Marvin's Window: Reining in the costs of medical malpractice

As I looked out my window this morning, I remembered the anxiety when my daughter had to change doctors while carrying my grandson.

High malpractice insurance was the culprit.

Josh is 16 now and the malpractice insurance problem for doctors who deliver babies is much worse.

Some Phoenix area hospitals have closed maternity wards, at least in part, because malpractice insurance costs make delivery of babies too expensive.

Las Vegas and Nevada have dodged bullets on both trauma unit care and maternity patients in the past month.

The Nevada legislature met in special session to change medical liability laws in an effort to decrease the size of malpractice awards and, hopefully, to decrease the insurance rates for doctors.

A recent cartoon shows the little boy and girl discussing what to play.

One suggests playing doctor.

The other says that they should play lawyer because the lawyer has shorter hours and makes all the money!

I once sold a computer system to a law firm in Phoenix that focused on medical malpractice.

The lawyer had a medical degree and had returned to college for a law degree.

He then used his medical background in the courtroom.

He took only malpractice cases.

His partner was a computer whiz who developed a system to keep track of cases, court dates, evidence and other court decisions.

This was before desktop computers were common and gave the team a great advantage.

The team won most of their cases of malpractice suing doctors.

No one wants to take away that right to sue doctors for mistakes.

However, we should always remember the lawyer usually takes such cases on a percentage.

When a family gets $24 million because something happens to a baby during delivery, the lawyer may get $8 million plus court costs!

I understood quickly why the Phoenix doctor switched sides and became a lawyer.

Who pays for the huge jury awards, the malpractice insurance and the lawyer's awards?

You!

Doctors who deliver babies pay the highest malpractice insurance rates in the industry.

Juries figure the full expected life span of the baby when making awards.

Everyone has sympathy for the cute and cuddly baby.

Maybe a lot of money will make the baby's life whole again, or at least, better.

But, what happens to health care for all the thousands of other babies? What do parents do when doctors no longer practice medicine for maternity care and baby delivery?

I made some assumption on costs from news accounts of the crisis in Las Vegas where doctors were no longer taking patients.

The numbers may not be exact, but they make the point.

Insurance rates for doctors delivering more than 125 babies per year increased to about $100,000 per year.

I don't have any idea how many babies a doctor can deliver in a year.

I suspect the doctor would not want to have ten pregnant women as patients who could all go to the delivery room on the same day.

That indicates some reasonable limit.

I chose 200 to make the math easy.

That doctor pays $5,000 in malpractice insurance for EACH baby.

I suspect the hospital pays at some high rate also.

Of course, there are a few other costs in addition to insurance for the doctor.

Be sure that your Blue Cross bill includes a portion of that $5,000 insurance cost.

Be sure your health insurance bill includes insurance costs for the emergency room doctors, the hospital and all other medical practitioners.

I have a question.

How much medical care would those huge awards buy for the rest of us?

Another question – Is it the best use of resources to pay high dollars to lawyers that could be used for medical care?

Liability and class action suits take billions of dollars out of the gross national product every year.

In some states the awards of billions from tobacco companies was divided with private attorneys asking for one third of the take.

I agree that individuals should have the right to sue and attorneys provide a service that has value.

I agree that doctors who make mistakes should pay although it is the general public that ends up with the bill.

However, I see a balance of resources and needs.

Health costs are going out of sight and excessive jury awards are a part of the problem.

Limits on awards and the "fair share" payment to lawyers must be examined.

In Nevada, the issue became a crisis—limit awards or forget health care in trauma centers and for maternity patients.

When you are asked, "Do you want your right to sue taken away" remember that the cost of keeping an unlimited right could mean no emergency room doctor when you arrive following an auto accident.

It already has limited your choice of doctors to deliver that next bundle of joy.