Comments on: Will medical malpractice reform be included in the final health bill? http://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: Physician's Spousehttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110719 Physician's Spouse Sat, 29 Aug 2009 16:55:51 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110719 Not to get off subject. But I recently read the AMA's statement about why physicians should support HR 3200 - because it will put physicians "at the table" to help make revisions and admendments to it. Although I am not a political expert, to me, that sounds like marrying a stranger and getting to know them later. Why would physicians back a bill that may (or may NOT) get the revisions they could support? Why can't the AMA wait to support the final bill once they KNOW it supports their goals for health care reform (which would include tort reform)? Not to get off subject. But I recently read the AMA’s statement about why physicians should support HR 3200 – because it will put physicians “at the table” to help make revisions and admendments to it. Although I am not a political expert, to me, that sounds like marrying a stranger and getting to know them later. Why would physicians back a bill that may (or may NOT) get the revisions they could support?
Why can’t the AMA wait to support the final bill once they KNOW it supports their goals for health care reform (which would include tort reform)?

]]> By: Matthttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110707 Matt Sat, 29 Aug 2009 14:51:24 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110707 "What is tort reform without a cap on damages? Doctors will still live in the fear of losing everything they have and order more tests just to be sure they are not missing anything."What is tort reform WITH a cap on damages? There's no evidence, after decades of caps, that physicians order any fewer tests in those states with caps than those without.Federal tort reform is meaningless, since a malpractice action is a state law issue.You will get your tort reform as part of embracing universal coverage.If physicians have a fear of losing everything with every patient, then they're even more foolish with their statistical analysis than they are with their political. “What is tort reform without a cap on damages? Doctors will still live in the fear of losing everything they have and order more tests just to be sure they are not missing anything.”

What is tort reform WITH a cap on damages? There’s no evidence, after decades of caps, that physicians order any fewer tests in those states with caps than those without.

Federal tort reform is meaningless, since a malpractice action is a state law issue.

You will get your tort reform as part of embracing universal coverage.

If physicians have a fear of losing everything with every patient, then they’re even more foolish with their statistical analysis than they are with their political.

]]> By: Dr. Mary Johnsonhttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110672 Dr. Mary Johnson Fri, 28 Aug 2009 21:04:50 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110672 I'm all for protecting good doctors from frivolous lawsuits.But actually, Dr. Kona, medical negligence is tolerated and overlooked everyday - because of the way our medical peer review system currently works (as a result of HCQIA) . . . from hospital review committees to the high and mighty medical boards it's very hard to bring a bad doctor down.On the flip side it's real easy to destroy a good doctor/medical whistle-blower - using the same means that can't seem to slow down a bad one.The AMA and JCAHO, hiding behind what I like to call "The White Wall" have been blind to the abuses (i.e. "bad-faith" peer review), and instead have adopted the (hospital-friendly) notion that all doctors are inherently "disruptive".And that makes it all the more easy to cut down whistle-blowers - because they are (of course) by definition "disruptive.The irony here is a lot of this came about (again via HCQIA) because of hospitals' fear of litigation.The medical profession is not going to get decent tort reform until it can convince the public ir can effectively police our own. And the medical establishment is not doing that.Today of all days drives this message home. Michael Jackson was killed by a doctor in his bedroom with a needle (loaded with "Milk of Amnesia").Where was/is the California Medical Board? I’m all for protecting good doctors from frivolous lawsuits.

But actually, Dr. Kona, medical negligence is tolerated and overlooked everyday – because of the way our medical peer review system currently works (as a result of HCQIA) . . . from hospital review committees to the high and mighty medical boards it’s very hard to bring a bad doctor down.

On the flip side it’s real easy to destroy a good doctor/medical whistle-blower – using the same means that can’t seem to slow down a bad one.

The AMA and JCAHO, hiding behind what I like to call “The White Wall” have been blind to the abuses (i.e. “bad-faith” peer review), and instead have adopted the (hospital-friendly) notion that all doctors are inherently “disruptive”.

And that makes it all the more easy to cut down whistle-blowers – because they are (of course) by definition “disruptive.

The irony here is a lot of this came about (again via HCQIA) because of hospitals’ fear of litigation.

The medical profession is not going to get decent tort reform until it can convince the public ir can effectively police our own. And the medical establishment is not doing that.

Today of all days drives this message home. Michael Jackson was killed by a doctor in his bedroom with a needle (loaded with “Milk of Amnesia”).

Where was/is the California Medical Board?

]]> By: Dr. Konahttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110667 Dr. Kona Fri, 28 Aug 2009 19:06:47 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110667 I second Dr. Mary Johnson's response to Sarah's comment. The goal of tort reform is not to protect negligence. Negligence in the medical profession has never been tolerated. Adjusting laws regarding how a patient may be compensated for an untoward outcome hardly protects negligent doctors. Patients will always be protected from negligent doctors, but why can't doctors be protected from abusive patients? I second Dr. Mary Johnson’s response to Sarah’s comment. The goal of tort reform is not to protect negligence. Negligence in the medical profession has never been tolerated. Adjusting laws regarding how a patient may be compensated for an untoward outcome hardly protects negligent doctors. Patients will always be protected from negligent doctors, but why can’t doctors be protected from abusive patients?

]]> By: SarahWhttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110665 SarahW Fri, 28 Aug 2009 18:03:15 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110665 Why should a patient have compensation for a bad outcome when it isn't the result of negligence rising to the level of malpractice? Why would you distribute compensation to people who haven't been harmed by anyone? Why should a patient have compensation for a bad outcome when it isn’t the result of negligence rising to the level of malpractice? Why would you distribute compensation to people who haven’t been harmed by anyone?

]]> By: Dr. Davehttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110662 Dr. Dave Fri, 28 Aug 2009 17:28:10 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110662 Just a slight correction here:"The broad Health Reform House Bill which passed before recess (HR3200) contains no language on tort reform"The bill passed the COMMITTEE stage; it did NOT pass the House. It hasn't made the floor yet.Oh...and if Democrats put tort reform in the final version of any bill, hell will freeze over and monkeys will fly out of everyone's butts. Just a slight correction here:

“The broad Health Reform House Bill which passed before recess (HR3200) contains no language on tort reform”

The bill passed the COMMITTEE stage; it did NOT pass the House. It hasn’t made the floor yet.

Oh…and if Democrats put tort reform in the final version of any bill, hell will freeze over and monkeys will fly out of everyone’s butts.

]]> By: @irb123http://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110640 @irb123 Fri, 28 Aug 2009 12:26:00 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110640 While I support tort reform, these suggested inclusion won't do much to fix the problem of defensive medicine. They will help stop the bleeding for docs in states without laws.See my recent blog: The Risks of Defensive Medicine and Why It Isn't Going Away Anytime Soon. Even with Tort Reform: http://bit.ly/xnSFD While I support tort reform, these suggested inclusion won’t do much to fix the problem of defensive medicine. They will help stop the bleeding for docs in states without laws.

See my recent blog: The Risks of Defensive Medicine and Why It Isn’t Going Away Anytime Soon. Even with Tort Reform: http://bit.ly/xnSFD

]]> By: Brianhttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110628 Brian Fri, 28 Aug 2009 01:19:36 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110628 The suit looks to be without merit. Additionallly, the AAPS is a group I cannot abide. Their positions tend to be heavy on the pomp, but light on the circumstance. The suit looks to be without merit. Additionallly, the AAPS is a group I cannot abide. Their positions tend to be heavy on the pomp, but light on the circumstance.

]]> By: Doc99http://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110625 Doc99 Thu, 27 Aug 2009 23:44:13 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110625 AAPS just filed suit against the White House for Free Speech Infringement (flag@whitehouse.gov).http://www.aapsonline.org/whohr-lawsuit AAPS just filed suit against the White House for Free Speech Infringement (flag@whitehouse.gov).

http://www.aapsonline.org/whohr-lawsuit

]]> By: LeeMhttp://www.kevinmd.com/blog/2009/08/will-medical-malpractice-reform-be-included-in-the-final-health-bill.html#comment-110624 LeeM Thu, 27 Aug 2009 23:28:33 +0000 http://www.kevinmd.com/blog/?p=39685#comment-110624 If "bad outcome" insurance replaced malpractice injured patients could be fairly compensated and overhead costs (lawyers and courts) significantly reduced.Before surgery patient signs away the right to sue in return for an insurance police covering the procedure paid for by a % of the surgeons fee.Assume a surgical procedure such as a knee replacement has the following historical outcomes and proposed compensation:Success - no major issues 95% :no payout Revision needed 5% : Cost of revision Bad side effect - loss of limb 0.2% : $100,000 Death 0.05% : $500,000After surgey the patient or estate can collect the specified amount simply by providing evidence of loss.The cost of the insurance for each procedure would be based on the expected outcome (riskier == more expensive) and surgeons past loss record. A surgeon would -not- be penalized for taking on risky cases since the risk would be factored in to the insurance fee. His fee would be higher to cover the risk, but that is a good thing.The surgeons would have incentive to improve their outcomes, and also their "expected results" disclosures to keep their rates low.The rare unlucky patient or family would be compensated without the trauma of a trial. There could also be an option for the patient to "buy up" additional coverage.The health system overall would benefit from the curtailing of high risk little chance of benefit procedures.Obvisouly this is grossly simplified but hopefully conveys the general idea. If “bad outcome” insurance replaced malpractice injured patients could be fairly compensated and overhead costs (lawyers and courts) significantly reduced.

Before surgery patient signs away the right to sue in return for an insurance police covering the procedure paid for by a % of the surgeons fee.

Assume a surgical procedure such as a knee replacement has the following historical outcomes and proposed compensation:

Success – no major issues 95% :no payout
Revision needed 5% : Cost of revision
Bad side effect – loss of limb 0.2% : $100,000
Death 0.05% : $500,000

After surgey the patient or estate can collect the specified amount simply by providing evidence of loss.

The cost of the insurance for each procedure would be based on the expected outcome (riskier == more expensive) and surgeons past loss record.

A surgeon would -not- be penalized for taking on risky cases since the risk would be factored in to the insurance fee. His fee would be higher to cover the risk, but that is a good thing.

The surgeons would have incentive to improve their outcomes, and also their “expected results” disclosures to keep their rates low.

The rare unlucky patient or family would be compensated without the trauma of a trial. There could also be an option for the patient to “buy up” additional coverage.

The health system overall would benefit from the curtailing of high risk little chance of benefit procedures.

Obvisouly this is grossly simplified but hopefully conveys the general idea.

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