Reducing malpractice means saving money
Today, Public Citizen joined with other consumer advocacy groups in a letter to the debt commission (PDF) condemning a dangerous proposal by Erskine Bowles and Alan Simpson, Co-chairs of the National Commission on Fiscal Responsibility and Reform, to use “comprehensive medical malpractice liability reform to cap non-economic and punitive damages and make other changes in tort law” as a way to reduce the national debt and urging the body to remove it from its final report.
Patients’ legal rights continue to be a scapegoat in the public debate on solutions to the country’s skyrocketing health care costs. However, the proof is in the pudding. When Public Citizen examined Texas’ experience with strict liability limits (PDF) since their adoption in 2003, we found that injured patients in Texas lost their access to the courts but the restrictions did not translate into health or cost benefits. Instead, the opposite has occurred. In Texas: the uninsured rate has increased, remaining the highest in the country; health insurance cost has more than doubled; spending increases for diagnostic testing (measured by per-patient Medicare reimbursements) have far exceeded the national average; and the cost of diagnostic testing in Texas (measured by per-patient Medicare reimbursements) has grown 50 percent faster than the national average.
Clearly, tort reform will not cut the fat.
To blame high costs on medical malpractice litigation is to ignore the facts. In 2008, the cost of medical malpractice liability fell to less than 0.6 percent of the $2.1 trillion in total nation health care costs as measured in 2006. In fact, there are nearly 10 times as many injuries caused by medical negligence (PDF) as there are malpractice claims.
If the debt commission really wants to slice the deficit, they will reject this recommendation by the co-chairs and follow the money.
Medical errors are the real crisis for health care costs. The Institute of Medicine estimated in 1999 that medical errors cost an estimated $17 billion to $29 billion annually for lost income, lost household production, disability and health care costs. Adjusted for inflation, these numbers are $22.1 billion to $37.7 billion today.
The recommendations of the co-chairs are just that, recommendations. Therefore, we urge the members of the commission to cut the fat where it counts, by removing this dangerous recommendation and inserting the solution that will save lives and costs: reducing the malpractice.
Christine Hines is the consumer and civil justice counsel for Public Citizen.
November 14, 2010 @ 5:05 am
I am writing you about a serious women’s health care crisis in the USA with a high psychologic and economic cost.
The simple fact here is that women in the USA are undergoing COUNTLESS unnecessary surgeries of the CERVIX and UTERUS. The winners are the hospitals and health care system. The losers are the women – who besides suffering the pain and costs of unnecessary surgery are being told they have CANCER or PRECANCER when in point of fact they do not. For the cervix, they are also being told they have VENEREAL DISEASE (VD) due to HPV (human papillomavirus) but they do NOT.
HERE IS A SUMMARY OF THE NATIONAL HEALTH CARE CRISIS OF UNNECESSARY SURGERY ON WOMEN
The problem is national and very large – many women are falling into the trap of having unnecessary surgery on their cervix or uterus. It is costing the health care industry at least $6,000,000,000 per year (yes – that is BILLION) and hundreds of thousands of women great emotional stress.
I am attaching a website of a woman named Sally. She is a NYC executive – and tells very eloquently how she almost lost her life because of this problem!!!
Sally http://www.sallytellsherstory.com would welcome the chance to talk to you if you want a woman’s side of this health crisis.
Let me briefly summarize the economics for you:
CERVIX
➢ According to the National Cancer Institute – about 55 million Pap smears are done in the USA/year (http://www.cancer.gov/cancertopics/factsheet/Detection/Pap-test)
➢ About 3.5 million women each year in the USA have abnormal Pap smears that lead to colposcopy and biopsy (same source)
➢ Of these women – about 2 million are given a diagnosis of Low grade SIL, high grade SIL, or ASCUS-H (rule out high grade SIL) on the Pap smear that leads to colposcopy WITHOUT THE FDA approved HPV in situ test, which would confirm or deny reliably the presence or absence of human papillomavirus
➢ From a review of the literature, and from work done by Dr. Gerard Nuovo, a nationally recognized expert in the area of GYNECOLOGIC PATHOLOGY, from 15-30% of these 2 million women DO NOT HAVE HPV disease = 300,000 -600,000 unnecessary biopsies and resultants treatments (laser therapy or LEEP or conization) – the cost of laser/LEEP is about $5,000 (gynecologist, pathologist, other related costs); conization is greater. Hence – unnecessary surgery about $3 BILLION dollars per year
➢ Of the remaining 1.5 million women with abnormal Pap smears who get a biopsy – the same percentage (from 15-30%) are given the incorrect diagnosis on biopsy of HPV disease – requiring LEEP/laser therapy or conization = 275,000 to 450,000 unnecessary treatments per year =about $2.2 BILLION dollars per year
➢ One then has to add the EMOTIONAL COSTS to the incorrect diagnosis of a venereal disease. Imagine if a woman was told she had HIV, or gonorrhea, or herpes WITHOUT actually detecting the infectious agent (all these venereal diseases are detected by molecular tests). Yet this is what is happening with HPV disease.
ENDOMETRIUM
➢ According to Wikipedia – about 650,000 women have hysterectomies per year in the USA
➢ About 65,000 were done for endometrial cancer (same source, either precancer or cancer); these diagnoses are done only by pathologists
➢ About 30-60% of diagnoses of endometrial cancer/precancer by the pathologist are incorrect (eg – see http://onlinelibrary.wiley.com/doi/10.1002/cncr.21649/abstract)
➢ The average costs of the hysterectomy is $20,000; the mortality rate is 5/1000 cases
➢ Hence – about 20,000 to 40,000 unnecessary hysterectomies are done for endometrial cancer/precancer per year in the USA = up to $800,000,000 per year of unnecessary surgery
SUMMARY
➢ About $6 BILLION health dollars per year are being used per year in the USA on women for UNNECESSARY surgery on the cervix or endometrium
➢ These women are suffering tremendous emotional distress as well, believing they have a venereal disease and/or cancer
➢ The easy solution is HPV testing for cervical HPV disease (FDA approved)
➢ The easy solution for endometrial and cervical precancer/cancer is review by GYN PATHOLOGY expert
➢ This is an enormous trap women need to be made aware of – Ms. Sally can give you details no man could provide.
➢ One hospital – Ohio State Unit Medical Center – has decided to FIRE Dr. Nuovo (tenured professor) for speaking out to try and STOP these unnecessary surgeries
It is in all women’s interest that this is brought to the public light, and this is the perfect forum to make this happen!
Thank you for your attention and please do not hesitate in contacting me for further information.
Margaret Nuovo MD