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Ralph Nader > In the Public Interest > RN’s Opinion of Clinton’s Health Plan

Two notable areas were not mentioned in President Clinton’s address to the Congress on his health insurance plan.

The first area dealt with the largest source of non­addictive fatalities in the nation–medical and hospital malpractice. Extrapolating from the Harvard study of hospitals in New York state, at least 80,000 people lose their lives in hospitals due to negligence or worse. Tens of thousands of lives are lost in the more seamy “mills” in the inner cities and other bad doctoring out of clinics and offices. The fatality count is greater than crime in the streets, fire deaths and traffic deaths combined. For weeks the Clinton White House has been pondering this matter. The facts were available to Clinton aides: malpractice costs patients and the economy billions of dollars each year. The combined premiums paid for malpractice insurance by both doctors and hospitals last year was less than what is spent on dog and cat food–just over $4 billion paid to those very profitable companies. That sum is less than one half of one percent of the total health care costs in the USA.

The Clintonites also knew that one in ten victims of malpractice receive any compensation whatsoever and the total payout to victims in verdicts and settlements is under $3 billion a year.

In his speech, Clinton made no mention of the malpractice scourge. He only mentioned “doctors who order unnecessary procedures” in his paragraph on responsibility. Nor did he give any example of the horrible human toll taken by bad doctors whom the good doctors worry and whisper about so frequently. He gave human interest capsules about people who did not have insurance

or people who lost their insurance due to no fault of their own except losing a job or getting sick.

He could have mentioned Avis and Mark Bennett’s three year old daughter Heather who died as a result of malpractice at the hands of a neurosurgeon with falsified credentials. Or Frank Cornelius, who was totally disabled from malpractice in connection with simple orthoscopic knee surgery. Or Betty Keeling’s seven year old daughter Cindy who died due to malpractice during a routine tonsillectomy.

Clinton’s chief problem since entering politics has been cowardice. He can’t get himself to stand up for what he knows should be done against powerful lobbies. He fudges, he dodges, he ducks, he tries to fuzz the issues.

Consumer groups asked the Clinton people to consider several policies to prevent malpractice itself. Beefing up the state medical licensing review boards to be more effective and more expeditious was one way. He said no. Requiring medical malpractice insurance companies to experience rate the bad doctors was another proposal (the way bad drivers are surcharged). He said no.

The only one he agreed to was to open the National Practitioner Data Bank that the federal government keeps on the status of physicians’ license, malpractice claims, and other information reflecting on competence and honesty. Presently, these data are not accessible either to patients or doctors.

What Clinton focused on in his remarks was to further restrict the rights of patients harmed by malpractice. He did not go as far as the American Medical Association wanted, such as capping the most serious injuries’ compensation rights for pain and suffering, but he stuck it to innocent patients far more than he did to reckless or even criminal medical practitioners. But then patients and their kin are not organized and powerful. However, he’ll be hearing from them the coming weeks.

The second silence in Clinton’s speech is whether he, Gore, members of Congress and their staff will be required to enroll in this new plan or whether they can keep their very generous health care program. Cong. Pete Stark thinks they should, observing that if members of Congress are in the least expensive health plan, there would be powerful people to complain and correct, should there be poor or no service.

Sen. Paul Wellstone has introduced legislation, similar to Stark’s to require that members of Congress enroll in the same plan as everybody else. Imagine Clinton proposing that when he spoke to the joint session of Congress the other night. He would have received a second moment of silence to add to that devoted to the victims of the railroad crash in Alabama.