A Malpractice Conundrum

One issue often neglected in the debate over medical malpractice insurance is the system's efficiency in compensating injured patients. The most exhaustive look at this issue is a recent study of 31,000 hospital admissions in New York State by a Harvard University team headed by Paul Weiler, Howard Hiatt, and Joseph Newhouse. Its findings: Some 4% of admissions involved treatment-caused injuries. One-fourth of the injuries involved negligence. One-seventh resulted in death.

On average, only one malpractice claim was filed for every 7.5 patients suffering a negligent injury, and only half of these were ultimately paid. So, "the legal system is paying just 1 malpractice claim for every 15 torts inflicted in hospitals." Those suffering non-negligent injuries--that is, caused by care not yet deemed inappropriate--got nothing. Thus, the study concludes that rather than a surplus, there is a litigation deficit because so many injured people wind up uncompensated.

Weiler says the current proposed $250,000 cap on malpractice awards is a "dreadful remedy for the problems of the system, which would penalize those suffering the worst injuries." He advocates a "no-fault" enterprise-based insurance system. Under such a setup, hospitals or provider organizations rather than individual doctors would purchase insurance, and patients could seek compensation for any medically caused injury without having to prove negligence (thus obviating the need for costly and lengthy legal proceedings).

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