Built to Fail: Canadian Healthcare + US Legal System

mindthis.ca
mindthis.ca

 

Canadians take pride in having non-American healthcare.

US healthcare makes millions by driving activity:  patient visits, tests, and procedures.  American lawyers take money back with lawsuits.  Canadians have a very similar legal system, also based on English common law.

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If healthcare is a commodity that can be bought and sold, patients should be able to sue for bad product.

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But, if healthcare is a public offering paid for with tax dollars, patients should have rigid limits on lawsuits, or not be able to sue at all.

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Here’s why:

Threat of suit changes behaviour, but not for patient benefit. Providers change behaviour to protect providers, not patients. Physicians order tests far beyond what’s needed, just in case.

Defensive medicine is expensive.  Providers know that ordering more tests protects them in court.  More testing also fits commercial interests: sell more.  So, commercialized medicine and medio-legal activity benefit each other: more tests and more law suits!

Extra tests put patients at risk. Every test carries some inherent risk: radiation, discomfort, etc. Tests also carry the risk of false positive results that can lead to useless surgeries (with risks) and more useless tests.

Publicly funded healthcare was designed for necessities, not to generate more business. It never existed to create work for itself. Doing more in a system designed to cover only the necessities eventually leaves too little to cover the basics.

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We need legislated legal reform.  Our publicly funded system will go bankrupt if it exists with our current, American-style legal system.

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Benefits of reform:

  1. Improved quality of care.  While you’d think that keeping all healthcare providers in perpetual fear of punishment and lawsuits would improve care, it doesn’t.  Instead, it creates a culture of covering up, or denying errors at all costs.  Medicine, like life, is full of errors.  Errors present an opportunity to improve quality, not something to hide or run-away from.  Quality improves very slowly in a system that crushes speaking up.
  2. Patient experience. Patients do not want to go through useless tests. Most want what’s necessary medically, not what’s necessary to protect providers in court.
  3. Efficiency.  If providers didn’t have to practice defensive medicine, we would see a drastic change in ordering behaviour. Huge numbers of imaging tests and lab investigations would be dropped in favour of clinical judgement.
  4. Capacity. If providers only performed tasks that directly added value for patients, we could care for more patients; wait lists would disappear.

What do you think?  Does it make sense to have a US-style legal approach to a publicly funded healthcare system?