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Tuesday, August 25, 2009

Why isn't malpractice reform an issue for the democratic party?

Malpractice reform is not traditionally an issue that Democrats support. Why?

I think it is because democrats feel strongly that everyone, no matter how poor or disenfranchised, has a right to his or her day in court.

This is good: we are right to hold on to systems that allow people who have been wronged to be heard. But our tort system does not work in the case of medical injury and malpractice.

Most people with a medical injury never sue for malpractice. Most of their injuries are too small for a lawyer to take the case, and many of the injured don't want to enter into the complex and contentious world of the legal system.

Most cases that go to court are ones in which a person has a very bad and often expensive outcome, in which a lawyer could hope to get an amount of money worth his or her time. Most of these cases have no convincing level of negligence, and so there is no significant benefit for the injured party.

During the time that the case is being prepared, usually a number of years, the injured party must continue to be injured, and so has a powerful motivation not to get his or her life back on track, and not to heal up from whatever bad thing happened. The provider being sued is encouraged by the lawyer representing him or her to feel sure of how good and appropriate the care was, and thus not learn from any mistakes.

I have noticed that in my hospital when something bad happens to a patient, and there is no perceived risk of a malpractice suit being brought, that the whole medical community comes together with meetings and discussions to figure out just what happened, and what can be done to make it never happen again. They will organize educational opportunities, change protocols, talk to patients and families who were involved. If the event has a threat of malpractice, all discussion is hushed.

Doctors live in fear of being called into a malpractice case, which will use up countless hours of their productive life, and leads to bitterness and isolation. The vast majority of doctors will at some point be sued for malpractice, but that doesn't make it any easier on each individual, who is ashamed and shaken.

Bottom line--the malpractice system is horribly ill. It is damaging to everyone who comes in contact with it, and continuing to do it they way we do is a huge missed opportunity for improving health care and reducing unnecessary costs.

To fix the problem, in a way that is substantial and could really work, we need major changes. The whole process of taking care of medical injury and negligence could be taken out of the courts and placed in the hands of a board, consisting of physicians and lay people, with the ability to give no-fault compensation to the injured party, analyze and remedy whatever process led to the injury, and educate and punish, if appropriate, anyone who was negligent.


DADvocate said...

The answer: Lawyers/law firms are the top contributor to the Democratic Party over the last 20 years.

Perhaps you can answer this question for me. 20 years ago, I worked for a nursing home. As I remember, Medicaid/Medicare requirements stated, in effect, no body could be charged less for services, etc. that what Medicaid/Medicare paid. Without getting too technical, is this correct?


DADvocate said...

Here the link to the lawyer reference if you want it.

Janice said...

I think that it is in effect true, but not actually true. Any insurance company will pay no more than they are charged, and medicare/medicaid are the lowest payers, so nobody would charge less than they pay.