Injuryboard Commentary - Health

Are Malpractice Claims Running Doctors Out of Business?

Mike Ferrara — Tue, 08 Dec 2009 21:06:14 GMT

In an effort to cap or otherwise limit malpractice claims across the country, tort reformers tell us again and again how the high cost of malpractice insurance is running doctors out of business. They’re scarcely scraping by, we hear, and tort reform is the only answer.

There are a number of reasons why this is bogus (check out our Cherry Hill blog for more info), but here is the latest from Forbes Magazine’s Top 25 Paying Jobs in the US. The salaries speak for themselves.

No. 1 Surgeons

Average Annual Pay: $206,770

One-Year Change: +8.0%

Employees in Field: 47,070

Best-Paying State: Wisconsin

The Job: Treat diseases, injuries and deformities by invasive methods, such as manual manipulation or by using instruments and appliances

No. 2 Anesthesiologists

Average Annual Pay: $197,570

One-Year Change: +2.5%

Employees in Field: 34,230

Best-Paying State: Kentucky

The Job: Administer anesthetics during surgery or other medical procedures.

No. 3 Orthodontists

Average Annual Pay: $194,930

One-Year Change: +5.2%

Employees in Field: 5,500

Best-Paying State: New Hampshire

The Job: Examine, diagnose and treat dental malocclusions and oral cavity anomalies. Design and fabricate appliances to realign teeth and jaws.

No. 4 Obstetrician and Gynecologists

Average Annual Pay: $192,780

One-Year Change: +5.0%

Employees in Field: 19,750

Best-Paying State: Wisconsin

The Job: Diagnose, treat and help prevent diseases of women, especially those affecting the reproductive system and the process of childbirth.

No. 5 Oral and Maxillofacial Surgeons

Average Annual Pay: $190,420

One-Year Change: +6.7%

Employees in Field: 4,760

Best-Paying State: Michigan

The Job: Perform surgery on mouths and jaws.

No. 6 Internists, General

Average Annual Pay: $176,740

One-Year Change: +5.7%

Employees in Field: 46,980

Best-Paying State: Wisconsin

The Job: Diagnose and provide nonsurgical treatment of diseases and injuries of in

No. 7 Prosthodontists

Average Annual Pay: $169,810

One-Year Change: +0.3

Employees in Field: 370

Best-Paying State: New Jersey

The Job: Construct oral prostheses to replace missing teeth and other oral structures.

No. 8 Physicians and Surgeons, All Other

Average Annual Pay: $165,000

One-Year Change: +6.3%

Employees in Field: 26,850

Best-Paying State: Minnesota

The Job: All physicians and surgeons outside of the main specialties.

No. 9 Family and General Practitioners

Average Annual Pay: $161,490

One-Year Change: +5.1%

Employees in Field: 106,210

Best-Paying State: Wisconsin

The Job: Diagnose, treat and help prevent diseases and injuries that commonly occur in the general population.

No. 10 Chief Executives

Average Annual Pay: $160,440

One-Year Change: +6.0%

Employees in Field: 301,930

Best-Paying State: New Jersey

The Job: Determine and formulate policies and provide the overall direction of companies or private- and public-sector organizations within the guidelines set up by a board of directors.

No. 11 Dentists, General

Average Annual Pay: $154,270

One-Year Change: +4.9%

Employees in Field: 85,910

Best-Paying State: Alaska

The Job: Diagnose and treat diseases, injuries and malformations of teeth and gums and related oral structures.

No. 12 Psychiatrists

Average Annual Pay: $154,050

One-Year Change: +4.4%

Employees in Field: 22,140

Best-Paying State: Nevada

The Job: Diagnose, treat and help prevent disorders of the mind.

No. 13 Pediatricians, General

Average Annual Pay: $153,370

One-Year Change: +5.6%

Employees in Field: 29,170

Best-Paying State: Kentucky

The Job: Diagnose, treat and help prevent children's diseases and injuries.

No. 14 Dentists, All Other Specialists

Average Annual Pay: $142,070

One-Year Change: +18.0%

Employees in Field: 4,770

Best-Paying State: Oregon

The Job: Specialist dentists excluding oral and maxillofacial surgeons, orthodontists and prosthodontists.

No. 15 Podiatrists

Average Annual Pay: $125,760

One-Year Change: +5.0%

Employees in Field: 9,670

Best-Paying State: Idaho

The Job: Diagnose and treat diseases and deformities of the human foot.

Originally posted at InjuryBoard by Mike Ferrara

Senator Delay, Senator Defend, And Senator Defend: Do The Job For Insurance Companies

Mike Bryant — Mon, 07 Dec 2009 23:17:14 GMT

We have talked about the insurance company strategy of Deny, Delay, Defend many times here at the Injurboard. A couple of companies have almost come right out and admitted that is their strategy. Say no. Some people will go away. Say you need more time. Some people will die or give up. Say Hell No! Some people will not have the resources or the help to fight. It is the way to push the unrepresented around.

Well should we be surprised the tactic is at the heart of what the Republicans are doing in the Senate with the Heath Care Bill? How do we know? They told us.

Here is the whole letter and supporting documents.

If you think maybe they are doing what's right for the consumer. Keep in mind, many of these same Senators had the chance to do something about health care in the past. They didn't. Just like insurance companies could pay the bills they are responsible for.

Originally posted at InjuryBoard by Mike Bryant

Where Do The Doctors Go?

Mike Bryant — Mon, 07 Dec 2009 09:56:00 GMT

There has been an going mantra from fans of tort reform that the main reason you need medical malpractice change is that doctors are quitting and fleeing states because of premiums. Many of the writers here at the Injuryboard have looked at this issue. There really doesn't seem to be support for the claim.

But, there are areas that are seeing reduced numbers of doctors. The question is why? A special report may have found some of them. The report found:

Doctors have been flocking to the area and surrounding Westchester County since the 1970s, drawn in part by an upper-class clientèle who demand top-notch medical care and have the means to pay for it.

The answer was that money is what drove doctors to an area. Is that why Texas , with it's high medical costs, is seeing more doctors in the area? As TortDeform recently pointed out:

Ask a doctor if they’d rather practice in White Plains, where everyone has health insurance and the doctor risks being sued, or if they’d rather practice in the California central valley (or any other poor, uninsured area) and be completely immune to malpractice lawsuits. Most doctors are going to pick White Plains because money matters.

It's time that we get beyond the myths and into what, not only makes sense, but also is the reality of what is going on. Minnesota doesn't have damage caps and it has medical facilities continuing to sprout up all over.

Originally posted at InjuryBoard by Mike Bryant

Employers who hire day laborers still responsible for workers comp benefits

Doug Landau — Sun, 06 Dec 2009 21:15:21 GMT

Employers who hire day laborers, undocumented workers and cash only laborers still responsible for workers comp benefits, according to workplace injury lawyer Doug Landau of ABRAMS LANDAU, Ltd. In a decision in favor of Landau's client handed down by the Workers Compensation Commission, the worker's medical bills (without any deductibles), temporary total disability, out of pocket expenses for his prescription medications, travel to see his health care providers and permanent injury were all ordered to be paid by the insurance company.

FACTS: The worker was picked up at the Herndon 7-11, since, in their infinite wisdom, the Town Council closed the Herndon Day Labor Site and brought those seeking employment back to Elden Street where everyone who visits the "Historic" Town can see them every morning lining the roadway. The construction company owner selected several men with experience in the building trades who would be paid cash at the end of the day. The owner was driving a company truck, wearing the company uniform and had the company's tools in the back. Several of the laborers were dropped at a commercial construction site before Landau's undocumented client was dropped off with another worker at a residential property with the company's sign out front. The claimant was ordered to clean up the construction debris and was injured while doing so. When the injured worker sought help, he was told by the construction company that he was not an employee, and their insurance company added that he was not on their list of employees, not on their insured's work site and not covered by their policy. When the worker cam to ABRAMS LANDAU, he had received no benefits of any kind.

The injured worker had no documentary evidence other than the owner's business card and a recall of the address where he was injured. The ABRAMS LANDAU team was able to investigate his claim and find out that the residence was owned by the boss's sister, and that indeed, the company's sign had been out front. The injured workers law firm was able to show the Workers Compensation judge that by all appearances, this was indeed one of the company;s work sites, an that the men were hired by the company. Using the legal doctrine of "apparent agency," lawyer Landau was able to convince the comp judge that the claim was indeed meritorious and the judge ordered the construction company's insurer to pay the benefits sought. The construction company thought it could get away with hiring these men and then avoid responsibility if they got hurt. However, the Workers Compensation Commission ruled that the company was indeed responsible for the men it engaged and had working under its direction, regardless of their legal, temporary employment or work status. If you or someone you know has been injured in an on the job accident, e-mail us at ABRAMS LANDAU, Ltd., or call 703-796-9555 today.

Originally posted at InjuryBoard by Doug Landau

Heath Insurance Coverage Shouldn't Be A Deterrent To Rape Reports

Mike Bryant — Sun, 06 Dec 2009 19:51:00 GMT

Interesting series in the Huffington Post last week, which looked into the issue of what happens to women who make certain kinds of medical claims. Spotlighted were the cases of women who, after being raped, needed to go through courses of HIV protection measures or who needed post-traumatic care.

Imagine even having to consider whether to report the brutality of being raped because you might later be denied for a preexisting condition. This is just an almost unthinkable deterrent.

It is the quandary that so many insurance companies profit from. The reason for the ongoing fairy tail that there is a litigation explosion out there. They profit from getting as many people as possible to buy more and more coverage. You never know when you will be sued, get sick, suffer a loss. Alternatively, they scare the heck out of people from ever using their coverage. Rates will go up, I will be denied, and I won't be able to get future care.

Just another reason why the health care debate needs to be about the consumer. That real issues , involving real people have to be at the center of any debate. This is not a time for profits over people. It is also most likely the reason why, just like in auto claims, the insurance companies have gone to the old Delay, Deny, and Defend policy.

Originally posted at InjuryBoard by Mike Bryant

The Senate Health Care Debate Continues To Be About Money Instead Of Consumers

Mike Bryant — Sun, 06 Dec 2009 17:05:22 GMT

I've written a number of times about what the issues should be at the heart of the health care debate: making sure more people have insurance, helping businesses that are being crushed by insurance costs, and most importantly, making sure we have good care. Of course, to do these things we have to talk about how to pay for them. But, I've been watching the debate for a week now, and continue to see opposition speakers get up and ignore the consumer. You can't be surprised, considering so many of them have been there for a long time and for the most part never even brought up the health care issue.

Instead it has been a stream of classic Bush/Rove attacks against the lawyers. Today, Sen. Ensign offered an amendment which would limit contingency fees in medical malpractice lawsuits to 33% of the first $150,000 of the total amount recovered by judgment or settlement, and 25% of any amount recovered in excess of the first $150,000 recovered by such judgment or settlement. The amendment also calls for the periodic payment of successful judgments.

Who does this bill help? Less people would be able to bring meritorious claims and the liability insurance companies would save money. Bad doctors could keep making money or at least feel safer in their malpractice work. The defense could spend all the money they want and delay more claims. And when a jury says they are supposed to pay, they get more time and a payment plan to do it. How does this make sense to anyone?

This idea doesn't even directly save the system money. The proponents argue indirect savings, but every such argument has been shown to be inaccurate:

Saving through the reduction of defensive medicine:

Tort Reformers Ask: "What? You asked for an X-ray!" Bah! Humbug!,Steve Lombardi, October 19, 2009 10:14 AM

Saving of reduced junk law suits:

I sn't Tort Reform Only About Frivolous Cases?, Wayne Parsons , October 25, 2009 2:08 PM

Savings through better care:

Health care Reform Must Put Patients First Because Medical Errors Happen All Too Often, Christopher Nace, November 16, 2009 10:00 AM

The shining example of Texas:

Straight Talk on Tort Reform from Texas, Bret Hanna , November 23, 2009 11:20 PM

The contingent fee system is only way that many Americans have any chance of being allowed the "key to the courtroom." People who have already suffered an injury, have medical bills and no income can only fight when they have the backing and support to do so. It is a protection that helps fulfill the basics of the 7th Amendments and protects vital consumer protections.

93,000 people die each year from medical errors. This amendment does nothing to make things safer. It does nothing to insure people have a remedy when wronged. Most of all it does nothing to deal with the real issues of the health care debate.

When the amendment comes up this afternoon, it needs to be stopped.

Originally posted at InjuryBoard by Mike Bryant

Why are Medical Bills so High?

Jon Lewis — Sat, 05 Dec 2009 13:49:34 GMT

Did you know that hospitals and physicians rarely ever receive the amount they charge for their services? Health insurance companies do not pay the actual bills invoiced by medical professionals. Why is that?

We had a client who was injured in a truck collision. His injuries were serious enough to warrant several nights in the hospital and a couple of surgeries. What were his medical bills? Approximately $72,000.00. What did the hospital and physicians get paid? $11,714.01, approximately 16% of the amount billed.

If you had a retail store, would you accept 16% of your prices? Why do hospitals and doctors? Are they over-charging, or are they getting paid too little?

What if you don't have health insurance? What happens then? Well, I can tell you that I handled collections for a hospital about 13 years ago, and if patients came in for emergency treatment and didn't have insurance, we sued them for the full amount, not 16%. Why do private pay individuals have to pay the full amount? I understand why health insurers receive a discount, but an eighty-four percent (84%) discount? What if Bill Gates doesn't want to get health insurance? He can pay any amount billed so why doesn't he receive the same discount as a company like BlueCross?

Is this a form of fraud or misrepresentation? In Alabama, BlueCross BlueShield has such a monopoly on health insurance that they dictate to hospitals and physicians what they can charge for their services. Many doctors speak poorly of BlueCross BlueShield as a result of their influence. Some won't even accept their rates as a result. Should the health insurance companies be setting the rates for medical treatment? Is that capitalism?

I don't have the answers to all these questions, but I think they need to be discussed, especially in light of healthcare reform. What are your thoughts?

Originally posted at InjuryBoard by Jon Lewis

AAJ Goes Underground to Debunk Rumors About Tort Reform

David Mittleman — Fri, 04 Dec 2009 10:00:00 GMT

The American Association for Justice is getting an important message across by advertising in Union Station throughout December. Blanketing the metro station’s walls, the message reads “98,000 patients may die annually from medical errors…That’s like 737s crashing every day for a whole year…Tort law won’t fix health care…Tell Congress to put patients first.” The message is meant to counter Republican attacks against healthcare reform legislation: Republicans and health insurance companies have rallied for putting limits on medical liability lawsuit awards, claiming that tort reform is the answer to the escalating costs of private health care insurance.

Union Station is one of most highly-trafficked areas for commuters travelling to our nation’s capital. The American Association for Justice specifically wants to remind Senate staffers that many people die of medical errors, and will be left with no recourse if Republicans have their way with tort reform.

As the American Association for Justice so aptly states, “health care reform is about making sure that every American has access to quality, low-cost healthcare, not about limiting the rights of innocent patients harmed by medical negligence.” Despite the opposition’s arguments, tort reform would do very little in reducing current health care costs. In fact:

· Medical malpractice is a tiny percentage of health care costs – less than one and a half percent of overall spending – according to the Government Accountability Office (GAO) and Congressional Budget Office (CBO). Restricting patients’ legal rights would have little to no effect on premiums or health care costs.

· Medical malpractice suits are less than one percent of the entire civil caseload, and have been declining for nearly a decade.

· The GAO and CBO have found no evidence of so-called “defensive medicine,” instead determining that doctors run additional tests to generate more income or help diagnose patients.

Originally posted at InjuryBoard by David Mittleman

Government Contractor's Rape Case Exposes Senators

Mike Bryant — Thu, 03 Dec 2009 09:19:00 GMT

It was nice to see recently elected and finally seated Minnesota Senator Al Franken get his first amendment passed last month. Unfortunately, it was about a very weighty topic. The amendment to the 2010 Department of Defense Appropriations Act prohibiting the government from contracting with companies who require their employees to agree to resolve certain claims, such as sexual assault, through arbitration. The amendment arises from the testimony of Jamie Leigh Jones that she was drugged and gang raped by her co-workers while working for a contractor in Iraq. When she reported the rape to her supervisor, she was locked in a metal shipping crate. She only got out of Iraq by calling her father, who got in touch with their local Congressman in Texas. When she attempted to sue her employer KBR, Inc., a subsidiary of Haliburton, she was told that she had to resolve her claim through arbitration in accordance with her employment contract. Mr. Franken's amendment was to ensure that the government does not do business with a company who would force its employees to arbitrate such a case as rape.

The bill passed but it was voted against by 30 Republican Senators. The Daily show did a good job of calling the 30 out and pointing out their hypocrisy.

http://www.thedailyshow.com/watch/wed-october-14-2009/rape-nuts

After watching this, spend a little time thinking about why these 30 voted as they did. Who are they protecting and who's side are they on? This week, this same group has been leading the floor fight against the Health Care Bill. They have been calling lawyers names, they have been calling for damage caps, and they have claimed that the change isn't for the best. Ask again who's side they are on? It's never been the consumer.

Originally posted at InjuryBoard by Mike Bryant

No Preventative Medicine: Wellness as a Crisis without a New Health Care Bill

Christy Thompson — Tue, 01 Dec 2009 17:53:27 GMT

The main dispute about health care reform is that the cost is just too much for the American taxpayers, state or federal governments to afford. Indeed, there is no arguing that the cost to implement a quality health care system in this country from the ground up will come at a sizeable cost. But everything great in US history has come at a high cost: good public transportation (where it actually exists), highways that span the nation, railroads, ideals of public education, taxpayer supported law enforcement, mail service, armed forces and arms programs. So if we can afford the price tags associated with these -- in many cases whether we agree with them or not -- why do we as taxpayers not have the right to pay for something that will keep us well?

"Crisis health care" such as ONLY seeking medical attention after a severe accident or when extremely ill leads to worsening health conditions, more death, and more costs are incurred by taxpayers. Unpaid visits to the emergency room for Americans without insurance will eventually cost exponentially more than a new health care plan.

Seeing a doctor only when disease is consuming someone's body or when a patient has a railroad spike piercing his cerebrum is a careless use of the most high tech medical machine in the world. The message of prevention is lost on the American public because they have been without it for so long that entire generations don't even really know what it means to have it and how much it could better their lives.

Supporting prevention health care rather than crisis health care is the only sure bet for the long run of a successful American health care system. Preventative medicine means doctors who take the time to inform patients and health care programs that promote healthy living and wellness as a way of being rather than letting the public depend on emergency rooms that offer only a temporary fix; it's like patching a flat tire over and over again. Eventually there will be one last blow out that just isn't fixable. This is an apt metaphor for both human beings in the current health care system and the current system itself.

Originally posted at InjuryBoard by Christy Thompson