Why We Fight The Healthcare System

by Pearl Korn

National Healthcare Activist

Co-Founder, Citizens For Medical Safety

We fight because our government has failed to protect us. Our healthcare system is crumbling and dangerous. And so we are angry.
As children growing up we pledge allegiance to the flag and learn about our inalienable rights. And so we are angry when as adults we learn through personal experience that America is descending into a place of lies, cover-ups, and civil and human rights violations.
Our anger festers when we learn that our Courts are corrupt and subvert and manipulate the Law. The victim's place is a terrible place to dwell.
And since anger is good, we know it will create change.

Who Are We?

We are activists for medical malpractice victims throughout the country who believe that change in healthcare can only be achieved by working through the political process.

Too many other grassroots movements have been co-opted by the medical/industrial machine whose reach has been far and insidious. Hence, victims have not been able to rally in sufficient coalesced numbers. Still others are immersed in their own agendas and personal pain and are unable or unwilling to bring the major issues forward to the American Public.

We strongly believe in the need for a National Medical Safety Board that would be comparable to the National Transportation Safety Board. This new Board would regulate all aspects of medical activity performed by doctors and hospitals across the country.

The existing State Medical Boards would come under the direct supervision and guidance of the National Medical Safety Board. In turn, each hospital would have an office, supervised by the State Board, and responsible for insuring quality of care within the hospital. Systems of regulation would be established that would extend into group and individual medical practices. This plan for regulatory reform is needed to provide a high degree of uniform, high quality medical care for our citizens.

With the development of regulatory reform, it will also be possible to institute malpractice reform. Our medical tort law system is a major impediment to medical practice. It has been shown ("Medical Malpractice: External Influences and Controls," Can The United States Afford A "No-Fault" System Of Compensation For Medical Injury?" Spring Issue, Number 1, Troyan A. Brennan, in Law and Contemporary Problems, Duke University School of Law, Vol. 60 Winter & Spring 1997, Nose 1&2.) that "No Fault" more equitably compensates medical victims and most importantly provides a better approach to dealing with medical malpractice than existing approaches. Our medical tort law system is broken and should be discarded.

A Congressional hearing with the public present, as well as victims of so-called medical errors should be scheduled. Also, the uninsured and the under-insured must be represented. This hearing must be open to the television networks and other media to bring these urgent issues to the nation.

Here then are a list of the major issues highlighting the blatant deficiencies in medical care delivery in America:

1. WHISTLE-BLOWING - BIGGER THAN THE ENRON AND TOBACCO SCANDALS

Healthcare in America has failed to protect the public. This is a reality. Healthcare is often dangerous. The numbers of deaths are 180,000 every year and some sources feel this figure is too low. These death rates are due to medical mistakes and are more than breast cancer, accidents, and AIDS combined. Complaints against doctors from patients have risen 50% during the last 5 years nationally. From the "Harvard Medical Malpractice Study" of 1991 (Measure of Malpractice, Leape et.al., Harvard University Press, 1993), it has been shown that 7,000 persons die from medical mistakes in New York State alone. These were 1984 figures. The current system of medical delivery has failed to protect the American public. We now know the numbers of persons who are the walking wounded, i.e., the maimed and the crippled, has reached one million per year (Institute of Medicine, 1999.) We know that 2 million hospital-acquired infections occur annually throughout the country causing 100,000+ deaths per year (New York Times, 7/25/02). The cost to the country in lost wages, disruption of family, loss to the national economy, etc., is in the billions of dollars. The human cost cannot be described. The "system" covers it all up from the beginning to the end.

2. THE STATE DEPARTMENTS OF HEALTH PROTECT THE HOSPITALS AND THE DOCTORS

The victim of medical malpractice has two choices: try to sue and/or file a Department of Health complaint in his state. The DOH takes at least 1.5 years to respond and in many cases does not respond at all. In most cases, the DOH tells the victim that no doctor misconduct ever occurred- this even when the glaring written proof is shown to them. Up to 30% of all cases may be criminal in nature. Since there is no structure to deal with this criminality in medicine, the cases are dismissed. A standard form letter, what medical victims around the country call the "blow-off letter" goes out to the dismayed citizen. The deliberate concealment of criminality is not even realized by most victims.

3. VIOLATIONS OF CIVIL AND HUMAN RIGHTS AND THE COURTS

Courts and defendant hospitals and doctors conspire to shut down cases. Medical malpractice victims have even been threatened with court assigned guardians to control their finances and prevent them from suing. Some have been threatened with the removal of minor children from the home if they persist in seeking justice in the court system. Victims who win their cases generally are required to sign a "gag order" in order to obtain their compensation. The true extent of the harm from medical malpractice cannot be known to the public. These are some of the reasons why there has been no national outcry or marches upon Washington, D.C. These are terror tactics worthy of a totalitarian state. The victim is further victimized to the point of immobility. Courts entrap plaintiffs. The courts and the lawyers have perverted the meaning of the laws to support their own agendas, which is the denial of the truth. America is seriously in danger because of the breakdown of the judicial system - at least in the area regarding medical malpractice. This is a complete failure to protect the society.

4. THE FAILURE OF THE STATE ATTORNEY GENERAL AND THE LOCAL DISTRICT ATTORNEY

There is no mandate from the State Attorney General to take on a case of medical malpractice, even when it gives every indication of criminality and reckless endangerment. The District Attorney office directs all cases off to the civil courts in spite of clear evidence of reckless behavior and medical homicide.

5. THE INSURANCE INDUSTRY

Doctors not only invest in insurance companies but many are actually owned by physicians. Many insurance companies then go on to own hospitals. So, it is clear that when a victim files suit, and is lucky enough to obtain a lawyer, the case is kept on the back burner for years. Meanwhile the defendant hospital and doctor gets the best lawyer who, at all costs, must win the case. Medical malpractice victims always start at a disadvantage because the playing field is not level. No cases are taken where there is not a high degree of certainty on the part of the plaintiff's lawyer that a high settlement will be obtained. Where cases are "politically sensitive" lawyers can be persuaded to drop cases by pressure from the "system." Criminal medical malpractice cases are rarely pursued. Even egregious acts by lawyers go unpunished by the courts and state bar associations. The judicial system is broken as regarding medical malpractice.

6. OUR MANDATE FOR HEALTHCARE REFORM

44 million people do not have medical insurance in America. 45% of all personal bankruptcies are from medical debts that destroy families. Deaths due to doctor "errors" number 180,000+ annually according to AARP figures. Those with health insurance are finding their deductibles increasing and the quality of their medical care going down. Small businesses are struggling to stay alive and to provide medical coverage for their employees - if they can.

We rank 37^th in the world in the quality of healthcare according to the World Health Organization. This, despite the fact that our healthcare costs are higher than any other industrialized nation. By 1998 the United States was spending $4,270 per capita, about twice the spending of Germany ($2400), Canada ($2250), France ($2120), Sweden ($1820), and Japan ($1780). The United Kingdom spent $1450 per capita in 1998. Americans already pay enough to fund a national health insurance system, which is more generous than other nations. And in spite of the high amounts we pay, the most important issue is this- our health delivery system is unsafe. Why has our profit-driven system of medical care failed us?

A. Our healthcare is increasingly delivered through HMO's that ration health services. The bottom line is money and profits. 350,000 hospital beds are empty daily in the quest to save money for the HMO's. This way, increased profits are shared with the CEO's, doctors and stockholders.

One example of this is that low-income patents in poor health have a 21% increased risk of dying in an HMO plan rather than a one that is fee for service. This data comes from an early study by the Rand Corporation. The for-profit HMO's are increasing rapidly. Altruism in Medicine is long-passed. Doctors are stockholders and/or own the HMO's and many insurance companies. Furthermore, doctors working in HMO's are paid to withhold services especially to the very ill. This encourages them to drop their current HMO. They are too expensive to be maintained in the system.

B. Doctors are pressured to see more and more patients and thus spend less time with any single patient. Doctors can increase billing because of increased volume. Quality suffers and "Medical Error" follows this kind of medical care. Medical malpractice insurance premiums are on the increase. Cover-ups, lies, and denials attempt to avoid costly litigation that often drags on for years. Litigations often result in out of Court settlements with "gag orders" for victims of medical malpractice. This further escalates the medical costs - and so it goes.

C. We need a federally administered not for profit system that covers all medically necessary services. This is true universal health coverage for all Americans regardless of income and it is truly equal in quality for all.

D. The three core issues needed for the overhaul of healthcare, moving us into a Single Payer National Health Insurance Plan are Finance Reform, Regulatory Reform, and Malpractice Law Reform ("No Fault" insurance system.) When death or serious injuries, caused by doctors or other healthcare professionals takes place reparation would be mandated. The current Court system would be eliminated. Schedules of appropriate compensation would be instituted. This would eliminate the antiquated medical malpractice system now in existence, for what we have is cumbersone, expensive and unjust. A failed system. Aspects of this program would be developed by and extended into our Medicare system. This would cover all, Nationally. Our current Medicare system should be the framework for this new program. Medicare runs at an efficient administrative cost of 2% annually and not the 13-15% costs of our profit driven current system.

The federally administered system would include major regulation of all aspects of healthcare and its delivery. It would eliminate lawyers and insurance companies. The government would be the insurer in medical malpractice issues. Doctors would not worry about meeting exorbitant premiums. This would be "no fault" insurance for true accidents, since accidents do happen. But, reckless endangerment of patients would be dealt with differently and should be.

Pearl Korn

Elizabeth LaBozetta

Stephanie Speken

Ralph Speken

Rosario Zisa

Founding Members,

"Citizens For Medical Safety"