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Medical bill needs clearing-บทบรรณาธิการ Bangkok Post


Medical bill needs clearing
Published: 4/03/2011 at 12:00 AM
Newspaper section: News
http://www.bangkokpost.com/opinion/opinion/224699/medical-bill-needs-clearing

Let us admit it. Medical errors are an everyday reality whether in crowded state hospitals or fancy private ones. The challenge is how to fairly compensate patients and ensure sufficient protection for the physicians who have done their best under the circumstances.

The no-fault medical compensation draft bill aims to do just that. It is incomprehensible, therefore, why the Medical Council is fiercely opposed to this bill, resulting in an over-long delay to its deliberation in parliament.

Last week, health activist Preeyanant Lorsermwattana staged a sit-in protest in front of parliament when the Abhisit government was again going to put off discussing the bill. A small army of some 100 police officers rushed the protest site to shoo her away. In the public outcry that followed, Prime Minister Abhisit Vejjajiva eventually announced he would sponsor the draft bill as had been promised. It was the right move. There is a real need for legislation to heal the increasingly strained doctor-patient relationship and to prevent the number of medical lawsuits from exploding, given the rising public frustration at the medical profession's indifference.

The Medical Council says the bill as it stands will put physicians and other health personnel at higher risk of lawsuits, because meeting medical standards is difficult in crowded hospitals with poor support systems. Many doctors, out of fear and anger, have issued threats to quit the profession or to treat only a limited number of patients each day.

But such fears are groundless. The bill follows the same principle of no-fault liability in the medical compensation fund under the universal healthcare system. In its sixth year, the fund has enabled patients to receive prompt healing measures while freeing the physicians from the threat of lawsuits. The result is better doctor-patient relations and a marked drop in the number of lawsuits.

But this fund only covers 47 million people under universal health care or the gold card system, leaving out some 18 million people in the government and social security system. The fund also offers only primary financial assistance. The medical compensation draft bill, if passed into law, will cover the country's entire populace. It will also provide additional avenues to fix long-term health damages that are not included in the gold card system.

The council also wants the bill to prohibit all medical error and malpractice lawsuits. This cannot be _ not only because it violates citizens' legal rights, but also encourages negligence when check-and-balance mechanisms are removed. Furthermore, the draft bill already contains protective measures for physicians; the patients will lose their right to immediate and long-term compensation if they want to sue their doctors. Given the painfully long and costly court procedures, and judging from the positive response from patients to the compensation fund in the gold card system, physicians should not let fear prevail over reason.

But then again, the opposition to the medical compensation legislation might well be driven by money concerns rather than fear. The bill requires hospitals to contribute 3% to 5% of their income to the fund. Hospitals will also face legal punishment if they fail to contribute their share or reveal their real income.

The council's latest move has been to set up a special medical court to handle medical error and malpractice complaints, in order to fortify physicians' sense of self-protection. It is exactly this sort of attitude that explains the urgent need for a law to protect patients from medical error and malpractice.

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