Suppose you need gall bladder surgery. Suppose there’s a prestigious urban teaching hospital nearby with lots of famous doctors and researchers who get a lot of media attention for all the ground-breaking work they do. Suppose it’s in your insurance network and your surgeon has privileges in its OR.
Maybe. But suppose you undergo the operation and something goes wrong, as it sometimes does, and you suffer lasting harm because somebody made a mistake.
You retain an attorney, sue the hospital for damages and win the trial. Although you can’t undo the error, at least it was recognized and compensated, right?
Not necessarily. Or so it seems from a recent story in the New York Times. “Several of the city’s most troubled hospitals are partially or completely uninsured for malpractice…,” according to the story, “forgoing what is considered a standard safeguard across the country.”
The problem isn’t limited to New York, although certainly the Big Apple appears to have a serious problem, particularly in underserved, poorer neighborhoods. But it can happen anywhere.
You’d think any hospital would insure itself for what sometimes is the cost of doing business that has such great potential for causing terrible suffering. But as reported on Pop Tort, a consumer advocacy project of the Center for Justice & Democracy, a recent Consumer Reports survey revealed that 30 of the 50 lowest-rated U.S. hospitals in terms of quality of care were found in New York City. New York-Presbyterian, home of TV’s “NY Med,” for example, features open-heart surgery performed by star surgeon Mehmet Oz, and it performed 18 percent worse on the survey on than the national average.
Pop Tort referred to Time magazine’s article, “Why The ‘Best’ Hospitals Might Also Be The Most Dangerous,” and commented, “Clearly, the days when New York hospitals were more well known for their rampant medical errors (and tiny percentage of harmed people who sue) than superstar miracles, seem a distant past.”
Although many are insured, some aren’t. Without malpractice insurance, facilities are playing with fire, and it’s the patients who will get burned. As The Times pointed out, although some of these hospitals have financial reserves to cover liabilities, others have exhausted them. That means awards or settlements are paid from funds otherwise used for patient care. Some have closed certain practices, such as obstetrics, to reduce their exposure.
Many hospital executives claim tight budgets and high insurance premiums make it impractical to pay millions of dollars a year for insurance. But that’s just penny-wise, pound-foolish behavior that isn’t in the best interest of patients, and can place hospitals and their bondholders, including state-backed bonds, at risk if large judgments force them into bankruptcy.
Insurance law professor Tom Baker, from the University of Pennsylvania, told The Times, “From a social perspective, it’s very irresponsible. They’re taking in these people knowing they’re not able to make good on the harm they caused. Even a really good hospital is going to have a certain amount of medical malpractice. It’s inevitable.”
And hospitals don’t have to tell consumers if they are going “naked” or “bare,” as they call it in when they don’t carry insurance. That information at least would give you the option to seek treatment somewhere else.
So if you or a loved one requires hospital care, contact the patient advocate at each facility you’re considering and ask about its medical malpractice coverage. Whether or not your request for information is granted, consult the hospital comparison website from the Department of Health and Human Services to see how well your options stack up against national norms for patient care.