Sunday, December 28, 2014

Thoughts about reducing medical malpractice costs

I am concerned that medical malpractice costs are a significant contributing factor in the overall cost of healthcare.  I would like to propose some possible approaches to this issue.

First, I favor a Workman’s Comp model for medical malpractice.  

In the 19th century, litigation against employers for workplace injuries was endangering the existence of private enterprise.  It was recognized that on the job accidents were unavoidable, but that private enterprise was also a model that this country wanted to go forward with.  

As a result, the Workman’s Comp system was established. This is a system that allows some recovery for such injuries, but limits that recovery.  In particular, there are not punitive damages — and other amounts may be limited, as well.  Also, there is a universal, single provider system of insurance for employers in states, where employers pay in to protect themselves.

I would like to see us do something similar with respect to medical malpractice.  

We need to recognize that humans make errors.  In the case of doctors, those errors are going to cause medical problems and death.  Obviously, we need to work to reduce those errors, but the current solution is not working.  First, it unjustly penalizes a few doctors to the tunes of millions of dollars, but also unjustly penalizes all doctors every year, many of whom have to pay hundreds of thousands of dollars in malpractice insurance.

Second, tho, given the low amounts that Medicaid and Medicare are willing to reimburse, it is becoming increasingly difficult for doctors to take those patients.  I would like to propose that doctors be exempt from malpractice litigation for causes arising out of treatment of Medicaid and Medicare patients.  In this way, doctors who only take such patients would be able to forego malpractice insurance and reduce their costs.  This might be particularly attractive to new doctors, right out of medical school.

I don’t think that such doctors are necessarily going to be any worse than any other doctors, just less interested in making huge amounts of money, and more concerned about treating those who are low income.

Third, and most important, truly incompetent or corrupt doctors should have their licenses suspended or revoked, and possibly be subject to criminal prosecution.  Malpractice litigation is too capricious and random to be an effective tool in policing the medical profession.  

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