Supreme Court limits malpractice claims

[bokermmk]

Now this is a good start...

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[bigdan]

I'll defer my judgement on it. It COULD be good because the Court has taken a step at limiting malpractice awards, but I'm a bit worried that it essentially gives HMOs the green light to strongly discourage MDs from procedures and tests that may be necessary, all in the name of saving money, without fear from malpractice awards.

Time will tell. I don't like it yet.

dc

 

[skiz knot]

I'll defer my judgement on it. It COULD be good because the Court has taken a step at limiting malpractice awards, but I'm a bit worried that it essentially gives HMOs the green light to strongly discourage MDs from procedures and tests that may be necessary, all in the name of saving money, without fear from malpractice awards.

Time will tell. I don't like it yet.

dc

Absolutely. HMO's have taken the medical decisions away from the doctor treating the patient.

I'm gonna hate the day that I am gonna have to forego a test, against my better judgement, because the HMO says I won't get paid for it.

 

[flighterdoc]

Absolutely. HMO's have taken the medical decisions away from the doctor treating the patient.

I'm gonna hate the day that I am gonna have to forego a test, against my better judgement, because the HMO says I won't get paid for it.

HMO's deciding on treatment is awful. Imagine what it would be like if the government was deciding what treatment you got

But, keep in mind that (now, at least) you can always have the treatment you and your doctor think you need. You just need to pay for it yourself.

Until the left gets us a canadian style system, that is.

 

[ForensicPath]

Absolutely. HMO's have taken the medical decisions away from the doctor treating the patient.

I'm gonna hate the day that I am gonna have to forego a test, against my better judgement, because the HMO says I won't get paid for it.

Isn't it ironic that someone with less than half of the education of a doctor gets to make the decisions on how best to treat a patient?

 

[W222]

THIS HAS NOTHING TO DO WITH MALPRACTICE IN REALITY. The decision only refers to where a case can be brought (ie State vs Federal Court) and whether a patient can sue an HMO for not paying for treatment they deam un-necessary if it results in harm to the patient IN STATE COURT. The cases involved two people who brought suit because their insurance refused to pay for extra care and the patients felt they should have the right to sue in state court but the decision limits suits only to federal court and upholds State laws right to limit cases.

 

[bigdan]

Ahhh...true, true.

dc

 

[W222]

ForesicPATH Funny you should say this. I was having what are termed "partial simple seizures" last year. I basically get dizzy and space out for several minutes, I can still perform most things fine during a seizure but its just uncomfortable. So I went to my PC physician and asked for a referal which I got to see a neurologist. The neurologist said I should have a CT scan so I went. The insurance company said they refused to pay because an "educated health consultant" deemed both the neurologists appointment and the CT scan were not necessary. One year later and several collection agencies after me, I straightened it out. BUT I HAD TO PAY FOR THE CT OUT OF POCKET. Now do you know who made the decision, a nurse.

 

[fun8stuff]

THIS HAS NOTHING TO DO WITH MALPRACTICE IN REALITY. The decision only refers to where a case can be brought (ie State vs Federal Court) and whether a patient can sue an HMO for not paying for treatment they deam un-necessary if it results in harm to the patient IN STATE COURT. The cases involved two people who brought suit because their insurance refused to pay for extra care and the patients felt they should have the right to sue in state court but the decision limits suits only to federal court and upholds State laws right to limit cases.

You fail to see the big picture: if cases can be brought state court with a jury, then it is more likely that big $$ will be awarded more often. This is part of the reason costs of health insurance has been skyrocketing. So it is good in the respect that it limits these cases to be tried at the federal level. However, one of the points of having those hefty awards was that they were suppose to deter HMOs from being unfair, but obviously it hasn't worked- they still do what they want, just charge their customers more!

 

[juddson]

Now this is a good start...

This is an awfull decision for patients AND doctors. This isn't doctor versus patient. This is BIG BUSINESS versus everybody. It has little to nothing to do with the traditional struggle between patients and doctors via the tort system. It's big HMO's reaching into your pocket, interfereing with your decision making.

We all lose.

judd

 

[size_tens]

Let's keep in mind that the financial stability of insurance companies is critical to health care in the US right now. The only way we can avoid socializing health care is to have health insurance companies that can maintain a reasonable profit margin. Let's face it: doctors who can make extra profit by running expensive tests that aren't entirely necessary will often do so. There has to be some kind of system in place to maintain health care costs and keep them manageable for the general population. Unfortunately there aren't a legion of trained medical professionals that can make unbiased treatment decisions. The dilemma continues...

 

[Gleevec]

This decision has less to do with medical care and malpractice than it does simple federalism issues.

In any case, however, the overall effect of protecting HMOs and malpractice lawyers will diminish healthcare for the foreseeable future.

 

[mdterps83]

Actually in Canada you can buy private insurance and jump the queue. Get your monocle prescription fixed, Mr. Republican.

HMO's deciding on treatment is awful. Imagine what it would be like if the government was deciding what treatment you got

But, keep in mind that (now, at least) you can always have the treatment you and your doctor think you need. You just need to pay for it yourself.

Until the left gets us a canadian style system, that is.

 

[flighterdoc]

Isn't it ironic that someone with less than half of the education of a doctor gets to make the decisions on how best to treat a patient?

Its even worse. I used to manage the IT department for a large data center for Blue Cross/Blue Shield. I would overhear the comments made by the phone folk, talking to doctors about treatment. Often, they couldn't even pronounce most of what they were saying, and they certainly didn't know what the hell they were talking about in any sense of the word. They just read off scripts, and their team or unit managers would be RN's who would have the final say (on the phone).

And, thats for a large, (relatively) well managed and benign HMO. I can't imagine what the fly by night outfits do. Or what a government bureaucracy would do.

 

[flighterdoc]

Actually in Canada you can buy private insurance and jump the queue. Get your monocle prescription fixed, Mr. Republican.

That is completely contrary to everything I've seen and heard from Canadians, including Canadian physicians - got a reference for it?

You can do that in England, not Canada.

 

[mdterps83]

http://www.bluecross.ca/

BTW, how much contact could you really have with candian physicians?

That is completely contrary to everything I've seen and heard from Canadians, including Canadian physicians - got a reference for it?

You can do that in England, not Canada.

 

[JDAD]

http://www.bluecross.ca/

Sorry, but it doesn't work that way. Blue Cross is a supplemental insurance. It only pays for things such as ambulance rides, physical therapy and massage, getting a single hospital room, and so on.

Buying this insurance isn't going to improve your quality of care or allow you to skip the very long waiting lists, it just pays for the little things.


And buy the way, this decision sucks, just what we need, more insurance intervention.

 

[TravellinDoc]

Personally, I'm in total agreement with the court's decision, not just because of the ERISA law,but also because this is the current reality of the state of our insurance and health care system in the US. If you want innovation, you must allow for a business-like arrangement in providing medical care. The insurance companies are simply trying to make money or save it. I work in a clinic and deal with insurance companies and clinical aspects of medicine daily (esp medicare and medicaid codes) and I have found that all the limits HMOs put on diagnostic tests are very reasonable. A lot of the time doctors are just ordering tests which are blindly screening (Lipids, glucose for Diabetes, etc), covering their asses (Urine Cultures, Throat cultures) or simply satiating their own curiosity. I've never seen a patient not get a test covered when it was absolutely necessary according to the diagnosis. The HMOs do a good job of covering only medically necessary tests and in the process preserve the rest of our premiums, preventing them from skyrocketing. I wish everyone would stop going along with the pathetic cries of the very few patients getting "screwed" by HMOs and look at what's really going on. That's my 2 cents.
TD

 

[ForensicPath]

Personally, I'm in total agreement with the court's decision, not just because of the ERISA law,but also because this is the current reality of the state of our insurance and health care system in the US. If you want innovation, you must allow for a business-like arrangement in providing medical care. The insurance companies are simply trying to make money or save it. I work in a clinic and deal with insurance companies and clinical aspects of medicine daily (esp medicare and medicaid codes) and I have found that all the limits HMOs put on diagnostic tests are very reasonable. A lot of the time doctors are just ordering tests which are blindly screening (Lipids, glucose for Diabetes, etc), covering their asses (Urine Cultures, Throat cultures) or simply satiating their own curiosity. I've never seen a patient not get a test covered when it was absolutely necessary according to the diagnosis. The HMOs do a good job of covering only medically necessary tests and in the process preserve the rest of our premiums, preventing them from skyrocketing. I wish everyone would stop going along with the pathetic cries of the very few patients getting "screwed" by HMOs and look at what's really going on. That's my 2 cents.
TD

Do you know what a doctor has to do to convince HMOs that something is absolutely necessary? Its absurd the amount of paperwork and red tape that the insurance companies create for doctors and their staff. I was working with a doctor who prescribed a drug for a patient who has MS. The drug was not listed as an MS drug yet, but was listed for other neurological disorders, such as alzheimer's. However, there were numerous clinical trials that showed this drug to be an effective treatment for cognitive disfunction in MS. Anyway, it took months of back and forth letters between the doctor and what turned out to be a college student intern before the insurance company would cover the drug. That is unacceptable. This is not an isolated incident either, it happens all the time. It is time consuming and should not take place.

Let's not even go into the insurance companies that won't cover MS patients because it is a preexisting condition.

 

[on_the_fence]

But, keep in mind that (now, at least) you can always have the treatment you and your doctor think you need. You just need to pay for it yourself.

Until the left gets us a canadian style system, that is.

I talked to a woman from Norway the other day -- they have a system somewhat similar to Canada. Unfortunately, it still boils down to money. If you need a procedure that 50 other ppl need, you go on a waiting list. If you have money, you go somewhere else and get it done...

 

[calcrew14]

...... A lot of the time doctors are just ordering tests which are blindly screening (Lipids, glucose for Diabetes, etc), covering their asses (Urine Cultures, Throat cultures) or simply satiating their own curiosity. TD

So the restraint is going to be there, regardlessly. If it were not for the HMO, physicians would still inflict themselves with either the compromise of defensive medicine or their inquiring minds. Now, what about the cap on malpractice lawsuit? Would this court decision alleviate the malpractice insurance debacle in any way? I guess not! No matter what happens, this irreversible trend will still continue in the same direction. Eventually, all doctors here in the vicinity of medical Utopia will be completely incarcerated in straitjackets, manacles, shackles or whatever else available. But we can take them all, right? As long as it isn?t chastity belt...

Wait a hack! May be I should remind our dear adcoms that they are not screening people to become gods anymore. Obedience might be the key to a successful career in medicine, might not it?