Our society is increasingly concerned about the high cost of health care, and major changes are taking place in the reimbursement system in an effort to lower this cost.
However, one major aspect of the problem cannot be solved by changing the reimbursement system–and that is the staggering cost of malpractice litigation, estimated by the Illinois State Medical Society to add $1 billion a year to the cost of health care in this state alone. The number of malpractice suits filed in Illinois has risen dramatically in the last several years; jury awards have skyrocketed, and physicians have seen their malpractice premiums increase by 50 to 150 percent per year, reaching $50,000 to $60,000 annually in some specialties.
This is happening despite the fact that new technologies and increased physician competence have greatly improved medical care. For example, perinatal mortality–infants dying before or shortly after birth–has declined from 40 per thousand to about 12 per thousand in the last two decades, yet lawsuits against obstetricians, a rarity in the 1960s, are commonplace now.
No doubt part of the answer is the large number of lawyers, the increased tendency to litigation in our society and a growing feeling among the public that ”if something goes wrong, someone has to pay for it.” Beyond that, though, there is another factor: Society and the medical profession have never come up with a really good solution to the problem of bad medical outcome.
The central problem is that physicians deal with priceless commodities
–human life and health. A physician cannot be asked to assume unlimited liability for that, nor should he be forced to defend himself in court every time a patient is not satisfied with the outcome of the medical care provided. Lawsuits are an expensive, cumbersome and inefficient way of dealing with the problem. About 80 percent of medical malpractice lawsuits are dropped without award, yet each of these cases costs the physician, on the average, at least $6,000 in legal fees. Various studies have shown that only about 30 percent of the malpractice dollar ever reaches the injured patient. The rest goes to lawyers and insurance companies.
As anyone who has ever been involved in a lawsuit knows, it is a fight, not a dispassionate inquiry; the object is winning, not finding truth.
We must design a system that allows an individual who believes he or she has been injured by medical error to have ready access to a panel of experts who will render a fair, impartial and well-informed opinion. If that panel finds that the bad result was the unavoidable outcome of the disease process, there should be no award.
If, however, the outcome could theoretically have been avoided, there should be an award based on a ”no-fault” concept, and that award should have predetermined limits according to the nature of the injury. In all instances where an award is rendered, the appropriate state licensing board should be notified so that the substandard physicians can be disciplined.
The Illinois State Medical Society has introduced a package of legislation designed to address these issues and find solutions. The state legislature must recognize the seriousness of this situation and act to resolve it. We must not continue to spend hundreds of millions of dollars on clumsy and inefficient lawsuits that do not uniformly provide just and equitable settlements.
