Who Pays The Bill When A Medical Error Occurs?

Published on June 30th, 2016

When we endure a medical operation our lives are at the hands of the doctor performing the procedure. We trust that the procedure will be performed soundly and without error. However, medical errors do occur. When they do, who is responsible? If the error during the procedure makes that individual’s life worse – meaning they need more care than expected – who pays?

Resolutions of medical errors are handled on case by case scenario. Despite provisions in the 2010 health law that included an added emphasis on quality care, going to the hospital still has risk. Whether that risk be because of mistakes, bad luck, or those coming out not always coming out better, the risk is still present. According to a 2013 estimate from the Journal of patient safety, more than 400,000 Americans die annually in part because of avoidable medical errors.

It is estimated that in 2008 medical errors cost the country $19.5 billion, a lot of which was spent on extra care and medication. If a problem stems from negligence, a malpractice lawsuit may be an option. Some hospitals have rules that the patient must be told immediately if something happened that shouldn’t have and why. Typically, those rules also involve the follow-up care being free if an error has occurred. Hospitals may not always have a financial interest in admitting an error. However, research shows that patients are less likely to sue when the hospital is transparent about the medical mistakes.

According to Julia Hallisy, a patient safety advocate from California, most hospitals do not have these rules. However, that may change with a number of professional and safety groups that are urging more hospitals to adopt them. The supports include the American Medical Association, American College for Obstetricians and Gynecologists, Leapfrog, The National Quality Forum and the Joint Commission, and the federal Agency for Healthcare Research and Quality.

Determining when an error has occurred can be straightforward. There is also instances, where providers follow correct procedures but things go wrong. Hospitals can then deny culpability. If the hospital does not agree to pay for unexpected, employers may push them to because absorbing such costs might eat into the firm’s profits.
According to the American Medical Association, a privately insured patient can cost about $39,000 more – $56,000 vs. $17,000 – in hospital bills when surgery led to complications than when it did not.

Individuals with employer-based insurance, who have experienced complications, should contact their benefit offices. If it does not pan out the insurance may step in. In other situations, patients can complain about their experience to the insurer. The insurer will then work with the hospital to determine who is responsible.

Read The Full Story: The Washington Post

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