Doctors aren't reporting dangerous doctors

Here's a link to an AP report on a recent study by a Harvard Medical School doctor which found that "a surprising 17 percent of the doctors surveyed had direct, personal knowledge of an impaired or incompetent physician in their workplaces," but that "[o]ne-third of those doctors had not reported the matter to authorities[.]"

Any person, including a doctor, that engages in dangerous behavior should be held accountable. If, as a profession, doctors won't police themselves in order to keep their patients safe, who are we going to rely upon to do so? The only other mechanism to hold doctors accountable is a medical malpractice lawsuit when a patient is actually harmed due to a doctor's dangerous behavior. It's strange that doctors will usually speak out against trial lawyers, but won't consistently speak out against the dangers lurking within their own profession.

How the patent system could better solve our government's problems

Many citizens view the patent system as a way to protect ideas. This is true in a broad sense, so long as an inventor reduces her ideas to an actual product or process. What many people don’t know is that our patent system in America is designed to discourage inventors from sitting on their patents rather than using them.

This is particularly relevant to today’s public discussions on energy policy. As a country, we’re facing a crisis in the Gulf of Mexico due to BP’s oil spill, our dependence on foreign oil, and our general lack of viable energy alternatives for creating a substantial portion of our energy needs from renewable or carbon-neutral sources.

The Bayh-Dole Act of 1980 gives the government certain rights to patented technology maturing out of federally-funded research.  I mentioned this act in the context of a law review article published in 2008 on the viability of Americans growing their own ethanol-based fuel. Two rights reserved to the government are key:  first, if the government funds research at an institution, the government need not pay to use the intellectual property arising from such research. That is, the Bayh-Dole Act allows the government to sidestep the artificial markup for patented products that end consumers have to pay. Second, if the owner of the patented technology is not fully exploiting the technology to the benefit of society, the government may license the technology out to firms who will.

Over 7.5 million patents have been granted by our federal government. To point out a few examples, over 15,000 of these patents deal with transmission of electricity. Over 26,000 relate to wells and drilling for oil. 33,000 represent technological advancement in power plants. Nearly 64,000 address radiant (solar) energy.

The 7.5 million patents represent the collective knowledge of the best and brightest from around the world, and many of those patents were the product of federally-funded research. It seems to me that the federal government could mine some of the technology it has already paid for as a start towards creating new energy policies for our future.

We should all be for personal accountability

Most places you look these days, someone is blaming medical malpractice claims, and the “clever trial lawyers” that bring them, for the high cost of health care in the United States. This argument is unsupported by actual research performed by the Congressional Budget Office, who says that med-mal claims account for a mere 2% of health care costs. Furthermore, the actual practices of med-mal insurance carriers shows this argument to be untrue. For instance, Texas has strict tort reform and thus far fewer medical malpractice claim filings, but doctors practicing in Texas have malpractice premium rates double that of neighboring Arkansas in many practice areas.

The argument for tort reform also ignores the real problem underlying medical malpractice cases: some hospitals, doctors, and nurses are injuring the patients they are charged to protect. Medical malpractice laws are on the books to ensure that injured patients are made as whole as possible for the health provider’s errors. However, in many medical malpractice cases, it is impossible for patients to be made completely whole for the life-changing injuries they sustain.

That’s where medical malpractice claims step in. Civil law only provides one way for injured parties to make themselves as whole as possible:  money. That’s it. For example, consider a mother whose heart stops during labor due solely to the fault of her doctor and who has brain damage such that she will need assistance and care for the rest of her life. There are but two options for her care: either the responsible doctor pays for his mistake, or the mother receives some form of public assistance through Medicaid, Medicare, or the like.

Self-described conservatives and insurance companies would have you believe that caps on malpractice awards would reduce the cost of medical care in this country. That’s simply not true, because injured patients will require assistance and care no matter who pays for it. The health insurance lobby would rather taxpayers pay for these costs. It seems to me that pushing more injured patients onto the rolls of government health care is the opposite of the conservative movement’s stated objective.

Insurance companies accuse trial lawyers of being the scourge of the health care industry. Those same companies want to have their cake and eat it too. Notice that you don’t hear insurance companies talking about their profit margins, since that would expose the fact that insurance companies profit far more from the health care industry than do trial lawyers. For what? Taking money from one side and handing it to the other, albeit in as slowly and painstaking a fashion as possible.

Instead of providing the care patients need, insurance companies balk. Instead of paying doctors promptly, insurance companies ask that doctors negotiate an insurer discount. Instead of paying malpractice claims to injured patients, insurance companies make those same patients fight to recover through years of court proceedings while trying to recover at the same time. Industry insiders and trial lawyers call this unethical strategy “delay, deny, defend,” and it has added billions of dollars to insurance companies’ bottom lines at the expense of policyholders and taxpayers.

While some sort of tort reform may be justified, insurance reform is a more pressing issue for health care reform in this country. Conceptually, insurance is a good idea. It spreads risk throughout the population so normal people can have access to care and funds in times of need. However, insurance companies today aren’t living up to the traditional insurance laws, which require the insurance companies to put their insureds’ interests ahead of their own and to give insureds the benefit of the doubt.

In fact, insurance companies are lobbying to change these traditional rules so they can be even more aggressive in denying claims and withholding funds that properly belong to their clients. So far, the federal and state governments have turned a blind eye to this activity by giving antitrust exemptions to insurers and failing to enforce regulations that prevent insurers from abusing their clients.

A good start toward reforming health care would be to make the insurance market more competitive by strictly enforcing regulations requiring insurance companies to provide fair and prompt coverage to their policyholders. Until this happens, insurance companies will continue to take the money from our wallets and withhold it when we need it most. The only ones protecting the rights of policyholders and taxpayers from insurance companies are trial lawyers. Count us among those proud to carry that title.

BP showed us how liability caps work – poorly

This morning, the Arkansas Democrat Gazette reported on the Arkansas Congressional delegation's involvement in hearings about the Deepwater Horizon oil spill. Congress passed a law in 1990 capping oil companies' liability for oil spills at $75 million. Now, current leadership is considering a repeal of that law. Congressman Boozman supports repeal because he doesn't "want the taxpayer to be stuck with the liability."

This discussion illustrates two things. First, liability caps remove an incentive for companies ensure that they place public safety first. The Deepwater Horizon spill will wind up costing far, far more than $75 million. But, with liability for the spill limited to a fraction of the profits generated by the well and by BP generally, BP had no incentive to place the safety and reliability of its well over profits.

Second, when liability caps are in place, the taxpayer winds up footing the bill for harm caused by the wrongdoer. Whether its BP avoiding liability for environmental damage or a careless motorist avoiding liability for hurting another driver, someone else winds up footing the bill. All too often it is the government, whether it's the Environmental Protection Agency cleaning up oil or Medicare paying for medical treatment that should rightfully be charged to a negligent motorist.

It's strange to me that Congressman Boozman recognizes that we don't want to shift private liability onto the taxpayers, yet he still supports tort reform. Tort reform, at its core, is about shifting financial responsibility for harm caused by a private party to someone else, which all too often is the government payroll.