Posted on 03/18/2015 7:33:47 AM PDT by asinclair
With the Supreme Court potentially dealing a blow to Obamacare, why isn't the Congress considering a Plan B to make health care more affordable, and health insurance less expensive?
When asked, Senator Harry Reid said that he did not want to shut out poor people from suing the doctors and hospitals when things go wrong. He pushed back on limits to the right to sue, even as costs continue to skyrocket, and when costs go up, so do insurance premiums, both for the patient and for the doctors (malpractice insurance). And that last expense is passed right back to the patients and their insurance companies. In other words, a potential spiral of increased health care costs because of the legal system.
There are cases where it's appropriate to sue a doctor who is less than competent, a nurse who is less than antiseptic, an orderly who drops patients on the floor, a hospital that had infrastructure problems that kill people. I'm not saying to do away with lawsuits; let's limit the court activity to those instances where its appropriate. Eliminate the lawsuits where "Aunt May died, and I'm going to sue you for that" when the health care people did nothing wrong.
My proposal is a simple one. The medical societies already publish, for their members, a set of Best Practices for medical procedures and operations. The American National Standards Institute (ANSI), a 501(c)(3) organization, oversees the establishment of Standards in a number of professions and disciplines. I would suggest that ANSI form a department for medicine, qualify Standards Developers in the medical profession (American College of Surgeons, American Medical Association, and others), and have those group codify Best Practices as American National Standards.
The Standards Provider provides, as part of its application to become a Standards Provider, define how the provider will operate. In virtually every single case, ANSI requires that the provide open the process of developing standards to anyone interested in participating. That means that doctors, hospitals, insurance companies, politicans, and the general public can weigh in on the deliberations. I leave it to ANSI and the providers to develop rules that make sense.
Once we have National Standards codified in a regular way, Congress can then require that any lawsuit against a medical practitioner, institution, or vendor is restricted to where the responding party has gone outside the National Standards. This will prevent the was of dueling experts that prevails in some malpractice cases -- those decisions will already have been debated and reconciled during the Standards making process. (And for the health care providers, the Standards provide a concrete framework within which to operate, which takes some of the guesswork out of practicing medicine...and could save lives.)
Because the insurance companies are part of the process, they would use the Standards to determine what procedures they would cover. This would remove a lot of the arbitrary denials and partial payments because the insurance company doesn't want to cover some parts, or some procedures.
Another outcome is that "defensive" prescribing of tests would be reduced. When I had my heart attack, the attending physicial racked up a large number of tests that, when I asked, were not medically necessary but were driven by the opinions in past lawsuits -- the doc was covering his ass, not aiding the patient. Oh, and the hospital mandated some of those added tests, because it had been burned in the past, too. "Do it, or lose your admitting privs." Interestingly, some of those defensive tests were mandated by the malpractice insurance company...tests that were denied coverage by the patient's insurance company.
The implementation of this plan would have an interesting side effect: the cost of the lawsuits themselves would go down. What would be blocked is the pages and pages of medical mumbo-jumbo as the experts try to point-counterpoint on the witness stand. The witnesses would be limited to where the accused party strayed from Best Practice. A shorter, easier-to-understand trial, which makes the jury's job easier. And that further drops the cost of litigation, which drops the cost of malpractice insurance. Moreover, findings of violations of Best Practices can be presented to the various quality committies in hospitals and larger practices, so that bad doctors can be weeded, saving lives and unnecessary injury.
What about research? There are already rules of Best Practice in performing medical studies, including review of animal trials before human trials can be performed. That process can result in a Proposed Standard, passed by the appropriate Standards Provider group, to provide the necessary paperwork to define the framework for performing the trials. Yes, this is an added step to the researcher's process of human trials, but the protection to the researcher makes it worth it. Indeed, by reducing the legal exposure, it saves money for the researcher. BONUS: the research protocol can provide the basis for an American National Standard if it is proven to be effective -- much of the development would already have been done in preparing the research proposal.
Mr. Reid, I feel this plan addresses your concern about locking out the less advantaged from the legal system. Because the scope of the proceeding is limited to showing where Best Practices were not followed, justice goes faster and smoother. My father died in a hospital because of cross-infection. A lawyer approached my family immediately after the funeral, asking if we wanted to sue. We had already talked with hospital administration about what happened, and had decided not to take any action. That lawyer said we could win "a lot of money". Is that right?
The plan I proposed here is not complete, and could be completely off base. But I would like to see it considered. My attempts to have this plan considered back when Obamacare was a-bornin' failed miserably. Perhaps now is the time to consider this minor change to what was, and still is, a medical cost driver. And it's worth considering, regardless of how the Supreme Court rules in June.
..there’s too much money to be stolen.
The answer to the question is easy. Trial lawyers have one of the most powerful lobbies in Washington. And trial lawyers make billions on tort cases - don’t expect to see reform any time soon.
My assumption as well.
The EXEMPT are not only EXEMPT, like their families
and Staff and all Moslems, BUT they make money
off ObamaCARE.
EXEMPT Boehner, for example.
One of the DemoRATS who was instrumental in foisting this thing upon us pretty much admitted that they knew medical tort reform was needed, but if they tried to do it the lawyers lobby would torpedo the whole thing faster than you can say Slip ‘n Fall.
Toooo, toooo many lawyers, is all.
You are still operating under the assumption that any of them care about anything other than themselves.
It would be nice if I could say they don’t tackle healthcare tort reform because the Constitution has not given them that power. However, since the feds in general and Obama in particular have long since abandoned the restraints and limitations of the Constitution, that is certainly not the reason.
Nevertheless, We the People do ourselves a great harm when we encourage the feds to interfere with matter outside of their constitutional authority. Healthcare is a states’ issue. So is tort reform. Federal involvement in such is unconstitutional.
Death panel by a different name….and tort reform wouldn't just shut the door on "poor people" suing for damages.
why isn’t the Congress considering”
BRIBERY!!!
Amen brother!
As a smart guy once said on CNBC:
China has central planning by scientists, engineers, and mathematicians, and the US has central planning by lawyers.
Neither is good, but by definition we lose.
Cause most of them are lawyers and they benefit along with their buddies. They can’t cut off the gravy train and there will be no tort reform, of any kind, let alone healthcare, as long as the lawyers are in elected offices.
Exactly.
The tricky part about heath care tort reform is, simply, figuring out how to separate the legitimate lawsuits where health care people really DID do something wrong from the lawsuits where the health care people did not.
I’m all for Tort Reform, but you need to maintain accountability.
Exactly. The tort lawyers’ lobby is one of the most powerful in DC.
And they vote Left.
Why don't pimps work with the police to control prostitution?
Most medical malpractice cases take place in state courts, not federal courts. Most states have already addressed medical tort reform. Are you calling for a national standard to override the decisions made by the legislatures within the states?
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