January 20, 2018
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Prescription for health care costs: tort reform

By Bruce Rioux, Special to the BDN

I read with interest Cecile Martin’s passionate column advocating a single-payer health care system, “Americans deserve more from health care debate” (BDN, Sept. 26-27). She points out the crippling costs some patients face yet ignores that a single-payer system would transfer these crippling costs to the American taxpayer. The U.S. government already manages three single-payer systems in the Social Security, Medicare and Medicaid programs.

Most Americans entering the work force today are convinced that Social Security will no longer be available once they are ready to retire. Medicaid still owes health care institutions millions of dollars in reimbursement for health care already delivered and the government continuously tries to cut reimbursements to health care providers to sustain the Medicare program. It’s no wonder most Americans are skeptical of the government’s ability to sustain a viable single-payer universal health care program.

It’s fashionable to blame profiteering insurance companies, which assume all the risk, and pharmaceutical companies, which spend billions of dollars in research, for the problems with the present American health care system and to chastise the government for favoring legislation that favors their ability to remain a viable business. Correct me if I’m wrong, but shouldn’t the government of a capitalistic society favor legislation that allows businesses to remain profitable? Shouldn’t the laws of supply and demand regulate these companies like any other business?

These companies are in business to provide a service, but they must show a profit to their shareholders. Some say that the profits are obscenely high and this greed is what leads to the high cost of health care. While this is certainly an arguable point, it disregards other aspects of the health care debate. If insurance and pharmaceutical companies are so greedy, why are insurance premiums different in different parts of the country and why are pharmaceuticals less expensive in other countries?

The difference, in this country, is that too many Americans view the health care industry as a lottery. That is, if they don’t get a 100 percent satisfactory result from their health care experience, they’ll seek legal retribution and they won’t have any problem finding legal representation. The airwaves of radio and television are riddled with ads from legal firms seeking to get you the “financial reward you deserve.” This comes at a tremendous cost and is now being ignored in the health care debate. You cannot have a realistic discussion on health care reform without taking a serious look at tort reform. Otherwise you’re just blowing smoke.

The claim that patients have had poor and even fatal outcomes due to delayed or denied medical care, because of their inability to pay, is an alarming statement since it is against the law for a public health care facility to deny treatment for a life-threatening condition. As a nurse who works at Millinocket Regional Hospital for over 23 years, I have never witnessed a patient being denied treatment for a life-threatening condition at this facility.

Payment plans are sometimes asked of patients without insurance who seek medical care for routine or elective procedures,and some patients change their minds and elect not to enter the health care system. This is not denying care. In fact, all health care facilities, including Millinocket Regional Hospital, provide a substantial charity care program to eligible patients. Asking patients without health insurance, who have the financial means, to enter payment plans for nonemergency care allows these institutions to remain financially solvent so they can continue to provide health care to their communities.

There are some genuine concerns associated with our present health care system, but the insinuation that a single-payer health care system will provide American citizens with fair and equitable health care closer in line with European systems is inaccurate. Single payer or not, there are inequalities in every health care system across the globe, including Europe. The debate centers on whether we “throw out the baby with the bath water” and abandon our health care system to inherit another health care system that generates its own set of problems.

Bruce Rioux is the chief nurse anesthetist at Millinocket Regional Hospital. He has been a registered nurse for more than 26 years and a certified registered nurse anesthetist for more than 23 years.

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