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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 09:55 AM
Original message
AMA: Liability Claims Filed Nearly One Per Physician
Source: HealthLeaders Media

A report from the American Medical Association finds an average of 95 medical liability claims filed for every 100 physicians.

The report, released Tuesday, prompted renewed calls from the AMA for comprehensive national and state-level tort reforms.

* Nearly 61% of physicians age 55 and over have been sued.
* There is wide variation in the impact of liability claims between specialties. The number of claims per 100 physicians was more than five times greater for general surgeons and OB/GYNS than it was for pediatricians and psychiatrists.
* Before they reach age 40, more than 50% of OB/GYN have been sued.
* 90% of general surgeons age 55 and over have been sued.


Read more: http://www.healthleadersmedia.com/content/COM-254666/AMA-Liability-Claims-Filed-Nearly-One-Per-Physician##



Holy hell...is medical care really that bad in the U.S.? 50% of OB/GYN's have been sued by the time they reach 40, and 90% of general surgeons by the time they reach 55?
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notesdev Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 09:59 AM
Response to Original message
1. It's not medical CARE that's that bad
it's the lawsuit lotto system set up that is that bad.
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Doremus Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:01 AM
Response to Reply #1
3. heh, lawsuit lotto. Get that from NewsMax?
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notesdev Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:02 AM
Response to Reply #3
6. Are you kidding?
I got that phrase from a doctor in my family, probably 2 decades before you ever heard of the Internet.

Obviously you don't know any doctors in independent practice or you'd be nodding your head vigorously.
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Doremus Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:12 AM
Response to Reply #6
13. >rolleyes
Yup, NewsMax.
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Doremus Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:00 AM
Response to Original message
2. The AMA wants its piece of the pie too! Kill and maim with impunity! Yay!!
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:05 AM
Response to Reply #2
10. Strangely enough, I could have sworn that we worshipped the AMA just 1 year ago...
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Doremus Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:16 AM
Response to Reply #10
14. Who worshipped them? Certainly not anyone who wanted a public option.
And most assuredly no one who wanted single payer.

So who worshipped them ... besides you?
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:23 AM
Response to Reply #14
18. Hahah your sigline is classic considering your corporatist stance on everything. nt
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xchrom Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:01 AM
Response to Original message
4. The AMA is not an organization that's entirely trust worthy. Nt
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:03 AM
Response to Reply #4
8. This is the same organization we immediately cited when they supported the Health Reform law. nt
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zipplewrath Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:01 AM
Response to Original message
5. No one is perfect
And these guys are involved in high risk practices. It isn't surprising that something worthy of compensation happens. Something crazy like 95% of drivers who get their license at 16 will have an at fault accident by 25. But you don't have to sue to get your car fixed. Everyone agrees whose at fault and your car gets fixed. If we could have a system that would acknowledge that doctors are going to make mistakes, and allow them to "correct" them without exposing them to unlimited claims, we could not only fix what is wrong, but also identify those doctors that are truly a problem.

Single payer could fix much of this problem I'd point out. The government would be sitting in a very good position to pay out claims, keep them limited in scope, and identify and address the few doctors that really need addressing.
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Bigmack Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:03 AM
Response to Original message
7. Everybody makes mistakes....
but if a surgeon does... well, it's not like a bad weld or coming up $10 short on your cash register.

Having said that... let's all remember this piece is from the AMA, so you are supposed to say "Gosh, there are a lot of frivolous law suits being slapped on doctors."

How about we end all of this shit?

National insurance for doctors. Take the whole thing out of the hands of the insurance companies.

Hell, national scholarships for medical education. Take the whole thing out of the hands of the banks who lend the med students their money.

Not only would it change and humanize the medical profession, it would fuck the banks and insurance companies. Two birds... one stone.
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Deep13 Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:04 AM
Response to Original message
9. Anyone can make a mistake.
And filing a lawsuit does not necessarily mean the plaintiff will be successful.
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:09 AM
Response to Reply #9
12. Actually it is almost certain the suit will suceed.
Edited on Wed Aug-04-10 10:10 AM by Mojorabbit
My hubby is a family practice doc and was sued once in his 28 years of solo practice. He wanted to fight the suit as it was bogus but his malpractice insurance company has the final say and settled for a couple of grand. Cheaper for them to do so than pay court costs. So hubby ends up with a black mark and no option to have his say and our premiums increase.
We are all for people being compensated for negligence but there needs to be something done to sift through these suits. Every night while watching tv we see numerous commercials urging peopled to sue. It is kind of creepy.
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Deep13 Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 11:22 AM
Response to Reply #12
26. "...needs to be something done to sift through these suits."
There is in theory. It's called summary judgment. Even so, the rules are stacked in favor of denying a summary judgment motion. There needs to be some standardization for awarding damages. As it is, it's a crap shoot with the jury and with the jury pool. (City juries are more likely to be generous than rural juries.) When I worked for a plaintiff's law firm, I was told only to accept medical malpractice cases with grievious injuries and clear liability. Otherwise, it would not be worth the expense.

What we really need is a non-fault fund for compensating medically-caused injuries (negligent or not) and to impose some kind of predictability based on the nature of the injury. We also need state medical boards to be more aggressive in de-licensing doctors who routinely cause malpractice claims. One way to reduce damage claims is to eliminate compensation for the cost of treatment designed to repair damage caused by mistakes. We could do that with a single-payer national system.
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kanrok Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 12:13 PM
Response to Reply #12
29. Really?
Your experience is much different than mine. I am a plaintiff's PI lawyer. I've been doing this work for nearly a quarter of a century. Medical negligence insurance policies in all the jurisdictions I am familiar with generally have clause written into them requiring the doctor consent to settlement. The insurance companies will settle those cases that they deem appropriate to settle, and will try the rest. The statistics nationwide do not support your experience either. Nationally, plaintiff's win only 33.3% of the cases that go to trial. The other 66.6% are defense verdicts. In my view, insurance companies do not settle cases because of defense costs, at least not medical negligence cases. Another little fact that typically escapes doctors when they moan about "litigation lotto" is the cost associated with bringing a medical negligence claim. Plaintiffs need to have medical doctors in the same specialty as the defendant to testify that the defendant doctor violated the "standard of care" in treating the patient. In addition, we need to show that the injury sustained (almost always has to be death or catastrophic personal injury) was caused by the violation of the standard of care. That usually requires the assistance of a totally different medical doctor. These experts charge us anywhere from $250 to $1000 per hour. With complex cases, there will be thousands of pages of medical records for the expert to slog through. Plaintffs also typically have to go out of town to get their experts because specialists in any given area tend to know one another. So that increases the costs to the plaintiff. These cases tend not to settle early in litigation, rather later. As such, by the time the insurance company is ready to say "uncle" (and the defendant doctor actually consents to settle) we've spent upwards of $75-$100k. If we lose we eat that. Couple all this with the fact that only one in seven patient with a viable medical negligence claim actually gets to a lawyer, and you see a totally different picture than what your experience would suggest.
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 12:40 PM
Response to Reply #29
30. We were not allowed to fight
the suit. My husband was distraught over the whole situation. It was the one and only time he was sued.
We had absolutely no say in how it was handled. This was our experience.
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Bigmack Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:06 AM
Response to Original message
11. Another thing...
I've been involved in a lawsuit, and if you think the little guy stands a chance when he goes up against the big guy, let me dispel that myth for you.

Money wins because money can buy the best "experts" and outlast the little guy.

So before we weep too much for the docs and insurance companies, let's remember what it takes for an insurance company to pay up.
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MannyGoldstein Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:17 AM
Response to Original message
15. Malpractice payouts much less than 1% of health care costs
It may need reform, but it will have a very tiny affect on our staggering health care costs.
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Lightning Count Donating Member (701 posts) Send PM | Profile | Ignore Wed Aug-04-10 10:21 AM
Response to Reply #15
17. But malpractice insurance costs continue to rise much more than 1% per year.
And every doctor is being affected.
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Donnachaidh Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 11:24 AM
Response to Reply #17
28. it might help if the doctors did something to get the bad apples out of the business
Edited on Wed Aug-04-10 11:24 AM by Donnachaidh
Rather than circle the wagons and protect those that are causing their insurance premiums to rise. I have no sympathy for a group that would rather protect the bad ones because they *are one of us* rather than do something to protect the PATIENTS that are killed or maimed by a very few bad apples.
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Veilex Donating Member (115 posts) Send PM | Profile | Ignore Wed Aug-04-10 10:36 AM
Response to Reply #15
22. Malpractice suits have ever been a straw-man argument
for the medical AND insurance industry. Medical costs are typically inflated by at least 75% of suggested (not actual) cost. Typical arguments for this gouging behavior is that the hospitals have to accommodate for those who don't have health coverage. Yet, I've overheard nurses talk about tests that are automatically performed regardless of the circumstance... one even stated directly that the tests were done specifically to drive up rates. The reality is that if prices were kept reasonable, more people could pay their bills... simple as that.
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 11:22 AM
Response to Reply #22
27. I cant' speak for those nurses, but I can speak for the hospital I used to work at.
Edited on Wed Aug-04-10 11:23 AM by newtothegame
I am now manage a non-profit foundation for kids with cancer, but I was in a hospital foundation before this. 75% of our patient population was Medicare/Medicaid. Medicare paid us $.52 on the dollar for our costs (not inflated costs, our ACTUAL COSTS of providing care). Medicaid was even lower. That's right, on 75% of our patients we got half or less than our cost of providing them care. And even if we had gotten 100% of cost, it would have only covered keeping our doors open; that doesn't include any technology upgrades or outreach clinics. The 25% of patients that had commercial payors were actually the BEST payors, although we had to bilk them to make up for the shortfall on patients with goverment payors. We still ran in the red every year.

That is why I'm for Medicare-for-all, but only with some SERIOUS ADJUSTMENTS. The system cannot afford to adequately pay providers now when it's only covering a small percentage of Americans; I cannot even imagine how low the rates would be if it was covering EVERY AMERICAN. How would ANY hospital stay open if all their patients were on Medicare/Medicaid?

ed for sp
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Doremus Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:19 AM
Response to Original message
16. Lawsuit costs are 1% of total health care. Hardly out of control.
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NoNothing Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:32 AM
Response to Reply #16
20. Wrong
Lawsuit *payouts* are 1%. So if hundreds of thousands of dollars are spent on lawyers and court costs and the defendants win, that doesn't add to that figure at all. Nor does that figure include the costs of "defensive" medicine.
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MannyGoldstein Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 11:10 AM
Response to Reply #20
25. Premiums < 2% of health care spending
From a very good page from the Kaiser Foundation: http://www.kaiseredu.org/topics_im.asp?id=226&imID=1&parentID=59

The CBO estimates that malpractice costs account for less than 2 percent of national health spending and that even significant reductions in these costs would only modestly affect the growth in overall health spending. Concerns have also been raised over the practice of defensive medicine, which increases costs and jeopardizes quality. However, the CBO found little research to support the argument that changes in liability laws would substantially reduce use of unnecessary services and estimated that savings would be “very small.”


That 2% includes the cost of all payouts and defense - and, of course, enormous profits and salaries for the insurers.
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AngryAmish Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:26 AM
Response to Original message
19. It costs about 60-140,000 to bring a medical malpractice case to trial
These things are not undertaken lightly.

But, docs also earn a ton of money. And very few doctors leave the business because of lawsuits.

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warpigs Donating Member (69 posts) Send PM | Profile | Ignore Wed Aug-04-10 10:33 AM
Response to Original message
21.  Here is the study
http://www.ama-assn.org/ama/pub/news/news/medical-liability-report.shtml

I would recommend reading it.

For example:

"Sixty-five percent of claims were dropped, dismissed or withdrawn, 25.7 percent were settled, 4.5 percent were decided by alternative dispute mechanism, and 5.0 percent were resolved by trial, with the defendant prevailing in 90 percent of those tried cases."

"First, in any single year, being sued is a rare event. Only 5 percent of physicians had claims filed against them in that time frame. "

"This research finds that physicians who have an ownership interest in a practice are more likely to be sued than those who do not, 47.5 percent for owners compared to 33.4 percent for employees. This is consistent with the legal concept of vicarious liability and the Doctrine of Respondeat Superior, and suggests that some of the claims against owner physicians stem from care provided by employees of their practice."

42.2% of Physicians have ever been sued, which is different than what the title of that article suggests.
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Altoid_Cyclist Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:39 AM
Response to Original message
23. This was posted here last year although I can't remember which DU member to credit.
Edited on Wed Aug-04-10 10:44 AM by Altoid_Cyclist
Edited to add that this is from 2002

This is from Public Citizen.

This is a study on the Malpractice costs and why a small % of Doctors can skew the whole thing.

I'm not taking sides since I and my wife have both been the victims of "Doctors" who should have been sued (this according to other Doctors who had to fix or treat what the first one messed up). We have also been helped by Doctors who really do care about their patients and were the victims of frivolous lawsuits.

The article is very much worth reading though. It really has some shocking statistics and stories about some of the Doctors who make up the small % who should not be allowed to practice medicine.


Stopping Repeat Offenders:
The Key to Cutting Medical Malpractice Costs



The medical community has argued that medical liability litigation constitutes a giant "lottery," in which lawsuits are purely random events bearing no relationship to the care given by a physician. In reality, a small percentage of doctors are responsible for the bulk of malpractice in the United States, and better oversight by state medical boards could drastically reduce the damage they cause.

Public Citizen’s analysis of the National Practitioner Data Bank, which covers malpractice judgments and settlements since September 1990, found that about five percent of the doctors in the United States are responsible for half the malpractice. Specifically, 4.8 percent of doctors (40,118) have paid two or more malpractice awards to patients. These doctors are responsible for 51 percent of all the reports made to the Data Bank, and have paid out nearly $21 billion in damages, more than 53 percent of the total damages paid.

14,293 doctors, representing 1.7 percent of the doctors in the U.S., have made three or more payments, totaling $11 billion. These doctors are responsible for 27.5 percent of all malpractice awards.

Rather than a random, lottery-like pattern, this distribution very much resembles the pattern of drunk driving recidivism. Motor vehicle licensing bureaus have procedures in place to prevent or deter predisposed individuals from driving under the influence, such as mandatory counseling and license suspensions or revocations. Unfortunately, medical licensing boards do not use their authority with nearly as much vigor.

Much more here:

http://www.citizen.org/congress/article_redirect.cfm?ID=8308

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tpsbmam Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 10:47 AM
Response to Original message
24. Many are absolutely warranted and many aren't.
There are tons of lawsuits out there for serious malpractice & harm to patients. And there are also many lawsuits out there that are unwarranted. Ever watched the ads that predator attorneys have out for lawsuits based on medications prescribed by doctors? Holy shit -- next they're going to sue for docs who recommend a daily multivitamin with minerals and patients who've been hurt by those. When I see those ads about drugs I'm familiar with, they're talking about know side-effects and most responsible docs I know warn about the most serious side-effects. Yeah, there are plenty out there who don't and suits may be more warranted under those circumstances. But, yes, there are just plain unwarranted suits.

I'll give you one personal example, one that didn't end up in a lawsuit but could have. My mother saw a topnotch GP. He was thorough and excellent. He stayed on top of research and, when it was strong enough, treated patients based on what he'd learned from research. This was back when women were regularly prescribed hormone replacement drugs. Research supported it at the time. Only later did research discover the dangers of this therapy and recommendations became to prescribe it only on a very short-term basis or not at all.

Well, Mom was on them for a longer time than is currently recommended. She developed ovarian cancer, which eventually killed her. She asked me at one point if the meds prescribed by this good doc were responsible. She had no family history of OC and almost no risk factors except the meds. My answer? "Probably. But he followed what was the understood responsible medical practice at the time. IMO it's not his fault." Mom agreed. But others may have gone the other way and sued their docs. Were they wrong? No, they weren't. But for me it was a fine line and we chose to fall on the non-suit side of that fine line. Was a suit warranted? Some may decide it is -- we decided it wasn't.

There are more out there that aren't equivocal like my Mom's case and very clearly unwarranted, ones that use up court time, harm good physicians, drive up medical costs, etc.

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freebrew Donating Member (478 posts) Send PM | Profile | Ignore Wed Aug-04-10 01:01 PM
Response to Original message
31. This has personal memories.
It isn't easy finding an attorney that will sue a doctor or hospital.
A few years ago, my daughter was mis-diagnosed with a gall bladder problem.

She was almost refused admittance to the ER because she was 16 and the hospital had been having problems, according to the ER doc, with lawsuits arising from treating young women.

At first they were convinced she was anorexic. She had severe stomach pain, was losing weight from not eating.

The Hospital did some testing, she went into Gran Mal seizure from pain meds. Almost died.

Then, they decided it was all in her mind. Prescribed Ambien and some other drug for depression.
Those drugs almost killed her liver.

So, they took out her gall bladder. Told us it was pitted and kinked. We never saw it, they claimed they lost it.

She got worse. She couldn't walk w/o falling, her feet didn't work right, she was weak.

After this we took her some place else, we had been trying to get referred to anyone else that actually acted like they cared.

Finally, after months of this, she was diagnosed with porphyria. By that time she was paralyzed in her extremities, arms, legs and started to lose control of her breathing.

Treatment was started and in a few days she started to improve. The treatment, however, only stopped the attack of the disease. She was still paralyzed. It took months before she was able to walk, even a little. Wheelchair bound, and unable to wipe her own ass, it6 was another 4 months before she could accomplish the basics of being able to do things on her own.

Insurance paid about 2/3s of the ACTUAL bill, about $90,000. Although she used about $250,000 of her lifetime benefit(per BCBS).

So, I contacted several attorneys in an attempt to get the original hospital(we live close to that one) to help cover therapy costs.
Nothing more, no outlandish sum for pain and suffering, although she had suffered quite a lot, just help with therapy.

NOTHING. No return calls. Documents were not returned. Not even a call from the one and only attorney that would even agree to look at the case.

So, don't attempt to tell me that all these lawsuits are frivolous. I don't believe it at all. You can't find an attorney that will sue for good reasons, let alone for something made up..

Sorry for the long post, but this shit really hits home with me.
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newtothegame Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 01:41 PM
Response to Reply #31
33. No I completely understand...
That's why I asked, is medical care really that bad in the US? And apparently it is...
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Texano78704 Donating Member (215 posts) Send PM | Profile | Ignore Wed Aug-04-10 01:37 PM
Response to Original message
32. Medical malpractice claims are a mere one-fifth of one percent of health care costs
http://www.insurance-reform.org/TrueRiskF.pdf

The key findings on the second page are pretty amazing.
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JDPriestly Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Aug-04-10 04:37 PM
Response to Original message
34. No. It isn't that bad. It is that expensive.
Edited on Wed Aug-04-10 04:39 PM by JDPriestly
If people knew that the cost of repairing or caring for or living with the damage done to them during medical treatment would be paid by single payer insurance, they would not sue unless the loss of income was great.

But today, if your baby's brain is somehow injured during birth, the cost of the baby's future health care is horrendous. That is why families sue. Hopefully with the new health care reform, such a baby will at least be insurable -- but at what cost?

So, of course, parents always blame doctors.

Doctors need to educate the public much more about just what they do. The TV show House helps do that. Medicine is not an easy matter of 2+2 = a simple diagnosis. It is very complex. The number of factors that a doctor has to consider in diagnosing and treating a patient is sometimes mindboggling. People do not understand that there is inevitably a lot of luck involved and that there is probably at this time no way to avoid that fact.

But it makes no difference because someone has to pay for future medical care and loss of income when the inevitable mistakes are made.

That is why I believe so strongly in single payer healthcare. Medical errors are probably inevitable. For doctors and patients, they are a cost of doing business. We should all help pay for them as we should pool together to pay for all medical care for everyone.

Our current system is wasteful and inefficient. The cost of these lawsuits not just to doctors' careers but also to the public that funds the courts and to the families and doctors who pay the lawyers, but to society as a whole.

There are better ways to encourage care and diligence in doctors than our system of punitive lawsuits.
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Texano78704 Donating Member (215 posts) Send PM | Profile | Ignore Wed Aug-04-10 08:33 PM
Response to Reply #34
35. ...
I suspect that is why the US has such a reputation for being so litigious. Single payer health insurance would put an end to many law suits, since you would receive medical care regardless of who was responsible and whether or not they could afford to pay the cost.
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