Tale of Two Blunders

November 29, 2008

Patients, administrators, and family members of victims aired their reflections about medical errors in a video on the on-line New York Times this week (November 25, 2008).  They all lamented that if only doctors and hospitals could own up to their mistakes, there just may be fewer lawsuits.

Two stories I listened to more than ten years ago underline that theme.  A friend, a lawyer representing a medical provider, shared with me his concern about his client that he would be defending at trial that week.  He had advised his client to settle because the evidence against his client was strong and he was not optimistic.

The patient had acquired an infection while in the hospital.  The evidence was incontrovertible and the patient had died.  But the patient was old and infirm and had little time left and even less quality time.  The infection may have hastened the inevitable but it also made the end needlessly painful for both the patient and the patient’s family.

The family asked only that the hospital not bill them for the extended six month hospital stay caused by the infection.  If the hospital agreed they would not sue. The hospital could not admit to a mistake and, as a result, appeared headed for a judgment that would cost the hospital several times the hospital stay.

The second story was from woman I met while waiting for jury duty.  It seems that during stomach surgery her doctor had perforated her stomach and he did not discover it before she was stitched back up.  The stomach acids caused havoc on her intestines.  I asked her if she had sued her doctor.  Oh no, she was quick to reply.  The doctor was so distraught about the mistake.  She could not do that to him.  He had paid for all her medical expenses since the incident several years earlier.  In addition, he only operated on one patient after that accident, resigning from his surgical practice, but not from his medical practice.

Two stories, two very different responses form the blundering providers resulting in two very opposite victim reactions, and two very different litigation results.

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Health Insurance for Small Business

November 22, 2008

Every health care reform proposal attempts to offer some relief for small businesses.  According to the National Federation of Independent Businesses (NFIB), small businesses create 2/3 of American jobs, yet half of the uninsured are in small businesses.

Look at President-elect Obama’s health care proposal on his campaign’s web site.  The first two items:  

  • Require health insurance companies to cover pre-existing conditions so all Americans regardless of the health status or history can get comprehensive benefits at fair and stable premiums.
  • Create a new Small Business Health Tax Credit to help small businesses provide affordable health insurance to their employees.

What’s remarkable about these proposals is that we are still discussing them. Read the rest of this entry »


For College Students – It’s not simple

November 15, 2008

I support a simpler health care system.  That is my number one priority.   Thus I am unimpressed with the health care reform platform of our newly elected president.  I do share the hope and optimism of many that meaningful change can and will happen. 

But getting a simpler health care system means that some of the stakeholders need to be cut lose from the system.  That is a politically daunting task. It is why most health care reform proposals try to add more patches to what is already a shabby patchwork quilt of private and public programs.

One effort does try to simplify a small part of our current system.   Read the rest of this entry »


Administrative Simplification

November 8, 2008

Sometimes people are magically teleported outside of their health care silo.

This happened to a group of our participants every month for several consecutive months.
At the beginning of each month one of the members of this group would call our office – “The doctor won’t treat me because he/she was told I have no health insurance.”
Our Plan had recently approved coverage for domestic partners.    Somehow, the computer system of one of our carriers could not properly interpret the code for a domestic partner.    The computer saw this adult as a child.   Read the rest of this entry »


Seven dollars and forty cents – no sense

November 1, 2008

Seven dollars and forty cents hardly seems like an amount that should erect a barrier to health care.

In fact, when Mr. Koch (all names are fictitious) called to complain about this bill for seven dollars and forty cents, my first reaction was, “You should appreciate how lucky you are that you have a health care plan that pays most of your bills. Why are you quibbling over $7.40?”
Of course, that is not an appropriate customer service response.

But listen to Mr. Koch. “This bill is for two pain pills that were given to me when I was admitted to the hospital for an emergency surgery.   Medicare won’t pay for the pills because they were “self-administered.” Read the rest of this entry »