Hey everyone, I'm back! Thanks to all the well-wishers and commentors while I was gone. The appointment went well; I won't be having surgery for at least 2 and half weeks, possibly much longer. So rest assured I'll providing my usual commentary until then.
For now, I want to point you all to Graham, who wrote on Atul Gawande's recent New Yorker interview. The post originally caught my attention because someone highly recommended me Gawande's book, Complications: A Surgeon's Notes on an Imperfect Science.
In the magazine, Gawande comments on malpractice:
Are American doctors in a tougher position than those in, say, Great Britain or Canada?Gawande's point seems pretty solid to me. Health care costs for a disabled child or chronically critical loved one can easily reach $1 million, and when heatlh care coverage isn't assured, that's a terrifying sum.
The major difference between malpractice here and in Great Britain and Canada turns out not to be in the number of lawsuits. At this point, the U.K. and Canada seem to be catching up with our rate of lawsuits. The big difference is that the awards are far smaller. This is partly because of the traditions of their court systems, but it’s also because they have universal health coverage. Patients in those systems already have their medical expenses covered for their lifetime, as well as some disability benefits. So malpractice awards are restricted to other costs—lost wages, or compensation for suffering, for example—and these are much smaller costs on the whole.
It makes sense, except that he's wrong. This Health Affairs article found that the average payment per judement in the UK was 36% higher than the average payment in the U.S.
Surprisingly, U.S. malpractice payments (including both cases that resulted in a judgment for the plaintiff and cases resulting in a settlement) were lower, on average, than those in Canada and the United Kingdom. In 2001 the average payment in the United States was $265,103, which was higher than in Australia but 14 percent below Canada and 36 percent below the United Kingdom. While U.S. media and public attention have focused on multimillion-dollar awards at the upper end of the range, the average was actually smaller than in Canada and the United Kingdom in 2001.So, I'm not entirely sure where Gawande is getting his numbers from, but there's a serious disconnect here. If the UK payments had been 5% higher than U.S. payments, that'd be one thing. But the average UK payment here was $411,171 to the U.S.'s $265,103.
I'm hoping to see some good letters to the editor point this out. Anyone else have an idea if this could be a reasonable discrepancy? Or is Gawande just flat out wrong?