Friday, December 28, 2012

Malpractice Insurance, Medicaid Savings, and Physicians for the Poor


What I consider to be the most promising idea was a proposal brought to the Board of the NJ Taxpayers' Association in 2012 by Dr. Alieta Eck, co-founder of the Zarephath Health Center in Somerset, NJ. Dr. Eck proposes that the State of New Jersey to offer physicians free medical malpractice insurance in return for volunteering to care for the poor in a deal that would significantly lower the State's annual Medicaid spending tab.

To give this proposal added weight, and credibility, look back as recently to the early 1960's when all physicians were required to voluntarily treat the poor. Many, if not most, hospitals demainde a certain number of hours of "clinic" care in return to hospital practicing privileges. I remember this as a child ... and I'm not that old. So a deal for free medical malpractice insurance in return for volunteering to treat the poor -- either in-office or at free clinics like the Zarephath Health Center.

When I looked further into her numbers and then some more facts, such as those listed below, I began to see substantial savings in physician, hospital, and diagnostics payments. Much of these savings will be derived from the benefits of more use of primary care physicians for primary care and prevention rather than the emergency rooms for primary care and hospital stays & drugs for late-stage disease & chronic care.

Dr. Alieta Eck has testified before the U.S. Senate Subcommittee on Health, Education, Labor, and Pensions as well as being interviewed and writing op-eds in various publications. Doctors Alieta and John Eck  has a private practice in Piscataway, NJ and serves as president of the New Jersey Chapter of the Association of American Physicians and Surgeons.



According to the our Doctors Alieta & John Eck's Zarephath Health Center proposal, New Jersey physicians pay a total of about $300 million annually in medical malpractice insurance premiums.

If all NJ physicians opt in, then NJ State would self-insure (with stop-gap) the equivalent of the $300 million annually for medical malpractice. If 10% of NJ physicians opted for the deal, then the State of NJ would self-insure the equivalent of $30 million annually. Of course the actual out-of-pocket costs to the State, likely will be much less.

On the other side of the equation, the according to the Kaiser Family Foundation (as in Kaiser Permanente founders) the State of New Jersey's expenditure on  Medicaid and will see substantial savings under this proposal's idea.

According to the Kaiser Family Foundation's "StateHealthFacts.org":
-- The State of New Jersey pays 48% of residents' Medicaid spending as of 2009.
-- The state of New Jersey spent $10+ billion annually on Medicaid in 2010,

That's right. The State of New Jersey's 48% share of the statewide Mediaid tab runs about $10+ billion annually. A mere 1% savings on that would be $100 million!

More specifically, of that $10+ billion annually spent by the State on Medicaid,, the $6+ billion spent on physicians, hospitals, diagnostics, and drugs (acute care), likely would see some savings immediately and substantial savings over the next 10+ years as the greater use of primary care physicians both reduces emergency room visits and hospital stays. The portion of that paid directly to physicians, an estimated $50 million annually, would be slashed immediately.

This looks like a good deal to me: More available physicians, greater use of primary care physicians, lower State of NJ outlay for Medicaid, and lower medical malpractice premiums for participating physicians.

Are you willing to learn more about this Medicaid-Malpractice solution proposal? Would you sign a petition, write letters-to-the editor & articles, share Dr. Eck's post on Facebook & Twitter, and contact your state & federal legislators?

By Steve Reichenstein

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