re: How Denmark Dumped Medical Malpractice and Improved Patient Safety

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In what % on the cases filed are there significant settlements made before trial?

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74% of suits filed against physicians are found to be meritless.
5.8% go to trial.
~20% settle out-of-court.

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Ok, but that litigation isn't something that is manufactured.

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Silicosis manufactured the hell out of it.

John Edwards manufactured the hell out of it.

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But the obstetrician, he argued in an artful blend of science and passion, failed to heed the call. By waiting 90 more minutes to perform a breech delivery, rather than immediately performing a Caesarean section, Mr. Edwards said, the doctor permanently damaged the girl's brain.

''She speaks to you through me,'' the lawyer went on in his closing argument. ''And I have to tell you right now -- I didn't plan to talk about this -- right now I feel her. I feel her presence. She's inside me, and she's talking to you.''

The jury came back with a $6.5 million verdict in the cerebral palsy case, and Mr. Edwards established his reputation as the state's most feared plaintiff's lawyer.

In the decade that followed, Mr. Edwards filed at least 20 similar lawsuits against doctors and hospitals in deliveries gone wrong, winning verdicts and settlements of more than $60 million, typically keeping about a third.

LINK

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1. The quality of medical care is no different today than it was 20 years ago, people just didnt sue doctors and hospitals then; or

2. The quality of medical care today is the driver in litigation.

From my end its number 2.

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There is not a hint of a skosh of a smidgen of a chance that medicine is magnitudes worse than it was 20 yrs ago.

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So you're in favor of single payer? Good

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No fault compensation is not the same as a single payer. Many countries who have the former also have the latter (see France), but it doesn't have to be this way.

The no fault strategy would increase the number of claims against hospital systems, but the cost per claim would go down dramatically due to much lower legal costs. There's a lot of debate on this subject.

The cost analyses I've seen show that it's mostly a wash as far as total costs go. What a lot of them don't discuss is that it would lower the amount of "CYA" medicine that many doctors practice as a result of the threat of litigation, where they are found personally at fault for medical errors. It also improves the rate of providers reporting medical errors (as pointed out in the article).

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There is not a hint of a skosh of a smidgen of a chance that medicine is magnitudes worse than it was 20 yrs ago.

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I dont think magnitudes would be fair, but it seems counter intuitive to say its not worse. Most of what we see is facility negligence and some of it is gross negligence.

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Correct. Except the Danish equation is "0.46(X)+Y+Z=C"

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Best I can tell NC Tigah were on the same team, but we want to call a different play.

You advocate we adopt the Danish system to cut current malpractice costs to 46% of today's, and I advocate cutting them to 46% without adding the other cost.

So you want to call a flea flicker, and I want a deep post. But, we both want a touchdown for the home team!

To bad neither one of us is the offensive coordinator!

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You advocate we adopt the Danish system to cut current malpractice costs to 46% of today's, and I advocate cutting them to 46% without adding the other cost.

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I'm not sure how you do that in an adversarial system.

In the US, an attorney sees an injured client in his office, and wants to help. He is often not going to be adequately apprised of appropriate facts (including those exonerating the defendant) until discovery, deposition and occasionally not even until trial. By then, both he and the client are invested, even if the facts don't seem to back the investment. The result is that 40% of such cases are brought without merit.

So despite "investment", when the attorney realizes his case probably lacks merit, why doesn't he drop it to save time and further personal expense, and to spare his client further trauma? He doesn't because despite forwarding a meritless case, he still has a decent chance to win. In the US system 30% of such meritless cases still end in findings for the plaintiff.

Since the current US system is adversarial, discovery and case prep are an expensive and prolonged process. The result is extremely high overhead cost. Only 46% of settlement money actually gets to plaintiffs. A European style system only runs a 5-10% overhead. That would effectively DOUBLE AVAILABLE SETTLEMENTS to US plaintiffs. It would concomitantly limit incentive for defensive medicine, knocking 10-20% off of US healthcare costs.

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The European Tort Model
How reform of the US System could look:

--- Offer two parallel options for plaintiffs.
The plaintiff can choose one or the other.

Option One:
An adversarial approach virtually identical to our current Tort System, but with the requirement that the loser pays the winner's costs. I'd propose the elimination of caps for pain and suffering under this option. (Danish Model differs slightly here. Goes with sanctions rather than remuneration)

Option Two:
A Worker's Comp type system. Injured patients would bring claims before a review board responsible for determining if compensation is in order and, if so, how much. The Board would then authorize payment out of a "compensation pool" which would be immediately awarded to the plaintiff. For a patient to get paid, the board would not have to find the doctor at fault, or that medical negligence caused whatever pain and suffering the patient is experiencing. Money for patient relief would come from a national compensation fund paid for by malpractice premiums placed on doctors, hospitals, pharmaceutical companies, etc.
The goal of such a system is not to find fault or establish causation. It is to provide compensation to injured patients regardless of cause.

This dual option mechanism is employed in various forms throughout Europe.
The vast majority of plaintiffs go with Option #2.

Isn't the line that we can't copy the Dutch because we aren't as homogeneous?

As in: Sorry NC, we can't use the Dutch approach to malpractice here it only works in small culturally homogeneous societies.

I think we should get rid of the lawyers, then there wouldn't be all this malpractice waste, poor people wouldn't be able to sue honest truck drivers for no reason and grocery stores when they fall down on purpose, and women wouldn't be able to divorce you and steal your stuff

When you think about it, the whole legal profession is based around theft. Lawyers are jackboot thugs taking money from honest hardworking people and giving it to lazy undeserving people

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despite forwarding a meritless case, he still has a decent chance to win. In the US system 30% of such meritless cases still end in findings for the plaintiff.

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You make a lot of good points. I don't do med mal work (used to defend some) but i'm wondering who, in these cases of findings for the plaintiff, is deciding the case was meritless?

interesting, but would like to see a lot more info.

Maybe one of Northeastern states could adopt this and see how it works?