Tuesday, September 23, 2003

Read Beyond the Blame: A No-Fault Approach to Malpractice with great interest. I feel that this sort of system bears looking at. One of the best parts of it is that case would be decided by a panel of physicians and laypeople. This would help eliminate the bad outcome/complication = negligence problem that is prevelant in medical liability today.
One problem I could see is that these panels could quickly become overwhelmed by cases, unless some guidelines of what is reportable and what is not are put into place. Is a simple wound infection "reportable"? Is a pneumothorax from a central line? If the figure of 97 percent of "negligent care" cases resulted in no suit, a panel to capture those patients could be quite busy.
One of the problems with a no-fault system is cost. As this Medical Economics article points out:

Affordability, though, is a real-life issue for New Zealand's no-fault system. Outlays for patients injured by medical errors and mishaps rose 82 percent from 1997-'98 to 2001-'02. The cost per claim has been rising dramatically, and the system piles on new claims even while it continues to pay on old ones. Some New Zealanders are so concerned about the level of spending that they've proposed having physicians reimburse the government for what it pays injured patients.

And about what to report....
New Zealand's situation doesn't surprise health care economist Patricia Danzon, a professor at The Wharton School of the University of Pennsylvania. "I don't think there's an advantage in moving away from a fault-based system," she says. "It's hard to define a compensable injury if you eliminate the idea of error. You don't want to pay for all bad outcomes, but where do you draw the line? The cost can go through the roof
Something to think about?
via D.B.'s Medrants
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