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Saturday, February 2, 2013

Accountable Care (Cost) Act


One of the biggest disappointments regarding Obamacare it its failure to address the impact of defensive medicine. The direct and indirect costs of medico-legal misadventures contributes to increased costs. Some are arguing that it is insignificant.

The Iceberg Effect

malpractice iceberg

In an article written by Kathleen Baiker in Health Affairs she and her co-authors evaluated the Malpractice Liability Costs And The Practice Of Medicine In The Medicare Program  (2007)

In addition to the observable financial figure, is the not so apparent and difficult to factor is the time/energy equation which diverts physicians from patient care where weeks and sometimes months are spent preparing defenses, attending depositions and court.

When one studies the exact nature and success rate of malpractice lawsuits, it becomes very apparent that the ‘injury'’ resulting in the lawsuit could be adjudicated in a better more professional and accurate way. It is often surprising to see just how often plaintiff’s do not gain financially as would be predicted. Juries often perform miscarriages of justice. Malpractice cases cannot be measured in terms of justice, right, wrong or terms of negligence.

A better model would be that of an investigative board, much like the National Transportation Board (NTSB) after an incident on public transportation. This investigative board would have the same subpoena and deposition power as a court of law.Fact gathering is performed by a variety of experts, presented to a board of review and a decision is rendered as to causation and assignment of responsibility for the event.

Tort Reform would reduce cost, and even more important it would increase the quality of care.  Time and energy could be better spent evaluating diagnostic and treatment protocols.

Tort statistics

The Medical Malpractice Tort system in the United States has three goals;

from;  Presentation “Patients for Fair Compensation” given to Florida Medical Association by Richard Jackson and Jeffrey Segal M.D. J.D.

1. deterrence of unsafe practices

2. compensation for injured purposes and

3.corrective justice

The Tort System is not accomplishing these goals.

              Sarah Z. Hoffman, ANNALS OF HEALTH LAW


The United States is unique in regard to medical malpractice.

Defensive Medicine


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