Deaths From Medical Error

* The Institute of Medicine issued a highly critical report stating that between 44,000 and 98,000 people each year die as a result of medical errors (Nov. 30). The report points out that although there is no “magic bullet” solution to the problem of medical errors, a combination of fundamental changes is warranted. One of those changes, the panel said, “is to make medical errors so costly to health organizations and providers that they are compelled to improve safety.”

This is exactly what the trial lawyers have been saying for years. The Medical Injury Compensation Reform Act limits are so ridiculously low that there is no real incentive on the part of the health care industry to improve the quality of care. This report, issued by an arm of the National Academy of Sciences, should act as a wake-up call to the Legislature that the MICRA limits should be raised in order to place true accountability upon the health care providers who are causing these tragic deaths and injuries. Until the real cost of medical negligence is shifted to the providers, we will not see a significant dent in these tragic statistics.

BARRY NOVACK

Beverly Hills

* Under a fee-for-service health care system, one provider’s error is another provider’s income. In an HMO system, medical errors reduce the income enjoyed by all providers collectively, as well as the return on investment to those hated stockholders. This is just another example of how the incentive structure of the capitated HMO realigns the profit motive of providers to fit the best interest of patients. The problem of medical errors exists today because fee-for-service medicine found no profit in fixing the problem.

JEFF McCOMBS PhD

Assoc. Prof. and Health Economist

USC School of Pharmacy