I know this veers off the usual topics for blogs, but as I sat this weekend at a get together where I was the only doctor but ALL of the talk was about healthcare, obamacare, and what is happening to medicine, I thought this was an interesting article.
It was from Medscape, and it was an interview between Leslie Kane and Philip Howards, who is an attorney and a founder of Common Good. He may be viewed as a little bit of a rabble rouser- he has books called “the Death of Common Sense” and “Life Without Lawyers.” His premise? “Throughout society people with responsibility no longer feel free to do what is right. ” He sees these issues throughout society (he uses the example of a teacher who can’t hug to comfort a child), but he says they really affect medicine. He feels doctors are trying to figure out what can reimbursed or what the practice guidelines require rather than try to understand what a patient needs.
He wants to make reliable decision making which separates “good” healthcare from “bad” healthcare. Currently there is a lot of variability in the system. He does not advocate patients injured by mistakes should not be compensated; he wants the system to be more consistent.
You hear often of “defensive medicine” where doctors order tests. He estimates the cost of defensive medicine runs between $45 Billion to $200 billion a year.
He formed an alliance with the Harvard School of Public Health to design a new system of justice for healthcare. In it, there are expert health courts which would not have juries. Instead there would be expert judges who write what is good care versus what is not. This would give consistency and consistent standards of what is expected by doctors. The good news for patients is the current legal system takes an average of 5 years to settlement, and 60 cents of ever dollar is used for lawyers fees and admin costs. In a healthcourt system, he says the turnaround would be 1 year and costs significantly less.
The healthcare court would be similar to special expertise courts in other areas: tax courts, drug courts, and patent courts. There is a wide range of support from Obama, many Republican candidates, every bipartisan deficit reduction commission, AARP, to patient safety experts. Who is against it? “So far, the trail lawyers have used their political muscle to stop it.”
His overall goal? To make healthcare affordable.
Interesting idea. For more information www.commongood.org.