T Nation

This One Is <u>NOT</u> A Conspiracy

Despite the recent rantings of several local and state American Bar Association leaders, the medical malpractice crisis is real. It’s not some conspiracy by Insurance companies to limit their cost or to (and this one really gets on my nerves when I hear it!) “To place a cost on a life”. (As if the average “Telephone Book” lawyer gives a damn).


The realities are these:


1)Many high-risk practices (Obstetrics/ Emergency Medicine and Several Surgical specialties) have gotten to the point where insurance cost have approached or even surpassed their net (and sometimes gross) income. None of you will work either at a loss or just to pay insurance. This is all coupled with less and less reimbursement.


2)The cost have gone up as a result of an explosion of multimillion-dollar jury awards and the practice of lawyers of creating so much doubt and chaos in a case that it is usually settled out of court (again for millions of dollars).


I’m no insurance company defender, but they are businesses that 1) have to be profitable and they do this by 2) insuring reasonable risk. Medicine has gotten to the point where nobody in their right mind would consider Medicine a “reasonable” risk. (Hey. I’ve got a novel idea. What if the American Bar Association began to offer insurance to Doctors?)


3)We have gotten to the point in several states where the only option for Malpractice Insurance are “physician pools”…and these are even beginning to be threatened. When they fall, other options simply won’t be there.


This post is NOT meant to say that mistakes and malpractice do not happen. (Envitably, these arguments digress into somebody wheeling out an injured loved one, or telling the story of how someone in Medicine injured them). Malpractice DOES occur.


Nor am I simply blaming laywers. (Actually…I think that they are merely a reflection of our “blame” society…and they “reflect” very well, I must say…)


With that being said, Americans need to face some hard choices, and in this case there are two: 1) The realization that life is not some zero-sum experience and that there must always be someone else to blame when it takes a difficult road and 2) Are handfuls of multi-million dollar awards worth the reality of literally millions of people not getting care?


Fire Away.

I’d have to agree with everything you say, except that I do blame the trial lawyers. They are often the impetus in ridiculous lawsuits that seek to rid our country of personal responsibility and make victims of us all.

Mufasa, I don’t want to sound racist but I’m very curious as to how you turned out so conservative. I completely agree with 99% of what you say on the forum, and to be honest with you I had no idea you were black until the recent “Black Maxim” thread. Where do you live, how where you educated, ect?

“Kill all the lawyers”

Once again, Tort reform!!!

I definitely agree that there needs to be tort reform. My personal belief is that putting stricter limitations on contingency fees and adopting the English rule that loser pays winner’s court costs would go a long way toward reining in the abuses of the plaintiffs’ bar.


The plaintiffs bar will object, as they are wont to do, that anything that makes it more difficult, risky or expensive to file a lawsuit risks trampling on the rights of poor people to file suit, but good, meritorious (read: likely to win) suits would still go through.


There are other reforms we could make as well. A pet idea of mine is not having juries on complicated civil lawsuits, as most potential jurors are not well educated enough in the intricacies that decide such suits to serve their intended function in any sort of competent manner. Don’t forget that all the lawyer abuse in the world wouldn’t amount to squat if the trier of fact, be it a judge or a jury, was intelligent enough to see through such shyster shenanigans.


Also, I’m glad you noted that the medical community is not blameless in all of this. My fiancee is a nurse, and from the stories she tells me I would be scared to be a patient in a hospital around here – and Boston is supposed to be among the best places in the country for medical care.


One of the prime problems is the ridiculous shifts that young residents and interns are expected to pull. It should surprise no one that a person at the end of a 36-hour shift is more likely to make a mental mistake such as operating on the wrong leg or mixing up medications than would someone who was allowed to get proper rest. The flimsy rationale that one needs to stay with patients for that whole time in order to learn what’s going on does not hold – a person who had to spend 5 min. to read a chart after a good night’s sleep would be infinitely more reliable at making a decision than someone “familiar” with the patient who is keeping himself awake via abusing methamphetimenes or cocaine – or even just someone who has been awake for 36 hours.


The only things keeping that system in place are the whole “I did it so they should do it” mentality of older doctors, as well as the need for older doctors to maximize the exploitation of younger doctors in order to keep the older doctors’ salaries higher.


Anyway, it’s a complicated problem – we need reforms on many different levels in order for something positive to occur. And, as a final thought, if you really want to cut the power of insurance companies, petition Congress to fix the problem they created by making health insurance tax deductible for employers but not for employees – namely that the buyers of insurance are not the customers, so the insurance companies have precious little incentive to make patients’ lives easier.


That’s my piece. Thanks for the good topic to get my mind off the Bar exam for a few minutes. Peace. Out.

I have an interesing take on this, as my grandmother was killed by an intern. This intern was in hour 34 of a 36 hour shift and gave her incorrect medication. My family had a straight line to a multimillion dollar lawsuit with no problem at all. We did nothing. I wouldn’t have brought her back, and there was no point in killing the career of a young intern who should never have been in that position in the first place.

Don't fool yourself, medicine is no longer about helping people, it's about money. The insurance companies decide on your treatment, and unless you are rich, you have to go along with what they say. I need to have custom orthodics made for my shoes, my insurance doesn't seem to think that they are important. So they would rather my problem advances to the point of needing surgery (cost: over $2000) than pay for orthodics which will correct the problem (cost: $150)

I know a nurse, she is required to have over a million in malpractice. She made an error once a long time ago and couldn't tell the patient. Why? Because he could have been badly hurt from the error. He could have sued her on the grounds that he might have had long term problems from the error. Everything came out fine, but the fact that he could have sued her based on something that MIGHT have happened is just plain stupid.

Reform has to start with the insurance companies and continue across the board. If your doctor says (and proves) you need a treatment they should be obligated to cover it. That's why doctors have medical degrees, last I heard, a medical degree was not required to write insurance company policy. It is such bullshit.

Thank you for letting me rant.

Instead of searching the net for some facts to back up my opinion I’m just going to copy and paste this piece from Laura Ingraham’s weekly e-blast. For those of you not familiar with her she’s a former lawyer turned conservative radio talk show host. Here it is:

After weeks of playing defensive domestic politics, the President shifted the political momentum last week when he traveled to North Carolina to take on the trial lawyers. The Bush proposal would limit the punitive and pain and suffering damages recovered in malpractice cases. These out of control awards have driven up the costs of health care for all of us while lining the pockets of plaintiffs' lawyers who in turn line the pockets of Democrats. So it was no big shocker that this modest step toward tort reform was greeted with wails and yelps from former trial lawyer and future presidential candidate Senator John Edwards. He countered that such limits showed no feeling for "victims." Although the White House denied presidential politics were at play in its choice of Edwards' home state for the President's speech, the move was brilliant.

Republicans have the facts on their side and should be relentless in deploying them. According to the Center for Responsive Politics, the Association of American Trial Lawyers gave $1.8 million to candidates so
far during the 2002 – 87 percent to Democrats. During 2000, lawyers and law firms distributed a staggering $112 million – 69 percent to Democrats. That’s more than double the $62 million that BOTP (“Big Oil,
Tobacco and Pharmaceutical”) gave in 2000 – 75 percent to the GOP.

The legal lobby has protected its turf beautifully over the years as tort reform has drifted on and off the political stage. But the current public anger at rapacious CEOs and shifty accountants shows that Americans are
hungry for justice. While plaintiffs’ attorneys prattle on about protecting the interests of the little guy, their clients in class-action suits often get crumbs while the law-firm collects its 33 to 50 percent.
The most recent outrage is the New York suit filed last week against the fast food industry, alleging a failure to warn about the products “addictive” and “harmful” qualities. (The lead plaintiff claims that even
after heart surgery, he found himself eating McDonald’s or Burger King four or five times a week.) These suits are following the lead of tobacco litigation, which have made hundreds of millions for trial lawyers coast
to coast.

The public needs a continuing education on the skyrocketing legal costs that amount to about a 3 percent hidden tax on our wages. Limiting
malpractice awards is a good start and should be followed by an aggressive push for “loser pays” initiatives, and caps on lawyers’ fees. President Bush stressed these issues on the campaign trail, but with the war and economic mess on his plate, the initiatives were neglected – until last week. Any time Republicans can force Democrats to defend lawyers, the Republicans will win. Speaking as a recovering attorney, I’d rather be on
the side of Big Business over Big Lawyers any day.