Regarding the current medical mal-practice cost crisis, a must-read appears in the May 2004 issue of Trial magazine (www.atla.org), entitled "The Truth About Med-Mal Premiums", an extended interview with Jay Angoff, former Insurance Commissioner of Missouri and past Director of HCFA provate health insurance group (p36). The information will not be news to those who have read the relevant offerings on the subject on this web-site (Health Law category). But it is always good to get some outside support. Of course, such disclosures most commonly appear after the person with the information leaves office, retires or otherwise "comes in from the cold". Americans could use such information and insights much earlier...but we are appreciative nevertheless.
Poor results in medical care occur. Some are unavoidable “Acts of God”. Others are avoidable and due to medical negligence, malpractice. All injured patients have a right to an explanation for a bad result. Victims of medical malpractice have a right to appropriate compensation. And the health care profession has an obligation to provide both an explanation and-where appropriate-compensation as a further means of serving the public as a profession.
But our “system” does not work that way. Rather, the approach depended upon by our Judicial System, and tolerated by a public looking for a malpractice sweepstakes, is one of denial, obfuscation, interminable delay, and trial by combat (the adversarial system). This serves the plaintiff’s lawyer (if he chooses his cases well), the defense lawyer (who works by the hour), the insurance company (the more delay, the more interest accrued on funds set aside initially for possible payout), and some doctors (who may unjustly win their case). The loser is the public.
The most recent documentation for all this appeared in a six-day series on medical malpractice in New York which appeared in the New York Daily News, March 5th through 10, 2000. Read it and weep. But don’t jump to conclusions. There is plenty of blame to go around:
a: a gullible public that continues to approach powerful 21st century medical care as it did in the uninformed previous centuries;
b: inattentive and/or negligent and/or greedy health care professionals who have forgotten, or more likely never took, the Oath of Hippocrates;
c: poor hospital oversight over the actions of its medical staff, due both to a fastidious aversion to “getting their hands dirty” by performing proper peer review, and also by a reluctance to losing substantial income from some of these “ providers”;
d: a “conspiracy of silence” among physicians, longstanding and still alive and well, especially within some specialties, and reflected in the poor oversight employed by some state Departments of Health (apparently including New York State); this wall of silence - in any profession or organization serving the public in a fiduciary relationship, including the “Blue Wall” of the police, is dead wrong.
e: the legal profession and the insurance industry, which continue to ignore alternatives like medical malpractice screening panels, mediation and arbitration - “Alternative Dispute Resolution” - which would provide much more justice to many more people at a fraction of the cost in time and money. I wonder why...
f: State administration (New York) which provides a medical malpractice insurance pool to physicians who have become uninsurable because of multiple malpractice awards against them, at a surcharge of only 12% above market rates.
There are alternatives, as suggested above. But only an aroused and incensed public can demand the necessary changes. Meanwhile: