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Honest Question: what would single payer / gov't healthcare do to "malpractice insurance"?

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FormerDittoHead Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 11:51 AM
Original message
Honest Question: what would single payer / gov't healthcare do to "malpractice insurance"?
One of the current gripes of doctors, and justification of high fees is malpractice insurance from those "run away law suits" and "outrageous jury awards". I already know that the news of these trials are usually much less than the headlines indicate, but they ARE used to justify the high cost of this insurance.

However, I'm not clear as to how this would work under a possible gov't run system. Under a gov't run system, for example, Even though any subsequent medical care would automatically be covered, such case settlements usually add such things such as loss of income, pain and suffering, etc.

I'm bringing this up because I can't help but think this would be yet another layer of expense that would be saved with a full-blown health care system, but I have heard absolutely no mention of it.
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no_hypocrisy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 11:53 AM
Response to Original message
1. Good question. Could you sue the government for malpractice as
it has an obligation to patients by sponsoring the healthcare provided by the physicians, the hospitals, and the nurses.
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Canuckistanian Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 05:33 PM
Response to Reply #1
23. Since government isn't "providing" the health care
Why should they be sued for it?

Single payer is just that. The government PAYS for health care. It does not provide the services itself.

The doctor or hospital acts as an independent legal body and as such, could be sued for malpractice.

Please don't perpetuate the myth of "government provided health care". Nobody's advocating for that.
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Dr.Phool Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 11:54 AM
Response to Original message
2. I don't have an answer to your question.
I never really thought about it.

But, just an observation, have you ever noticed whenever we have a major problem, there's an insurance company involved in it some how?
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frazzled Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 11:56 AM
Response to Original message
3. It would have to be 'nationalized,' too?
There would still be a need for 'pain and suffering' damages.

The woman who had both of her breasts removed in a mistaken double-mastectomy recently should receive some pain and suffering damages for the mistake that happened to her. I assume the government would run the malpractice insurance for doctors?
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Jackpine Radical Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 11:59 AM
Response to Original message
4. There needn't be any connection at all.
I'm a psychologist & carry malpractice insurance. When I perform health care services for an insured person, I'm reimbursed by that person's health insurance. If that person were to sue me, my malpractice coverage would have to pay, and they would consequently jack up my insurance premium or maybe even refuse to renew my coverage, but this would in no way affect the patient's health care coverage. Two separate insurance companies, two separate issues. If the patient were covered by a universal healthcare system, I would still presumably have to carry my malpractice insurance, and the patient would still have the right to sue me.

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Froward69 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:01 PM
Response to Original message
5. Under the current system
Edited on Mon Oct-08-07 12:06 PM by Froward69
When a Quack kills someone and gets sued, even when he looses, The insurance appeals and eventually pays a reduced amount.( or not if the claiment has no heirs) he keeps his medical license. Going on to mame/cripple/kill more people. How about if the doc kills someone through his ineptitude, He looses his license. They dont get malpractice insurance. Would cause them to be more vigilant to the patient and the For profit insurance company has no premium to increase. The Insurance industry is a scam. and needs to be removed from Health care Altogether. HMO's Created this mess to begin with.
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Mojorabbit Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:19 PM
Response to Reply #5
9. No so
my hubby was sued once and it was a frivolous suit. He had no say. The malpractice insurance company settled and would not let him fight it in court as it was cheaper for them. He was furious.That being said my hubby is all for patients being able to sue for negligence. They tried limiting suits in Texas and malpractice insurance premiums went up anyway. We pay an enormous amt in premiums.
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Froward69 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:42 PM
Response to Reply #9
13. just my point
there is an old saying that, "God does the healing and Doctors collect the fee." I espouse removing the insurance companys altogether. I also agree that frivolous suits are a problem. I feel he (your hubby) should have had a say, and been able to fight it... and alas the insurance company settled and increased the premimum.

If the claiment wouldent have had the option of suing to begin with, and the insurance was not allowed. I bet your Hubby would have been cleared by a board of his peers. nor would the For-profit insurance company have premimums to increase.
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Warpy Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:02 PM
Response to Original message
6. Awards would be considerably smaller and limited to pain and suffering
and possibly lost wages. There would no longer be a need for a multi million dollar award to provide enough income to cover a lifetime of medical care.

Not that many people get those awards. They're usually trumpeted in the press and used in GOP stump speeches but drastically reduced on appeal.
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tech3149 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:09 PM
Response to Original message
7. I expect that it would have very little effect
The biggest problem with malpractice in the medical profession is that state licensing boards and professional associations do not enforce ethical practices and professional quality within the profession. A very small percentage of practitioners are responsible for a large majority of malpractice claims. If those responsible were driven from the profession or forced into remedial training, there would be no justification for the exorbitant insurance rates.
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AnotherGreenWorld Donating Member (958 posts) Send PM | Profile | Ignore Mon Oct-08-07 12:21 PM
Response to Reply #7
10. Exactly.
"The biggest problem with malpractice in the medical profession is that state licensing boards and professional associations do not enforce ethical practices and professional quality within the profession."

It's an extremely corrupt profession.
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tech3149 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 04:04 PM
Response to Reply #10
18. I wouldn't call it extremely corrupt ,but their is a protect your own mentality
Until health care professionals are willing to hold their own accountable for their actions, the situation won't change.
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TreasonousBastard Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:14 PM
Response to Original message
8. Depends on how it's set up...
if the doctors are government employees, and hospitals government ganecies,they may not be personally liable for malpractice, and suing them would be like suing the government for anything else.

If they are still private practices reimbursed by government, they would have the same personal liability they have now and limits of liability could be legislated, just like they are now in some states.

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sutz12 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:23 PM
Response to Original message
11. It would go poof! nt
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cornmak Donating Member (8 posts) Send PM | Profile | Ignore Mon Oct-08-07 12:33 PM
Response to Original message
12. I used to live in Toronto and I had a very bad experience:
My wife fell and broke her ankle on a Sunday night about 10 years ago. We had to go to Toronto General. There they did the xray, gave her a few shots, reset the bone, xrayed again, and put a cast on it, telling us to return in a week. She began feeling a lot of pain after a few days and called back. They told us it was normal, to stay off it--she stayed in bed most of the time--and to show up on the date that she was originally given. When we did go in, they xrayed, then cut off the cast--it turned out that there was much more damage than a broken bone and now it was infected. It was almost a year before she could fully walk on it again after two surgeries and six months of rehab. She also couldn't work the entire time so she had to collect disability--about 1/4 of her normal salary. I actually had to leave school for a year because our money got so tight.

What really made us mad was the fact that she could not sue for malpractice to at least cover her lost wages because of the added time due to the mistake--properly treated, it should have only been 6 weeks. We talked to four different lawyers. The law there requires the malpractice to be "blatant" and mis-diagnoses does not fall under that. All of the lawyers told us that it is very hard, almost impossible one said, and takes a very long time to sue in the medical areas up there unless it is a private practice. Basically that mistake cost our family one year of my schooling and $75K of her salary.
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AnotherGreenWorld Donating Member (958 posts) Send PM | Profile | Ignore Mon Oct-08-07 12:48 PM
Response to Reply #12
14. It's almost impossible to sue for medical malpractice here, too.
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alittlelark Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:55 PM
Response to Reply #12
17. I doubt you would find an American atty that would take that case.
The malpractice needs to be pretty blatant for a case to get to court.
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shraby Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:50 PM
Response to Original message
15. The doctors/hospitals wouldn't
be run by the government. They would still be the same as they are now, only the payment system would be changed The docs/hospitals charge, the government pays instead of insurance companies or private individuals. The doctors/hospitals would still have to carry malpractice ins. for possible oopsies that harm people in their care.
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SoCalDem Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 12:54 PM
Response to Original message
16. It's hard for most people to remember, but there was a time when doctors
did NOT get sued routinely. Although doctors were held in high regard, the general public always felt that they were doing the best they could, and would never deliberately or wrongfully mistreat them or their family members. Doctors had a personal "relationship" with their patients and the patients felt that they truly cared..

HMOs & mega-clinics changed all that.. The doctors morphed into "hired contractors" who were strangers to the patients, and they charged a lot on top of that. It's after that all happened that patients started to question whether they had been mistreated or ripped off or that a loved one had actually been harmed..

It could be that if we truly nationalized health care, there would be less pressure on the doctors and the patients, and maybe that personalized care could once again emerge..

If the doctors are paid well, and the patients are well cared for, i think the anxiety level for all would drop significantly..and maybe the incidents of malpractice would drop.

Another thing that's happened is that as our technology improved, people can easily get unrealistic expectations of treatment outcomes.. The internet is partly responsible too.. people read about someone who has/had the same thing, and they got better, so of course people latch onto any ray of hope, and are devastated when things do not work out for them.. When someone dies or is hurt by a treatment, it's only natural to want to find blame...especially when there is guilt for having pushed so hard to get that treatment for them.

Patients & families are being forced to make medical decisions that they did not used to have to make, and living with those decisions if they go badly , can be a huge burden..
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Solon Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 04:14 PM
Response to Original message
19. As of right now, malpractice claims take up less than 1% of total medical expenditures...
Actually less than half a percent, .46%. So I don't see what the big worry is about, people LOVE to exaggerate the problem, to the point of ridiculousness.

http://content.healthaffairs.org/cgi/content/abstract/2...
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FormerDittoHead Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 04:40 PM
Response to Reply #19
20. I wonder why there's so much ado about "tort reform" then? Wouldn't seem worth the bother. n/t
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Solon Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 04:54 PM
Response to Reply #20
21. Most of the ones pushing it were Repukes and Big Business...
Besides that, tort reform didn't just involve medical malpractice but ANY civil suit against large organizations. The problem is that we get extremely rare lawsuits, where millions of dollars are awarded to someone, and that's so rare, it actually MAKES the news, think about that. Besides, even infamous ones, like the McDonald's coffee suit, was knocked down to a few hundred thousand dollars on appeal, as is normal for suits that actually go to court, most are settled out of court, for far less money.

Its one of those non-issues that Repukes love to bring up as a distraction about how horrible their other policies are.
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legaltender Donating Member (23 posts) Send PM | Profile | Ignore Mon Oct-08-07 05:32 PM
Response to Original message
22. There are many malpractice suits against
federally-run hospitals, doctors, and clinics now. Military dependents who are victims at military hospitals; veterans who are victims at veterans' hospitals; Native Americans (referred to in the law as Indians) at Indian Health Clinics.

They first file a claim under the Federal Tort Claims Act (FTCA). Once that is denied, or they can't reach an agreement, they can file a lawsuit in the district where the malpractice occurred. The federal courts apply state law, based on the state where the lawsuit is filed. Here in California, the federal courts are bound to apply the $250K cap on pain and suffering (there's no cap on economic damages, which would include past and future wages, past and future medical expenses, lost opportunity, hiring caretakers, etc.)

So, if the health care system were to become a federally-run, single-payer (U.S.) system, it's likely that malpractice cases would be handled under the FTCA.

At present, if military, VA, Public Health Service, etc. doctors are sued individually, the U.S. automatically substitutes in as the defendant. They technically don't need malpractice insurance, although some get it just for peace of mind. If the future health-care system follows the military/VA/PHS pattern, then doctors won't need to acquire malpractice insurance.

Any wonder why insurance companies are against it?
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Vinca Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 05:46 PM
Response to Original message
24. Single payer, universal healthcare is, essentially, a payment system.
The government doesn't own the hospitals or employ the doctors. Malpractice insurance is a separate issue. I've never seen the figures on how much money the insurance companies make off premiums doctors pay, but you have to assume they're being screwed just like their patients who can afford insurance.
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FormerDittoHead Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 08:57 PM
Response to Reply #24
26. I'm open to government employed doctors and gov't owned hospitals.
Edited on Mon Oct-08-07 09:00 PM by FormerRushFan
I understand that the brass ring of the day is single payer / private owned, but I have an open mind to a system of government employed doctors.

I seriously doubt that there would be fewer doctors if becoming a doctor stopped becoming a EZ-Pass to becoming a millionaire. There were doctors in the past who didn't become rich and in England, for example, doctors are government employees.

Oh, and before you say it, IMO, I believe that college and medical school should be fully gov't paid for. For crying out loud - we pay a billion a WEEK for defense because it's for the common good, right?

Both my late uncle was and my brother are doctors, I don't hate doctors, but to this citizen, gov't run health care would still be "on the table".
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Vinca Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-09-07 08:14 AM
Response to Reply #26
27. I'd be happy with an entirely government run system, too, but
it will never happen. It will be a small miracle if we ever get to the point where every citizen gets a healthcare card they can present to their provider for medical care and they don't receive a bill or stay up nights worrying about bankruptcy.
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FormerDittoHead Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-09-07 08:40 AM
Response to Reply #27
28. Yes, I literally pray that day comes before I'm forced to sell my house. n/t
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Vinca Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-09-07 12:12 PM
Response to Reply #28
29. Me, too. I can't afford insurance and I'm still 6 years away from Medicare.
Not that Medicare sounds so wonderful, either. You pay for it, but it only covers a portion of the bill. By the time you add on supplemental insurance you're pretty much back in the same old boat of not being able to afford any healthcare. It's paddling upstream.
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Selatius Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Oct-09-07 12:16 PM
Response to Reply #26
30. In France, they offer both private hospitals and state-run hospitals.
Edited on Tue Oct-09-07 12:18 PM by Selatius
Which hospital you attend is up to individual choice. Over there, they operate on single-payer health insurance, and their health care system is ranked as the world's best by the World Health Organization. Of course, French Social Security only foots about 75% of your health care bill on average, but people are free to purchase supplemental insurance to cover the last quarter.
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triguy46 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Oct-08-07 05:48 PM
Response to Original message
25. Not the same issue.
You do not want the ability to seek recompense for negligence if that is a cost of reform. A single payer system does not make physicians employees of the govt. It only decides who pays.
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