Pa. medical malpractice debate highlights flaws in the system
Dr. William Sage, an expert on the medical malpractice insurance situation in Pennsylvania, predicts the focus will shift from limiting jury awards for damages and move towards alternative ways to compensate injured patients.
The medical malpractice debate has persisted for years, and while dramatic changes have yet to occur, Sage believes the research it has yielded has been able to highlight flaws in the current system so that a greater attention can be placed on patient safety.
In a recent study, it found that huge jury awards, which have been cited as a major factor in skyrocketing medical malpractice insurance premiums, are rare. Between 1991 and 2003, the study showed that malpractice payouts increased four percent annually – consistent with the increase in health care spending.
There have also been claims that doctors are leaving states without caps on damage awards, including in Pennsylvania, but another study found that from 1985 to 2001, the states with major medical malpractice reforms, including caps, added 3.3 percent more doctors than states without such reforms. In addition, the study found that the number of doctors nationwide increased significantly during that period, even in the states that did not have caps.
While claims made in support of medical malpractice caps and other reforms have not held up to study findings, experts have also emphasized that 50,000 to 100,000 Americans die every year because of preventable medical errors, and even more are injured. Despite the high number of medical mistakes, a great majority of the injuries do not produce lawsuits or compensation.
The way the system is, according to Sage, patients are inadequately compensated while doctors are pitted against patients. Instead of addressing medical errors and studying ways to improve medical care, the errors are hidden. Sage thinks the federal government, based on what the studies on medical malpractice have revealed, should begin funding demonstration projects aimed at establishing an alternative to using lawsuits to compensate injured patients.
In 2003, legislators in Pennsylvania formed a committee to evaluate alternative methods of resolving medical malpractice claims, and in a March report, the committee said it sees promise in a “no-fault” system for handling such cases. The system would compensate victims of “avoidable” medical errors, regardless of who was at fault. An administrative body would make the ruling instead of a court, though decisions would still be appealed in a court.
The system still has a lot of obstacles, including Pennsylvania's constitutional ban on caps for damages awarded in lawsuits. Because the no-fault would rely on a schedule of damage awards, it would amount to caps. The no-fault system would also compensate many more patients, resulting in increasing payouts, and a system costing more is likely to receive a lot of opposition.
As the medical malpractice debate continues, Sage thinks that whatever the medical malpractice reforms are, they must first and foremost address patient safety and compensate a greater number of injured patients.
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