Medicare’s prospective payment system, rolled out in 1983, was a mandate for unreimbursed medical care and, in effect, a provider tax on hospitals. In this week of economic turmoil the tax was raised in the form of Medicare’s new policy regarding adverse hospital events. It couldn’t have come at a worse time.
Along with the tax increase has come a redefining of some unpreventable events as medical errors. Egregious media spin regarding the new concept has gotten the attention of the legal community. The consequences? We may be about to see a shift in the burden of proof for malpractice claims whereby the legal doctrine of Res ipsa loquitur, once reserved for cases of self evident negligence (e.g. leaving a surgical instrument in the abdomen) becomes applicable to common unavoidable hospital complications. Brace yourselves for the next malpractice crisis and an even more rapid exodus of doctors.