Sunday, November 27, 2005

In Defense of Medical Malpratice Law Suit Abuse.

Say, after years of giving premiums to your favorite insurance company, you need an operation on your prostrate, the doctor knowingly gives you an anti-biotic with known serious side effects, when other antibiotics are available, and he does this without your knowledge to reduce his costs. He does this in response to your insurers policies. The result is you are deaf for the rest of your life.

What happens?

You suit!

First there is no informed consent.

Second the doctor’s duty is to the patient not the insurance company.

Third giving the wrong medicine was a willful act.

Why is it that this seldom happens?

Because the damages that will be awarded far exceed any additional profit the doctor or insurer would receive. Hopefully most do not need this kind of threat to insure reliable medical care, but the threat of a suit tends to keep even the corrupt in line.

Granted there are problems with malpractice suit system, certainly in Illinois where I live. Any thing that can be receipted produces damages for the receipted amount When the question of “mental anguish” or punitive damages is in question there are no receipts and the amount of the settlement is often made by emotion rather than some sort of rational analysis. This produces highly inflated settlements, which is raising the overall cost of medical care. But is also makes it even more imperative that the medical provider run a clean operation. In the example above, since it is a willful act punitive damages are proper. I am not in favor of lawsuit abuse; it should be prevented and punished where it happens. But it is clearly better to have the malpractice suit system even with abuses than the alternatives that are used elsewhere.

Paul Belien of The Brussels Journal tells the story of his grandfather who went to the hospital for prostrate operation in May, was knowingly given the cheaper anti-biotic which left him deaf. What our courts would call “mental anguish” left him despondent and he was dead by November.

So what happened to the medical “practitioners.” Well, I’m sure it was just another forgetable day at the office.

How is the Belgium system different than ours. Basically it is a department of the government not medical persons in private practice. In the US one pays premiums to the insurer, when on gets sick the insurer pays the doctor. The role of the government is the honest broker between the patient and the provider if there any disputes. The government through programs like Medicare is becoming more of an insurance provider than before, but all most all medical personnel are not government employees. There is still enough differentiation of roles that the government, at least in court system, can still be an honest broker. In Belgium the provider of the insurance and the medical personnel is also the honest broker. Since the government also controls the right to suit, the government can just refuse to take the role of honest broker . Paul in his article notes that in Europe like the US the cost of providing health care is rising as a percentage of GNP. Where there is a major cost, there is a need to minimize it. Under a malpractice suit system the way to do this is work smarter and more carefully. With a system with no effective honest broker it is just so much easier to deny the care promised or use second class drugs, equipment and practices.

I do not support lawsuit abuse, but if that is price for a medical system where the goal is to treat the patient, not save the government money, I’ll take it
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