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The Fallacy of "Between You and Your Doctor"

The Congress must also expand health savings accounts, create Association Health Plans for small businesses, promote health information technology, and confront the epidemic of junk medical lawsuits. With all these steps, we will help ensure that decisions about your medical care are made in the privacy of your doctor's office -- not in the halls of Congress. – President George W. Bush, State of the Union Address

If this statement seems familiar, it’s probably because the President has mentioned “junk lawsuits” in almost every State of the Union speech since he took office. But he isn’t just repeating himself on that issue. We’ve also heard variations of “your medical decisions should be between you and your doctor, not you and some government bureaucracy” before, and not just from President Bush.

We take issue with both of those premises, and for the following reasons.

1. There is not and never has been an “epidemic” of “junk” medical malpractice lawsuits. The amount of lawsuits filed, judgments against doctors and settlements reached have been at the same level for decades.

2. Decisions about your healthcare haven’t been “between you and y our doctor” for a very long time. They are between you, your doctor, and a faceless insurance adjuster, who will either not pay for needed treatment or will only pay for the cheapest possible treatment available.

Again, There is no “Lawsuit Epidemic”

As we have mentioned time and time again, the “epidemic of junk lawsuits” is a fiction. It is an invented scenario where anyone who walks into a hospital is eligible for a million dollar settlement if the doctor so much as looks at him cross-eyed.

The Department of Justice sees things differently. And they aren’t going by the opinions of paid consultants, but are simply focusing on the numbers. According to a recent DOJ study:

- The majority of malpractice cases closed without payment.

- Less than 10 percent of the claims in Florida, Maine, Missouri and Nevada had payouts of $1 million or more.

- In Florida, Maine and Missouri, about two-thirds of the claims were closed with insurance payouts of less than $250,000.

- Among persons receiving compensation, insurance payouts were highest for claimants who suffered lifelong major or grave permanent injuries. In Florida and Missouri, claimants with these types of injuries received median payouts ranging from $278,000 to $350,000.

- Insurance payouts were lowest for claimants who suffered temporary or emotional injuries. In Florida and Missouri, claimants who suffered these types of injuries received median payouts ranging from $5,000 to $79,000.

As we have stated before, this is not the hospital-crippling debacle that the insurance companies would have you believe.

It’s Between You and the Insurance Companies

We have noticed that amidst all the debate over “socialized medicine” and “universal healthcare,” nobody is stating the obvious. The problem with American healthcare isn’t the lawyers, or the skill or compensation level of the doctors. The problem is that when someone gets seriously ill in this country, that person will almost certainly end up bankrupt even if they do have insurance. Getting the treatment you need isn’t a problem. It’s getting your insurance company to pay for it that is practically impossible. And yet a discussion about the way that the insurance companies operate never seems to be part of the debate.

We have yet to have a client that was injured in a car accident that didn’t have almost half of his medical claims rejected. We have represented countless injury victims who are suddenly thrown into a truly desperate financial state because their insurers arbitrarily denied their medical claims. And while politicians debate over how much all this universal healthcare would cost, it apparently hasn’t occurred to them to consider the alternative of simply regulating the insurance companies in an effective manner.

The state of Washington recently passed the Insurance Fair Conduct Act, which makes insurance companies that engage in bad-faith practices pay triple damages. Maryland recently passed a bill requiring insurers to act promptly and within the guidelines of their policies. Other states all over the country are standing up to insurance company greed.

So since the states have long since noticed that something is terribly wrong with the way insurers do business, we have to wonder why the Federal Government has yet to mention this completely obvious problem whenever they discuss health care reform.

If you or a loved one has been in an accident and feel that you are being treated unfairly by an insurer, contact our offices for a free legal consultation today.

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Lewis & Tompkins
927 15th Street N.W., 9th Floor
Washington, DC 20005

Phone: 202-296-0666

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