Doctors-It's A Good Thing

[Wolverine]

Malpractice reform bills designed to retain doctors
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Rising insurance rates drive many to leave Ohio practices

By Amy McCullough
Enquirer Columbus bureau

COLUMBUS - A few pieces of a much larger puzzle were put into place this week when Gov. Bob Taft signed two medical malpractice reform bills.

The bills are part of a movement to keep Ohio's doctors in the state by lowering liability insurance rates, which can cost over $100,000 for some high-risk specialties.

The increased cost of insurance is forcing some doctors into early retirement or to move their practices to other states where the rates aren't quite as high, according to an ad campaign run by the Ohio State Medical Association in early May.

The medical association says that rates will continue to increase as long as trial lawyers continue filing extensive "frivolous lawsuits."

But the trial lawyers say the insurance companies are at fault.

As the reason for the skyrocketing rates continues to be debated, most agree that Ohio's medical malpractice insurance market is in crisis.

The state medical association ad campaign attempted to educate Ohioans on the state's insurance crisis and encouraged people to support legislation aimed at curbing the problem. It named a bill sponsored by Rep. Jean Schmidt, R-Loveland, that requires trial witnesses to be more qualified and provides a system for tracking frivolous lawsuits.

The second bill - sponsored by Sen. Scott Nein, R-Middletown - requires insurers to give notice of cancellations or rate increases 60 days before they take affect. The bill also requires that policyholders give 120 days notice before canceling their coverage.

"This change will ensure that any forms issued are protective of consumers and in compliance with current state law," Nein said during sponsor testimony of the bill.

Both bills go into effect 90 days from the date Taft signed them.

"The governor is concerned with the rising malpractice insurance rates in the state. When he signed the bills he called it a good start to stabilizing the malpractice insurance market and keeping doctors here in Ohio," spokesman Orest Holubec said. "But, it's just a start."

Tim Maglione, senior director of government relations for the state medical association, said he is optimistic that the bills will help stabilize the market because other states with similar legislation have seen positive results. He says it is not a question of if the market will stabilize but when.

http://www.enquirer.com/editions/2004/06/19/loc_malpractice19.html

[postfeminist]

this is becoming a problem all over the country. doctors are moving to arizona & new mexico where malpractice insurance is supposed to be cheap.

[BigSugar]

LOL! the rate of malpractice cases has remained reletively steady for years. yet malp. rates have risen exponentially in the same period. it's easy to blame the trial lawyers, but how about we put the blame where it lies, on the insurance companies who made real, real bad investments and then got shelled in '01/'02 when the market went to shit and are trying to recoup through increased premiums.

insurance companies suck pig anus'.

[supra-genius]

Originally posted by BigSugar
LOL! the rate of malpractice cases has remained reletively steady for years. yet malp. rates have risen exponentially in the same period. it's easy to blame the trial lawyers, but how about we put the blame where it lies, on the insurance companies who made real, real bad investments and then got shelled in '01/'02 when the market went to shit and are trying to recoup through increased premiums.

insurance companies suck pig anus'.

Is it possible that both lawyers and insurance companies are to blame??? While the rest of us just get screwed...

[bluelupis]

I don't see a problem with socialized medicine. Just seems to make more sense for everyone and we are one of the only countries in the world that does not utilize it to at least some extent. That would shut everyone the fuck up. The lawyers, the insurance companies and those doctors that supercharge to make up for insurance gouging and still make a bazillion dollars.

[BigSugar]

have you missed the whole Medicare/Medicaid thing for the last 40 years? that's socialized medicine. it doesn't work. See, Canada.

[bluelupis]

Originally posted by BigSugar
have you missed the whole Medicare/Medicaid thing for the last 40 years? that's socialized medicine. it doesn't work. See, Canada.
No that is not true socialized medicine. I work with those here at a healthcare corporation and they are far from true socialized medicine. Take a look at the Netherlands and how they do it. It is tax based. They do pay large amounts of taxes but they see threir returns from the government in respects to healthcare.

[DaysWithoutEnd]

Gee, good thing somebody is helping those doctors. I'm tired of them begging for quarters in the Oregon District on friday nights. Poor bastards always seem to run out of gas before they make it home.

[BigSugar]

Originally posted by bluelupis

No that is not true socialized medicine. I work with those here at a healthcare corporation and they are far from true socialized medicine. Take a look at the Netherlands and how they do it. It is tax based. They do pay large amounts of taxes but they see threir returns from the government in respects to healthcare.

exactly. more taxes. more govt. that's ALWAYS the best solution. again, i direct you north to Canada where if you are DX'd with 6 months to live, you may get treatment in 3 years (actual case from personal family experience).

just b/c Medicare/Medicaid isn't "full socialized medicine" as you want, it's a form of socialized medicine and it sucks. if a little bit of socialized medicine run by the govt sucks hind titty, what makes you think a whole lot of it won't suck hind titty just as hard too? there's no milk in that teet son. quit sucking on it.

[aqualou]

Originally posted by BigSugar
insurance companies suck pig anus'.

Now that's something I think we can all agree on.

I've been to both a GP and the emergeny room in Onterio and never had a problem. I've seen waits just as long at US hospitals.

[BigSugar]

Originally posted by aqualou
I've been to both a GP and the emergeny room in Onterio and never had a problem. I've seen waits just as long at US hospitals.

those were the lines just to get a number for the other line which gets you in to see the nurse who then gives you a number to see the doctor who then says "we can give you asprin for that headache, but you'll have to wait a year." :)

[sueque222]

Originally posted by DaysWithoutEnd
Gee, good thing somebody is helping those doctors. I'm tired of them begging for quarters in the Oregon District on friday nights. Poor bastards always seem to run out of gas before they make it home.

dude, ya gotta have some respect. this isn't simply a case of republican officials sheltering profits for other rich s.o.b.s - malpractice in this country is a serious problem. many (including my own father) are being forced into retirement, especially high-risk specializations like ob/gyn. I don't exaggerate.

[Megs79]

Originally posted by sueque222
many (including my own father) are being forced into retirement, especially high-risk specializations like ob/gyn. I don't exaggerate.

I read stuff about this all the time- some docs are switching to gyn only, because there's too much litigation in ob.

Does canada have a lot of drs that operate privately (outside the socialized system)? France has a socialized system, but they also have private practice drs who treat people that are willing to pay for their services... In other words, the government plan is there for everyone, but you CAN get treatment elsewhere IF you can pay for it.

[aqualou]

Originally posted by BigSugar


those were the lines just to get a number for the other line which gets you in to see the nurse who then gives you a number to see the doctor who then says "we can give you asprin for that headache, but you'll have to wait a year." :)
You must have gone to a whole other place. You're pretty sure it's like getting bread or toilet paper in the former USSR don't you?

[bluelupis]

Originally posted by Megs79


I read stuff about this all the time- some docs are switching to gyn only, because there's too much litigation in ob.

Does canada have a lot of drs that operate privately (outside the socialized system)? France has a socialized system, but they also have private practice drs who treat people that are willing to pay for their services... In other words, the government plan is there for everyone, but you CAN get treatment elsewhere IF you can pay for it.
That is true socialized medicine in a capitalistic society and leans towards what I was talking about. It alleviates much of the doc's pressure. Big Sug, you always so up in your face? I don't mind or nothing it's just that if you only look at Canada then your sight is so narrow, no wonder you are Republican. As far as more government, bah! Because the taxes are paid at a higher mark in these other countries does not mean the government is into their lives deeper. It means they can count on having a way to have the child or get the stitches without worring about insurance. I am not going to argue it any further. I am sorry your family got screwed in Canada man. That really sucks.

[supra-genius]

Looks like its not a good day for lawyers

Court limits HMO suits over care denial
Supreme Court rejects malpractice cases based on state laws
The Associated Press

Updated: 1:25 p.m. ET June 21, 2004WASHINGTON -

The Supreme Court said Monday that patients who claim their HMOs wouldn't pay for recommended medical care cannot sue for big malpractice damages, removing a weapon that trial lawyers and patient rights advocates said was crucial to keep the insurers honest.


The court was unanimous in saying that two HMO patients in Texas cannot pursue big malpractice or negligence cases against their insurers in state court, as they claimed a Texas patient protection law allowed them to do.

The case involves an issue that has stymied Congress, which has tried and failed to pass national patients' rights legislation. Some states have passed their own patient protection laws in the meantime, but the scope of protection varies.

The biggest question unresolved until Monday was whether patients could seek hefty damage awards in state courts, or whether they are limited only to federal courts, as insurers claimed.

The choice is significant, because state court juries can often be generous to sympathetic victims. Insurers have claimed that patients could only go to federal court, and then only to recover the value of whatever benefit the HMO denied.

The ruling weakens the Texas patient protection law and those of other states.

Ruling based on 30-year-old federal law
The court based its ruling on the language of a 30-year-old federal law, originally meant to protect employee pensions and other benefits, but now applied to the managed care industry.

The law, the Employee Retirement Income Security Act or ERISA, forces the HMO patients at issue in the case to sue only in federal courts, Justice Clarence Thomas wrote for the court.

The insurance industry had argued that ERISA trumps state patient protection laws or other state laws that allow medical negligence suits in local courts, and lower courts were divided on the issue.

The case concerns a gray area of medicine and insurance, in which decisions about what treatment to pursue and what coverage to offer are mingled. The situation arises frequently in managed care, where doctors belong to a closed network of providers overseen by administrators who may not be doctors but who nonetheless decide what the company will pay for.

The court ruled against a hysterectomy patient, Ruby Calad, who had claimed that Cigna Healthcare of Texas essentially evicted her from a Houston hospital after only one day of recovery.

The HMO would not pay for a longer stay, even though her doctor recommended it.

Complications set in after discharge
She was back in the hospital a few days later, suffering complications she claims could have been avoided had she remained hospitalized longer after surgery. She later went to court, seeking to make the HMO pay a price for what she called negligent care.

The Supreme Court did not decide whether Calad deserved better — only whether and where she could bring her lawsuit.

Trial lawyers, patient rights advocates and others had argued that HMOs need the threat of hefty jury awards to keep them honest.

Health insurers, backed by the Chamber of Commerce and others, argued that lawsuits drive up the cost of health care for everyone, and HMOs must draw the line somewhere.

In the Calad case and a companion one involving post-polio patient Juan Davila, insurers tried to pull their lawsuits out of state court and then sought to have the complaints dismissed in federal court.

Davila took what he claims was inferior but cheaper pain medication, instead of the Vioxx his doctor had recommended, because his Aetna Health plan would not pay for the more expensive drug right away.

The cheaper medication caused bleeding ulcers, and he almost had a heart attack, Davila said.

HMOs an increasingly popular option
Employers provide most private health insurance to American workers, and HMOs or other managed care options are increasingly popular choices as health care costs rise.

Texas and nine other states regulate HMOs, making decisions about whether treatment is medically necessary, state attorneys general backing Calad and Davila argued in a friend of the court brief. Other states have passed some form of consumer protection from HMO decisions, and still more states are considering such laws, the state lawyers wrote.

Arizona, California, Georgia, Louisiana, Maine, New Jersey, Oklahoma, Washington and West Virginia have laws similar to Texas’s.

The cases are Aetna Health Inc. v. Davila, 02-1845 and Cigna Healthcare of Texas Inc. v. Calad, 03-83.

[BigSugar]

LOL! yeah, they used a 40 year old ERISA (Employee Retirement Insurance law) to justify this. Interesting. So, if you get cancer, your HMO denies treatment, and you die as a result, then your estate can only recover the amount of the proposed treatment and not damages for the wrongful denial of services (assuming arguendo that it was wrongful). sounds fair. NOT!

my uncle (psuedo uncle anyway....best friend of my dad from the Phillipines) was DX'd in canada with terminal cancer and given 6 months to live. He was then placed on a waiting list for treatment that was at a minimum 3 years long. He came to the States, got treatment and has lived another 10 + years as a result. the all knowing and great socialized medicine would have seen him dead before they treated him.

the govt. has a few operations......maintain the roads, provide for the national defense, and stay the hell out of the way of the individuals exercise of their inherent rights. sure, that's a simplistic view of the role of govt., but the ever expanding role of govt. is a bad thing, and socialized medicine is just another big goddamned welfare plan. It won't rid us of insurance companies, but it will suck more and more taxes out of our paychecks and be just another giant bureaucratic sinkhole in DC. want to opt out of national healthcare b/c you have a better plan? too bad, 'cause you have to pay for everyone else who doesn't pay enough taxes to support the system. pay for healthcare 2x or 3x, but only use it once.

[FitterHappier]

Richard Scruggs, the Mississippi litigator who took on and beat big tobacco, has declared war again. This time around he's targeted the non-profit hospital industry, unleashing a barrage of lawsuits challenging their business and accounting practices.

A team of consultants working under Scruggs' direction has built a mountain of evidence against 13 of the nation's largest non-profit hospital chains, including Advocate Health Care Network, Catholic Healthcare Partners (CHP), Baptist Health South Florida and Provena Health. The claims are revealed in 13 class action complaints filed Wednesday in various federal courts across the nation and obtained by Mother Jones. The suits provide a glimpse into the underbelly of the non-profit hospital industry, accusing Advocate and others of systematically defrauding the American public.

The suits seek undisclosed damages, including "revenues in an amount sufficient to provide the Plaintiffs and the class mutually affordable medical care." Scruggs, whose $286 billion settlement against cigarette makers made history and netted him a fortune, says the new fight will likely be even bigger. Given the number of plaintiffs, the extent of their holdings, and the ambitious nature of the damages being sought, Scrugg could be right. And, as in 1994 when he joined with Mississippi Attorney General Michael Moore in suing the cigarette makers, Scruggs is hoping to convince several states to join the fight. Because the class action alleges abuse of public funds and resources, Scruggs is hopeful that a number of attorneys general "will take notice of this and take action."

Scruggs says the legal argument behind the suits is a fairly simple one. "A non-profit hospital, in order to obtain freedom from taxation, has to prove that they provide charity care." The beneficiary of that care, he says, should be the poor and uninsured. But the suits' plaintiffs contend that non-profit hospitals have systematically reneged on their obligation, ignoring charity care in order to make – and keep – more money.

"These are hospitals that are flush with cash… they're just hoarding money," Scruggs says. He contends that the liquid assets of the nation's non-profit hospital chains could actually exceed the liquid assets of all 50 states.

The rest at MotherJones (http://www.motherjones.com/news/update/2004/06/06_300.html).

[DudeMan]

I read that some doctors were considering not treating these medical malpractice vulture attorneys. I doubt they'll do it, but one can always hope.

One good bit of news is that Governor Barbour of Mississippi just got passed tort reform in his state, which has been notorious for some of the abusive lawsuits that have been filed there. So maybe there's hope.

[onest2.0]

Originally posted by DudeMan
I read that some doctors were considering not treating these medical malpractice vulture attorneys. I doubt they'll do it, but one can always hope.

Whatever happened to the hippocratic oath?

[DudeMan]

Originally posted by onest2.0

Whatever happened to the hippocratic oath?
It's probably in the same place as the Trial Lawyer Association of America's ethics -- lost at sea somewhere.