Redesigning laws that define medical errors would be one of the pivotal components to overhaul our exhaustive healthcare system. Since the inception of our modern health system, medical facilities, hospitals, and clinics have encountered perpetual legal disputes regarding the operational efficiency and destitute quality of care of patients. In 2008, medical errors accounted for approximately $19.5 billion of healthcare expenditures, and the prospective economic impact for the upcoming year would total to $1 trillion (Andel, Davidow, Hollander, and Moreno, p. 39). This upward trend in medical discrepancies and their financial implications have led to a new wave of reforms. This brief essay will argue that there should be a statute that encourages the harmed patient and accused doctor to settle the issue before it enters the judicial system.

              It would be imperative to implement legislation that would reassure the concerns of the patient and safeguard the physicians. This would be known as the Medical Reassurance and Security Act. This approach would prevent expensive financial expenditures, while also considering the perspectives of the offended and accused parties. Medical errors are a result of displeased, harmed, or injured patients. In most cases, these individuals are in lower socio-economic conditions, and they are battling physicians with greater social capital and financial backing from their employers, such as hospitals and medical/health organizations. Opposing sides of the argument face emotional, financial, and social stress as a result of these claims, and having a law implemented to delay the issue from producing negative implications.

              Medical errors are inevitable outcomes of medical procedures; therefore, it would be essential to enact a policy that would prepare for unavoidable errors that would occur during healthcare delivery regardless of the amount of precautions implemented. This piece of legislation would make it easier when there has been an unintended medical outcome, when there has been alleged malpractice or even proven malpractice. Similarly to Iowa, it is an enactment that would be voluntary on both sides and would not reduce anyone’s ability to file a lawsuit if that is the route they decided to choose. This would provide an alternative mechanism so that if all the parties involved wanted to, they could freely meet to discuss the issue without going through the court litigation process. As a result, medical error expenditures would decrease by millions upon millions of dollars, and healthcare delivery outcomes would be controlled.

Bibliography

Andel, C., Davidow, S., Hollander, M., & Moreno, D. (2012). The economics of health care quality and medical errors. Retrieved May 01, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/23155743

Purpose: This briefing is a composition of a myriad of policy conundrums in health and healthcare policy. Such topics were discussed during an event hosted by The Hill. I plan to use this event as an “information catalogue,” given that there are so many topics that I can explore from an economic perspective. From biotechnology to patient-centered care, these topics will enhance my understanding of the many elements that constitute domestic and global healthcare economic markets, and how I can propose sustainable policy solutions to improve them. These notes will prepare me for further economic analyses of efficient policies and programs. This post demonstrates my ability to compose comprehensive notes on a variety of health-related policy areas.

Date: Wednesday,
June 26, 2019

Location: Long
View Gallery, 1234 9^th St. NW, Washington, DC 20001

Time (start-end):
9:00 am – 3:15 pm

Estimated attendance:
Approximately 200 people in attendance

Seating arrangement (diagram): Conference room

Hosts, Panel, Keynote Speakers:

• Dr. Amy Abernethy, Principal Deputy Commissioner & Acting Chief Information Officer, US Food and Drug Administration
• Dr. Justin Barad, Co-Founder and CEO, OSSO VR
• Dr. Georges Benjamin, Executive Director, APHA (via video conference)
• Senator Bill Cassidy (R-LA), Member Senate Committee on Health, Education, Labor and Pensions
• Paul Cohen, Vice President of Strategy, One Medical
• Dr. Rena Conti, Associate Research Director, Institute for Health System Innovation and Policy, Boston University
• Dr. Dennis Cryer, Co-Convener, Biologics Prescribers Collaborative
• Dr. Ezekiel Emanuel, Vice Provost of Global Initiatives, University of Pennsylvania
• Matt Eyles, President and CEO, America’s Health Insurance Plans
• Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases
• David Genetti, President, Clinical Technologies, Astarte Medical
• Colin Hill, Chairman, CEO and Founder, GNS Healthcare
• Leah Howard, Chief Operating Officer, National Psoriasis Foundation
• Julia Jenkins, Executive Director, Everylife Foundation
• Ann Mond Johnson, CEO, American Telemedicine Association
• J. Stephen Jones, President and CEO, Inova
• Dr.Scott Koenig, President and CEO, Macrogenics
• Lisa Lacasse, President, American Cancer Society Cancer Action Network
• Dr. Rachel Levine, Secretary, Pennsylvania Department of Health
• Senator Joe Manchin (D-WV), Ranking Member, Senate Committee on Energy and Natural Resources
• Janet Marchibroda, Fellow, Health Innovation, Bipartisan Policy Center
• R. Shawn Martin, Sr. Vice President, Advocacy Practice Advancement and Policy, American Association of Family Physicians
• Dr. Laquandra Nesbitt, Director, District of Columbia Department of Health
• Steve Papermaster, CEO and Founder, Nano Vision and Former Senior Advisor to President George W. Bush
• Dr. Karlyne Reilly, Director, Rare Tumor Initiative, National Cancer Institute Center of Cancer Research
• Lori Reilly, Executive Vice President, Policy, Research and Membership, PhRMA
• Andrew Spiegel, Executive Director, Global Colon Cancer Association
• Representative Greg Walden, Ranking Member, Energy & Commerce Committee
• Laura Wingate, SVP, Education, Support and Advocacy, Crohn’s & Colitis Foundation
• Dr. Elias Zerhouni, Professor Emeritus, Johns Hopkins University, Former Director, National Institutes of Health

Organizations represented:

• The Hill
• Biotechnology Innovation Organization
• Horizon
• Amgen Biosimilars
• American Public Health Association

Brief summary of presentations and dialogue:

Health Policy Blueprint: View from Congress

• Senator Manchin
  • He spoke of the necessity to have more options
    and more incentives in the health care system.
  • Some Congressmen/women worry about investment in
    biotechnology and medical innovation at a time when the health care system
    needs to be restructured.
  • ACA needs to be reformed, not eliminated.
  • A hint of talk about doubling the NIH budget.
  • Opioid addiction and prevention are top
    priorities.
• Senator Cassidy
  • Biggest issue affecting Louisiana residents:
    high drug costs.
  • Surprise billing legislation should pass by the
    end of July.
  • Support for Association Health Plans.
  • Republican health care package would be
    market-based and provide leverage for the patient.
  • Price transparency is a top priority.
  • Apprehensive about the insolvency of Medicare
    and not a supporter of Medicare-for-All.
  • Rural hospital care and telemedicine are emerging
    topics on the Hill.

The Innovation Ecosystem

• Fixing financing for access to therapies is of
  upmost importance.
• Innovation in prevention is lacking, so reform
  is crucial for substantial system reform.

Sponsor Perspective: Biotechnology Innovation Organization

• Biotechnology Innovation Organization’s members
  innovate 60% of drugs marketed to patients.
• Issue: lack of accessibility to affordable
  biotechnological innovations.
• Solution: reforming insurance plans – both
  private and public – to accommodate biologic, biosimilar, and medical device
  coverage.

Technology Transforming Care

• Addressing the rural and urban divide in
  telemedicine.
• Discussion of the role of primary care and
  advanced medical technology.
• Virtual care is a significant milestone; however,
  the issue now lies in the fragmentation of care.
• Precision medicine is a core medical model that
  would lower health care spending by 25%, improve patient outcomes, and lower
  health care costs for patients.

Regulation in the Innovation Age

• Reforming the 21^st Century Cures Act.
• The approval of biosimilars is gaining traction
  in Congress.
• The rising usage of technology in medicine is
  leading to patient privacy concerns.

Patient-Centered Care: What’s Next?

• Addressing the social determinants of health.
• Progression towards a value-based,
  patient-centered model is possible within the next couple of decades.
• Health care system may become decentralized due
  to a value-based model of care.
• Reformation of the electronic health record
  system to promote consistency between inpatient and outpatient providers.
• Issues pertaining to the affordability of the
  system.
• Addressing three tenets of patient health
  performance: health security, housing security, and economy security.

Data-Driven Cures

• Despite tremendous advancements in medicine, we
  have made the least progress in giving patients access to these innovations.
• Social determinants of health should be factored
  into the equation.

The Future of Public Health

• Addressing the social determinants of health –
  they care not health-based; however, they influence health outcomes.
• Policy Solutions: upstream approach to care,
  updated data systems, data-driven policy initiatives and access to data.
• Emphasis on improving health promotion and
  health prevention.
• Constructing a health preparedness framework
  that can address various issues pertaining to patient health.
• Rural hospitals are stifled by the
  fee-for-service model; a population health model is a solution.

Supporting Patients: A Policy Approach

• Surprise billing is a pertinent issue affecting
  patients and families.
• Innovations in medicine are not the problem; it
  is affordability and insurance coverage.
• Telehealth should be modernized, such as
  allowing doctors to cross state lines.
• Reformation of the VA.

Summary of Q&A:

• Focus on how innovation can impact prevention
  measures and procedures.

Purpose: As an intern for a respected lobbying firm in Washington D.C., I had the tremendous honor of attending many congressional meetings on Capitol Hill. I attended one in particular that explored whether the government or the physcician/provider should have input in health-related decisions that affect the patient. I believe in little to no government participation, given that physicians are the preeminent stakeholders that best understand the elements that contribute to disease and health than any other healthcare actor. This brief will prepare for further economic analysis of how political philosophy can certainly impact health policy and healthcare regulation. I hope to utilize this perspective as a foundation for further interpretations and economic evaluations of sustainable health policy. This post demonstrates my ability to associate political philosophy with healthcare policy.

The understanding of a social contract is arguably the most pivotal aspect of the health care system in the United
States. Unlike other nations in the Western hemisphere, the United States has implemented a more dispersed model of health care procedure; that is, pluralism in the medical profession is revered, specialization and up-to-date technology are highly valued, and emphasis on tertiary care services is greatly preferred. Patients would not accept these specificities if they weren’t openly engaged in and approved of a social contract with the health care system and, more specifically, the physician in practice. 

Social contract theory is a moral and politically philosophical idea rooted within the “state of nature” paradigm of political theory. It is, essentially, the notion that demonstrates the reasoning in which (perceived) rational individuals decide to voluntarily consent to renounce their natural freedom to obtain the benefits of order and accordance. The individual gives up her rights to the state for a myriad of reasons, such as for security, safety, and protection.

This relationship between the state and the individual is analogous to the relationship between the physician and the patient. The physician/patient social contract is an agreement between two parties: one party, the patient, relinquishes her right(s) to acquire medical training and expertise and entrust her physical, social, and mental wellbeing to her physician; the other party, the physician, must provide adequate care to enhance the health conditions of the patient and ultimately prevent death. Principally, “professional sovereignty” of physicians is granted for the betterment of patient health outcomes.

Our interactions, transactions, correspondence, and procedural endeavors rely on the agreement set forth by the patient and the physician. If the relationship is not established, the success of the health care system would inevitably be non-existent. The providing of medical and health care to those in need embodies a certain level of
professionalism. Within the context of American medicine, the physician/patient relationship is the “medical” version of social contract theory, for “in return for the privilege of autonomy, physicians bear the responsibility for acting as the patient’s agent, and the profession must regulate itself to preserve the public trust” (Bodenheimer and Grumbach, p. 57).

Bibliography

Bodenheimer, T., & Grumbach, K. (2016). How Health Care Is Organized – 1: Primary, Secondary, and Tertiary Care. In Understanding Health Policy: A Clinical Approach (pp. 45-59). Place of publication not identified: McGraw Hill Education.

Earning Patient Trust Crucial to Health Care Reform. (2017, April 27).
Retrieved February 05, 2019, from
https://deloitte.wsj.com/cio/2015/04/27/earning-patient-trust-crucial-to-healthcare-reform/