The Feres doctrine applied to Medicare and Medicaid?

The Happy Hospitalist doesn’t agree with malpractice immunity in military medicine:

I fail to understand how getting something for free removes recourse for gross negligence. If national interest was really at the heart of complete immunity for gross negligence, I would argue that all physicians who see Medicare/Medicaid patients should be granted complete immunity from all legal recourse, including gross negligence. Failure to do so has resulted in hundreds of billions of dollars a year in defensive medical spending that threatens the financial security of our nation.

Comments

Anonymous
See the ongoing discussion at Sermo.
Military physicians can and are sued occasionally. Even in peacetime, many often work in a very different environment than civilian physicians. The protection is from BS cases is quite reasonable.
It doesn’t entirely eliminate defensive medicine but it seems to be less of an issue there than in the civilian medical world.
The Happy Hospitalist
anyone can sue anyone any time for any reason at all. Whether they win is a different story entirely.
Anonymous
I don’t see the Happy Hospitalist’s logic. In the case of the military, the logic is that the military as an organization provides lifetime care anyway, so why let people sue them for lifetime care expenses? It is a loss that they don’t have. Is the military to pay them AND provide care?
In the case of Medicare and Medicaid, it is not medicare or medicaid that is the organization providing the care–it is the physician who is independent of the payment mechanism. Furthermore, neither medicaid nor medicare are as comprehensive in their coverage as that provided to soldiers via the military and then the VA.
Proof that 12 years of post-secondary education does not remove the need for conscious effort in order to think logically, especially where ones own interests are involved.
Anonymous
Er, no. The military protection from malpractice lawsuits is that you can’t be sued unless the DOD decides to allow it.
A patient can file a complaint. That gets reviewed by a DOD medical panel. If they say “no”, then the patient can’t file suit, period.
That’s how it was taught to me when I was a military doc. Maybe a lawyer here might clarify.
I can see where an outsider could be upset about this but having been in that crazy system, I can’t imagine what a mess it’d be if we’d had lawyers to deal with as well.
The Happy Hospitalist
anon 0538: as you state:
the logic is that the military as an organization provides lifetime care anyway, so why let people sue them for lifetime care expenses? It is a loss that they don’t have. Is the military to pay them AND provide care?
The answer is yes.
Let me give you an example why your logic doesn’t hold water. Lets imagine you have severe mental retardation and are a ward of the state and live your life in a state institution. You are completely dependent on the state for all your cares in all aspects of your life. Now imagine that an orderly at the home assaulted you intentionally because you pooped all over them. The orderly broke both of your legs and gave you an intracranial bleed. Using your logic, you would have no recourse for compensation for your injuries because the state provides all your care for you.
You can extrapolate this out to prisoners, who are completely dependent on the state, or federal system for all their cares. Using your argument prisoners would have no rights for recourse towards physical or sexual violence by state employees.
Extrapolate out your logic to nursing home patients who are completely dependent on Medicaid and social security checks for their survival in a nurshing home. Should a nursing home patient be allowed physical and sexual abuse with no recourse simply because they get everything paid for?
This logic that because you get all your medical care for free, you should not have any legal recourse for gross negligence simply doesn’t hold water in civilian life. So the doctrine protects the military in the interest of national security.
As far the the comprehensiveness of medicare/medicaid, how do you suppose an 80 year old nursing home patient on Medicaid fails to get everything they needed paid for. These folks have no money or assets. Medicaid pays for everything. You can’t get more comprehensive than everything.
As for my education and logic, you needn’t worry about me. I’m doing just fine.
Anonymous
Consider that most doctors go into the profession because it’s the way for them to make the most money. So you go to see a GP to get antibiotics for swimmers ear, he runs you through an $800 blood test. Why? Because he has the machine in his office. He uses his professional standing to rip you off, same as a cop shaking a guy down in a traffic stop.
I live in Thailand, where I get BETTER medical care for one-tenth the cost in US. Not the same, better. What accounts for the other 90% of peoples’ money? Not sure, but it’s kind of like the thieves running the prison.
Supremacy Claus
Casualties from both sides and from civilian population are piling up at the scene of battle. Surgeons have eliminated helicopter travel in Iraq. They work at full speed, at the battle scene, an Iraq war innovation.
Let me get this straight. People want our full speed surgeons to be subjected to medical malpractice litigation. Our military surgeons are to be parsed for record-keeping irregularities and second guessed by weasels in the comfort of federal court for decisions they made about piles of shredded up Iraqis and soldiers?
The military surgeon is far better off not forming a patient-doctor relationship, and watching shrapnel filled, little, Iraqi kids die without lifting a finger. Ending the Feres doctrine is insanity.
Yo, Thailand. Stay healthy. Try to not age. Wait til you get sick. See how great cheap Thai medicine is.
The Happy Hospitalist
supremacy clause, substitute medical surgeon American physician. Substitute Iraqi soldier for elderly American citizen.
I see no difference when you word it like this.
Michael Rack, MD
“As far the the comprehensiveness of medicare/medicaid, how do you suppose an 80 year old nursing home patient on Medicaid fails to get everything they needed paid for”
Everything they get is paid for, but they don’t always get everything they need (unless you define “need” exactly the same way CMS does).
The Happy Hospitalist
Michael, now you’re talking about providing for a studio apartment vs a beach front mansion. A Geo mMtro vs a full size Lexus SUV. Rice cakes vs lobster.
The same argument could be made for the military. They provide you everything you need, as defined by them.
Anonymous
HH:
At this point in time, the relationship of the enlistee or officer to the military is voluntary. You give up rights when you enlist or take a commission, voluntarily. One of those rights is the right to sue your employer. As it is voluntary, you can elect to avoid that circumstance by not volunteering in the first place. Drawing distinctions between a civilian and a military person is meaningless; you are trying to make those differences seem an injustice. (And if the association were not voluntary in the first place there might be a better argument that it wasn’t just, but since press gangs and the draft are a things of the past, that argument is moot. The same comparisons could be made for other disadvantages of military service, for instance not being able to buy life or disability insurance that covers duty-related death and disability. It just goes with the job.)
The Happy Hospitalist
anon 1152, so let me get this right.
If I am a doctor, and I have a patient sign a waiver indicating that if they want me to treat them, they cannot sue me, even if I am grossly negligent and cause them harm.
I wonder if that document would hold up in court. If it did, why don’t we as doctors just have all our patients sign away their legal rights.
I mean, it’s all voluntary. Right?
Supremacy Claus
Anon: “See the discussion at Sermo.”
If you want to see abusive terms of service, Sermo’s are an example.
http://www.sermo.com/about/terms
Discuss some innovation to get some feedback, they may own the intellectual rights. You are providing total liability insurance to the limits of the last button on your last shirt with that indemnity clause.
Docs sign that. What is wrong with the Feres Doctrine to protect doctors under fire by terrorists, and seeking to save our civilization?
This is an IMedExchange favoring site, here. I can recommend it, so far, as an intelligent alternative to Sermo. So far, IMed has not trotted out abusive Terms of Service.
Anonymous
HH:
Your example is already in play in southeast Florida: some doctors have started requiring patients to sign waivers before becoming patients in their practices. If you don’t sign, you are shown the door.
And it’s legal.
Look at just about every service you buy anywhere: there are waivers for jury trials for all disputes, agreements to arbitrate in a specific location and frequently limitations to what can be disputed and for how much. States have passed laws that limit liability for state-related institutions. It is all legal. Feres is really a federal version of the same type of limitation.
You are assuming that malpractice has no consequences in the military. That isn’t true. Military physicians are subject to adverse credentialing actions and are reportable to the National Practitioner Data Bank.
Anonymous
Military doctors should obviously be held accountable for gross negligence. Just because they provide a free service should not let them off the hook in extreme cases.
http://www.latimes.com/news/nationworld/nation/la-na-feres20apr20,0,7217346.story
Take this case, the guy could have been saved several times but the efforts of the hospital staff ended up killing him. The staff’s conduct was extremely negligent and in such cases as this one the military should be held responsible. I don’t see how anyone could disgaree. For all of those who do, put yourself in this family’s shoes, i doubt you would be supporting the Feres Doctrine if it was your husband or wife who was killed because of some absolutely foolish mistakes.
Ed
The Feres Doctrine boggles the mind. This needs to be overturned. My son Michael Fremer was killed at Fort Polk, La on 2/13/08 because of Army Negligence during a training exercise. The Army can not be held accountable because of the Feres Doctrine. Why is the Army exempt from being held accountable for Negligence? Our young men and woman are risking their lives. This is how our country treats the soldiers and the families? How many others die because of poor training? It seems the Army keeps this quiet.
There are other cases that involve the feres Doctrine. For example Medical Malpractice in the army. Also Marines being exposed to Toxic chemicals on US Bases. The Military is exempt from being held accountable on all of these matters. The Feres Doctrine needs to be overturned.

Previous post: Military analysts and industry-sponsored CME

Next post: Pain as art

The Feres doctrine applied to Medicare and Medicaid?

Related Stories

More in Uncategorized

Comments

Site

Channels

Subscribe

Related Stories

More in Uncategorized

Comments

Site

Channels