As I wrote here in 2009, if you want to predict what you should be worrying about tomorrow, find out what insiders are worried about today. For example, it’s ever-so-enlightening to eavesdrop on the internal reports that health care industry stakeholders are reading, where simple, dull-witted heart patients like me can find intriguing musings from the pundits paid to stay one step ahead of the prescription pad.
I found such an insider recently in the form of LifeHealthPro. This company’s website explains:
“LifeHealthPro.com is the only complete online destination for life and health insurance advisors. The site is designed to provide advisors, insurance wholesalers, CPAs, and estate planning attorneys the essential elements they need to run their practice and increase their bottom line.”
One recent posting, for example, called “$50M+ Healthcare Super Losses On the Rise” has some scary industry warnings about medical malpractice lawsuits in the arguably litigious U.S. of A. The piece is from Bill Coffin, editor-in-chief of National Underwriter, Life & Health, who explains:
“Despite improved healthcare quality and patient safety measures, the cost of medical malpractice continues to climb, with juries awarding over $1 billion in damages for just seven medical liability cases in the last two years, according to Bermuda-based specialty healthcare insurer Hiscox (LSE:HSX).
“Many healthcare institutions show only modest medical liability losses, but others are experiencing mid-sized losses that are rising, Hiscox says. It also points to more frequent catastrophic medical liability losses that can be attributed to shortcomings such as inadequate staffing in nursing homes or medical negligence in hospitals.
“Seven U.S. states in 2011 announced their largest-ever medical malpractice awards, Hiscox says, and from March 2012 to the present, seven particularly large awards have cost the healthcare industry more than $1 billion in liability losses. Hiscox says:
“While some cases have been, or will be revised down on appeal, there are clear signs that the overall trend in ‘super losses’ is upwards.”
“Ian Thompson, Senior Vice President, Healthcare, Hiscox, expressed concern that such “super-losses” are increasing in both frequency and severity. He pointed to cases such as an ongoing investigation into over-stenting in Maryland as just the kind of case that can ultimately become a catastrophic medical liability loss. This concern is compounded by increasing evidence that batch losses (in which insurers can place losses together under an aggregating cause) are also becoming larger and more frequent.
“According to Hiscox figures, more than half of the largest healthcare claims in history have been paid in the last five years. Thompson adds;
“We are already seeing numerous and very public reports coming out of the Hospital Data Privacy area, and challenging times appear to be ahead. With insurers charging premiums for catastrophic events often based on a 1 in every 200- or 300-year loss, it is time that the healthcare insurance sector took a careful look at its catastrophic exposures.”
RISE OF THE SUPER LOSS: RECENT JURY AWARDS |
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| Date | State | Award | |
| March 2010 | New York | $60.9m | Negligence at birth |
| July 2010 | California | $670m | Inadequate staffing at assisted-living facilities |
| July 2010 | Florida | $114m | Wrongful death suit against a nursing home |
| May 2011 | Connecticut | $58.6m | Negligence at birth |
| August 2011 | West Virginia | $91.5m | Nursing home negligence |
| October 2011 | Michigan | $144m | Negligence at birth |
| January 2012 | Florida | $168m | Brain damage following surgery |
The Ethical Nag 
While juries may have awarded those large amounts, the plaintiffs will never see them or anything close to them. The insurers will simply appeal and then negotiate a much reduced settlement amount within policy limits.
The real problem with malpractice is malpractice itself and the failure of the medical boards and medical profession to really do much about it. Over the last 20 years only about 2 percent of physicians have been responsible for over half of all the money paid out for malpractice. Many of this 2 percent have multiple payments in their records but no action against their licenses or clinical privileges. The way to reduce malpractice costs (and incidentally reduce injuries and deaths) is to retrain physicians who cause the bulk of the problem or restrict or revoke their licenses.
Bob, thanks for your astute comment – I couldn’t agree more. Yet this problem seems to be systemic, starting with profound reluctance to admit medical errors in health care, never mind address their root cause through retraining. The Harvard School of Public Health reported in 2003 that physicians document fewer than 30% of their mistakes. And 44% of specialists claimed that they were actively discouraged from reporting their medical mistakes.
Have you seen the article on medical errors in The Walrus this month? Truly frightening.
I’ve written about this previously here and here.
The current system is unsustainable on many levels. All the money paid to a small number of individuals (in what is essentially a legal lottery) is money that is not available to others who may need some of it. Doctors are human and do make mistakes. If someone thinks you can eliminate error it would be great to hear from them. So far the only way not to make any mistakes is to not do anything.
Things are not this bad in Australia but some days I wonder why anyone (including me) is crazy enough to practice medicine or want to be a doctor.
Hi Dr. Joe – you’re right, doctors are human and, like everybody else, do make mistakes. But if my mechanic makes a mistake in replacing my windshield wipers, it’s not going to kill me – the same can’t be said about my health care providers. Our fears as patients are about those mistakes identified as preventable errors that are actually killing us (24,000 Canadians every year). These include misdiagnoses, surgical slips, system breakdowns, inconsistent hand washing protocols, or poor communication during patient transfers. The alarming story of debriding a patient’s pressure ulcer in The Walrus article (see comment above) is a perfect example of a deadly and entirely preventable medical error. Something has to be done about what is essentially a medical crisis.
Agree. Preventable errors are different to bad outcome where things have been done correctly or “mishaps” where genuine unavoidable error occurs. Your point about the car is valid but if the mechanic makes an error on the brakes rather than the wiper it could be more serious too!