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The Role Of State Governments In Preventing Medical Errors

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On August 7, 2008, the Chicago Tribune posted a blog entitled Illinois ponders how to treat medical errors (chicagotribune.com). It was a scathing commentary on the lackluster performance of the Illinois Department of Healthcare and Family Services in protecting the states residents against medical mistakes, wanton neglect, incompetence, abuse and callous disregard of patients safety and well-being that runs rampant in hospitals and nursing homes across the State of Illinois and America. The reporter, Judith Graham quoted the Health Department spokesperson, who said, Were still in the very preliminary stages and itll probably be a while until we make a decision. This shameful public display of indecisiveness and indifference from the states bureaucrats unfortunately reflects the attitude of the leadership in the governors mansion toward public safety.

While I applauded Ms. Graham for bringing this travesty to light, I must respectfully admonish her for grossly understating the problem. Since the Federal Government, through the Institute of Medicine (IOM), made public the fact that hospitals were needlessly killing more than 100,000 people per year in 1999, actions taken that proved ineffective were as follows:

1.Hospital executives hired consultants to study the root causes of medical errors and make recommendations for prevention;
2.State legislators passed laws requiring full disclosure of medical errors;
3.State legislators passed laws requiring that health care workers take a one-time 2-hour course in the prevention of medical errors for licensure or registration renewal;
Moreover, to make matters worse, some thirty states, including Florida passed laws creating roadblocks to finding legal representation to prosecute medical malpractice by cutting the contingency fees that lawyers may charge by at least two thirds. These new statutes completely undermined the whole concept of health care provider accountability. Then, of course it was no big surprise to find out that a private organization called Healthgrades, Inc had, in June of 2004, published estimates of more than two hundred thousand unnecessary hospital deaths per year and brought out the fact that hospitals across the board inadvertently kill 1 out of every 500 people admitted. Moreover, these statistics did not count the 192,000 reported annual deaths due to hospital-acquired infections.

Now, we have federal and state governments taking unilateral actions to deny payment for services arising out of never events, which are acts of gross negligence by omission or commission. While the jury is still out on these new fiscal tightening policies, we have yet to find even one lawmaker who will give a single thought to enforcing health codes, truth in advertising laws, statutory standards of care and fiscal responsibility regulations. Lawmakers and health authorities have yet to realize that in cases of flagrant violation of patient safety standards, they need to put those corporate criminals in jail where they can no longer perpetrate their wanton and callous disregard for human life.

On the other hand, notwithstanding that the great State of Illinois is now just beginning to look at the problem of medical negligence being the fifth leading cause of death in the United States, the rest of the more aggressive states are simply denying payment for treatment of untoward complications, without any system for adjudicating accountability. This will cause a serious delay in the payment of hospital bills and further undermined the financial integrity of an entire industry that is already strapped for cash. Hospitals will inevitably challenge most of the payment denials based on claiming that the complication in question was the result of the disease process and not attributable to the ever-expanding list of never events. This situation will also cause an additional financial burden with attorneys fees and the processing of tens of thousands of new denial of claim challenges. For the solution, it all boils down to holding individual members of the institutional controlling bodies accountable for deliberate decisions that place peoples lives in jeopardy, either civilly, criminally or both as the case may be. There also needs to be licensure for key positions in hospital management to ensure that those in charge are sufficiently knowledgeable as to how operate within acceptable standards of care.
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