Have you been watching the tv news or the tv news magazine shows lately
about the sharp increase in medical malpractice insurance premiums and
agitated physicians walking off their jobs in some states? If you have,
didn't they leave you with the impression that lawsuits against bad
doctors were the cause? And these poor old insurance companies being
forced to raise those premiums, 30%, 40%, 70% all of a sudden!
Propaganda and slanting the news are going hand in hand these days,
choreographed by the hidden persuaders hired by the American Medical
Association together with the behind-the-scenes lobbyists of the gouging
insurance companies.
Why in the world would some physicians be willing tools of the insurance
companies who are gouging them regardless of whether they are competent,
caring doctors or the negligent, incompetent few who account for most of
the claims by injured patients? Part of the answer is that the insurance
companies are scaring many doctors with spectres of litigation volume
that simply does not exist.
Malpractice cases filed and actual payments in constant dollars have
been level for many years; about nine of ten malpractice harms do not
result in any law suits being filed, according to various studies. Yet
the human toll is deadly. A Harvard study estimated that gross
malpractice just in hospitals takes 80,000 American lives a year plus
causing hundreds of thousands of serious injuries.
Good physicians should delve deeper into the way medical malpractice
insurers do their accounting, their reserving, and their actual
practices. If physicians would total the entire amount of premiums they
paid last year and divide it evenly by all the physicians practicing in
the United States, the average premium is less than $10,000 per doctor
per year. Very manageable.
So why are some doctors paying $50,000 or $100,000 a year to their
malpractice insurers? Because the companies have learned in the past
thirty years to over-classify their risk pools, thereby reducing their
number to specific specialties like obstetrics or orthopedic surgery in
order to charge much more. In addition, by not surcharging the few bad
physicians in these specialties (known as experience loss rating), the
good specialists pay as much as incompetent ones with a large number of
payouts to their wounded patients.
There is another political benefit for this kind of over-classification.
When obstetricians are gouged, they scream loudly, threaten not to
deliver babies or actually go on strike. This makes perfect visuals for
television ‚ crying babies, physicians in their garb blaming trial
lawyers, who after all still have to persuade juries and judges (the
latter being mostly former business lawyers). Meanwhile, the insurance
companies are laughing all the way to the bank.
There are no visuals for the slowly dying and other human casualties who
receive neither justice nor compassion nor compensation. Nor do people
like Donald J. Zuk get any television time. Mr. Zuk, chief executive of
SCPIE Holdings Inc., a leading malpractice insurer in the west, told the
Wall Street Journal (June 24, 2002) in a very revealing analysis, "I
don't like to hear insurance company executives say it's the tort
injury-law system ‚ it's self-inflicted."
Neither organized medicine nor the insurance companies are really going
after bad doctoring. The AMA's web site does not report any data about
incompetent or crooked physicians who give medicine a bad name. And loss
prevention is something the insurance companies leave to professors of
insurance to talk about.
Instead both lobbies are funding and pressing legislators to enact laws
that politicize the courts, tie the hands of judges and juries ‚ the
only ones who see, hear and evaluate the evidence before them ‚ and make
it harder for innocent men, women and children to bring tragic cases to
court and obtain an adequate award.
A favorite way to achieve this callous goal is to put a $250,000
lifetime cap on pain and suffering. Apart from the fact that some
insurance executives make that much in one week, every week, from your
premium insurance dollars, consider how such a cap wrecks the innocent
in California.
Two year old Steve Olson, now twelve, became blind and brain-damaged
because the hospital refused to give him a CAT scan that would have
detected a growing brain mass. His mother left her job to take care of
her son. A jury awarded Steven $7.1 million in non-economic compensation
for his life of darkness, pain, and around-the-clock supervision. But
the judge was forced by a California law, that these lobbies now want
Congress to enact nationwide, to reduce the amount to $250,000.
Don't think for a moment that restricting your court rights will reduce
malpractice premiums for physicians. Not only have past restrictions not
done so, but insurance industry and company spokespeople have openly
said they will not do so and in some cases have raised premiums right
after a state enacted restrictions.
There is an obligation for the many good doctors to speak out. Just a
few weeks ago, nine of the doctors who walked out of Wheeling Hospital
in West Virginia, had cost their insurers at least $6.3 million in
malpractice claims. Among the damage they caused , wrote the Charleston
Gazette, was operating on the wrong knee, causing the need for a liver
transplant by leaving a surgical clip on an artery, and causing a
massive and fatal infection by inadvertently slicing into a patient's
stomach."
The whole malpractice insurance premium business amounts to about what
this country spends on dog food and is one half of one percent of health
care costs in this country. Isn't it about time to focus on malpractice
prevention first and foremost, instead of pounding on the rights of
hundreds of thousands of Americans who leave their doctors far worse
than when they greeted them?
If you want to find out more about "questionable doctors" in your area and
how little the state medical licensing boards are doing to protect you,
log on to www.citizen.org/hrg/
For more information on the malpractice crisis, go to www.centerjd.org
And get ready to contact your members of Congress before it is too late.
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