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Third in a series
Two weeks ago I wrote about the role the post-WWII wage freeze had upon the start of the giant upward spiral of health care costs. Last week it was the onset of Medicare which was considered. This week I want to take a look at the role Medical Malpractice Insurance companies played in this problem.
On the surface, one would think that one of the last organizations which would want to have the price of health care escalate would be those companies which provided physicians with malpractice insurance. Yet, as one examines this more carefully, the profits of the insurers would increase in relationship to the amount of premium they could charge. If the amount of payout for claims were to go up, then the premium rate would increase in direct relationship.
So, what started happening? The insurance companies started offering the complainants a settlement even though there was no evidence of proven injury. I know. I’ve been there! In the mid-sixties, I was a family doctor in Michigan. Shortly before I left for the Navy, I repaired a fairly severe cut on the sole of a patient’s toot. He developed a stitch reaction and I tried to refer him to one of Michigan’s top foot surgeons who practiced in the same building as I did. And - - I also tried to refer him to one of the top trauma surgeons in that area. He refused both offers.
While I was in the Navy, I got a letter from the patient’s lawyer, alleging that I had not properly treated the injury. I got advice from the base legal office and notified my insurance company. Very shortly after that, I got orders to go to Vietnam. After I returned, I was back in Michigan for another reason. I went to the office of the lawyer who would have defended me in the foot case. I asked him about the status of the case. “Oh, they settled that to keep it from going to court!” This was in direct violation of my contract, which required that I agree to any out-of-court payoff - before the fact.
When asked why they had settled the case without my permission, “We knew that you were in Vietnam and didn’t think we could find you.” They didn’t even try! If the amount of investigation that company did in that case was as little as they did in trying to find me, I don’t think they would have settled. Even though they had had contact with my wife, a trained medical records librarian, for information in my files on the patient, they did not even try to communicate with her seeking for a way to find me in Vietnam.
Yes, there is definitely something wrong with the system when I got paranoid while practicing medicine. Well, maybe they were picking on me, after all. But this was just the beginning. I don’t know how much money my patient wanted, because no complaint was ever filed in the courts. But, I think the payoff was $3,500.00. In today’s thinking, that was not a lot of money. Today a plaintiff asks for $10,000,000.00 and the insurance company readily offers to settle for $1,000,000. - - out-of-court. The malpractice insurance I had cost about $50 - 60 per year, in those days. But with today’s settlements, the cost of malpractice insurance has increased much more than the equivalent amount would indicate.
Today, there are a lot of physicians who are just closing their doors because of they cannot pay the premiums.
Dr. Miller is a retired physician who resides in rural Markle.
by DR. TOM MILLER
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