HR 1215 advancing through the house, the subject of medical neglect to come up again. HR 15 would limit noneconomic damages to $250,000 on medical neglect claims throughout the country. This would affect states’ rights to decide their own law about medical liability by taking away the right to make a decision. The bill is call the Protecting Access to Care Act of 2017. Always remember, whenever you read the title of a bill, it does the opposite of what you might suggest. This bill protects medical providers from their bad actions.
With the radio show a couple of weeks ago we had some spirited debate about the issue. A younger medical intern had questions and we had a really good discussion about the issues. After that, an older doctor called up to was very pro-tort reform. He argued that there is too much defensive medicine and so the government should cap damages in medical neglect suits. He argued that there is some evidence that 85 billion could be saved by capping defensive medicine, as if capping damages will suddenly get rid of all defensive medicine. Here is a link to the podcast.
There are a couple of things I would say in response to the older gentleman. Concerning defensive medicine, the New England Journal of Medicine says caps cause little effect on defensive medicine. He also argued that many people are sued when they should not be. Presumably his friends have told him that they had been sued in cases that lack merit. I have no doubt many doctors say such things regularly. Howver, Illinois does have a certificate of merit for medical neglect claims which requires a doctor to certify that there is malpractice before the suit can proceed.
With the recent studies showing incredible amounts of malpractice occurring in the United States the proposed legislation seems like a bad idea. Here are a few statistics:
- The most recent estimate by the British medical Journal, hardly a pro plaintiff organization, puts medical errors as the third leading cause of death in the United States behind cancer and heart disease. See also NPR on the issue.
- Before that, we had the Institute of medicine’s report “to err is human” which put the numbers at 99,000 per year in deaths.
- This would put medical neglect above the numbers of car wrecks and work injuries combined in the United States.
- We’ve also seen a study from Harvard which indicates that there were medication errors in 50% of surgeries.
- On average people hospitalized in US hospitals are improperly medicated, due to errors, once a day.
- There is evidence that patient safety falls after tort reform is enacted.
- 7% of deaths are caused by medical errors.
With so much evidence of a malpractice at epidemic proportions, focusing on patient safety rather than worrying that we are spending too much on testing is appropriate. While everyone wants to save money, and our healthcare delivery system is clearly too expensive, a focus on over testing is not the best approach. The amount of money lost by the deaths of 250,000 people per years, plus the loss to society of the medical neglect that injures, rather than kills, the victim would dwarf the loss of over testing. Caps on damages can improve patient safety because medical providers worry about being sued. Caps on tortfeasors’ responsibility will not help patient safety.