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Originally Posted by AOII Angel
(Post 1878920)
I haven't proposed capping malpractice verdicts, just asking that lawyers actually check that they sue the correct physicians before they send in the paperwork. I don't like being accused of being incapable of performing procedures I didn't perform!
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Oh, I wasn't implying that you were in favor of tort reform - I'm pointing out that "large verdicts" really cannot be a part of the malpractice insurance problem, because capping awards affects less than 10% of the cost of the insurance.
The problem is deeper than "too many lawsuits" or "juries giving out truckloads of money" - I was agreeing with you, and providing some evidence to support your points.
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The problem is that defensive medicine is not good for patients and is expensive which drives escalating health care costs. (Please see earlier posts)
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I'm not really sure what you mean by this. Ordering every test under the sun doesn't mean you are going to improve outcomes. A lot of tests have ambiguous results, lead to further tests and have complications.
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My point is that "defensive medicine" (which everyone will agree sucks) isn't really a consumer issue in the truest sense. That's what the logical fork was intended to show - I'm not sure why "defensive medicine" is a health care cost issue since the arrow can only go one direction. I don't mean to say it's the "fault" of doctors - that's really not the issue - but I don't really see how health care reform can address this issue without taking odd steps that benefit those other than doctors/patients the most.
Longer-form issue: if such a tiny proportion of Mal insurance costs are tied to non-economic damages, how exactly do we propose curtailing those costs? It's a chicken/egg dilemma at that point, it seems. Do you simply say "this is what something is worth" and limit income? Do you force f-ed up rates on insurers? Do we increase the disparity for those using certain types of medicine (aka "screw pregnant women one more time")? It's tough.
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Don't get me started on cerebral palsy. This is not due to BIRTH TRAUMA. It's perinatal ischemia. OB-GYNs get so much shit for delivering babies. It is impossible to tell when the brain injury occurred unless there is a VERY WELL documented incident during the delivery. Most of the time, there isn't.
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Obviously I did not imply anywhere that some non-specific trauma "causes" cerebral palsy - and I'm sure everyone's seen the commercials for James Sokolove or Ken Suggs, it can certainly be a factory-firm game, but that doesn't mean CP cases are somehow implicitly exploitative.
The bolded is definitely true, mostly because the womb isn't see-through and knowing exactly when, say, hypoxic ischemic encephalopathy (which I'll use as an example, since it's the most common claim in my experience) takes place is impossible, and because the very term "CP" is borderline useless due to its umbrella nature (actually, that's not true - it's insanely useful to, again, defense council, because the "WE DON'T EVEN KNOW WHAT CAUSES CP!" defense is one of the strongest on the planet, although it is akin to saying "WE DON'T EVEN KNOW WHAT CAUSES BROKEN LEGS!" in many ways . . . again, not passing judgment, but it is one of many benefits the defense enjoys in MedMal cases).
Most of the time, a link is indeed very hard to prove - which is why so very few cases make it to court. This is actually the case with every non-traumatic MedMal request - obviously causation is easy for a sponge, and difficult for a non-specific brain injury. I'll agree that OB/GYNs, along with ER doctors and some other specialists, receive the brunt of the litigation maelstrom, fairly or unfairly. Of course, it's also perfectly feasible that OB/GYNs make poor decisions that carry much more tangible and lasting impact, too, but either way, the train has so much momentum that it will be next to impossible to stop.
However, in court, the issue is basically whether we can say with 50.0001% certainty that a certain poor decision led to the hypoxic event, and that the event led to the injury. About 0.3% of babies are born with CP - of course, some of those "bad decision" births were already in trouble. However, it's quite the coincidence, don't you think?
OB/GYNs get a bad name both because their cases are high-profile and high-emotion (there is no puke like seeing 45 minutes' worth of PowerPoint slides on a kid looking cute just before a seizure with no other purpose than fiddling the heart strings) and because negligence that leads to HIE is probably worth about $16 million. It's just the way it is.
And, to bring this back to the health care bill . . . Congress apparently does not address this issue, or the others we've discussed, in the slightest. Medical malpractice is barely touched at all, from what I've read. So, apparently, we're going to "reform" health care and get it to everyone, for cheaper, with better service, without addressing any of these fundamental issues. Pardon me if I'm skeptical.