We need to stop our foot pounding and finger pointing and get down to business. We need to leave our self interests and lobbyists at the door. Let's look at the whole picture and make lasting changes that are sustainable.
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ACEP News: Vol 28 – No 12 – December 2009Beyond addressing access to care, we can improve the cost/inflation of health care so that the patients, physicians, and the taxpaying public all benefit.
One possible solution is actually quite simple, has been on the table for well over a decade, and has been supported strongly by the American Medical Association and other nonprofit groups: the establishment of health courts.
In 1995, the ACEP Board of Directors adopted a policy statement saying that the College "endorses the need for comprehensive litigation reform and supports the concept of health courts as an alternative to the current process."
The hallmark of health courts would be full-time judges who are trained in health care issues. A limited set of full-time judges would help to define and interpret standards of care in malpractice cases, relying on neutral experts paid by the court. They would ensure that patients who are injured by medical mistakes are fairly and promptly compensated, with the goal of resolution within 1 year of filing the claim.
Currently, the average time to resolution is about 5 years, blocking the patient from the compensation they need and deserve, increasing the stress on all involved, and dramatically increasing administrative costs of litigation.
There would be no cap on economic damages, but noneconomic damages would be based on a fee schedule established by a health court task force.
Having a limited number of judges who are specially trained and who hear only these cases would allow more accurate decisions based on standards of care, and written judgments would create predictability in similar cases.
This, in turn, would greatly reduce the practice of "defensive medicine" and could also thereby potentially stabilize malpractice insurance costs, as litigation would be much more predictable. Litigation costs would drop to about 15% (based on models currently used in New Zealand, Sweden, and Denmark), and awards would more accurately and fairly reflect damages.
Medical law is complex, and fair and consistent decisions require some modicum of training and experience. It is unfair to think that juries, who are typically uneducated in this regard, can reach consistent conclusions using different sets of rules, varying by state.
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