The Root of the Problem

Most Americans believe that frivolous and medical malpractice suits are a huge part of skyrocketing health care costs, but most don’t realize just how astoundingly large the numbers are. A recent report indicates that over $54 billion is spent each year on medical malpractice systems. While that only accounts for 2.4 percent of annual healthcare spending, it’s still a staggering amount.

It would seem that America’s healthcare system has bifurcated into two separate, but related predicaments. The first, healthcare suffers an alarmingly high rate of medical errors that lead to lawsuits. Second, the malpractice liability structures have continually operated at a less than satisfactory level. In a 1999 study, the Institute of Medicine, approximated that nearly 98,000 patients died yearly from mistakes occurring during inpatient hospital stays. Shamefully, most of the mistakes were completely avoidable. For the last two decades, this problem has been growing. Howard H. Hiatt, a Harvard University Public Health expert, once stated that the unstable atmosphere surrounding medical-malpractice, litigation, and liability insurance within America’s healthcare system will reach crisis level. Well, here it is.

The debate rages on as to which one of the two issues has caused the most problems. Are the costly mistakes that doctors, nurses, hospitals, and other institutions the root of the problem? Or is it that medical personnel are so fearful of being sued that they pass along the cost of high liability premiums to patients?

The media would spout that an overwhelming number of malpractice claims are filed each year, but in reality, when patients suffered harm, lawsuits were filed less than two percent of the time. Malpractice insurance does indeed cost medical professionals quite a chunk of change and health care spending increases because of insurance claims. Some states have passed legislature that protects medical personnel from extraneous lawsuits and limits the amount of money a claimant can sue for. There is indication that insurance premiums rise at a much slower rate in these states than in others without legislation. Still, costs are climbing and Americans are paying for it.

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Next Generation Making Patient Safety a Priority

MIAMI - APRIL 02:  (L-R) James Sikora, Kay Sch...
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In the September issue of “Health Affairs’, Darrell G. Kirch, M.D., President and CEO of the Association of American Medical Colleges, or AAMC, stated the coming generation of medical personnel will forge an atmosphere of patient safety and impact the medical community through mentoring faculty and colleagues.

Kirch’s article, co-written with Philip G. Boysen, University of North Carolina’s, or UNC’s, executive associate dean of graduate medical education, indicates that available classes where patient safety is the main focus have increased over the last few years. Additional classes are needed. Both Kirch and Boysen believe that patient safety training should be a continual learning process that’s sprinkled throughout a medical student’s education and real-life experiences within clinical settings.

To achieve such a high-level of safety consciousness, medical schools and health systems will have to work together like never before. Kirch and Boysen suggested five areas where improvement is necessary to achieve such a massive change. These are: team work among healthcare personnel; emphasis on safety during residencies; leadership from upper levels; student contribution; and health information technology. Improvements in these areas will lead medical personnel to offer better care for patients overall, but especially at bedside.

These five areas were emphasized and examined at UNC’s School of Medicine’s graduate medical education program. Many other scholastic medical centers are participating, along with UNC, in the Agency for Healthcare Research and Quality patients safety initiative known as Team STEPPS, or Strategies and Tools to Enhance Performance and Patient Safety, to see how focusing on these areas can improve patient results.

The curriculum offers patient safety training for health care personnel that’s customized for individual institutions and focuses on beneficial transformations. By adhering to Team STEPPS recommendations and guidelines, UNC has seen fewer infections in patients that originated during hospital stays and an overall increase in patient satisfaction. UNC currently has over two dozen patient safety trainers, many of which are resident physicians that will take their training into hospitals and clinics for the rest of their careers.

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Types of Health Insurance Plans

America’s Health Insurance Plans
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When it comes to choosing health insurance, it may seem a bit overwhelming and confusing. There are actually several options when it comes to insurance and choosing the plan that works best for you and your family might be a tough choice. In the United States, there are four primary insurance plans: HMO, POS, PPO, and Fee-based. There are other options out there, but these four are the main types of plans you’ll encounter when you go looking for insurance. Let’s take a look at the different plans.

Health Maintenance Organizations (HMO) is where you pay for coverage in advance in the form of premiums, rather than paying for medical care as you go. HMOs provide a wide range of benefits. Some of those benefits may include preventive care and dental coverage.

Point of Service Plans (POS) are like HMOs, only they allow you a little more control. With POS plans, you don’t have to rely on a referral from your primary care doctor to go to any kind of specialist. You can choose to go to your primary care physician, use another provider in your network, or choose a doctor from an outside network.

A Preferred Provider Organization (PPO) is a plan that negotiates rates with doctors, hospitals, clinics, and other medical providers. This is a plan where you choose a doctor from one of the networks providers, and then you have a lower rate. However, you still have the option to go outside of the network; it will just cost you a little more money.

And finally, there’s Fee-based plans. This is a plan where you pay for your services as you go and on a case by case basis. The plan will usually require you to pay a deductible before any reimbursement begins, but you have a lot more freedom to go to the doctor you choose with a fee-based plan. Along with above mentioned insurance plans, though looks weird, you can insure your pet’s health; pet insurance typically helps pet owners to cover money spent on veterinary costs. Initiated in 1982 by Veterinary Pet Insurance, today American’s spend almost $24 billions for insuring their pets!

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