Medical errors spur calls for cost waiver
By Bruce Japsen
Chicago Tribune
CHICAGO — If you go to a restaurant and get a bad meal, you probably won't have to pay for it. And lemon laws allow consumers who buy cars that never work right to get their money back.
But in healthcare, there is no tradition of rebates — even when a hospital surgical team leaves a sponge in a patient's chest cavity after open-heart surgery, or when a mix-up of a patient's medication causes a prolonged illness, employers and insurers say.
Tired of paying for botched medical procedures and low-quality medical care, some of the nation's largest businesses yesterday called on U.S. hospitals to agree to apologize and waive costs related to so-called "never events" — medical errors these employers say should never happen.
Both the Leapfrog Group, a national coalition of large healthcare purchasers such as Boeing, General Motors and General Electric, and the Midwest Business Group on Health, a Chicago-based business coalition representing more than 80 employers, said hospitals should commit to new policy on 28 healthcare "never events" as a way to make providers of medical care more accountable.
Many of the errors, such as a surgery performed on the wrong body part or mixing up donor sperm for an artificial insemination would seem obvious fodder for a malpractice suit and a settlement worth more than the bill for the procedure.
Other errors on the list, such as "retention of a foreign object in a patient after surgery" or patient injury associated with "contaminated drugs, devices or biologics provided by the healthcare facility," are probably more common and fixing them compounds the soaring cost of healthcare.
While it seems obvious that most consumers and many companies would support a don't-pay-for-errors approach, the industry is also expected to sign up given momentum in Washington and state governments to demand that medical providers adhere to basic quality standards. The seriousness of the errors on the group's list would make defending fees for these errors hard to defend and cause a political firestorm if hospitals did not comply.
One hurdle to moving forward on this now is that few states require hospitals to report their errors.
There is, however, momentum to go beyond serious errors to consider more routine problems, such as hospital-borne infections and other quality issues, as part of the nationwide debate over paying medical providers based on performance.
Still, when such serious errors occur, the business community picking up the tab says patients should get an apology and patients and their insurers or employers should not be billed. Such errors only add to healthcare costs that have spiraled upward for years. At least one study suggests medical errors and low-quality healthcare account for 30 percent of the more than $2 trillion spent on medical care in the United States.
The push by U.S. businesses comes as Congress and the Bush administration consider financial penalties for medical providers when such errors occur. Earlier this year, the Centers for Medicare & Medicaid Services, which runs the nation's largest health insurance programs, said it would work with Congress to investigate potential ways to reduce reimbursement to providers that commit so-called never events.