Malpractice Reform Research Paper
UNIT 1 INDIVIDUAL PROJECT
1
Unit 1 Individual Project
Health Care Services Delivery and Finance
Cindy Myerly
American Intercontinental University
Dr. Earl Greenia
UNIT 1 INDIVIDUAL PROJECT
2
Abstract
The purpose of this paper is to review ways to reduce the cost of health care. This paper will identify two methods of reducing the gross domestic product spent on health care. The paper will analyze and support the two methods chosen. The chosen methods are insurance reform and malpractice reform.
UNIT 1 INDIVIDUAL PROJECT
3
There are many options for an individual to pay for health care in the United States.
Some of the options are selfpay, privateinsurance, medicaid, and medicare. Medicare is a …show more content…
federally funded health program for the elderly and the disabled. Medicaid is a federally and state funded program for children and the elderly that cannot afford to pay for the health insurance. Paying for health care insurance has become one of the biggest problems and issues in the United States. There are some ways healthcare organizations are able to absorb the rising cost of healthcare by acquiring other healthcare facilities, merging with other healthcare facilities and by diversifying the services provided. However, these actions have not lowered the gross domestic product costs across the board. (M.U.S.E., 2013)
One of the ways that could be beneficial to cutting the gross domestic product percentage is Insurance reform. One major issue with the health insurance is the complete lack of true regulations mandating the sufficient amount of coverage provided to individuals seeking health care coverage. Due to the amount of health care coverage plans physicians and healthcare facilities have an extremely difficult time trying to figure out the level of coverage a patient may have and if the procedure needed is covered by the individual’s healthcare plan. By trying to figure out coverage issues this raises the administrative cost for both the medical provider and the insurance provider. These cost are higher than any healthcare insurance system in the world.
Despite the rising cost of insurance, many computer manufacturers are making money hand over fist providing new and improved healthcare systems and software for billing to physicians and hospitals, yet administrative costs continue to rise and billing issues have not been fixed.
(Hammond, 2009)
UNIT 1 INDIVIDUAL PROJECT
4
One of the most known model for insurance reform is the Health Insurance Reform
Simulation Model (HIRSM). The HIRSM model is a simulated model for insurance coverage, insurance cost and possible tax ramifications of healthcare insurance coverage proposal expansions and other reforms to the health insurance industry. The model collected national data from employers, employees and others not in the labor market to simulate choices of insurance providers, employers and individuals using current insurance systems and individuals using the reformed insurance. This allows for prediction of coverage types chosen and potential alternatives to the choices made. This model can also simulate the possible effects the health insurance reform has on private insurance markets as well as public programs. The model also looks at the current laws for the insurance industry before looking into the insurance industry reform. This model gives some security in the knowledge of the insurance provider and possible insurance choices. If the insurance industry is regulated and some government controls put in place there will not be as much cost surrounding the industry. Insurance companies can still make money however insurance reform would provide insurance to everyone and not just some of the population. Many countries provide medical insurance to the citizens free of charge therefore there is not a question of how the population’s healthcare will survive. Insurance should be a right not a privilege. Having a big screen television is a privilege, having an iPad is a privilege, insurance of any kind should not be considered a privilege but a right. (Blumberg,
2003)
Although many in the United States government do not want/agree Obamacare to continue, the model is based on other countries that provide health insurance for all citizens. For the first time in the history of the United States every citizen has health insurance and/or access
UNIT 1 INDIVIDUAL PROJECT
5
to health insurance. In addition to Obamacare, employers have been mandated to provide insurance to all employees. This enables parttime employees to sign up for insurance through the employer as well as fulltime employees. Insurance reform is extremely important to the healthcare system. If the healthcare system is going to get any better insurance reform has to happen. (Feldstein, 2011)
An example would be that a patient does not have medical insurance and needs medical insurance for health issues. Due to existing medical issues the patient cannot get medical coverage for the medical issues. Under the insurance reform, the patient would be able to get insurance right away with no waiting period and getting coverage for existing medical issues.
Another important impact to healthcare reform is malpractice reform. Too often physicians are sued for malpractice and the patient is given what seems to be an unlimited amount of money for damages. There needs to be a cap on the amount of money an individual can receive from a malpractice lawsuit. If the cost of malpractice insurance continues to rise due to the cost of the malpractice lawsuits brought against the physicians by the patients. The individuals that have argued against malpractice reform the most have been the injured patients and the attorneys that have represented them. These individuals argue that if malpractice reform comes about then the injured patients will not have any protection against physician’s negligence. The physician’s argument for malpractice reform believe that the reform will lower the cost of healthcare since the physician’s will not have to pay the higher cost of malpractice insurance. The physicians also believe that reform would also increase patient accessibility to healthcare services that otherwise would not be easily available. Since malpractice reform is such a diverse issue that represents emotional issues as well as political issues the federal government
UNIT 1 INDIVIDUAL PROJECT
6
has tried to avoid addressing the issue of malpractice reform.
In order for reform to happen, the physicians and government officials need to come to an agreement on malpractice reform. The reform has to happen at the federal level. There is no other way for the reform to happen therefore the federal government needs to step in and make reform happen. The physicians need come to an agreement where they change the way they charge for services. If these two things can happen then the reform will work. (Corapi, 2014)
The Georgia legislature has come up with a potential bill that would take malpractice lawsuits out of the courtroom and place it in the hands of a mediator committee. It would also reduce the cost of malpractice lawsuits, defensive medicine and the lack of justice for injured patients. This proposal would create a compensation system that would be overseen by an administrative board consisting of eleven members which would compose of an attorney, an accountant, hospital administrator, business leaders, patient advocates and physicians. The board would manage the compensation system of patients, hire/employ staff members, adjustments …show more content…
to the physician contributions and the approval of compensation schedules. The processes to resolve each patient’s claim would be reviewed by the administrative law judge that would make sure that the process is in accordance with the law. This malpractice reform model would be based on the process and not the size of the malpractice lawsuit payout. Once the claim is taken care of the data is then recorded and then the information is then shared as a teaching tool for healthcare professionals so that there may be lessons learned and not repeated.
The Georgia
Malpractice Model would benefit patients, physicians and the healthcare field as a whole.
(Kuehl, 2013)
UNIT 1 INDIVIDUAL PROJECT
7
An example of malpractice reform would be a patient had surgery and the surgeon was to go in and take the right ovary but when the surgeon went in to remove the ovary he/she noticed that the left ovary had a mass on it too so he/she the took the left ovary as well. The surgeon tells the patient after the surgery that he/she had to take both ovaries and not just the right ovary. In the scenario now the patient can sue the surgeon for an unlimited amount of money for the surgeon taking the left ovary however under the reform there would be a cap on the amount of money can be awarded for the malpractice lawsuit.
In conclusion, if there is to be changes made in the healthcare system then everyone must get on the same page so that the changes can be made. If patients want lower health insurance, healthcare cost and access to medical procedures faster the patients and the attorneys should agree to potential changes for the healthcare system. It is imperative that changes are made
and in order for improvements to be made more people need to agree to the improvements instead of the greed from all sides.
UNIT 1 INDIVIDUAL PROJECT
8
References
M.U.S.E. (2013).
Financing Health Care.
Retrieved from My Unique Student Experience: https://class.aiuonline.com/_layouts/MUSEViewer/Asset.aspx?MID=1179508&aid=1179525 Hammond, John Phd., (2009, September 8).
Why Insurance Reform is Desperately Needed.
Retrieved from Insurance Reform Watch: http://www.insurancereformwatch.org/problems/reform.shtml Blumberg, Linda J., Shen, YuShu. (2003, July).
The Health Insurance Reform Simulation
Model.
Retrieved from Urban Institute: http://www.urban.org/research/publication/healthinsurancereformsimulationmodelhirsm Feldstein, Paul J. (2011).
Health Policy Issues: An Economic Perspective.
Retrieved from
VitalSource: https://online.vitalsource.com/#/books/9781567935141/pages/226499010 Corapi, Sarah. (2014, January 6).
Could Malpractice Reform Save the U.S. Healthcare System?
Retrieved from PBS News Hour: http://www.pbs.org/newshour/rundown/couldmalpracticereformsavetheushealthcare UNIT 1 INDIVIDUAL PROJECT
9
system Kuehl, Nancy. (2013, November 12).
Innovative Medical Malpractice Model Commands
Attention at State Legislative Conference.
Retrieved from AAFP:
http://www.aafp.org/news/insideaafp/20131112statelegliability.html
1
Unit 1 Individual Project
Health Care Services Delivery and Finance
Cindy Myerly
American Intercontinental University
Dr. Earl Greenia
UNIT 1 INDIVIDUAL PROJECT
2
Abstract
The purpose of this paper is to review ways to reduce the cost of health care. This paper will identify two methods of reducing the gross domestic product spent on health care. The paper will analyze and support the two methods chosen. The chosen methods are insurance reform and malpractice reform.
UNIT 1 INDIVIDUAL PROJECT
3
There are many options for an individual to pay for health care in the United States.
Some of the options are selfpay, privateinsurance, medicaid, and medicare. Medicare is a …show more content…
federally funded health program for the elderly and the disabled. Medicaid is a federally and state funded program for children and the elderly that cannot afford to pay for the health insurance. Paying for health care insurance has become one of the biggest problems and issues in the United States. There are some ways healthcare organizations are able to absorb the rising cost of healthcare by acquiring other healthcare facilities, merging with other healthcare facilities and by diversifying the services provided. However, these actions have not lowered the gross domestic product costs across the board. (M.U.S.E., 2013)
One of the ways that could be beneficial to cutting the gross domestic product percentage is Insurance reform. One major issue with the health insurance is the complete lack of true regulations mandating the sufficient amount of coverage provided to individuals seeking health care coverage. Due to the amount of health care coverage plans physicians and healthcare facilities have an extremely difficult time trying to figure out the level of coverage a patient may have and if the procedure needed is covered by the individual’s healthcare plan. By trying to figure out coverage issues this raises the administrative cost for both the medical provider and the insurance provider. These cost are higher than any healthcare insurance system in the world.
Despite the rising cost of insurance, many computer manufacturers are making money hand over fist providing new and improved healthcare systems and software for billing to physicians and hospitals, yet administrative costs continue to rise and billing issues have not been fixed.
(Hammond, 2009)
UNIT 1 INDIVIDUAL PROJECT
4
One of the most known model for insurance reform is the Health Insurance Reform
Simulation Model (HIRSM). The HIRSM model is a simulated model for insurance coverage, insurance cost and possible tax ramifications of healthcare insurance coverage proposal expansions and other reforms to the health insurance industry. The model collected national data from employers, employees and others not in the labor market to simulate choices of insurance providers, employers and individuals using current insurance systems and individuals using the reformed insurance. This allows for prediction of coverage types chosen and potential alternatives to the choices made. This model can also simulate the possible effects the health insurance reform has on private insurance markets as well as public programs. The model also looks at the current laws for the insurance industry before looking into the insurance industry reform. This model gives some security in the knowledge of the insurance provider and possible insurance choices. If the insurance industry is regulated and some government controls put in place there will not be as much cost surrounding the industry. Insurance companies can still make money however insurance reform would provide insurance to everyone and not just some of the population. Many countries provide medical insurance to the citizens free of charge therefore there is not a question of how the population’s healthcare will survive. Insurance should be a right not a privilege. Having a big screen television is a privilege, having an iPad is a privilege, insurance of any kind should not be considered a privilege but a right. (Blumberg,
2003)
Although many in the United States government do not want/agree Obamacare to continue, the model is based on other countries that provide health insurance for all citizens. For the first time in the history of the United States every citizen has health insurance and/or access
UNIT 1 INDIVIDUAL PROJECT
5
to health insurance. In addition to Obamacare, employers have been mandated to provide insurance to all employees. This enables parttime employees to sign up for insurance through the employer as well as fulltime employees. Insurance reform is extremely important to the healthcare system. If the healthcare system is going to get any better insurance reform has to happen. (Feldstein, 2011)
An example would be that a patient does not have medical insurance and needs medical insurance for health issues. Due to existing medical issues the patient cannot get medical coverage for the medical issues. Under the insurance reform, the patient would be able to get insurance right away with no waiting period and getting coverage for existing medical issues.
Another important impact to healthcare reform is malpractice reform. Too often physicians are sued for malpractice and the patient is given what seems to be an unlimited amount of money for damages. There needs to be a cap on the amount of money an individual can receive from a malpractice lawsuit. If the cost of malpractice insurance continues to rise due to the cost of the malpractice lawsuits brought against the physicians by the patients. The individuals that have argued against malpractice reform the most have been the injured patients and the attorneys that have represented them. These individuals argue that if malpractice reform comes about then the injured patients will not have any protection against physician’s negligence. The physician’s argument for malpractice reform believe that the reform will lower the cost of healthcare since the physician’s will not have to pay the higher cost of malpractice insurance. The physicians also believe that reform would also increase patient accessibility to healthcare services that otherwise would not be easily available. Since malpractice reform is such a diverse issue that represents emotional issues as well as political issues the federal government
UNIT 1 INDIVIDUAL PROJECT
6
has tried to avoid addressing the issue of malpractice reform.
In order for reform to happen, the physicians and government officials need to come to an agreement on malpractice reform. The reform has to happen at the federal level. There is no other way for the reform to happen therefore the federal government needs to step in and make reform happen. The physicians need come to an agreement where they change the way they charge for services. If these two things can happen then the reform will work. (Corapi, 2014)
The Georgia legislature has come up with a potential bill that would take malpractice lawsuits out of the courtroom and place it in the hands of a mediator committee. It would also reduce the cost of malpractice lawsuits, defensive medicine and the lack of justice for injured patients. This proposal would create a compensation system that would be overseen by an administrative board consisting of eleven members which would compose of an attorney, an accountant, hospital administrator, business leaders, patient advocates and physicians. The board would manage the compensation system of patients, hire/employ staff members, adjustments …show more content…
to the physician contributions and the approval of compensation schedules. The processes to resolve each patient’s claim would be reviewed by the administrative law judge that would make sure that the process is in accordance with the law. This malpractice reform model would be based on the process and not the size of the malpractice lawsuit payout. Once the claim is taken care of the data is then recorded and then the information is then shared as a teaching tool for healthcare professionals so that there may be lessons learned and not repeated.
The Georgia
Malpractice Model would benefit patients, physicians and the healthcare field as a whole.
(Kuehl, 2013)
UNIT 1 INDIVIDUAL PROJECT
7
An example of malpractice reform would be a patient had surgery and the surgeon was to go in and take the right ovary but when the surgeon went in to remove the ovary he/she noticed that the left ovary had a mass on it too so he/she the took the left ovary as well. The surgeon tells the patient after the surgery that he/she had to take both ovaries and not just the right ovary. In the scenario now the patient can sue the surgeon for an unlimited amount of money for the surgeon taking the left ovary however under the reform there would be a cap on the amount of money can be awarded for the malpractice lawsuit.
In conclusion, if there is to be changes made in the healthcare system then everyone must get on the same page so that the changes can be made. If patients want lower health insurance, healthcare cost and access to medical procedures faster the patients and the attorneys should agree to potential changes for the healthcare system. It is imperative that changes are made
and in order for improvements to be made more people need to agree to the improvements instead of the greed from all sides.
UNIT 1 INDIVIDUAL PROJECT
8
References
M.U.S.E. (2013).
Financing Health Care.
Retrieved from My Unique Student Experience: https://class.aiuonline.com/_layouts/MUSEViewer/Asset.aspx?MID=1179508&aid=1179525 Hammond, John Phd., (2009, September 8).
Why Insurance Reform is Desperately Needed.
Retrieved from Insurance Reform Watch: http://www.insurancereformwatch.org/problems/reform.shtml Blumberg, Linda J., Shen, YuShu. (2003, July).
The Health Insurance Reform Simulation
Model.
Retrieved from Urban Institute: http://www.urban.org/research/publication/healthinsurancereformsimulationmodelhirsm Feldstein, Paul J. (2011).
Health Policy Issues: An Economic Perspective.
Retrieved from
VitalSource: https://online.vitalsource.com/#/books/9781567935141/pages/226499010 Corapi, Sarah. (2014, January 6).
Could Malpractice Reform Save the U.S. Healthcare System?
Retrieved from PBS News Hour: http://www.pbs.org/newshour/rundown/couldmalpracticereformsavetheushealthcare UNIT 1 INDIVIDUAL PROJECT
9
system Kuehl, Nancy. (2013, November 12).
Innovative Medical Malpractice Model Commands
Attention at State Legislative Conference.
Retrieved from AAFP:
http://www.aafp.org/news/insideaafp/20131112statelegliability.html