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Senate Aging Committee Hears
Alternate View on Tort Reform
Improving nursing home care suggested as
alternative to tort reform
July 15, 2004 The U.S. Senate Special Committee
on Aging held their hearing today on Medical Liability in Long-Term Care
without any consumer advocates but the committee chairman did not hear
what he wanted from all the witnesses. At least one testified an
alternative to tort reform could be improving the quality of care.
Some have argued that recent litigation trends
bolster the case for relying on conventional tort reforms in the nursing
home sector. I would caution
against this conclusion, testified David Stevenson, an assistant
professor in the Department of Health Care Policy at the Harvard Medical
School..
One response to these concerns is to enact tort
reform of the kind recently attempted in Florida, Texas, and other
states. The goal of such reforms is to stabilize the nursing home and
liability insurance markets without eliminating incentives that
litigation may provide to deliver high quality care, Stevenson said.
An alternate approach to curbing litigation is to
rely on redoubled quality improvement and quality assurance efforts. In
theory, quality-oriented efforts could remove the presumed basis of
lawsuits poor quality nursing home care, he said.
The news release from the committee led with the
following paragraph.
With medical liability insurance costs for doctors
in nursing homes rising dramatically, the chairman of the U.S. Senate
Special Committee on Aging warned today that Americas seniors are at
great risk of receiving limited, or in some cases, no medical care
unless the system is changed. His comments came at a hearing titled
Medical Liability in Long-Term Care: Is Escalating Litigation a Threat
to Quality and Access?
What is happening now is that many doctors are
leaving nursing homes because their insurance premiums are skyrocketing.
Congress needs to understand why that is and what we can do to ensure
that seniors are protected by having access to a doctor. While I am not
proposing legislation yet, I believe we in Congress need to explore
solutions to this growing problem, Chairman Larry Craig (R-Idaho) said.
The senator from Idaho noted that legal claims
against long term care providers nationwide are the fastest growing area
of health care litigation.
The cost of claims for the last 3 years is
estimated at over 2 billion dollars and the average medical insurance
premium cost is over 200 percent higher than it was in 2001. These
rapidly escalating costs are a massive challenge, especially for smaller
providers serving the elderly in rural communities, Craig said.
The Chairman of the Special Committee on Aging said
the increases in long term care litigation costs are two-fold.
First, excessive litigation is forcing many
doctors to quit serving patients in nursing homes; and second, this
situation is draining resources that should be used to provide quality
patient care to nursing home residents. These trends cannot be allowed
to continue. We must ensure that quality long term care services are
available to the most vulnerable elderly when they are in their greatest
need, Craig said.
He warned that Congress must balance the needs of
negligently-injured seniors and their families, with the needs of
nursing home professionals who care for our nations seniors.
Norman Estes, President
and CEO, NHS Management, Tuscaloosa, Alabama, said, The number
of Americans requiring long-term care is growing rapidly: In 2010, the
number of individuals 85 and older will be 3.5 million. Their numbers
will double to seven million by 2020 and will double again to 14 million
by 2040.
Estes and others primarily presented information
and statistics on litigation in the long-term care industry.
Here were the other presenters:
Theresa Bourdon, Managing Director and Actuarial, Aon Risk Consultants
Inc., Columbia, Maryland
James E. Lett II, Immediate Past President, American Medical Directors
Association, Carmichael, California
Marshall B. Kapp, Distinguished Professor of Law and Medicine,
Southern Illinois University - School of Law, Carbondale, Illinois
Mr. Kapp received the Journal of Healthcare Risk
Management Award for Writing Excellence as Author of the Year from the
American Society for Healthcare Risk Management. The American Society
for Healthcare Risk Management is a personal membership group of the
American Hospital Association
Lawrence M. Cutchin, MD, President, North Carolina Medical Society,
Tarboro, North Carolina
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