Friday, June 11, 2010

Is Help on The Way?



The issue of how much medical malpractice adds to the cost of healthcare in the United States has been on the front burner for physicians, yet legislators turn a deaf ear to this challenge. Medical malpractice adds to the cost of each patient encounter not only due to the premiums physicians pay, but the even more significant costs of practicing 'defensive medicine'.  This fuels the additional non medically indicated ordering of high tech laboratory and other expensive imaging and other tests.


By Katherine Hobson

Today the government begins to hand out $25 million in funding for demonstration projects attempting to find some fixes for the medical malpractice system, the WSJ reports. The one- and three-year grantees include projects focusing on alternative dispute resolution programs, rapid medical error disclosure and the development of guidelines to reduce lawsuits.

This project was initiated last year, in the heat of the health-care debate. But the overhaul bill that ultimately passed Congress included another $50 million in grants for states that want to explore alternatives to traditional tort reform proposals, American Medical News reported this week. (The paper is published by the AMA.)

Grant-winners haven’t been announced yet. But experts told medical liability insurers at a recent meeting about several different alternatives that might be funded as test projects, AMN says. Here they are:

Health courts: The notion of courts dedicated to medical malpractice has kicked around for a while and was endorsed in 2007 by then-presidential candidate Mitt Romney. The courts would have judges who specialize in medical-liability cases, as well as “neutral experts, preset timelines and compensation schedules,” which hopefully would produce a more predictable and efficient system, AMN reports.

Early offers: Just what the name indicates — a defendant could opt to pay economic damages and lawyers’ costs within 180 days of a claim, avoiding lengthy litigation. The patient, however, would have to skip non-economic damages.

Apology programs: The hope is that when doctors apologize for or at least communicate about errors with patients and family members rather than immediately lawyering up, the risk of litigation may decline. (Here’s a WSJ story on the subject.)

Medical review panels: Already used in many states, these nonbinding panels of medical and legal experts review suits before they go to trial to cull the most egregiously silly and advise plaintiffs and defendants on the merits of the evidence. (Here’s a 2009 AMN story about the concept.)

The AMN reports some caution on the second round of grants: Funds have to be appropriated by Congress, and by the terms of the program, test projects can’t limit the rights of plaintiffs and defendants to pursue claims through traditional means.

Some sucess has already occurred with "caps' on awards for punitive damages in several states.

The funding for this initiative has yet to be passed by the congress.

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