Jeffrey Segal, M.D, a board-certified neurosurgeon and the founder and president of Medical Justice Services, Inc., offers a potential cure to the nation's healthcare blues:
What if we all stopped and looked at healthcare in America? Would we like what we saw?
Think about it. Millions are uninsured – and the cost of their care drives up the cost of healthcare for those that can pay. Health insurance rates are high, driven by the increased costs of defensive medicine, which is primarily practiced, after all, not to provide care but to provide a defense to a lawsuit.
Medical malpractice premiums have increased, in some areas, to the point where specialists in trauma neurosurgery and high-risk ob/gyn are leaving for better climes, which leaves some patients without access to the care that they need. And patients have reasonable expectations, that they’ll receive quality care, that they’ll be safe, that they’ll be made whole again if they are injured through the negligence of others.
What if there was a better way? I have a suggestion. It’s called HealthCare 2.0™. And it would work like this:
Patients would be eligible to participate in a voluntary program in which they would assign their rights to sue for medical negligence to the health insurance carrier. In exchange, the patient gets a lower healthcare premium, subsidies for disability and life insurance and guarantees of implementation of patient safety systems.
The carrier and physicians collectively develop algorithms for cost-effective treatment of certain conditions. If doctors adhere to these guidelines, they are immune from any lawsuit.
The carrier will only sue – and then only under agreed upon limits of recovery – if the physician has not followed the guidelines, the patient has been injured and there is evidence of negligence. If there is a recovery, some or all of it goes to the patient.
Think about it. Physicians could concentrate more on patient care and less on defensive medicine. The savings could be used to provide care for most of the estimated 45 million uninsured Americans, with enough left over to implement patient safety systems that until now have been too costly. Physicians who are negligent would be held accountable. Patients themselves, who actually have more of an interest in being financially solvent than in suing their physician, would be protected from financial ruin by “no-fault” disability or life insurance.
The main benefit to HealthCare 2.0 is that it addresses the collection of issues, to everyone who either gives or receives services in the healthcare system: Access to healthcare, patient safety, decreasing the frequency of frivolous medical malpractice lawsuits, combating the rise in healthcare premiums. And it does it without having to take away substantively from any one of those groups to give to any other. Better yet, it overcomes the objections to other proposed solutions that are out there, including isolated caps on non-economic damages, health courts, arbitration agreements, pre-litigation hearings and on and on.
The essence of the model is you have to give to get. Here, you get more than you give.
It’s time to stop and think before the status quo gets worse.
Comments