In Greenwood, Mississippi, a Leflore County grand jury has indicted a former employee at Golden Age Nursing Home in Greenwood on seven counts of illegally obtaining drugs while on duty. The Greenwood Commonwealth reported that 46-year-old Stephanie Ray Barton is accused of taking painkillers from residents. If convicted, the licensed practical nurse faces up to 35 years in prison.

Barton is accused of stealing Lorcet, a prescription painkiller containing hydrocodone, by signing for the drug on patients’ records and then keeping it.

 

The mainstream New England Journal of Medicine published a thorough article by physicians advocating comprehensive overhaul of our medical care system, and among other recommendations, advocating against arbitrary damage caps:

“More than 75% of physicians — and virtually all physicians in high-risk specialties — face a malpractice claim over the course of their career. Regardless of whether a claim results in liability, the risk of being sued may cause physicians to practice a type of defensive medicine that increases costs without improving the quality of care.
Strategies to control costs associated with medical malpractice and defensive medicine must be responsible and targeted. These strategies must not impose arbitrary caps on damages for patients who are injured as a result of malpractice. According to the Congressional Budget Office, arbitrary caps on damages would reduce national health spending by only 0.5%. But although such caps would have a barely measurable effect on costs, they might adversely affect health outcomes.”

Vermont Gov. Peter Shumlin made history earlier this year when he signed into law legislation that would make his state the first state to lay the groundwork for a single payer health care system.  Vermont begins building a single-payer health system that will move many state residents into a publicly financed insurance program and pay hospitals, doctors and other providers a set fee to care for patients.   "Under the plan, single payer coverage will be a right and not a privilege, and will not be connected to employment," he wrote in a recent blog post. "This is groundbreaking. But our success in guaranteeing coverage depends on our ability to control health care costs, so our plan is focused squarely on that goal."

Now, another governor is looking to take advantage of flexibility in Obama’s health care law in order to establish a single payer system in his state. Gov. Brian Schweitzer (D-MT) announced that he will be seeking a waiver to set up his own universal health care system in his state modeled after the single payer Canadian health care system.

Gov. Brian Schweitzer will ask the U.S. government to let Montana set up its own universal health care program.  The popular second-term Democrat would like to create a state-run system that borrows from the program used in Saskatchewan. He said the Canadian province controls cost by negotiating drug prices and limiting non-emergency procedures such as MRIs.

Here are some of the issues involved:

Green Mountain Care would be a state-funded-and-managed insurance pool that would provide near-universal coverage to residents while reducing health care spending.   The law allows for either a completely public system or a public-private venture where the state could contract out some administrative functions to private insurers. Employers with self-insured plans (usually large companies) would be able to keep their current health coverage.

 Supporters say that a single-payer system is friendly to consumers and providers and will help reduce the rate of health-care cost increases. A Commonwealth Fund report concluded that such a system could cut health care spending by 25 percent after it is fully implemented. After adding coverage for the uninsured and expanding other services, including dental care, the system would save Vermont households and employers nearly $200 million in the first year alone. Savings would come primarily from lower administrative expenses, reduced fraud and abuse, greater delivery system integration and malpractice reform. The report also found that the system would create about 3,800 new jobs and increase the state’s total economic output by more than $100 million in 2015.

Dr. David Himmelstein, a professor at the City University of New York’s School of Public Health and a proponent of a national single payer system, said: "If they follow through like they say they would, it would be a fabulous thing, an enormous gift to the nation."

Meanwhile, some single-payer advocates believe that the new system does not go far enough. Himmelstein said that the law should be more explicit about not having copayments and deductibles and make a greater commitment to global budgeting, in which providers pay for a patient’s healthcare with a set fee for the year.

 

We wanted to help explain the study that was published in the New England Journal of Medicine . The study examined medical malpractice claim rates and payments. Only 1 in 5 malpractice claims against insurance companies lead to a settlement or other payout.   This study has proven two points: insurance companies deny far more medical malpractice claims than they pay out and doctors’ perceptions of medical malpractice claims are not in line with their actual risk.  The researchers found that most claims are dropped without payment.

The researchers looked at closed claims made against doctors across 24 specialties and three time periods (1991-1995, 1996-2000 and 2001-2003). The study was conducted by Anupam Jena, Seth Seabury, Darius Lakdawalla and Amitabh Chandra of Harvard and the University of Southern California and was funded by RAND.

 

 

There are also two important points to clarify with the study. First, the researchers and some of the subsequent media coverage use the words “sued” and “claim” interchangeably. This is not accurate. This study only looked at claims filed with one insurance company, not lawsuits filed in courts. Additionally, this study does not evaluate the merit of the claims that are dropped. Studies that have actually looked at the merits of closed claims have found that most negligence claims involve medical error and serious injury.

 

 

Hundreds of thousands of Americans are injured by medical negligence every year without compensation or apology.  Previous research has shown the majority of malpractice claims are valid and meritorious.    The "high cost of litigation" is actually a myth that has been built up by the scare tactics of insurance companies and tort reform groups.

The study does not support a common opinion among doctors and many jurors that most malpractice lawsuits are frivolous.  However, a tiny fraction of the patients harmed by medical mistakes actually file claims because of cost and caps on malpractice awards.

 

Celina Jacobson at Mastersinhealthcare.com recently shared an article with us titled  “20 Incredibly Educational Alternative Medicine Blogs”.  We thought it was informative and wanted to share it.

Many nursing homes do not offer any options on treatment including alternative treatments that are effective in other countries.  When you choose a nursing home, ask them if they offer alternative medical treatments.

 

The Hill reported the new medical malpractice study that (once again) proves that the cost of litigation for health care costs is minimal.  The study shows medical liability consumes only 2.4 percent of the nation’s healthcare spending each year.  The report shows that limiting the rights of injured patients will do practically nothing to lower health care costs.

Our focus should be on preventing the 98,000 deaths that occur every year because of preventable medical errors. The new study — published in the journal Health Affairs — found the annual cost related to medical liability is $55.6 billion. Most of that spending ($45.6 billion) is related to so-called "defensive medicine" — the preventative and diagnostic tests, drugs and other procedures that doctors prescribe in order to limit the risk of malpractice.

 
 

Alex Nussbaum of Bloomberg had a great article about health care spending and the lack of need for tort reform. Some highlights from the article are below:

Annual jury awards and legal settlements involving doctors amounts to “a drop in the bucket” in a country that spends $2.3 trillion annually on health care, said Amitabh Chandra, a Harvard University economist. Chandra estimated the cost at $12 per person in the U.S., or about $3.6 billion, in a 2005 study. Insurer WellPoint Inc. said last month that liability wasn’t driving premiums.

“Medical malpractice dollars are a red herring,” Chandra said in a telephone interview. “No serious economist thinks that saving money in med mal is the way to improve productivity in the system. There’s so many other sources of inefficiency.”

About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans.  The figures were taken from a March 2003 study by the U.S. Department of Health and Human Services that estimated the direct cost of medical malpractice was 2 percent of the nation’s health-care spending and said "defensive" medical practices accounted for 5 percent to 9 percent of the overall expense.

A 2004 report by the Congressional Budget Office also pegged medical malpractice costs at 2 percent of U.S. health spending and “even significant reductions” would do little to reduce the growth of health-care expenses.

The proportion of medical malpractice verdicts among the top jury awards in the U.S. has declined during the past 20 years, according to data compiled by Bloomberg. Of the top 25 awards so far this year, only one was a malpractice case. At least 30 states cap damages in medical suits, primarily for “pain and suffering” awards.

The development of new drugs and medical procedures, and their growth in price, has been a bigger factor in costs, said Chandra, citing his research and that of other economists. Studies haven’t found a link between increasing procedures, such as Caesarian-section births, and areas with rising malpractice damages, he said.

Medical malpractice is “not a major driver” of spending trends in recent years, Indianapolis-based WellPoint, the largest U.S. insurer by enrollment, said in May 27 report. The report cited advances in medical technology, increasing regulation and rising obesity as more significant reasons for rising costs.

The U.S. Institute of Medicine found a decade ago that medical errors kill 98,000 Americans a year, said Les Weisbrod, president of the lawyers’ association. “By taking away the rights of people to hold wrongdoers accountable, the quality of health care will suffer tremendously,” he said.