OPINIONISTA: There will always be medico-legal claims— and the NHI needs to take that into account

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OPINIONISTA: There will always be medico-legal claims— and the NHI needs to take that into account By Donald Dinnie

National Health Insurance is the proposed funding model for universal health care. Nowhere does the draft deal with the financing of, and financial provision for, and management of medico-legal exposure.

This is pure speculation because if there is a national detailed plan to deal with medico-legal exposure in state facilities, beyond the platitudes of a commitment to deliver quality care and put the patient first, that has not been communicated, nor, based on the ever-increasing media reports of claims successfully actioned.

If private medical facilities and health care practitioners are to have their fees capped, or regulated in any way, will that take into account the medical malpractice insurance premiums required to be paid and the risk exposures to claims of the different areas of specialisation? At a state level, there is a need and opportunity to focus on and structure financial accountability for medico-legal exposure and claims in a far better way than has been done before. The authority to insure that exposure is another avenue worth exploring. Any insurer would want the comfort of knowing that they could implement appropriate risk control processes and reward programmes including reduced premiums and/or deductibles in return for appropriate risk reduction and control behaviours.

The states of Florida and Virginia have birth-related neurological compensation legislation financed by a fund contributed to by participating hospitals and doctors who contribute on a sliding scale depending on their participation time period. To be eligible for payment, certain criteria need to be met. That includes the suffering of a birth-related neurological injury as defined in the governing legislation.

 

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