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	<title>Comments on: Health courts, and how they can save our health care system</title>
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	<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html</link>
	<description>medical blog</description>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90794</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 04:50:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/04/health-courts-and-how-they-can-save-our-health-care-system.html#comment-90794</guid>
		<description>Actually, Kevin, you did not misquote the study, you simply quoted Mr. Howard misquoting the study.  For a more accurate summation of its findings, one should go to the horse&#039;s mouth:&lt;br/&gt;&lt;br/&gt;&quot;Most claims involving injuries due to error received compensation (653 of 889 [73 percent]), and most claims that did not involve errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not. Overall, 73 percent (1054 of 1441) of all claims for which determinations of merit were made had outcomes concordant with their merit. Discordant outcomes in the remaining 27 percent of claims consisted of three types: payment in the absence of documented injury (6 of 1441 [0.4 percent of all claims]), payment in the absence of error (10 percent), and no payment in the presence of error (16 percent). Thus, nonpayment of claims with merit occurred more frequently than did payment of claims that were not associated with errors or injuries. All results hereafter relate to the subsample of 1404 claims that involved injuries and for which determinations of error were made.&quot;&lt;br/&gt;&lt;br/&gt;Again, however, these are CLAIMS, not necessarily litigated cases.</description>
		<content:encoded><![CDATA[<p>Actually, Kevin, you did not misquote the study, you simply quoted Mr. Howard misquoting the study.  For a more accurate summation of its findings, one should go to the horse&#8217;s mouth:</p>
<p>&#8220;Most claims involving injuries due to error received compensation (653 of 889 [73 percent]), and most claims that did not involve errors (370 of 515 [72 percent]) or injuries (31 of 37 [84 percent]) did not. Overall, 73 percent (1054 of 1441) of all claims for which determinations of merit were made had outcomes concordant with their merit. Discordant outcomes in the remaining 27 percent of claims consisted of three types: payment in the absence of documented injury (6 of 1441 [0.4 percent of all claims]), payment in the absence of error (10 percent), and no payment in the presence of error (16 percent). Thus, nonpayment of claims with merit occurred more frequently than did payment of claims that were not associated with errors or injuries. All results hereafter relate to the subsample of 1404 claims that involved injuries and for which determinations of error were made.&#8221;</p>
<p>Again, however, these are CLAIMS, not necessarily litigated cases.</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90793</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 04:39:00 +0000</pubDate>
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		<description>One can read the full text of the study and judge for oneself here:&lt;br/&gt;&lt;br/&gt;http://content.nejm.org/cgi/content/full/354/19/2024&lt;br/&gt;&lt;br/&gt;Note this quote:&lt;br/&gt;&lt;br/&gt;&quot;Our findings point toward two general conclusions. One is that portraits of a malpractice system that is stricken with frivolous litigation are overblown. Although one third of the claims we examined did not involve errors, most of these went unpaid. The costs of defending against them were not trivial. Nevertheless, eliminating the claims that did not involve errors would have decreased the direct system costs by no more than 13 percent (excluding close calls) to 16 percent (including close calls). In other words, disputing and paying for errors account for the lion&#039;s share of malpractice costs. A second conclusion is that the malpractice system performs reasonably well in its function of separating claims without merit from those with merit and compensating the latter. In a sense, our findings lend support to this view: three quarters of the litigation outcomes were concordant with the merits of the claim.&quot;&lt;br/&gt;&lt;br/&gt;Not sure how Kevin can read that and think this study supports his position that our system is so bad and health courts would be better.  Maybe he means no-fault?</description>
		<content:encoded><![CDATA[<p>One can read the full text of the study and judge for oneself here:</p>
<p><a href="http://content.nejm.org/cgi/content/full/354/19/2024" rel="nofollow">http://content.nejm.org/cgi/content/full/354/19/2024</a></p>
<p>Note this quote:</p>
<p>&#8220;Our findings point toward two general conclusions. One is that portraits of a malpractice system that is stricken with frivolous litigation are overblown. Although one third of the claims we examined did not involve errors, most of these went unpaid. The costs of defending against them were not trivial. Nevertheless, eliminating the claims that did not involve errors would have decreased the direct system costs by no more than 13 percent (excluding close calls) to 16 percent (including close calls). In other words, disputing and paying for errors account for the lion&#8217;s share of malpractice costs. A second conclusion is that the malpractice system performs reasonably well in its function of separating claims without merit from those with merit and compensating the latter. In a sense, our findings lend support to this view: three quarters of the litigation outcomes were concordant with the merits of the claim.&#8221;</p>
<p>Not sure how Kevin can read that and think this study supports his position that our system is so bad and health courts would be better.  Maybe he means no-fault?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90792</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 04:35:00 +0000</pubDate>
		<guid isPermaLink="false">http://clients.emmense.com/kevinmd/2009/04/health-courts-and-how-they-can-save-our-health-care-system.html#comment-90792</guid>
		<description>The Studdert study is indeed the gift that keeps on giving, but not like Kevin represents.  From its conclusions:&lt;br/&gt;&lt;br/&gt;&quot;Frivolous litigation is in the bull&#039;s-eye of the current tort-reform efforts of state and federal legislators. The need to constrain the number and costs of frivolous lawsuits is touted as one of the primary justifications for such popular reforms as limits on attorneys&#039; fees, caps on damages, panels for screening claims, and expert precertification requirements. Our findings suggest that moves to curb frivolous litigation, if successful, will have a relatively limited effect on the caseload and costs of litigation. The vast majority of resources go toward resolving and paying claims that involve errors. A higher-value target for reform than discouraging claims that do not belong in the system would be streamlining the processing of claims that do belong.&quot;&lt;br/&gt;&lt;br/&gt;Also, Kevin misquotes the study, for it does not say &quot;around 25 percent of CASES&quot;, it says CLAIMS.  An insurance claim does not mean a lawsuit was necessarily filed.&lt;br/&gt;&lt;br/&gt;It further concludes:  &quot;Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them.&quot;&lt;br/&gt;&lt;br/&gt;Not sure that makes the case for health courts, unless there&#039;s some evidence their admin costs will be significantly cheaper.  Nor does it necessarily make the case for mediation (perhaps you meant arbitration, since mediation is nonbinding?).</description>
		<content:encoded><![CDATA[<p>The Studdert study is indeed the gift that keeps on giving, but not like Kevin represents.  From its conclusions:</p>
<p>&#8220;Frivolous litigation is in the bull&#8217;s-eye of the current tort-reform efforts of state and federal legislators. The need to constrain the number and costs of frivolous lawsuits is touted as one of the primary justifications for such popular reforms as limits on attorneys&#8217; fees, caps on damages, panels for screening claims, and expert precertification requirements. Our findings suggest that moves to curb frivolous litigation, if successful, will have a relatively limited effect on the caseload and costs of litigation. The vast majority of resources go toward resolving and paying claims that involve errors. A higher-value target for reform than discouraging claims that do not belong in the system would be streamlining the processing of claims that do belong.&#8221;</p>
<p>Also, Kevin misquotes the study, for it does not say &#8220;around 25 percent of CASES&#8221;, it says CLAIMS.  An insurance claim does not mean a lawsuit was necessarily filed.</p>
<p>It further concludes:  &#8220;Claims that lack evidence of error are not uncommon, but most are denied compensation. The vast majority of expenditures go toward litigation over errors and payment of them.&#8221;</p>
<p>Not sure that makes the case for health courts, unless there&#8217;s some evidence their admin costs will be significantly cheaper.  Nor does it necessarily make the case for mediation (perhaps you meant arbitration, since mediation is nonbinding?).</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90791</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 04:13:00 +0000</pubDate>
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		<description>&quot;54 cents of every dollar paid in malpractice cases goes to administrative expenses like lawyers, experts and courts.&quot;&lt;br/&gt;&lt;br/&gt;Wouldn&#039;t health courts have all the same things?  Will they somehow be cheaper?</description>
		<content:encoded><![CDATA[<p>&#8220;54 cents of every dollar paid in malpractice cases goes to administrative expenses like lawyers, experts and courts.&#8221;</p>
<p>Wouldn&#8217;t health courts have all the same things?  Will they somehow be cheaper?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90787</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 01:08:00 +0000</pubDate>
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		<description>If any of the malpractice reform groups were really interested in helping patients they would back no fault and push insurers to pay injured people faster.  Wonder why they don&#039;t?</description>
		<content:encoded><![CDATA[<p>If any of the malpractice reform groups were really interested in helping patients they would back no fault and push insurers to pay injured people faster.  Wonder why they don&#8217;t?</p>
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		<title>By: Anonymous</title>
		<link>http://www.kevinmd.com/blog/2009/04/health-courts-and-how-they-can-save-our.html/comment-page-1#comment-90786</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Fri, 10 Apr 2009 01:04:00 +0000</pubDate>
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		<description>Great, another backdoor run at damage caps by the tobacco industry&#039;s law firm, except this time we add more cost to the taxpayer too. Is anyone surprised that this isn&#039;t getting traction, US Constitution aside?</description>
		<content:encoded><![CDATA[<p>Great, another backdoor run at damage caps by the tobacco industry&#8217;s law firm, except this time we add more cost to the taxpayer too. Is anyone surprised that this isn&#8217;t getting traction, US Constitution aside?</p>
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