Monday, June 13, 2011

Cutting Costs in Medical Negligence Cases - the New York Model

I blogged previously about the government's proposals to get rid of lawyers in medical negligence cases and to take these cases out of the court system into a bureaucratic agency. The rationale offered was that the existing legal process was just too costly and time consuming. As I said before, the proposal is overbroad and ultimately harms both patients and healthcare providers.

There are other approaches to reducing costs and cutting down the length of the adjudicatory process. The NYT has an article today on how the issue is being tackled in New York:
The approach, known as judge-directed negotiation, is seen by the Obama administration as offering states a way to curb liability expenses that have sharply increased health care costs nationally. Getting judges involved earlier, more often and much more actively in pushing for settlements, is its crucial ingredient...
New York officials say the program bypasses years of court battles, limiting legal costs while providing injured patients with compensation that is likely to be less than a jury would award but can be paid out years earlier, without lengthy appeals.

Under a $3 million federal grant, the city courts are now expanding the program beyond the Bronx, where it started in cases against city hospitals, to courts in Brooklyn and Manhattan, as well as to cases against private hospitals. It is to begin in Buffalo courts in the fall.
By some estimates, the program could save more than $1 billion annually if state courts adopted it nationally, Dr. Battles said. The city’s public hospitals say the program, along with other changes, like sharply increased attention to safety, has helped save $66 million in malpractice costs a year.
Under the New York program, cases are assigned from their earliest stages to a judge with training in medical issues who holds frequent settlement conferences, often after months, rather than years. A nurse with legal training helps the judge. Lawyers are required to have the authority to settle. Justice McKeon, who started the approach when handling cases against public hospitals in the Bronx, said settlement became more difficult the longer a case lingered.
The New York model sounds a lot more sensible than a system that gets rid of lawyers and courts.