Medical costs over the last number of years have increased significantly. However, these significant increases are not related to medical malpractice lawsuits, but rather to other factors, such as the increase in injuries through medical errors and unjustified medical costs.
Rise In Medical Errors
The Institute of Medicine, in its seminal 1999 work “To Err Is Human,” indicated that there were more than 100,000 deaths per year as a result of medical errors in hospitals in the United States. More recent studies have shown that there has been a dramatic increase to more than 180,000 deaths per year as a result of medical malpractice in U.S. hospitals, according to the U.S. Department of Health and Human Services. An additional 1.4 million patients are seriously injured by hospital medical care.
This is an alarming statistic in our health care system, which will require vigilant and further action by the federal government through Medicare regulations. Obviously, these statistics are in large part causing an increase in medical costs.
These more recent studies are of great concern and demonstrate that hospitals must enforce more stringent safety precautions with their own staffs and attending physicians.
Many physicians and insurance companies have claimed that the ordering of unnecessary tests — “defensive medicine” — is causing a significant rise in the cost of medical malpractice insurance.
This oft-cited canard is without foundation; no reliable scientific study supports that assertion. Quite to the contrary, any studies that have been done reveal that defensive medicine is a very small percentage of general medical costs throughout the U.S.
Dr. Darrell Kirch, the president and chief executive officer of the Association of American Medical Colleges, recently gave a lecture indicating that the general assertion in reference to defensive medicine is not scientifically supported and that the cost of defensive medicine is in fact very small. Professor Thomas Baker, of the University of Pennsylvania, in his 2005 book, “The Medical Malpractice Myth,”also debunks the myth that defensive medicine is significant in driving up the cost of medical malpractice insurance in his chapter on “The Goods on Defensive Medicine.”
It is important to note that when a physician orders a test through Medicare, that physician must certify to Medicare that the test (treatment, medication, equipment) is medically necessary for the patient’s condition. How can a doctor claim he or she ordered an unnecessary test when they certify that the test is medically necessary? Studies have demonstrated that physicians who have a proprietary interest in a testing facility order more tests.
My personal experience is that a very significant part of the medical errors which form the foundation of the medical malpractice cases handled by our firm are based on the fact that necessary testing is not ordered.
Physicians and insurance companies have frequently maintained that malpractice is on the rise, and that there is an increase in malpractice actions in Connecticut. This is clearly not supported by the number of case filed. Connecticut’s malpractice cases have decreased significantly over the last 10 years. In 1993-1994, 337 cases were filed. This number dropped to 298 in 2010-2011.
Reasons For Higher Costs
Steven Brill, in his Time magazine article, “The Bitter Pill: Why Medical Bills Are Killing Us” (February 20, 2013), has exposed the enormous unfounded costs of hospital care. He recently discussed this article at “Reform to Transform: Shaping Health Care in Connecticut,” the first public forum sponsored by the Universal Health Care Foundation and the Connecticut Health Advancement and Research Trust, which was hosted by Quinnipiac University at its Frank H. Netter MD School of Medicine. His article should lead to a further exploration of the real costs of medical care in hospitals.
In a recent news article, the Stamford Advocate pointed out that an MRI at Stamford Hospital cost $2,363. At Yale-New Haven Hospital, it cost $2,247. A local private radiology group claimed its cost for the same MRI was $754. While it may be true that in a hospital setting costs are higher (in part because hospitals are rendering uncompensated costs as a result of indigents and members of the public without insurance), in Connecticut, these costs are reimbursed, to some extent, by the state. In no event can a price difference of three times be justified.
One way that our enormous hospital costs in the U.S. might be reduced is through government intervention through the mechanism of Medicare control and oversight.
Earlier this year, the New York Times reported on a study published in The Journal of the American Medical Association which stated: “Hospitals make money from their own mistakes because insurers pay them for the longer stays and extra care that patients need to treat surgical complications that could have been prevented.”
The researchers state that changing the payment system to stop rewarding poor care may help to bring down surgical complication rates. However, if the system does not change, hospitals have little incentive to improve.•