Malpractice

Managed Care Malpractice Suits

Legislation now before Congress would allow patients to sue employer-sponsored health plans and administrators for malpractice in state courts. Under the proposals, workers could sue employers as well if they helped decide health coverage. Damages would be sought if needed benefits were denied or curtailed.

Health insurers, business groups and employers are fighting the proposed laws, contending the change would wreck the cost-cutting gains made in health care in recent years. But doctors' groups and trial lawyers are backing the proposals.

  • More than 80 percent of Americans with employer-sponsored health insurance belong to a Health Maintenance Organization, a preferred provider organization or a point-of-service plan that lets members pay more for care from doctors outside their plan's network.

  • That proportion is about double what it was in 1990.

  • While national health spending topped $1 trillion in 1996, the 4.4 percent rate of increase in prices was the lowest in 30 years -- a hard-won improvement business leaders don't want to see jeopardized by a cascade of new lawsuits.

  • Some 123 million Americans are covered by private employer plans -- the largest group by far covered under the existing six health-care systems.

The other five health care systems are state and local government employee plans, covering 23 million; federal employee plans, 9 million; individual insurance plans, 16 million; and Medicaid and Medicare enrollments, 37 million each. Some 41 million Americans are uninsured.

Medical malpractice awards have reached as high as $100 million, according to the Physician Insurers Association of America.

Source: Robert H. Gettlin, "New Malpractice Target: HMOs," Investor's Business Daily, June 4, 1998.

Wrong Prescriptions Cost Lives

Two new studies published in the Journal of the American Medical Association establish that hospital errors in prescribing drugs are costing some patients not only more money, but their lives as well. Such preventable errors include ordering doses that are too high or prescribing drugs to which a patient is allergic.

One study, led by David Classen at LDS Hospital in Salt Lake City, found that:

  • For every 100 patients admitted, 2.43 drug errors occurred.

  • Drug errors doubled the risk of death for a patient.

  • Due to adverse drug reactions, each error prolonged hospital stays an average of two days and cost an extra $2,262 per patient.

  • Using a computerized system in the prescription process cut drug errors in half -- but they are used in fewer than 10 percent of hospitals.

The other study, led by David Bates at Brigham and Women's Hospital in Boston, concluded that preventable drug errors cost the hospital $2.8 million a year. Bates estimates that overall such errors cost the health care system an extra $2 billion a year.

Source: Tim Friend, "Hospitals' Drug Errors Cost Lives, Drain Resources," USA Today, January 22, 1997, and Lawrence K. Altman, "Drug Errors and Adverse Reactions Are Studied," New York Times, January 22, 1997.


Too Many Mistakes In Medicine

More than one out of every three people say they have been in a situation where a medical mistake such as a misdiagnosis was made, according to a Harris Poll survey conducted on behalf of the American Medical Association's National Patient Safety Foundation. The AMA began organizing the NPSF last year following number of widely reported medical blunders.

  • Some 42 percent say they or a friend or relative have been involved in a medical mistake situation.

  • A total of 40 percent were affected by misdiagnoses or wrong treatment, and 28 percent reported being affected by medication errors.

  • Some 22 percent cited mistakes during a medical procedure.

  • More than half the respondents in the telephone survey of 1,513 adults blame medical errors on carelessness, improper training and poor communications.

Lucien Leape of the Harvard School of Public Health, an NPSF board member, estimates that as many as three million medical errors occur in hospitals each year, costing up to $200 billion.

Source: Doug Levy, "Medical Mistakes Happen to Many, AMA Poll Finds," USA Today, October 10, 1997.

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