Bush pushes for medical malpractice limits

Bush pushes for medical malpractice limits – Health-Care – Economy

President Bush traveled Wednesday to an Illinois county tagged by critics as the nation’s worst for frivolous lawsuits, setting the stage for a series of congressional measures designed to limit litigation against doctors and businesses.

In a speech in Madison County, across the Mississippi River from St. Louis, Bush charged that “frivolous lawsuits” were driving good doctors from their practices, leaving patients to scramble for adequate health care and pushing up medical costs for all Americans.

Bush implored Congress to pass legislation that would put a cap of $250,000 on non-economic damages in medical malpractice cases.

“What’s happening all across this country is that lawyers are filing baseless suits against hospitals and doctors. That’s just a plain fact,” Bush said. “And they’re doing it for a simple reason. They know the medical-liability system is tilted in their favor.”

Bush also used the visit to reiterate a call for other measures that backers say will hold down frivolous lawsuits, including legislation that would shift many class-action lawsuits from state courts to the federal bench and action to resolve thousands of asbestos-related lawsuits…

It’s way past time.

For a look into Madison County, the venue for President Bush’s speech: American Spectator – Tort Reform?s Ground Zero

Madison County is one of those little rotten boroughs that — with the help of the trial lawyers — has turned lawsuits into a cottage industry. At last count close to 20 percent of the asbestos lawsuits in the nation were being heard before a single Illinois state judge in Madison. Out-of-state corporations as diverse as Prudential, Ford, AIG, Philip Morris, General Motors, and dozens of others have had to troop down to Madison County before judges and juries obviously intent on stripping them of their worldly goods.

My biggest worry is that this will lead the fight into arguments about individual venues and their problems, avoiding addressing the Lawsuit Lottery mentality gripping America.

When Lotteries were being pushed in Texas (“It’s for The Children and The Schools”, remember that?), the detractors of state-sponsored gambling were marginalized as nuts, or worse. I now have an entirely different outlook on lotteries and the ‘something for nothing’ mentality they contribute to.


Comments

  1. Matt Bishop says:

    So I guess this guy won the lottery:

    http://www.boston.com/news/local/massachusetts/articles/2005/01/06/125m_settlement_said_reached_in_arndt_case/

    He is so lucky. Why, it’s just like playing Powerball, except with a lifetime of pain!

  2. Many people have bad outcomes after back surgery. I’m sorry that happens, but it’s a fact: they can always make you worse.

    Was this particular idiots’ action to leave during an operation inexcusable? YES. It iwas nearly terminally stupid, and he should be punished for that.

    And, if you think money fixes pain, or even compensates for pain, then you’re wrong, and I’ll be the first to tell you that.

  3. Matt Bishop says:

    As someone who has represented many people who have had back injuries, I’m well aware it doesn’t.

    But as a society we have decided that since we’re not going to jail people for negligence, they should have to compensate those that are harmed in some way. Basically, money is the only way we have. Is it imperfect? Of course. But the alternative is no consequence at all.

    What do you suggest for say, the following person:

    http://www.cnn.com/2003/HEALTH/01/20/cnna.mastectomy.mistake/

    I guess many people have their breasts removed by mistake, eh?

    The point is merely this. Any case significant enough to be affected by caps is probably one with severe injuries that are significant and long lasting, both physically and emotionally. You are hurting only those people who have already been hurt plenty. It won’t eliminate one bs lawsuit. Nor will it lower your insurance rates.

  4. No, the point is that very very few people have this kind of thing happen to them, yet lawsuits abound.

    Also, lawsuits which allege “Negligence” at bad outcomes hurt many more good doctors than are patients harmed by bad doctors. For every high-profile case where a doctor clearly screwed up I’d be willing to bet there are thousands where there was a bad outcome without any negligence.

    I am aware that caps aren’t perfect. Neither are people, and docs are people. I’m not at all opposed to compensating people for actual losses, which can be substantial. I am against “oh, and send a message for an extra mil or so”.

    You will not be changing my mind on this subject.

  5. I often wonder how the legal community would react should every unhappy legal client find himself able to get tort representation just as easily as an unhappy medical patient does.

  6. Matt Bishop says:

    The fact that you won’t change your mind on a subject merely illustrates the fact that you don’t care what the case involves, you don’t think malpractice ought to be compensated for. I think the fact that you believe Bush’s tort reform will help the individual physician is even more illustrative of the fact that you’re out to simply stop any injured party from recovering. Because it certainly will not help you personally in any way.

    Med mal lawsuits abound? Got any statistics for that claim? Because in most states where accurate records are kept, statistics say claims are down or have barely increased at all.

    You “believe” all these things about the legal system, with no facts whatsoever other than maybe a newspaper article or two. Yet would you even dream of second guessing another physician based on a newspaper article? Of course not.

    No one is asking that doctors be perfect, merely that they meet the standard of care. And really, that’s what a negligence suit is in all cases. It asks that we meet the standard of care in our driving every day as well.

    If you pull out in front of someone else today and hurt them, if they recover from your insurance company is it because you weren’t perfect? No. Does that mean they shouldn’t recover at all? Or how about if they pull out in front of you? People never think that THEY me be the one who needs the lawyer one day. Or do you think insurers just pay for thousands in medical bills and future care automatically?

    By the way, if someone came to you with what you believed to be a legit case of malpractice, and their attorney asked you to testify, would you? If not, why not?

  7. Alright lawboy, I’m sick of your badgering on this comment thread… i can picture your unfair cross examinations perfectly.. that’s what you trained to do in life, isn’t it?
    Here’s seventy pages of FACTS debunking your cristicisms.
    http://www.ama-assn.org/ama1/pub/upload/mm/450/mlrnowdec032004.pdf

  8. Nice work Dr. Charles, I’ve tried to wade through that a few times…but haven’t made it all the way through as of yet.

    I swear that there are a building full of lawyers somewhere scouring the internet looking for any mention of the terms “tort” and “medical” in the same sentence. They collectively/individually pounce everytime the argument for reform is thrown up…and every time they cite individual cases. It’s an example by example argument that tends to ignore the bigger picture and merely plays on emotions. It’s tough to get around.

    Then again…lawyers argue for a living.

  9. Matt Bishop says:

    How come neither of you would answer my question? Maybe you didn’t see it:

    If I handled med mal cases and came to you with a legitimate case of medical malpractice would you testify on my client’s behalf?

    If not, why not?

    By the way Dr. Charles, why are you so afraid of honest debate. I don’t think less of physicians, in fact I respect them immensely. I am just trying to point out a few facts from the other side, because in my experience most physicians are as familiar with how a med mal case works from the injured parties’ perspective as lawyers are with performing brain surgery.

    As to your treatise, I’ve only just started it, but let me point out to you one example of the kind of misleading statistic you’ve been sold on:

    “c. As of 2002, U.S. tort costs accounted for slightly more than 2% of GDP, reflecting the highest ratio to GDP since 1990.28″

    What you’re not told is that “tort costs” includes legitimate judgments. The link earlier about the doc that paid the $1.25 million? That’s included in “tort costs.” When physicians sue insurers for fraud, that’s a “tort cost.” When shareholders of WorldCom sue for fraud and get a multimillion dollar judgment, that’s a tort cost.

    Another example is the “defensive medicine” claim. A study in NY looked at claims of defensive medicine both before and after tort reform in that state. It was found not to exist. And there’s not a physician out there who will admit to performing an unnecessary test. Why? Because it’s insurance fraud if they billed for it.

    You need to stop taking this as a personal attack and realize we’re fighting for the same people – the patients.

    Think about the obnoxiousness of the current Bush proposal. Even if one gets around the thorny question of state’s rights (are there any Republicans who believe in limited government anymore?), lets think about the periodic payment provision. If you are injured as a result of a physicians’ malpractice, and can no longer work, have medical bills of $100,000, future medicals of $50,000 a year, plus all of your usual bills – mortgage, car, kid in college, the insurer only has to pay $50,000 a year in periodic payments, NOT indexed for inflation.

    And what do you doctors get out of it? What has any insurer PROMISED you that you get? Nothing. Nothing at all.

    That’s why I post on these sites, so at least maybe one of you will look up and say “How does all this help US?”

  10. Some of the points which are missed in this debate are the indirect costs of the medical liability environment. I am referring to the medical practice patterns which have emerged which are driving medical inflation

    As a physician who has practiced for 15 years I have personally seen this in action. We used to debate the initiating of a test or consultation on the basis of improvement in outcome, some concrete measure which justified the action and associated expenditure based upon sound statistical or perhaps experiential evidence. Now we do most everything on the basis of protecting ourselves from any potential claim. Therefore, if any common jurer might look at the information at hand would they consider the ommission of action as negligent. In hindsight, when an outcome is known, it is extremely easy to criticize a decision.

    The consequences are simple, we order every test we can for any condition which may exist without regard to cost, or probability of existence. This results in excessive interventions which, while most often innocuous, do cause comorbitiy themselves. The cost of this environment is immeasurable.

    The other consequence of the liability environment is the unwillingness of many physicians to make decisions for their patients. Most physicians have been instructed to simply lay out the pros and cons and have the patient decide. That may work in some theoretical world but most patients are looking to their physicians for guidance on the decisions they must make. When the decision is clear cut physicians will make semifirm recommedations (frequenlty bostered with numerous disclaimers) but most medical decisons fall within gray areas. As such, patients often are left having to choose a medical path without the advice and guidance that they normally require from a professional whose decision making has been completely emasculated. This does not serve our patients well.

    And to answer your earlier question, If I were approached by an attorney with a case which I felt represented negligence on the part of the physicians involved, I would feel a moral obligation to act on this case and testify to such.

    As a physician who was falsely accused of professional negligence as supported by a ‘professional medical expert’, a case which after 10 years in the making, three different legal representations for the plaintiff, $250,000 of defense legal expense, 6 weeks away from practice and immeasurable personal grief which was dismissed by a jury after 2 hours of deliberation, I would also want to see such ‘professional medical experts’ forcefully eliminated from this egregious system.

  11. Matt,

    The two cases you cite earlier should never go to court. Tort reform shouldn’t affect those two. They should be settled out of court (one of them was). The doctors fouled up.

    As for the cap, the cap doesn’t affect medical cost coverage, no? It should only affect pain and suffering damages–meaning future medical bills related to the injury are covered, right?

    And if I know someone was negligent I would testify against them.

    I prefer to blame the insurance companies for this mess. Both lawyers and doctors tend to enter their profession with a desire to help people–it’s part of their core. I don’t get that same feeling from the insurance company.

  12. Matt Bishop says:

    Jeremy,

    If anything, more cases will go to court. Why? Because insurers will be less likely to settle. They know their maximum exposure on what previously might have been a million dollar case is now only $250,000. They might as well go to trial and see if they can get even less.

    I am glad to see that some of you would testify. Have you cleared that with your insurer?

    Thanks for the enlightening debate. I appreciate what entdoc said and I understand his frustration. I still don’t see how the current proposal from the White House addresses his problem, though.

  13. Look, as long as insurance companies are paying the lawyers, nothing is going to get solved! They are the big winners in the whole thing with the motivation to keep things the same. Insurance companies make out like bandits taking criminally high premiums from good doctor’s to pay out settlements/judgements for the few bad eggs who could CARE LESS BECAUSE THE INSURANCE COMPANY IS PAYING FOR IT!!

    Our current system does not dissuade true malpractice. Malpractice lawsuits cannot prevent bad outcomes when everything that can be done is done.
    I just had skin cancer removed from my nose. Am I now supposed to sue the makers of the immunosuppressant? NO, it was a risk of the drug and I knew it! So I do my blood work, I do my skin checks and I follow the protocol ..but guess what, those are there because BAD OUTCOMES HAPPEN ANYWAY!!!!!!

    It’s lawyers and the malpractice insurance companies that are going to drive out all the good doctors and leave us with only doctor’s who could care less because they’re only paying the premium not the settlement!

    I don’t know what the answer is. Somehow, the doctor’s true actions, not just bad outcomes have got to start being accounted for, so the good docs are not sued for things that happen as a part of working with the human body!

  14. The current White House proposal is only one arm toward the resolution of the problem. There needs to be meaningful regulation of the malpractice insurers as outlined in a Medical Economics article in january The reinsurers killed our current insurance market. The system is a claims made system so money is held in reserve for potential liability. When an insurer leaves a marketplace they place the ‘fully funded’ at undo exposure. The reinsurers, which by the way will require some form of federal regulation, also were able to raise their risk corridors and place the smaller insurers at added exposure thus making their current reserves inadequate to cover potential liabilities. This was a major factor in driving up malpractice rates recently but this is never mentioned anyware?!

    Physicians also have to do their part as well. They must police their specialties better HOWEVER, attorneys attack any effort on our part to self police as “restraint of trade”. We are afraid to take action against our own because of potential liability relative to that action.

    The most worrisome part of this is that physician behavior is a very slow moving target so the indirect costs which I have referenced previously as a result of “risk management” philosophy will not self correct quickly; It will take decades, if possible, to change the physician’s practice culture. I am afraid that we are all stuck with a medical system which is destined for progressive institutionalization. The era of a personal physician taking individual responsibility for a patient’s care outside of “approved” guidlines will be lost. Patients already complain bitterly about being cared for as a part of a system rather than an individual. They haven’t seen the worst of it yet!