Monday, July 23, 2007
HEALTH RELATED TORTS: A NEED FOR HONEST DISCUSSION
Most of us have friends who are doctors. Some of us have relatives in that profession. Let’s be honest – those folk have a problem with the cost of their malpractice insurance in our too often litigious society. Further, they have problems with the red tape of our medical bureaucracies – both governmental and private insurer bred.
That being said -- their patients have problems with the cost of health care, the cost of insurance, assembly line medical practices, loss of personal identity and control, and problems of being lost in a morass of insurance, governmental, and medical system entanglements. Sometimes they fall through a crack, get too little attention, and bad things can happen to patients in the medical system. They see too much profiteering in the health care system at the sacrifice of the sick and the poor.
Doctors need help. Patients need adequate protection. The health care system is over-priced and inefficient.
Most of us have friends who are lawyers, as well, and we need them. Different constituencies resort to the legal system to resolve problems. Patients want the right to go to court, if aggrieved, and the doctors want protection through changes in law and a relief from threat of courts. Some politicians are sincere in trying to help one side or the other, while others are posturing for the sake of campaign donations or voting blocs.
Resolving the issue of tort claims and liability insurance for medical practitioners will not solve the problems of health care services in America. But proper resolution could make life easier for professionals while not necessarily removing the rights of redress for patients.
Some of the following ideas might help in developing a common sense system:
A screening system should be put in place for frivolous lawsuits of all kinds. This should not be that difficult to do, and still give each plaintiff the right of due process for his grievance.
All legal processes and procedures should be streamlined, cutting delays and costs.
Award limits for medical and other torts may not always be reasonable, but some system can be put in effect which will be just and yet allow for degrees of hurt and degrees of negligence. Award guidelines should be developed with participation from affected sectors. A range of limits for findings of different degrees of damage and different degrees of offense might be appropriate, and a special awards adjudication panel set up to decide these within that range.
Hospitals should have a base billing system for all patients, insured or uninsured, public or private. The lowest present rate (Medicare) will do, or a ratio thereof.
Some kind of common screening system or ombudsman service should be established for examining hospital and provider item charges, sifting these for gouging and careless processing. Penalties should be assessed for repeat offenses.
Third party coverage entities should have uniform claim forms and compatible computer data transfer systems.
The array of health insurer coverage schedules, private or public, should become standardized with a limited number of plan options, such is now the case with Medicare supplement policies. This should extend to prescription plans. Insurers could compete on prices for common packages of coverage.
The grouped experience cost records and administrative cost data used for rate setting by insurers operating in the malpractice arena or in the health insurance area should be open to examination by the insurance commissioner, legislators or state officials, the courts, the press, and the public.
Frivolous filings for workers comp should be screened in some form of simple process. Only those with serious claims should have further access to the system or the courts.
No person should be forced to accept the opinion or the treatment set by the doctor chosen by an interested adversary acting unilaterally. Differences may be resolved by the court, using a third practitioner’s counsel if needed.
Legal consultants have a role to play in adjudication of differences and in advisement of adversarial parties. The Bar itself should undertake to establish ethical limits and standards for practice in this area. If it does not properly do so, the legislature should establish a panel from the courts to make recommendations.
Perhaps attorney fees should be set and paid by the workers’ comp court system itself, assessing the insurance program for costs.
In closing, it should be mentioned that the writer has not yet seen the Michael Moore film, and that all ideas expressed herein are those developed from within his own apperception regarding these particular legislative issues which consistently plague our state and consume our political energies year after year.
Dr. Edwin E. Vineyard, AKA The Militant Moderate
That being said -- their patients have problems with the cost of health care, the cost of insurance, assembly line medical practices, loss of personal identity and control, and problems of being lost in a morass of insurance, governmental, and medical system entanglements. Sometimes they fall through a crack, get too little attention, and bad things can happen to patients in the medical system. They see too much profiteering in the health care system at the sacrifice of the sick and the poor.
Doctors need help. Patients need adequate protection. The health care system is over-priced and inefficient.
Most of us have friends who are lawyers, as well, and we need them. Different constituencies resort to the legal system to resolve problems. Patients want the right to go to court, if aggrieved, and the doctors want protection through changes in law and a relief from threat of courts. Some politicians are sincere in trying to help one side or the other, while others are posturing for the sake of campaign donations or voting blocs.
Resolving the issue of tort claims and liability insurance for medical practitioners will not solve the problems of health care services in America. But proper resolution could make life easier for professionals while not necessarily removing the rights of redress for patients.
Some of the following ideas might help in developing a common sense system:
A screening system should be put in place for frivolous lawsuits of all kinds. This should not be that difficult to do, and still give each plaintiff the right of due process for his grievance.
All legal processes and procedures should be streamlined, cutting delays and costs.
Award limits for medical and other torts may not always be reasonable, but some system can be put in effect which will be just and yet allow for degrees of hurt and degrees of negligence. Award guidelines should be developed with participation from affected sectors. A range of limits for findings of different degrees of damage and different degrees of offense might be appropriate, and a special awards adjudication panel set up to decide these within that range.
Hospitals should have a base billing system for all patients, insured or uninsured, public or private. The lowest present rate (Medicare) will do, or a ratio thereof.
Some kind of common screening system or ombudsman service should be established for examining hospital and provider item charges, sifting these for gouging and careless processing. Penalties should be assessed for repeat offenses.
Third party coverage entities should have uniform claim forms and compatible computer data transfer systems.
The array of health insurer coverage schedules, private or public, should become standardized with a limited number of plan options, such is now the case with Medicare supplement policies. This should extend to prescription plans. Insurers could compete on prices for common packages of coverage.
The grouped experience cost records and administrative cost data used for rate setting by insurers operating in the malpractice arena or in the health insurance area should be open to examination by the insurance commissioner, legislators or state officials, the courts, the press, and the public.
Frivolous filings for workers comp should be screened in some form of simple process. Only those with serious claims should have further access to the system or the courts.
No person should be forced to accept the opinion or the treatment set by the doctor chosen by an interested adversary acting unilaterally. Differences may be resolved by the court, using a third practitioner’s counsel if needed.
Legal consultants have a role to play in adjudication of differences and in advisement of adversarial parties. The Bar itself should undertake to establish ethical limits and standards for practice in this area. If it does not properly do so, the legislature should establish a panel from the courts to make recommendations.
Perhaps attorney fees should be set and paid by the workers’ comp court system itself, assessing the insurance program for costs.
In closing, it should be mentioned that the writer has not yet seen the Michael Moore film, and that all ideas expressed herein are those developed from within his own apperception regarding these particular legislative issues which consistently plague our state and consume our political energies year after year.
Dr. Edwin E. Vineyard, AKA The Militant Moderate
