by the hospital in question--publicity reasons?
Also there, heard of a patient who was uninsured who got a VERY good cardiac surgeon to do his case for FREE and then had a less than optimal outcome (this is what you risk when you have your chest opened, fees paid or no) and then SUED the charitable soul.
Since, I've seen authentic medical disasters unfold. A routine procedure (thoracentesis, needle in the chest to drain off fluid) leading to, in various cases, a ruptured lung requiring a chest tube (guy thought it was the best thing that had happened to him, had never breathed better), or a lacerated spleen (required emergent surgery; lost some of her immune system to it but accepted the sincere apologies offered her by everyone involved and understood the risk going in) or lacerated liver (lead to a disastrous 4 month hospital course with cardiac arrests, brain damage, multiple infections, etc--same thing--family knew the risk going in and accepted apologies).
Then there's the little girl who snuck into our country for the medical care, got the wrong organs at Duke, got sick, got more organs when she shouldn't have, and will likely end up having earned her parents millions even though she would have died at home. I'm not saying no settlement is in order, but I smell vengeance in some of these larger ssettlements. Does that help the girl? The hospital? The family? The other patients? No.
Fact is people get sick and people die--mortality is stuck at 1 per person. Life is tough. Having bad luck or a bad outcome does not entitle you to unearned wealth!! I am revolted by the idea that people have a right to a good outcome and by people who have used threats of lawsuits, for example, to have many-thousand dollar procedures done on patients for no good reason (no benefit expected or delivered) who were almost unconscious due to their terminal brain cancer.
That said, it's astonishing how much slop there is in medical work. There was a recent study where charts were reviewed and people weren't getting an indicated treatment about half the time. There are often reasons, ranging from cost to patient noncompliance to other concerns being prioritized. But the safety standards are poor. If airplane mechanics had our standards, planes would be dropping from the sky left and right.
There needs to be a system of checks and reviews on the care people receive including MD reminders and treatment protocols. For example, if you come in with a heart attack, a physician should, in my mind, be required to either provide an aspirin, a betablocker, an ace inhibitor, a cholesterol lowering drug, and in some cases other medications, or specifically list contraindications, as these are established and proven lifesaving therapies. I would love to see this done but the reality is nothing will ever be truly required... MD's will gripe about their autonomy.
The trouble is if that autonomy is based on inaccurate perceptions or out of date learning, patients suffer. Prescribing those betablockers, for example, correlates directly with year of graduation from med school--the younger doctors have heard it emphasized more, they do it more. Meanwhile I knew a physician who didn't read or didn't "like" the research on heart failure and was still treating it with drugs that were clearly and definitively WRONG for the condition--he "liked" to use them for it. That is not an autonomy I could ever support. I myself have lost a handful of patients who INSIST on anitibiotics for viral conditions even though they don't help, have costs, have side effects, and cause antibiotic resistance. Other doctors are HAPPY to please the individual patients and spoil these drugs and raise costs for all of us. Still other doctors insist on using one of the world's most heavily advertised drugs, Norvasc, for high blood pressure, despite findings and recommendations that repeat OVER and OVER and OVER that an unadvertised, very cheap ($1 vs $60) drug called hydrochlorothiazide does a BETTER job.
If physicians can't autonomously do their jobs properly I say we should not be allowed to function autonomously. Standards should be set and enforced, with flexibility for doctors to alter the usual for special circumstances. Incidentally, switching people to cheaper generics against the impulses of their phsyicians would go a long way towards helping to lower costs.
Anyone who concentrates on protecting patients by supporting gazillion dollar settlements for a miniscule population without doing concrete things like standard setting... well, it's like kicking 20 homeless kids on the way to a rally to prevent very infrequent late term abortions. They've been watching too much television. We need to sit down as a country and set some sane limits about what we're going to do for people. Treating pneumonia after pneumonia after kidney failure is not really helping our demented elders, and it's fabulously expensive. Flailing away at rapidly terminal late stage cancers for another month of suffering is just not worth it. We need to make honest decisions about how we can help our patients the most with the resources we have.
On reread, this is a harsh post with a lot of unadorned opinions... but I haven't seen platitudes solve our healthcare mess yet. For perspective I've stayed up many nights studying or working when I didn't have to, and I spend far more time answering questions and discussing things with people than most, and I've fought hard for people that everyone else had given up on, when I thought it was in the patient's best interests. I have a distaste for the way these issues are sometimes warped by politicos because of my involvement at the bedside and practical level.
*the local word was that evidence emerged that the two families knew each other before the babies got "swapped" by the "hospital;" this wasn't played up by the hospital in question--publicity reasons?
--Ian
-
gmattson
- Site Admin
- Posts: 6073
- Joined: Wed Sep 16, 1998 6:01 am
- Location: Lake Mary, Florida
- Contact:
How does a caring physician remain in the "system"
As a new doctor, you must butt heads with the "establishment" quite often. How do you fit in with old guard?
GEM
"Do or do not. there is no try!"
"Do or do not. there is no try!"
-
Ted Dinwiddie
- Posts: 537
- Joined: Thu Sep 16, 1999 6:01 am
- Location: Charlottesville,VA,USA
Ian,
We need more honesty in general. I pray that someone of your obvious ability and forthright approach is not crushed under the weight of the "old Boys" fraternity that pervades the professions in this country. Being right and being able to prove it are not enough. When a spouse's jewelry, living in the "right" neihborhood, belonging to the "right" clubs, ... ad nauseum is threatened by the right approach born of well informed common sense, well... Money is what everything comes back to in our world, right and wrong are completely relative.
You can't expect some old guy to give up his golf, or his ski trip to keep up with modern advancements. You can't expect Senior Engineers to actually review what the younger guys are doing. Heck, then they'd have to give up their nights and weekends, too.
So many of these professions are filled with nest-padding, greed-beings that honest achievement of real objectives is nigh on impossible. If you're lucky, it's three steps forward, two steps back. Most aren't lucky.
I'll stop now.
We need more honesty in general. I pray that someone of your obvious ability and forthright approach is not crushed under the weight of the "old Boys" fraternity that pervades the professions in this country. Being right and being able to prove it are not enough. When a spouse's jewelry, living in the "right" neihborhood, belonging to the "right" clubs, ... ad nauseum is threatened by the right approach born of well informed common sense, well... Money is what everything comes back to in our world, right and wrong are completely relative.
You can't expect some old guy to give up his golf, or his ski trip to keep up with modern advancements. You can't expect Senior Engineers to actually review what the younger guys are doing. Heck, then they'd have to give up their nights and weekends, too.
So many of these professions are filled with nest-padding, greed-beings that honest achievement of real objectives is nigh on impossible. If you're lucky, it's three steps forward, two steps back. Most aren't lucky.
I'll stop now.
ted
"There's only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." - P.J. O'Rourke
"There's only one basic human right, the right to do as you damn well please. And with it comes the only basic human duty, the duty to take the consequences." - P.J. O'Rourke
-
Gene DeMambro
- Posts: 1684
- Joined: Sat Dec 12, 1998 6:01 am
- Location: Weymouth, MA US of A
Remember, these "anti-social" lawsuits start with a physician (or nurse or pharmacist or whomever...) not doing their job correctly. They didn't fulfill a duty to provide acceptable care. The plaintiff never wins a lawsuit for professional or medical negligence if no duty existed, or if that duty was met. Period.I, too, am apalled by these anti-social law suits. I can't even add anything. They're just ridiculous and disgusting.
See what I mean? The treating physician fulfilled his/her duty to inform the patient of the risks of the particular medical procedure involved. Sounds like good care to me. And it took a lawsuit for this concept to be beaten into the heads of physicians, who never took patient autonomy seriously until they started loosing big money.or a lacerated spleen (required emergent surgery; lost some of her immune system to it but accepted the sincere apologies offered her by everyone involved and understood the risk going in) or lacerated liver (lead to a disastrous 4 month hospital course with cardiac arrests, brain damage, multiple infections, etc--same thing--family knew the risk going in and accepted apologies). (emphasis added)
Did the patient win? What were the grounds for the suit? What duty did the patient allege the doctor violated? It all starts with "What duty must the doctor (or nurse or pharmacist or whomever...) meet?".Also there, heard of a patient who was uninsured who got a VERY good cardiac surgeon to do his case for FREE and then had a less than optimal outcome (this is what you risk when you have your chest opened, fees paid or no) and then SUED the charitable soul.
Doctors (or nurses or pharmacists or whomever...) are not in the business of making "moral judgemens" regarding the "social worth" of patients. Is it your contention that because the patient was an illegal, she is allowed a lower standard of care?Then there's the little girl who snuck into our country for the medical care, got the wrong organs at Duke, got sick, got more organs when she shouldn't have, and will likely end up having earned her parents millions even though she would have died at home.
No, but having the doctor verify the donor's and the recipient's blood types would have helped her.Does that help the girl?
Well, now they know to verify the donor's and the recipient's bllod types more closely from now on, don't they?The hospital?
I'd be willing to bet this type of error doesn't happen at Duke again, as a direct result of this.The other patients?
Therefore, is it:I would love to see this done but the reality is nothing will ever be truly required... MD's will gripe about their autonomy.
(a) Cap malpractice awards, and allow doctors (and nurses and pharmacists and whomever...) to continue to practice as before (by Ian's observation filled with all kinds of slop)
OR
(b) Change the way health care is practiced to clean up the "slop there is in medical work", ergo reducing the number of lawsuits, as care rises?
Well, thet's precisely what the physician's and insurance lobby wants to do: Protect themsleves vs. big awards, without changing the way health care is practiced.Anyone who concentrates on protecting patients by supporting gazillion dollar settlements for a miniscule population without doing concrete things like standard setting
Gene
By anti-social, I meant the enormous numbers of frivolous and... over priced suits. Those cost the MDs staggering sums of money that could be much better spent elsewhere.
I definetly agree if someone is negligent a law suit should happen... those aren't anti-social, but rather for the good of society (protecting other patients).
Perhaps some sort of criminal charges (with changes in the law) would help? This would stop people from being get-rich-quick-at-the-expense-of-society-as-a-whole, while still stopping-- and severly punishing when needed.
I definetly agree if someone is negligent a law suit should happen... those aren't anti-social, but rather for the good of society (protecting other patients).
Perhaps some sort of criminal charges (with changes in the law) would help? This would stop people from being get-rich-quick-at-the-expense-of-society-as-a-whole, while still stopping-- and severly punishing when needed.
-
Gene DeMambro
- Posts: 1684
- Joined: Sat Dec 12, 1998 6:01 am
- Location: Weymouth, MA US of A
In order for a suit for negligence to get past the preliminary stage, the plaintiff must show (among other things) that a duty was breeched. Frivolous lawsuits, ones that by definition don't meet this criteria, get tossed. Juries never hear frivolous cases, because they never make it that far.
And judges and Courts of Appeal has the discretion to reduce jury awards to numbers more reasonable.
And judges do have the authority to sanction lawyers and parties with monetary penalties and injunctions for bringing frivolous suits.
Gene
And judges and Courts of Appeal has the discretion to reduce jury awards to numbers more reasonable.
And judges do have the authority to sanction lawyers and parties with monetary penalties and injunctions for bringing frivolous suits.
Gene
-
Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
And YOU asked not to be flamed? Shame on you, Gene, for making this statement.Well, thet's precisely what the physician's and insurance lobby wants to do: Protect themsleves vs. big awards, without changing the way health care is practiced.
What you fail to mention, Gene, is that the insurance industry and doctors are going to make their money at the end of the day. Doctors and malpractice insurance companies are not in the business of losing money. The cost of litigation gets passed on to the consumer. If there is no money to be made, then an insurance company leaves the market and/or doctors leave the area. The only beneficiary in this scenario are the trial lawyers. And I challenge you to come up with any credible economic analysis that suggests otherwise.
The situation's gotten so bad in some areas that Emergency Departments have been shut down. So how is the consumer supposed to get emergency care when there is no such care available in the immediate area?
Remember, the Department of Health and Human Service's position paper states...
Also, you wroteIn theory, the tort system is designed to compensate those who have been injured, and prevent further injury to others. However, whether the tort system does either is arguable. In reality, medical malpractice claims are expensive to pursue, can take years to resolve, and can result in the injured party receiving little of the settlement.
When a patient sues, the health care practitioner (physician, hospital, nurse practitioner, acupuncturist, chiropractor, etc., etc.) loses - regardless of the merit of the case. That's the way our legal system works. The accused and/or his insurer must foot the bill to defend him/herself. The accused must take time away from patient care to prepare the case and to testify. A legal victory may be a moral one, but it is a financial and psychological disaster.Did the patient win?
As a result of what, a lawsuit? Apparently you haven't been keeping up on the subject of quality improvement and quality assurance.I'd be willing to bet this type of error doesn't happen at Duke again, as a direct result of this.
W. Edwards Deming - considered the father of quality - discusses 14 points needed to change a system to a quality one. (Out of the Crisis) Point 8 - Drive out fear. A fear-based quality control system doesn't work. Why do you think the Japanese make better quality products? It isn't because their tort system is more punitive.
How about...(a) Cap malpractice awards, and allow doctors (and nurses and pharmacists and whomever...) to continue to practice as before (by Ian's observation filled with all kinds of slop)
OR
(b) Change the way health care is practiced to clean up the "slop there is in medical work", ergo reducing the number of lawsuits, as care rises?
(c) Cap malpractice awards. This way, only those in the sytem devoted to patient care get reimbursed. Furthermore, medical system can concentrate on quality and elimitate the information vacuum. The poor quality and high cost practice of defensive medicine can be reduced.
There is no right to medical care in The United States - even for its legal citizens. This is the land of opportunity - not entitlement. An illegal has even fewer rights. It is not the responsibility of The United States and its health care system to care for the world. To suggest otherwise is to invite economic disaster.Is it your contention that because the patient was an illegal, she is allowed a lower standard of care?
Sing Kumbaya all you want, but I'll be damned if my tax dollars are going to pay for the transplant of an illegal when many of our own legal, taxpaying citizens cannot afford such deluxe care.
- Bill
-
Le Haggard
- Posts: 116
- Joined: Fri May 02, 2003 3:38 am
- Location: Ballard area of Seattle, Washington State
I disagree with your interpretation of "rights." That is another discussion. However, I will ask this since you brought the issue up:Bill Glasheen wrote:
There is no right to medical care in The United States - even for its legal citizens. This is the land of opportunity - not entitlement. An illegal has even fewer rights. It is not the responsibility of The United States and its health care system to care for the world. To suggest otherwise is to invite economic disaster.
Sing Kumbaya all you want, but I'll be damned if my tax dollars are going to pay for the transplant of an illegal when many of our own legal, taxpaying citizens cannot afford such deluxe care.
You wrote "It is not the responsibility of The United States and its health care system to care for the world. To suggest otherwise is to invite economic disaster."
So why is the government trying to do just that by picking fights in other parts of the world and leaving the US responsible for rebuilding other countries? Why should we support US Presence in other parts of the world which includes improving their medical and education systems when the government denies those to our own citizens?
I don't really expect an answer to this. I just want to point out the hypocrisy of a government that claims to care enough about people to finance and "liberate" the rest of the world, but refuses to do so for its own people. A government that continues to do so is destined to fall in my opinion.
And for the record, I do agree with several points here. The reason the lawsuits exist are because of the high profits in the industry. The reasons the malpractice exists also have to do with the profits in the industry, doctors, hospitals, et al out to make money and disregarding the people they are supposed to be healing in the process. What happened to the hypocratic oath? Seems to me that it is just more hypocrisy when the goal of medicine is money.
Le'
