Thursday, October 24, 2013

Compensation for Medical Negligence - Does it solve the problem?

My first reaction to the following news was discomfort - 
The Supreme Court on Thursday awarded a whopping Rs 5.96 crore as compensation to be paid by Kolkata-based AMRI Hospital and three doctors to a US-based Indian-origin doctor for medical negligence ...
It did not feel right. In  fact, it reminded me of Michael Sandel's concerns about becoming a market society where money dominates even moral and ethical issues. 

It feels terribly wrong that the difference is compensation can be so large based on a person's status in life. I wonder how courts will value a child. Will it based on the expected earnings as determined by his or her family background - an obvious reality but hardly the one we should be condoning and encouraging.

The US health care system is not exactly an inspiring example of a system which provides excellent care, without negligence, for all.

The chances are that even in India :
  • the hospital will have an insurance cover
  • insurance company will pay
  • insurance company will raise insurance rates
  • hospitals and doctors will raise their rates
  • we will pay more
  • the doctor will make no fewer errors as it is highly unlikely that the doctor wanted to make a sloppy diagnosis or provide wrong care
  • high costs result in perverse incentive for delaying/avoiding treatment
The same logic is true for motor vehicle accidents. I have not heard of a single person who is a more careful driver because of the compensation he may have to pay in case of an accident.

What may be more effective?
  • A person who makes the error should be accountable and punished.
  • Revocation of a license quickly (not 15 years later) in case it is malpractice or an error which should(not could) have been avoided
  • Limit compensation to a socially valuable amount. A poor victim's family needs financial help a lot more than a rich victim's.
  • Impact of a victim's lost income should be covered by the individual's own insurance policy and not the insurance company covering the doctor (or the driver in case of motor vehicles).
I may even be inclined to favour an insurance cover by the doctors and hospitals where all care costs of the patient are returned in case treatment does not succeed regardless of whether a medical error was involved.

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