Monday, September 08, 2003


With health care costs spiraling out of control -- I’ve always wanted to use that phrase, and I’d like to thank health care costs for making it possible -- it seems sensible to ensure that our health care dollars are being spent wisely.

But that’s not so easy, apparently, so instead we find ourselves being pressured to accept such insane notions as a $250,000 cap on medical malpractice payoffs. (Insane because the caps would apply in cases in which a doctor had actually been found guilty of malpractice. Clearly insurance companies, which endorse the caps, could continue to pay off those diminished amounts comfortably, meaning they would be less of a financial burden and therefore less of an incentive for doctors to not commit malpractice. It actually goes a great distance toward invalidating the free market’s impact on health care, but for some reason is generally backed by Republican politicians. Other than these three things, the caps make perfect sense.)

This comes up because the Journal of the American Medical Association posted a report last week concluding that evaluating and rating doctors’ competency has a long way to go.

“Even then,” the report says, it “may be technically impossible to accomplish in a valid and fair way.”

Well, if it’s difficult to say who’s good, can people shopping for a physician at least be told who’s bad? Physician Sidney M. Wolfe, director of the Public Citizen’s Health Research Group, blames doctors' failure to police their own through state boards. “From 1990 to 2002, just 5 percent of doctors were involved in 54 percent of the payouts -- including jury awards and out-of-court settlements -- according to the National Practitioner Data Bank of the Department of Health and Human Services,” Wolfe writes.

And it’s states who don’t discipline doctors that suffer insurance crises most severely, Wolfe notes, because bad doctors go on practicing.

The records of doctors, including the bad doctors causing so many problems, can be seen by hospitals and medical boards, but not by consumers. We don’t get to see it, Wolfe says, because “thanks to pressure from the American Medical Association, Congress forbids it.”

Still, check out

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