I have a question about Medicare/Medicaid & Malpractice

Do people that get treatment via Medicare/Medicaid sue their doctors for malpractice? Does malpractice insurance cover cases that are paid for by Medicare/Medicaid?

The reason I am asking is that I've heard the claim that US medical costs are so high because of malpractice insurance. I am wondering if a public option would help reduce the number of malpractice lawsuits and in turn, lower the cost of malpractice insurance?

3% of medical expenses goes to malpractice lawsuits. Hardly a drop in the bucket of health costs. Plus the hardships of the ones suing are heart-wrenching.

I'm not talking about actual malpractice lawsuits. I'm talking about malpractice insurance and the familiar canard that medical costs are high because doctors and facilities must pay exorbitant fees to those insurers.

has much more to do with the stock market than it does with any perceived increase in the number of malpractice suits. Insurance companies don't really make their real money on premiums, they make it by investing those premiums. When the market goes down, premiums go up.

That's depressing.

Are you saying that doctors and medical facilities pay high premiums because of market fluctuations and not because of actual malpractice? How do insurance companies get away with that?

Premiums for malpractice insurance go up when the market goes down. The insurers, of course, don't readily admit this - although it's obvious - and instead dishonestly attribute the high premiums to malpractice claims, which are actually quite low.

How do the insurers get away with doing that?

If a patient feels like he/she got bad care then they can sue, no matter who the insurance carrier for the patient or the doctor happens to be. It is an individual suit of patient against doctor and his insurance carrier. The doctor sees patients from all types of companies and carry their malpractice insurance to cover all claims. Now, of course, the patient can sue their insurance company if they denied coverage and the patient felt the recommended treatment was necessary.

Several years ago a woman who had cancer sued her insurance company because they denied a hysterectomy recommended by her doctor. She ended up having to have fund raisers, family and friends helping her cover the cost of the surgery. She recovered and then sue her insurance company. The jury awarded her millions of dollars for denying coverage and forcing a delay in needed care.

Doctors have to prove malpractice insurance to most companies before they will let them accept their patients. At least, that's the way it works in Kentucky.

Have you ever heard of someone on Medicare/Medicaid suing their doctor or medical facility for malpractice?

company of the patient is but who allegedly committed the malpractice, the doctor and/or facility. The only time it gets hinky is if the service is provided at a government facility like an Army post hospital, Veteran's hospital. The government will stall, delay, etc. for years to keep from settling. Law firm I used to work at represented a woman who's wrong breast was removed during cancer surgery at Ireland Army Hospital. That case went on for over 10 years.

That's just a fact. If Plaintiff (the injured person) wins a malpractice suit, the liable party pays for the injury. If Plaintiff loses, "we the people" pick up the tab.

Who would you prefer to pay?

"Tort reform" is a give-away to insurance companies that are already rich.

:dem:

-Laelth

What I'm looking for is a selling point for the public option. My theory being that people that get their health care via this option would be less likely to sue their doctors and/or medical facilities because a) people with government-paid health care don't sue and b) the government would require stricter standards of accountability for the medical professionals that are paid by the public option.

Am I making any kind of sense?

I was on Medicaid, back in the day and I never ever heard of anyone on the program that sued a doctor or medical facility.

It is certainly harder to sue the government and win than it is to sue a private citizen or a corporation and win. The only way for us to make this a selling point for the public option, however, would to be to completely nationalize health care, i.e. make the hospitals government-owned and make the doctors and nurses government employees.

A private citizen doctor who is paid by medicare is as easy to sue and win against as a private citizen doctor who is paid by an insurance company. afaik.

Hope that helps.

:dem:

-Laelth

We need every to stress every "pro" in order to deflect the other side's "cons". Something like: "A Public Option will reduce malpractice lawsuits." That sounds strong and sound bitey and I'm just wondering if there's any logic and/or data to back it up.

the patient's health coverage. Medicaid and Medicare patients can and do sue for malpractice. The vast majority of malpractice lawsuits are against health care providers, not insurance companies. You cannot separate out malpractice awards from the cost of malpractice coverage. They go hand in hand, since the amount of historical awards is a very significant component to how malpractice liability and thus 'cost' is calculated. In many cases, hospitals and other institutions self-insure for malpractice (meaning that they calculate a overall exposure and then put money aside for it) or they belong to group malpractice programs where they only pay an administrative fee on top of settlements and legal defense costs.

Medical malpractice does contribute to the cost of health care. On the institutional side, it is far from being the most significant driver of costs. However, it is a higher component of the cost of certain types of doctors' practices. Different specialties have differing levels of premiums based upon the potential for suits/ awards. Psychiatrists pay very little. Obstetricians pay very high premiums: this is because awards consist of both actual (future health care costs for the injured party) and punitive damages. The amount of money to provide for the care of a baby through the end of their natural life can be very high. On top of that, the punitive damage portion of it can be very extremely high. I've read that some of the European countries only allow suits for actual monetary damages.

When a person that was covered by Medicare/Medicaid wins a malpractice suit against a doctor or facility - Does the doctor/facility/insurer pay the damages to the government or does the complainant/patient get paid?

The patient's health insurance MAY subrogate against the doctor or the facilities malpractice insurance if they feel they have paid out more than the original claim should have cost due to the errors of the doctor or the facility. The monies out of a malpractice suit is to the patient to attempt to make the patient (or their family) "whole" again.

I realize my original question sounds strange but I've learned a lot from this thread, regardless. :)