March 31, 2010
“Hot Coffee reveals what really happened to Stella Liebeck, the Albuquerque woman who spilled coffee on herself and sued McDonald’s, while exploring how and why the case garnered so much media attention, who funded the effort and to what end. After seeing this documentary film, you will decide who really profited from spilling hot coffee.”
March 16, 2010
For every injury or illness, there are a range of possible treatments. The (very crude) drawing below represents that range. At the left end of the scale is to “do nothing” and see if the injury gets better on its own. At the far right end of the scale is immediate surgery to try and correct the problem. The bracket in the middle represents treatment within the permissible standard of care for a hypothetical injury. For this hypothetical injury, it would be inappropriate to do nothing, and it would also be inappropriate to take the patient to surgery immediately. Medically appropriate treatments might include administering drugs, ordering an inexpensive diagnostic test, and ordering an expensive diagnostic test. Doctor Smith may be conservative with his treatment and decide to order an inexpensive diagnostic test, while Doctor Jones may be aggressive and order the administration of drugs and the expensive diagnostic test. While both doctors treated the same injury in different ways, neither doctor committed malpractice. More importantly, if Doctor Smith is afraid of being sued and orders the expensive test, we cannot say that his fear of being sued led him to order a medically unnecessary test. The worst we can say is that the tort system nudged the doctor towards being more cautious.
March 16, 2010
Myth No. 1: Rising healthcare costs can be tied to malpractice claims
According to the most reliable of sources, the projected costs of healthcare spending in 2009 were approximately $2.5 trillion – with a T. Of that, even including the costs of insurance premiums – figures that other studies have conclusively shown to be inflated without being tied to actual claims experience – the amount assignable to malpractice litigation is a mere 2 percent of the total.
The claim of inflated expenses due to so called defensive medicine, tests designed to get at the root of a problem and ensure for the patient as accurate a diagnosis as possible, are immeasurable and cannot be properly brought into the discussion without resorting to wholesale speculation.
Myth No. 2: Madison County-Judicial Hellhole
Reality sometimes intrudes on fantasy, and this is one sure case. Contrary to the popularly held belief, the Courts of Madison County have been among the most hostile to malpractice Plaintiffs in the State of Illinois. Case filings are down dramatically, even while announcements of new arrivals of physicians, the opening of hospital wings and the expansion of oft times competing specialty services fill the newspapers.
Truth be told, with the current litigation climate and juror attitude, no place is more hospitable to the negligent hospital or the clumsy surgeon than the Courts found in Edwardsville.
Myth No. 3: Malpractice premiums can be related to claims filed
Doctors in the Metro East have been consistently abused by their own captive insurance carrier, the Illinois State Medical Insurance Exchange – (ISMIE). Rates were set without regulation, and were naturally raised without remorse. Rather than focus on the real culprit, the strawman of the “frivolous lawsuit” – truly a myth given the oppressive costs involved for any such case – was created to deflect attention.
March 5, 2010
About a week after my father’s death, The New Yorker ran an article by Atul Gawande profiling the efforts of Dr. Peter Pronovost to reduce the incidence of fatal hospital-borne infections. Pronovost’s solution? A simple checklist of ICU protocols governing physician hand-washing and other basic sterilization procedures. Hospitals implementing Pronovost’s checklist had enjoyed almost instantaneous success, reducing hospital-infection rates by two-thirds within the first three months of its adoption. But many physicians rejected the checklist as an unnecessary and belittling bureaucratic intrusion, and many hospital executives were reluctant to push it on them. The story chronicled Pronovost’s travels around the country as he struggled to persuade hospitals to embrace his reform.
It was a heroic story, but to me, it was also deeply unsettling. How was it possible that Pronovost needed to beg hospitals to adopt an essentially cost-free idea that saved so many lives? Here’s an industry that loudly protests the high cost of liability insurance and the injustice of our tort system and yet needs extensive lobbying to embrace a simple technique to save up to 100,000 people.
March 4, 2010
To preserve brand identity and maintain secrecy, many businesses use groups like the Chamber to launder money for political means. For instance, health insurance companies lied and told the public all last year that they were supportive of reform — while simultaneously funneling up to $20 million dollars for attack ads through the Chamber (the other $80 million spent on Chamber attack ads against health reform is still unaccounted for).
Although reform would benefit the business community at large by controlling insurance costs and improving worker health, the Chamber is taking a rigid, ideological approach. Indeed, the Chamber is known to have become increasingly partisan under the leadership of Tom Donohue; an analysis by the Wonk Room found that the Chamber’s board is dominated by Republican donors. The Chamber seeks to kill large progressive reforms in order to kill progressive policies in general. Chamber officials have even gone on record noting they hoped to block health reform as a tactical measure to kill clean energy reform, a priority of many Chamber member companies.
March 1, 2010
But maybe we shouldn’t be too harsh with the rich and their political lackeys. They may know sheiks have a private floor at the Kahler Hotel in Rochester, Minn., with a convenient passageway to the Mayo Clinic. Other sheiks find similar resources in London.
These probably are the same Republicans who believe they can control health care costs by a federal takeover of malpractice laws. Their dirty little secret is that tort reform already has been enacted in 38 states, and it isn’t controlling rising costs, anywhere, anyhow.
Colorado has had tort reform since 1988. And guess what? Increases in health care costs there over the last 22 years are among the nation’s highest.
Tort reform may lower physicians’ malpractice insurance premiums — and increase insurance company profits. But physicians do not usually lower their fees when their malpractice premiums go down.
But people seem happy with this Republican faux-solution, and they keep chanting it.