Maintaining Optimism in the Face of Reality. Occasional observations on the state of the world, society, business and politics. Usually anchored by facts, always augmented by opinion.

Sorry I Cut Off the Wrong Arm; You Can Still Sign a Check, Right?  | e-mail post

Yesterday's Star-Tribune reported on the new policy by HealthPartners, a large Minnesota HMO on their new policy of not paying hospitals or doctors for "never" mistakes (27 mistakes identified by the National Quality Forum as "serious reportable events"). In addition, the HealthPartners contracts will bar the medical provider from billing the patient for those unpaid fees. (You can get a PDF with the list from the Minnesota Hospital Association.)

I can't say I think it is too unreasonable to have an economic penalty for these errors such as operating on the wrong body part or the wrong patient, leaving a foreign object in a patient after surgery, or delivering a toxic gas through a line marked as oxygen. In fact, they are so infrequent that HealthPartners doesn't even think it will have an economic impact on them. (Minnesota is among only a few states that have mandatory state reporting for the mistakes, and only 40 or so "never" mistakes have been reported in the first nine months of the year.)

I am not sure if it was planned, but HealthPartners announced it the day before the Minnesota Medical Association was holding their annual meeting, and the medical community is starting to respond. The MMA's president, Dr. Michael Gonzalez-Campoy has already come out against the idea: "He can say whatever he wants to say. What it really is about is HealthPartners not paying for medical care." (from ABC) Not paying for grotesquely negligent medical care, that is. He goes on to say: "To penalize financially individuals that in his mind are making mistakes is something that doesn't happen in any other industry. If you go to have your car fixed and they replace a part that they shouldn't have, you're still going to have to pay for the service." This is flatly absurd. We aren't talking about replacing a part they shouldn't have, we're talking about taking your car in for an oil change and when you come back the car doesn't even start and then you look under the hood and there's no engine. I'm pretty sure no car dealer would charge you for that oil change.

This kind of thing is just infuriating. I am a huge proponent of broad medical liability reform (and tort reform generally), but when docs take opposition to being held accountable for these most egregious of errors, it plays into the hands of those who would say we need the tort system to remain unchanged, as it is the only real method today for holding docs accountable.

e-mail post | Link Cosmos | [Permalink]  |  | Thursday, October 07, 2004
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