As a personal injury lawyer at a law firm which handles plaintiff's side, medical malpractice cases, I find the following reported numbers startling:
1. The majority of medical malpractice claims close without payment to the injured person.
2. Only 2% of medical malpractice victims make a claim.
3. 80% of the time the doctor or the hospital wins in cases that go to jury verdict
How to reconcile these statistics:
First, most Americans are not litigious and find the idea of making a claim against a doctor or hospital is distasteful. So, even though over 80,000 Americans are killed by medical negligence each year and many more are hurt, 98% of them never make a claim. They want to trust that their doctors are looking out for them and are forgiving errors because after all, doctors are human. so, it means that the vast majority of people who are killed or severely injured by medical malpractice never even contact an attorney.
The same study that showed that most claims never result in any compensation to the victim also showed that clients did not file medical malpractice claims immediately after injuries. Typically, according to the report, medical malpractice claims are not filed with insurance companies until about 15 to 18 months after the injury. Even though the statute of limitations for medical malpractice is two years in Virginia (VA), the injured patients are giving the doctors and hospitals time to correct their errors and waiting to see if the harm is permanent and catastrophic, before even bringing it to the attention of an attorney.
The batting average for Plaintiff's lawyers against the insurance defense lawyers in medical malpractice is hardest for me to understand. Part must be that some of the meritorious cases are resolved during the litigation process prior to jury verdict by way of settlement. Perhaps, the quality of the Plaintiff's bar handling these cases is not as good as it should be, given the complexity and specialized knowledge involved in trying medical malpractice cases. The ability of the doctor defendant to get his colleagues to circle the wagons and support him must account for some of the bad trial results for the injured patients. Even an experienced personal injury lawyer with a background in medical malpractice would typically only be able to find and afford one or two good quality experts to testify against the doctor on the standard of care, showing that the doctor committed negligent error. For every one good expert we have, the Defense is typically able to find 3 or 4 extremely well credentialed colleagues who will come to aid the doctor standing trial for his negligence. However, some doctor groups go a step further and deliberately try to put pressure on the few doctors who are independent enough to be willing to help Plaintiff's lawyers in these cases. Some medical organizations have threatened to revoke the membership of the physicians who dare to speak out about violations of standard of care. This conduct I think is extremely unethical. Plaintiff's medical malpractice lawyers and the doctors who are brave enough to come forward and tell the truth in court about other doctors errors really are heroes. They are the ones who are forcing the medical profession to take a hard look at itself and get rid of bad apples. Not only are we helping to get compensation for deserving people with terrible injuries, we are also holding up a mirror to the health care system to show where things are not being done as they should be.
source:norfolk.injuryboard.com
Thursday, June 28, 2007
Surprising number in medical malpractice claims
Lawyers battle over state malpractice proposal
A hot issue among California lawyers -- whether tens of thousands of them should be required to tell prospective clients that they carry no malpractice insurance -- isn't just a legal abstraction to San Francisco attorney Paul Frassetto or the destitute businessman who recently approached him.
As Frassetto described it, the man had spent years refurbishing a low-rent San Francisco hotel to qualify it for a city-funded temporary housing program, and ran out of money as he finished the repairs. When he tried to file for bankruptcy, a local attorney mishandled the filing, the lender foreclosed on the building and the client lost his life's savings, more than $1 million in equity, Frassetto said.
It was only then that the client, whom Frassetto declined to identify, learned that his lawyer had no malpractice insurance or other assets that would cover his losses, he said.
Frassetto, who has spent the last 20 years suing fellow lawyers, said he has agreed to handle the man's malpractice case. But that's unusual, he said -- for the most part, he and his colleagues won't sign onto lawsuits against uninsured lawyers because their fees depend on winning an award for damages, and there's little prospect of collecting damages from an attorney without coverage. The clients, he said, are generally out of luck.
Such horror stories would be less common, Frassetto said, if the State Bar adopted a proposal before it to require lawyers who have no malpractice insurance to notify prospective clients of that fact, as well as the bar. The bar would post that information on its Web site.
"It's unfair to a client for a lawyer to represent them without having insurance," Frassetto said. Requiring lawyers to disclose that they don't have coverage "at least would let the client make an informed decision."
But opponents say such a rule would actually hurt more consumers than it helps.
Los Angeles attorney Diane Karpman, who writes a legal ethics column for the State Bar Journal, said the proposal would hit hardest at the lawyers least likely to be insured, those who represent lower-income clients and middle-income clients in small or one-person firms. Some would lose business; others would buy coverage to avoid public stigma, adding $4,000 to $7,000 a year to their operating costs, she said.
"Who's going to end up paying this? The poor and the middle class," Karpman said.
Her views are widely shared among lawyers. Nearly 80 percent of the more than 100 attorneys who have commented on the proposal to the bar oppose it. A resolution denouncing the plan was approved overwhelmingly by delegates of local bar associations at last year's State Bar convention.
"It sets up a two-tiered bar, those with insurance and those without," said Los Angeles attorney J. Anthony Vittal, co-author of the resolution with Karpman.
Another critic, attorney John Dutton of Auburn (Placer County), is a member of the State Bar Board of Governors, which is scheduled to take up the issue this fall. He said the proposal would unfairly brand uninsured lawyers with a "scarlet letter."
Malpractice insurance protects clients who lose money because of a lawyer's negligence -- missing a filing deadline, for example, or providing incompetent representation that affects the outcome of a case.
A lawyer's insurance status is "a highly relevant piece of information that a new client deserves to know," said San Jose attorney James Towery, a former State Bar president and head of a task force that drafted the proposal.
The proposed California requirement would be the most stringent of its kind in the nation.
Only one state, Oregon, requires lawyers to carry malpractice insurance. Twenty other states have insurance disclosure rules, but none requires that lawyers notify both the bar and their clients, officials say.
Most of California's 142,000 private lawyers are insured through their firms, but State Bar officials say about 1 in 5 is uninsured. Nearly all of those are in one-person or small firms, said bar official Starr Babcock.
The proposal before the bar's governing board would require that uninsured lawyers notify new clients and the bar, which could suspend lawyers who failed to comply.
The bar's Web site now lists lawyers' educational backgrounds and fields of specialty, and states whether they have been disciplined for misconduct. No public agency keeps records showing whether a lawyer has been successfully sued for malpractice.
Towery, who was appointed by the State Bar's then-President John Van de Kamp in 2005 to lead the organization's task force on malpractice insurance, acknowledged that mandatory disclosure would chiefly affect lawyers who practice by themselves or in small firms. But he said those lawyers' clients are among the ones most in need of protection against legal blunders.
Towery, a partner in a corporate firm, said small-firm lawyers typically handle cases involving issues such as consumer law, personal injuries, immigration, bankruptcy and family law. "When those lawyers make mistakes and don't have insurance, it really creates the potential to cause harm," he said.
But co-author Vittal, who handles business litigation as the sole lawyer in his Los Angeles firm, said compulsory disclosure would cause more harm than good. Prospective clients who learn that a lawyer is uninsured will probably be misled into thinking the lawyer is incompetent and go elsewhere, he said. Clients who get no such notice may be reassured, but they won't know whether their lawyers' insurance is enough to cover their cases.
The result, he said, will be that some lawyers serving needy clients will lose their practices, others will face discipline for conduct that "has nothing to do with ethics," and the bar will have done nothing to make insurance more available or affordable.
Babcock, who oversees the bar's low-cost insurance program for new lawyers, agreed that the organization "ought to have some kind of carrier of last resort." But he said such a program might require legislative action.
He said the disclosure proposal, now in its final round of public comment, would go before the Board of Governors for a vote in November and, if approved, would be submitted to the state Supreme Court for final review. Implementation is probably at least a year away, Babcock said.
Online resources
Information about the State Bar's proposal to require lawyers to reveal that they don't carry malpractice insurance can be found at:
links.sfgate.com/ZHJ
by:bob egelko, chronicle staff writer
Vitamins a good insurance policy
It's estimated that half of all American adults take a daily vitamin supplement. Yet, in spite of the popularity of the pills, many wonder whether they're good for our health.
CNN learned more about vitamins from Dr. George Blackburn, director of the Center for Study of Nutrition and Medicine at Beth Israel Deaconess Medical Center in Boston, Massachusetts.
CNN: What do you say when asked by patients whether they should take vitamins?
Blackburn: I say take a simple, once daily vitamin or mineral that costs about 7 or 8 cents as insurance, not to help their health or treat a disease but to ensure that they don't have a vitamin/mineral deficiency. (Health Minute: Watch to learn more about the benefits of vitamins and supplements Video )
CNN: Is that general advice for a healthy person?
Blackburn: I think it's important to realize that most people taking vitamins and minerals are healthy. Very few Americans are sick other than for a short time and therefore they should be concentrating on a healthy diet: fruits, vegetables and whole grains. Unfortunately, only 25 percent of Americans do that, so it's for them that we want the once daily vitamin/mineral.
CNN: What about taking calcium and folic acid supplements?
Blackburn: We've built some of it into the food supply. Now the flour we get has folic acid in it that takes care of most of the folic acid problem. We're now facing a shortage of calcium and vitamin D. We prefer three servings [daily] of low-fat dairy, yogurt, and cheese. We're learning that we may need more vitamin D. If we see a person isn't getting a good supply of dairy and dark green vegetables we definitely are urging that they take a calcium supplement and a vitamin D supplement.
CNN: Are we at risk of getting too many vitamins because of fortified foods?
Blackburn: I don't think the fortification, the intake of vitamin and mineral fortification of food, has been other than good so far. It's not likely that a person is going to overdose in a food fortification. You would have to be taking a high dose, single supplement to worry about overdose.
CNN: Are natural vitamins better than synthetic?
Blackburn: They are the same. It doesn't matter when they are absorbed into the body whether they were synthetic or natural sources; most supplements are synthetic.
CNN: Is there any scientific proof that vitamin supplements are a magic bullet?
Blackburn: Any claim to preventing disease or extending life with vitamin/mineral supplements is unproved.
CNN: So what's your advice to patients who can't decide whether to take a vitamin supplement?
Blackburn: Concentrate on eating a healthy diet with dark green vegetables, whole grains and fruits. Start your day with a healthy breakfast and watch your portion control. If you're physically fit and eating a healthy diet you'll get things that are not in any supplement. The good news for people looking at supplements, if they just stay with one multivitamin a day they'll be safe.
by:Judy Fortin is a correspondent with CNN Medical News. Accent Health reporter Linda Ciampa contributed to this report.
Health plan protects China's poor
Chinese hospital administrator Yang Xizhong is more than willing to talk about a new medical insurance scheme for farmers that has been extended to his county.
Waving his arms around enthusiastically, he explains how 90% of people in Chiping County, in Shandong province, now benefit from the government-backed scheme.
"Using this system, ordinary people really benefit," he says of the plan, in which the state pays part of the cost of the treatment.
"It solves the problem of going to see a doctor," he adds.
On a tour of the new wing of the Chiping County People's Hospital, Mr Yang introduces several bed-ridden patients who also give the new system their approval.
Farmers like these, Mr Yang says, would not have been able to afford hospital treatment before the introduction of the New Rural Co-operative Medical Scheme.
Success story
Even when you go outside the hospital - and away from Mr Yang's influence - people tell a similar story.
Twenty minutes drive away, in the village of Donglu, home to around 500 people, 75-year-old Huang Beiyou is recovering from treatment for an inflamed prostate.
A few months ago Mr Huang, who tends a herd of goats, spent more than 20 days in Mr Yang's hospital at a cost of around 10,000 yuan ($1,300). The government paid half.
"Before, when we became ill, we had to pay for it ourselves. Sometimes we couldn't afford the treatment so we didn't have it," he says.
"But now the government reimburses part of the cost, so we can afford it more easily. This system is a lot better. The government is really looking after us."
The scheme that is receiving so much praise was first introduced in 2003 to a select few counties in China, but is now being rolled out to rural areas across the country.
In a keynote speech given in March this year at the National People's Congress, China's parliament, Premier Wen Jiabao said he wanted 80% of rural people covered by the end of December.
With the central government spending close to 10bn yuan ($1.3bn) on rural healthcare this year, the Chinese health ministry was able to announce that it had met that target just one month later.
The scheme itself is relatively simple.
Each farmer pays as little as 10 yuan ($1.3) a year to join the insurance plan. The government then adds a similar amount.
Each county can have slightly different rules, but in Chiping the local government will repay 30% of medical fees for treatment costing up to 2,000 yuan ($263), according to Mr Yang.
If the cost is between 2,000 and 5,000 yuan, the government pays 45%. Above that, it guarantees to pay half the cost.
New system
A new insurance scheme for the countryside became necessary after China introduced radical economic reforms in the 1980s.
Under the old system, farmers' medical costs were paid by local communes, but when these were disbanded, rural people were left to fend for themselves.
That left many people in the countryside unable to buy even basic medical treatment without seriously affecting their household finances.
According to a popular countryside saying, a trip in an ambulance means a pig has to be sold at market, once a hospital bed has been slept in a year's farm earnings go down the drain and a serious illness requires 10 years of savings.
While experts both inside and outside China praise the new scheme for extending medical coverage to China's poorest people, there have also been some criticisms of the plan, not least over whether local governments have enough money to pay their share of the costs.
James Murray, of the humanitarian organisation Plan International, which runs medical programmes in Shanxi province, says rural areas have always received less health spending than China's towns and cities.
Rural areas have traditionally been allocated just 20% of total health spending, despite the fact that 70% of China's population live in the countryside, he says.
And he adds that if rural people are to enjoy all-round good health, there needs to be more emphasis on basic health education instead of just promising to reimburse farmers when they become ill.
"It's not only infrastructure, it's not only machines that are needed to achieve better health. The population needs to be aware of what causes diseases and how to prevent them," Mr Murray says.
He might be right, but that is not going to dampen the enthusiasm of health workers like Mr Yang about what has already been achieved.
by:news.bbc.co.uk
ABI: Popularity of personal private medical insurance grows
For the first time in recent years, the number of subscribers to personal Private Medical Insurance (PMI) policies has grown year-on-year. Latest figures from the ABI show that in 2006, 1,030,000 people subscribed to personal PMI policies, an increase of 1.8% from 1,012,000 in 2005. Personal and corporate PMI plans now cover 5.9 million UK adults and children.
Commenting on the data, Nick Starling, the ABI’s Director of General Insurance and Health, said:
“Private Medical Insurance offers people greater choice of treatment and other services for a wide range of medical conditions and injuries. It also takes pressure off the NHS, so by buying PMI, people are effectively reducing the burden on Britain’s hard-pressed health service.
“It is encouraging that more individuals are choosing to buy PMI for themselves and their families. PMI bought by companies on behalf of their employees has continued to increase in popularity too, helping to ensure that people can get back to work sooner after illness or injury.”
- ENDS -
Notes for Editors
1. The ABI has revised its data for corporate PMI in order to separate out all healthcare trust business. Previously, some companies had included healthcare trust business (schemes administered, but not underwritten, by insurers) in their PMI returns to the ABI. From now on we will publish data separately for 1) the total number of people covered by personal and corporate PMI schemes and 2) those covered specifically by corporate trust schemes.
2. In 2006, there were a total of 3,375,000 subscribers to PMI policies, up by 3.3% from 3,266,000 in 2005. This comprised 1,030,000 personal and 2,345,000 corporate subscribers, up from 1,012,000 personal (up 1.8%) and 2,254,000 corporate (up 4.1%) respectively in 2005.
3. Gross earned premiums in 2006 totalled £3.071bn, up by 4.4% from £2.942bn in 2005. Individual premiums rose by 4.2% from £1.449bn in 2005 to £1.509bn in 2006, while corporate premiums rose by 4.6% from £1.493bn in 2005 to £1.561bn in 2006.
4. A table giving full details of PMI sales, subscribers and people covered is available on the ABI web site, www.abi.org.uk.
5. The ABI is the trade association for Britain’s insurance industry. Its nearly 400 member companies provide over 91% of the insurance business in the UK. It represents insurance companies to the Government, and to the regulatory and other agencies, and is an influential voice on public policy and financial services issues. ABI member companies hold up to a sixth of all investments traded on the London Stock Exchange, on behalf of millions of pensioners and savers.
by:www.politics.co.uk
State budget has more for education, medical insurance for poor
HARTFORD -- The General Assembly is expected tonight and over the weekend to approve overwhelmingly a new biennial budget that orders huge spending increases for education and health care while avoiding major tax hikes.
The plan also includes modest increases both for nursing homes and for private, nonprofit social service agencies, two components that received little new money under earlier proposals.
The budget won't include any income tax changes. Both the $500 tax break for middle-income families and the tax rate hike for households earning above $272,000 -- both Democratic proposals -- have been scrapped.
"When folks take a look back at this," Senate President Pro Tem Donald E. Williams Jr., D-Brooklyn, said late Thursday, "this will truly be viewed as the historic budget year it was."
House Minority Leader Lawrence F. Cafero, R-Norwalk, who led the push this spring to reject major tax hikes proposed by both Democrats and Republican Gov. M. Jodi Rell, predicted "overwhelming" Republican support for the final package.
"It's a compromise document," Cafero said, adding that while Republican lawmakers are wary of the spending growth, they are pleased to see major investments in health care and education.
The House of Representatives was scheduled to convene at 6 p.m. and begin the budget approval process by adopting the main appropriations and revenue bill.
Besides that measure, lawmakers also need to approve three technical policy bills to implement new and revised programs within the budget, as well as three or four bonding bills that will outline state government's capital program for the next two fiscal years.
House and Senate leaders say they hope to have all measures approved by both chambers by the end of Saturday.
Full details on the budget's bottom line were not available early today. Legislative leaders said general fund spending -- which covers the bulk, but not all, of government operations -- should grow by just under 9 percent in the coming fiscal year.
State government is operating this year with a $16.1 billion total budget, with a general fund of more than $14.8 billion.
Rell, who initially called for $660 million in new taxes and then reversed herself in May after state revenue forecasts improved, will score her biggest victory in terms of education.
The governor, who asked for more than $600 million in additional Education Cost Sharing grants to towns over the coming two years, will see a healthy share of that request in the final budget.
ECS grants will top this year's $1.6 billion level by $181 million in 2007-08, and will reach $261 million over current spending by 2008-09. That $442 million in additional ECS outlays is the largest increase in any budget since state government launched a major education grant system in response to the 1979 Connecticut Supreme Court's decision in the Horton vs. Meskill lawsuit.
Democrats, who control two-thirds of both the House and Senate, campaigned largely on a plan to bolster the state's faltering health care safety net.
And the budget reflects that priority, pouring more than $215 million total over the next two years into boosting state reimbursements to doctors, dentists, hospitals, community health clinics, and other care providers who treat poor patients on state assistance.
The budget also:
-- Expands the Husky health insurance program's eligibility rules for pregnant women.
-- Allocates $39 million to give nursing homes a 2.9 percent funding increase next fiscal year. Both Rell and the Democrat-controlled Appropriations Committee hadn't recommended any hike in their plans.
-- Provides for a 3 percent increase for private, nonprofit groups, with whom the state contracts to provide the bulk of social services in Connecticut. It was unclear late Thursday whether that increase would begin with the start of the fiscal year on July 1, or on Oct. 1 -- a date when several past nonprofit rate hikes had taken effect.
Rep. Denise W. Merrill, D-Mansfield, said she and many other Democrats are disappointed that Rell wouldn't allow an income-tax hike on wealthier households so that middle-income families could receive a tax break. But she added that the health care and education increases will make a huge difference.
"We are talking about large increases in very important programs," Merrill said, adding many of the health care rates had been neglected for a decade.
Rep. Henry Genga, D-East Hartford, said "I'm disappointed that the property tax relief we wanted isn't there," referring to a Democratic proposal to boost the property tax credit within the income tax system from $500 to $1,000. "I think the Republicans did what they wanted to do: protect the rich," he added.
by:Keith Phaneuf, Journal Inquirer
Private Medical Insurance gaining popularity
Despite Tony Blair’s claims this week at King’s Fund event to launch four reports into the health service, that there have been “real and transformative reductions” in NHS waiting lists since 1997, more people are turning to the private sector, according to research by the Association of British Insurers (ABI).
ABI figures show, that for the first time in many years, the number of subscribers to Private Medical Insurance has grown year on year.
In 2006, 1,030,000 people has private medical insurance polices, and increase of 1.8% from 2005’s figure of 1,012,000.
“Private Medical Insurance offers people greater choice of treatment and other services for a wide range of medical conditions and injuries,” said Nick Starling, Director of General Insurance and Health at ABI.
“It also takes pressure off the NHS, so by buying PMI, people are effectively reducing the burden on Britain’s hard-pressed health service.
“It is encouraging that more individuals are choosing to buy Private Medical Insurance for themselves and their families.
Private Medical Insurance bought by companies on behalf of their employees has continued to increase in popularity too, helping to ensure that people can get back to work sooner after illness or injury.”
by:www.fairinvestment.co.uk
