Does Health Care Reform Keep Patients Safe?

The Cost of Medical Error

Largely missing from the debate about the “cost” of health care is the human and fiscal toll of medical and medication errors, and defective medical devices.

IB News has reported on the repeated surgeries needed to remove migrating synthetic surgical mesh, used to treat hernias and incontinence, or when medical devices are later found to be defective after being approved to market.

And medical errors are not limited to doctors. Steven Olsen, 18, is now blind and brain-damaged after an HMO refused an $800 CAT scan after he fell on a stick in the woods.

Just this week, the Rhode Island Hospital was fined $150,000 after its fifth wrong-site surgery since 2007. The latest blunders were precluded by three botched brain surgeries and a wrong site procedure on a child’s cleft palate.

“The problem’s not going away,” said Peter Angood, vice president and chief patient safety office at the Joint Commission, an independent organization that accredits hospitals about doctors’ failure to go through a checklist.

Preventable medical and medication errors and preventable hospital infections kill upward of 200,000 people a year, uncovered in a recent investigative report by the Hearst newspaper group “Dead by Mistake."

And these errors are costing Americans $17 to $29 billion annually, the Institute of Medicine (IOM) found a decade ago in its “To Err is Human” report.

Many instances of medical malpractice repeated by the same estimated five percent of doctors, finds Public Citizen.

When Error Equals Cost

Yet health care legislation makes only modest steps to address the cost of medical error.

When the “To Err is Human” report first sounded the alarm about widespread medical errors and its cost, Congress rushed in and held hearings with promises of reform, but no patient safety bills were adopted, according to Consumers Union in its follow-up report.

IOM recommended implementing safe medication practices, creating accountability through two national mandatory reporting systems to track the problems, and to raise the standards for patient safety.

Nonprofit, Consumers Union says health reform bill H.R. 3962 does require public reporting of health-care acquired infections in an effort to reduce them.

Protecting People or Profits

What’s notable is the extent to which the Republican alternative, introduced this week goes to protect the health care industry over patients.

The text, “Amendment in the Nature of a Substitute” was offered by John Boehner of Ohio.

While the Congressional Budget Office finds the Republican plan would increase the number of Americans with no health insurance coverage by 3 million more Americans leaving 52 million uninsured, it’s what the legislation does to further hurt injured patients that is notable.

The Center for Justice & Democracy calls the Republican plan “Outrageous, Pointless and Cruel” because of what it does contain:

• Limits liability of doctors who make errors, hospitals, HMOs and nursing homes as well as the pharmaceutical industry
  
  
• Place a ceiling on patients’ legal rights by placing a $250,000 on the amount an injured patient could receive for non-economic injuries, even if he or she has a lifetime of care that could run into the millions of dollars. Women, low-income earners, seniors and children are most impacted as they would typically receive most of their compensation in the form of non-economic damages. Punitive damage would be limited to two times the amount of economic damages off $250,000 whichever is greater.
  
  
• It reduces the statute of limitations, the amount of time an injured patient hs to file a lawsuit against a doctor, hospital, Nursing home or HMO.
  
  
• It would eliminate joint and several liability for economic and non-economic damages. That is a centuries-old doctrine that protects injured consumers if more than one is responsible for the injury but cannot pay. For example, if a nursing home assistant assaults a resident but is insolvent, it would allow the victim to obtain full compensation against the nursing home.
  
  
• For the injured who have no money but turn to a lawyer to take their case, the contingency fee system has allowed the lawyer to be paid, if he or she is successful only. The Republican substitute limits contingency fees by capping them along a sliding scale so fee percentages decrease as judgments increase. For the injured who are out of work and options, this guarantees that if they cannot afford a $150 to $250 hourly bill and the cost of experts to bring their case, they will be unable to.

If the House bill passes it will then move the action to the Senate version where both sides would have to work out their differences. President Obama wants to sign a bill by the year’s end. #