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Medical Mistakes 3rd Leading Cause of Death In The United States: Top 25 Ways Insurance Companies Buy Judicial Verdicts and Manipulate Information to Cover Up Deadly Medical Errors

May 6, 2016

The trumpeting of lowering of medical malpractice lawsuits had unintended consequence for the American consumer: death. Medical errors are the 3rd leading cause of death in the United States. You read the correctly: medical errors kill more people than accidents or strokes. And no one is doing anything about it.

How can that be? It’s a complicated insurance company regime, and it has deadly consequences, but it was a form of political strategy that while killer for patients, has been wildly successful insurance companies. What is the strategy? Well, I will spell it out in a  few simple steps:

  1. Mislead the public into believing lawsuits are a “bad” thing. Remember the woman burned by hot coffee that supposedly drove the lawsuit blood bath? A documentary Hot Coffee was made about how her, but she really was injured. The media lied about her. She was really injured, was an 80-year old woman with second degree burns to her vagina, not something people talked about.
  2.  Dump money into judicial elections to get the desired results you want in the courtroom. Putting money into judicial campaigns is good business sense for insurance companies–put a little into a campaign and buy decisions favorable to insurance companies. How much is a “little,” well, there is big money in judicial elections, and insurance companies donate 5% of all the donations, but don’t forget that insurance companies often donate through business groups, such as a “Business Council.” Here is the data on judicial elections from Follow the 2009 and 2010, 72 high court races were on the ballot in 35 states and 253 intermediate appellate court races were decided in 31 states.Of the 475 judicial candidates who ran for these seats, 265 raised money totaling slightly more than $45 million: $26.6 million by high court candidates and $18.5 million by appellate court candidates.Partisan races typically attract the lion’s share of money raised in judicial elections and the elections in 2009 and 2010 were no exception. Partisan judicial races attracted $33.5 million—nearly four times the $8.7 million raised in nonpartisan races…However, some interesting findings about state supreme court elections across the country were revealed in The New Politics of Judicial Elections, 2000–2009. For instance, the Business Council of Alabama, which was one of the top ten contributors to judicial races in Alabama between 2000 and 2009, also holds a top spot in this 2009–10 analysis of all states.
  3. Use the Chamber of Commerce to donate to judicial elections: The U.S. Chamber of Commerce, in particular, has become a powerful player in judicial races. From 2001 to 2003 its preferred candidates won 21 of 24 elections. The chamber spent more than $1 million to aid the 2006 campaigns of two Ohio Supreme Court justices, and in the most recent high court election in Alabama, money from the state’s chamber accounted for 40 percent of all campaign contributions.
  4. Buy your judge’s vote: studies say it works! Judges have been found to rule in favor of their campaign contributors up to 91% of the time, according to a NY Times report:An examination of the Ohio Supreme Court by The New York Times found that its justices routinely sat on cases after receiving campaign contributions from the parties involved or from groups that filed supporting briefs. On average, they voted in favor of contributors 70 percent of the time. Justice O’Donnell voted for his contributors 91 percent of the time, the highest rate of any justice on the court.In the 12 years that were studied, the justices almost never disqualified themselves from hearing their contributors’ cases. In the 215 cases with the most direct potential conflicts of interest, justices recused themselves just 9 times.Even sitting justices have started to question the current system. “I never felt so much like a hooker down by the bus station in any race I’ve ever been in as I did in a judicial race,” said Justice Paul E. Pfeifer, a Republicanmember of the Ohio Supreme Court. “Everyone interested in contributing has very specific interests.”“They mean to be buying a vote,” Justice Pfeifer added. “Whether they succeed or not, it’s hard to say.”Three recent cases, two in Illinois and one in West Virginia, have put the complaints in sharp focus. Elected justices there recently refused to disqualify themselves from hearing suits in which tens or hundreds of millions of dollars were at stake. The defendants were insurance, tobacco and coal companies whose supporters had spent millions of dollars to help elect the justices.After a series of big-money judicial contests around the nation, the balance of power in several state high courts has tipped in recent years in favor of corporations and insurance companies…The court’s decisions, the study found, were rife with potential conflicts. In more than 200 of the 1,500 cases, at least one justice cast a vote after receiving a significant campaign contribution. On scores of occasions, the justices’ campaigns took contributions after a case involving the contributor was argued and before it was decided — just when conflicts are most visible and pointed.Contributors did well with those whose campaigns they had financed. Of the 10 justices in the Times study, 6 sided with contributors more than 70 percent of the time. Justice O’Donnell, who has been on the court for only three years and has participated in fewer decisions than most of the justices studied, had the highest rate — 91 percent.Lawyers who gave money were not nearly as successful. Five justices voted for the positions represented by these contributors half of the time, and the average rate was 55 percent. Recusals in cases involving contributors were all but unheard of.
  5. Tell judges to keep quiet about how campaign contributions impact rulings:And they are succeeding. Not long ago, the Ohio Supreme Court was controlled by liberal justices whose campaigns had been financed in large part by plaintiffs’ lawyers and unions. Now that business groups are outspending their adversaries, the court has become dominated by more conservative justices. And the court’s decisions are no longer markedly sympathetic to people claiming injuries.Justice O’Donnell, a Republican, won his seat with the help of big contributions from the insurance, finance and medical industries. He is running for re-election this year, and his opponent, Judge William O’Neill, is making contributions an issue.“We have to stop selling seats on the Ohio Supreme Court like we sell seats on the New York Stock Exchange,” said Judge O’Neill, a Democrat on the 11th District Court of Appeals in Warren, in northeast Ohio. He says he will not accept contributions.Justice O’Donnell, who has raised more than $3 million since 2000, refused to be interviewed for this article despite more than a half-dozen requests to his campaign, his chambers and the court. In a statement, he said, “Any effort to link judicial campaign contributions received by a judicial campaign committee for major media advertising to case outcomes is misleading and erodes public confidence in the judiciary.”
  6. Make sure insurance companies donate more than plaintiffs’ attorneys to buy judicial decisions that favor insurance companies: “law firms that work mostly for plaintiffs have fared poorly in the court. A look at a sample of 14 big plaintiffs’ firms showed that they won 64 percent of the cases in the study before 2003. In the next three years, [after the rise in spending to elect] of the court’s conservative wing, their success rate dropped to 17 percent.”
  7. Use your money to make sure the judges rule in favor of insurance companies as opposed to injured individuals so you don’t have to pay out insurance for medical injuries: If recent history is any guide, the trends are ominous for individuals suing corporations. The states that have seen the most money in judicial elections now have supreme courts that are dominated by pro-corporate judges. The Appendix to this report lists all high court rulings on cases where an individual sues a corporation from 1992 to 2010 in the six states that have seen the most judicial campaign cash in that time period—Alabama, Texas, Ohio, Pennsylvania, Illinois, and Michigan. The data includes 403 cases from 2000 to 2010, and in those cases the courts ruled in favor of corporations 71 percent of the time. The high courts that have seen the most campaign spending are much more likely to rule in favor of big businesses and against individuals who have been injured, scammed, or subjected to discrimination…This report discusses how the soaring cost of judicial elections led to state supreme court decisions that favor corporate litigants over individuals seeking to hold them accountable. The report provides illustrations from six states— Alabama, Texas, Ohio, Nevada, Wisconsin, and Michigan—of how corporate interest groups that desire a certain outcome have donated money to judges, and the same judges have then interpreted the law in a manner that achieves their corporate donors’ desired outcome.
  8. Have your bought judge “interpret” the law in your favor:A party to a lawsuit in West Virginia repeatedly asked a state supreme court justice to recuse himself after an executive with the opposing party, a coal company, spent more than $3 million through an independent entity to support the judge’s election. The judge refused and cast the deciding vote overturning a $50 million verdict against the coal company. In 2009 the U.S. Supreme Court ruled the judge should have recused himself. The court noted that the executive’s contribution was three times more than the spending by the justice’s own campaign. The U.S. Supreme Court stated, “Just as no man is allowed to be a judge in his own cause, similar fears of bias can arise when … a man chooses the judge in his own cause.”Even judges are alarmed at the growing influence of money on courts. A 2002 survey found that 84 percent of state judges are concerned about interest groups spending money on judicial campaigns. The Wisconsin Supreme Court recently warned of an inherent risk “that the public may inaccurately perceive a justice as beholden to individuals or groups that contribute to his or her campaign.” Justice Paul Pfeifer, a Republican on the Ohio Supreme Court, has criticized the money flowing into his state’s judicial campaigns. “Everyone interested in contributing has very specific interests,” Pfeifer said. “They mean to be buying a vote. … whether they succeed or not, it’s hard to say.”
  9. Now that judges rule in your favor, you insurance companies don’t have to pay medical malpractice claims, and your profits skyrocket. Notice that the nation’s largest medical malpractice insurer is in Alabama, the state with the most corporate spending delivered to judicial races (Business Council of Alabama was one of the top ten contributors to judicial races in Alabama between 2000 and 2009):Payments made to victims of medical malpractice are down, lawsuits filed against doctors and hospitals continue to plummet, and the industry in 2013 posted an underwriting profit for the eighth straight year, according to a May report by A.M. Best Co., an insurance company rating service.Some of the profits are even being passed on to doctors and hospitals through cuts in premium rates or dividends, the report noted.”This is a boom time for physicians,” said Michael Matray, editor of the Medical Liability Monitor, a Chicago trade magazine that follows the medical malpractice insurance industry. “And the industry is making money.”Wisconsin’s largest provider of medical malpractice insurance, ProAssurance Corp., the fourth-largest medical malpractice insurer in the country, recorded a 103% profit margin on its premiums nationwide in 2010, records filed with insurance regulators show. The company, which is based in Alabama, has continued to post extraordinary profits on its national medical malpractice business, with a 64.7% profit margin on its premiums last year, following margins of 86.4% in 2012 and 91% in 2011.
  10. Lie to Legislators to claim their is a medical malpractice crisis, when there really isn’t:Today’s profits are partially the result of the industry’s blowing its call at the beginning of the 21st century by putting millions of extra dollars into reserve to pay claims that never surfaced.Critics charge it was an intentional move by the insurers so they could raise rates and support their argument that the nation was in the midst of a malpractice insurance crisis — which in turn led lawmakers to enact reforms such as capping the damages that can be paid in a medical malpractice lawsuit.“They were intentionally over-reserving. This was completely predictable,” said Joanne Doroshow, executive director of the Center for Justice & Democracy, a left-leaning national consumer rights organization. “There is a political element to this: Create a crisis, raise rates.”
  11. Don’t let the injured go to court. Lie about a manufactured medical malpractice crisis so that the injured can’t go to court and publicize medical mistakes:In Wisconsin, the second bill signed into law after Gov. Scott Walker took office in 2011 was a tort reform measure that said incident reports written by nursing home staff could not be used as evidence in court — a change that lawyers for plaintiffs say makes it more difficult to bring a case against the facilities.About 35 states, including Wisconsin, have caps on the amount of noneconomic damages, such as those paid for pain and suffering or loss of companionship, that can be awarded in a malpractice case. Wisconsin caps the damages at $750,000.Charles Huber, an A.M. Best senior financial analyst, said damage caps and other tort reform measures help the bottom lines of insurers.“The fewer claims that get into the court system keep your expenses down,” Huber said.
  12. Don’t pay costs for people who are injured: “A study of 8,231 closed malpractice cases evaluated the influence of standard of care on the resolution of the malpractice claims. Payment was made in 43 percent of the 8,321 cases…only 51 percent of all payments went to plaintiffs who had actually suffered medical injury due to negligent care. Another study illustrates that the total number of payments to injured patients has dramatically decreased.
  13. Lie about how much insurance premiums cost physicians to manufacture a non-existent crisis:That’s right, $4,926.63 for the whole year! (It says $5025.63 because they want a voluntary $99.00 yearly PAC contribution that they add to the the bill.) This is the fifth straight year that I’ve paid less than $5,000 for my malpractice and my premiums have been as low as $3,000 for the year.So, why so little? If the cost of medical malpractice is breaking the back of healthcare in this Country, why is my bill so low? Is it because I’m such an outstanding doctor that my insurance provider long ago recognized that I would never be sued? Well, I’d like to think that were true but, no. Here’s how much other doctors in my community pay for medical malpractice insurance2015:”The nephrologist who has an office one floor below me pays about $4,980 this year; $54 a year more than I pay and she runs a dialysis unit.A pulmonologist I work with pays $6,342 this year, an ophthalmologists less than $7,000, emergency room physicians: $11,000-$12,000 this year, anesthesiologists: $12,000-$14,000 this year, surgeons (including orthopedics) $20,000-$22,000 this year and Ob/Gyn about $34,000 (obstetrics always has the highest malpractice premiums).You can see from those amounts that medical malpractice premiums aren’t bankrupting me or any of my colleagues. But that just covers the area where I practice. What about the rest of the country? Is medical malpractice driving up medical costs elsewhere in the US? Lets examine the data.A really good source for medical malpractice claims data is the National Practitioner Data Bank which posts data on all paid medical malpractice claims since 2003. A summary of the data for the US as well as for each individual state is here. As the following graphs show, both the number of paid medical malpractice claims as well as the total amount paid on these claims has been dropping steadily since 2003.”
  14. Lie about how much “defensive medicine” costs to drive the hype over the insurance-company-created-fake crisis. According to a physician doing research on the strange misperception of costs in healthcare, defensive medicine. Defensive medicine accounts for less than 1% of the  “cost” in the healthcare system, .056%, or only 1/2% of a point: “The cost of defensive medicine in the US was done by the Blue Cross Blue Shield association. Blue Cross and Blue Shield are health insurance providers so they actually do pay for some of this defensive medicine. They estimate that defensive medicine costs about $45.6 billion a year, which is still a lot of money, but only a small fraction of the amount doctors guessed that it cost…the entire combined revenue for all hospitals in the US in 2010 (the year this study was published) was about $815 billion
  15. Lie about tort reform helping to reduce costs–TORT REFORM TO LIMIT MALPRACTICE PAYOUTS ACTUALLY RAISES COSTS:Of the 33 states that had any sort of active tort reform law in 2013, 16 had per capita malpractice costs that were above the median, 16 were below the median and Oregon had the median amount. It would be hard to have demonstrated less of an effect that year. The list for 2014 yielded similar results with 15 States that had active tort reform laws having above median medical malpractice costs and 18 States with below median costs.
  16. Lie about how buying the judiciary and rigging the Legislature lowers medical malpractice cost–malpractice costs actually drop when Constitutional rights are preservedMissouri has a similar story to Illinois when it comes to medical malpractice costs and tort reform laws. Missouri also passed a law in 2005 capping non economic damages in medical malpractice cases at $500,000. This law was overturned by the Missouri Supreme Court in 2012. In 2011, the year before the law was overturned, Missouri had their highest medical malpractice costs in more than a decade. The year after the law was overturned, medical malpractice cost dropped significantly in Missouri.                                                               Another example occurred in Illinois, when unconstitutional med mal laws were reversed, costs actually dropped:Illinois passed a law in 2005 that capped non economic damages in medical malpractice cases at $500,000. After the law was passed, malpractice costs began to drop in that State. In 2010, the Illinois State Supreme Court declared the law unconstitutional. Ever since that law was overturned, medical malpractice costs in Illinois…have continued to drop. They dropped by more than 30% in Illinois after their tort reform law was overturned.                          This is not just a small coincidence, in seeing a reduction in medical malpractice cases when tort reform laws were overturned: Add to this the fact that there were dramatic drops in medical malpractice costs in Delaware and Iowawithout any tort reform laws. Or that Minnesota and Vermont have among the lowest rates for Medical Malpractice per capita in the US (again without any need for tort reform) and the case for tort reform laws becomes very murky...Also, even very strict laws aimed at reducing medical malpractice costs appear to be ineffective in certain States (e.g. Massachusetts, Louisiana). But most importantly, a 27% drop in medical malpractice costs in the US has coincided with a 64% rise in overall health care costs. Clearly, tort reform laws have done nothing to reduce overall health care costs and are only partly responsible for reducing medical malpractice costs
  17. Pretend doctors don’t want to pay when they cause an injury, instead of telling the truth that insurance companies deny payment for injuries. It’s easier to make doctors the bad guys.  It’s a trump card that insurance companies like to hold out in front, the idea that all doctors hate the idea of paying any insurance to a person they have injured, and it’s simply not true. One man who became a doctor had sued for an injury he sustained, but even he said that the insurance companies don’t pay when they should: ““I think the malpractice system has run amok,” he finally said. “I don’t think that my little experience has anything to do with it—the system is just so rampant with problems. But, if you’re damaged, you’re damaged. If we screw up, I think we should eat it.” Wasn’t he contradicting himself? No, he said; the system was the contradiction. It helps few of the people who deserve compensation.”
  18. Lie about how many people die from medical errors: In 1999, 98,000 people were reported to have died because of medical errors, 90% of medical errors being unreported. By 2014, 251,454 people died from medical errors, making death due to medical error the 3rd leading cause of death in the United States.
  19. Don’t report deaths from medical errors to the public:The Johns Hopkins’ authors said the inability to capture the full impact of medical errors results in a lack of public attention and a failure to invest in research. They called for adding a new question to death certificates specifically asking if a preventable complication of care contributed.“While no method of investigating and documenting preventable harm is perfect,” the authors write, “some form of data collection of death due to medical error is needed to address the problem.”Anderson, however, said it’s an “uncomfortable situation” for a doctor to report that a patient died from a medical error. Adding a check box to the death certificate won’t solve that problem, he said, and a better strategy is to educate doctors about the importance of reporting errors.“This is a public health issue, and they need to report it for the sake of public health,” he said…Dr. Eric Thomas, a professor of medicine at the University of Texas Houston Medical School whose research was cited in the Institute of Medicine’s landmark “To Err is Human” report, said existing estimates aren’t precise enough to support immediately listing errors as the third-leading cause of death.But collecting better cause-of-death data is a good idea, said Thomas, who agreed that medical errors are underreported.“If we can clarify for the public and lawmakers how big a problem these errors are,” he said, “you would hope it would lead to more resources toward patient safety.”
  20. Say that all doctors are responsible for medical malpractice costs when only 2% of doctors nationwide are responsible for the majority of the costs. Consumer Reports points out that only 2% of the nation’s doctors are responsible for the majority of medical malpractice costs. Removing that 2% of physicians who have repeated instances of medical malpractice could lower medical costs for everyone and make medicine safer for consumers. A VERY SMALL PERCENTAGE OF DOCTORS have accounted for most of the country’s medical malpractice payouts over the last quarter century. That’s according to an analysis done for Consumer Reports of the National Practitioner Data Bank, a federal repository that has collected disciplinary actions and medical malpractice payouts since 1990.Robert E. Oshel, who worked as the associate director for research and disputes at the NPDB for almost 15 years until he retired in 2008, ran the numbers and figured out that less than 2 percent of the nation’s doctors have been responsible for half of the total payouts since the government began collecting malpractice information.
  21. Change the legal definition of negligence so that it limits your insurance pay-outs. How do doctors define malpractice? By failure to do something that results in harm to the patient. How does a doctor-turned lawyer define negligence? “There is a legal definition of negligence (“when a doctor has breached his or her duty of care”), but I wanted to know his practical definition of the term. Lang said that if he finds an error that resulted in harm, and the doctor could have avoided it, then, as far as he is concerned, the doctor was negligent.”
  22. Ignore the solution of “tell the truth and fix it,” even when it lowers medical care costs, because that doesn’t fit the crisis narrative you have created. Studies show that doctors worry about medical malpractice cases, not just because they are heartless jerks looking to save their own skin, but because they honestly feel badly about causing someone injury and would would like to apologize, if they felt their insurance carrier would let them. In fact, studies have proven that when 3 things happen, injured patients are less likely to sue: 1) physician acknowledges a mistake 2) physician apologizes and 3) physician offers means of addressing the problem. That type of discussion doesn’t fit the “medical malpractice crisis” the medical malpractice insurance agency has created, so it’s not part of the discussed solution. A study published by the NIH advocates physicians apologizing and helping to correct an error:

    Physicians, like patients, are profoundly affected by medical errors; physicians worry about harm caused to patients; are anxious about the consequences of error for their reputations, fearing that patients and colleagues will no longer trust and respect them; experience distress, feelings of guilt, and loss of self-confidence; and are anxious about the possibility of a lawsuit [6, 13, 20, 57]. Indeed, physicians describe the “sickening realization of making a bad mistake” [60] and the sense of dread on realizing that one has made an error [13].

    Many physicians express the desire to apologize to patients when an error has occurred [13]. However, there is a disconnect between patients and physicians in their expectations and attitudes about the communication they will have after a medical error. In contrast to the desires and expectations of patients for disclosure and apology, there is evidence many physicians tend to provide minimal information about what happened, what led to the error, or what might be done differently in the future; to choose their words carefully so as to avoid being explicit about the error; and to believe patients who want more information will ask for it to be provided [13]. Similarly, there is evidence that providers are reluctant to make any offers of compensation for medical errors unless and until a lawsuit is filed [2, 15, 23, 43].”

    Another surgeon wrote about the medical malpractice system and how few people it really does serve, demonstrating that physicians do understand that they are not perfect, but neither do they want the people who get injured to be left without any resources: “Ninety-eight per cent of families that are hurt by medical errors don’t sue. They are unable to find lawyers who think they would make good plaintiffs, or they are simply too daunted. Of those who do sue, most will lose. In the end, fewer than one in a hundred deserving families receive any money. The rest get nothing: no help, not even an apology.” Physicians are highly educated individuals, capable of understanding that when people get hurt there should be a system in place to help them get the insurance payment the physicians are paying the premiums for in order to practice.

  23. Insist that there is a system of “watch-dogs” keeping bad physicians away from the public that doesn’t include your company paying an insurance liability, when there is no such form of consumer protection. The medical malpractice insurance industry wants the public to believe that there is some sophisticated system of safety networks in place to protect patients that doesn’t involve medical malpractice lawsuits, because lawsuits are “bad.” Remember that lawsuits are “bad,” and don’t over think it, or you might wonder what happens to all the doctors who now are not being brought into court for causing injuries. Since the majority of medical malpractice costs are related to only 2% of the doctors causing repeat patient injuries, according to Consumer Reports, and since medical errors the 3rd leading cause of death in the United States, above any other kind of accident or injury, if there was a system in place to protect patients, we wouldn’t have repeat physician offenders causing injuries and death.
  24. Use the money you set aside to pay for patient injuries as profit and then pay yourself bigger dividends. It’s not rocket science–the less insurance companies pay out to injured patients, the more money they make, all while raising premiums to physicians after convincing the public that the boogeyman-medical-malpractice-crisis exists. Why is it allowed? Who knows. When vaccine manufacturers were being sued for vaccine injury, they stopped issuing a “fault” system and determined a sort of “no-fault” fund to cover vaccine injuries, much like no-fault auto insurance, except patients, the ones who are forced into medical bankruptcies, aren’t allowed to pay into that pool: Vaccines now carry a seventy-five-cent surcharge (about fifteen per cent of total costs), which goes into a fund for children who are injured by them. The program does not waste effort trying to sort those who are injured through negligence from those who are injured through bad luck. An expert panel has enumerated the known injuries from vaccines, and, if you have one, the fund provides compensation for medical and other expenses. If you’re not satisfied, you can sue in court. But few have. Since 1988, the program has paid out a total of $1.5 billion to injured patients. Because these costs are predictable and evenly distributed, vaccine manufacturers have not only returned to the market but produced new vaccines, including ones against hepatitis and chicken pox. The program also makes the data on manufacturers public—whereas legal settlements in medical cases are virtually always sealed from view. The system has flaws, but it has helped far more people than the courts would have.
  25. Pretend that this system is the only way to do business, and that way you will have no competition.  If you’re the only game in town, it makes sense to eliminate any other kind of system that could interfere with your money-maker. Buy your justices so you get judges who restrict individual rights, even when factual data demonstrates that medical malpractice rates go down and cost less in states without the “tort reform” you bought. Cover up the financials so that people don’t know that the money doctors pay in premiums never gets paid to injured patients, making the doctors pay for something from which no one benefits except the insurance companies. Imply that it never works for physicians to apologize, even when study after study proves that medical malpractice costs could be lowered by simply apologizing, admitting to the mistake and offering to fix it. Hey, we’re in it for the money, not the science, and definitely not the people. There you have it, a hugely successful money-maker that delivers zero benefit to society–doctors pay, but get no benefit. Patients who are injured get no benefits. Medical costs rise, even as premiums rise, and the only one left standing to benefit is the insurance company, particularly when everyone else is dying because of these mistakes.



3 Comments leave one →
  1. Name permalink
    May 20, 2016 8:18 pm

    “lowering of medical malpractice lawsuits had unintended consequence for the American consumer: death”
    unintended? typo?

    “medical errors … no one is doing anything about it.”
    hmm, many people are trying to (and succeeding at) reducing medical errors.

    • brokeharvardgrad permalink*
      August 17, 2016 9:08 pm

      Nope, unintended isn’t a typo. No one guessed failing to discipline doctors in lawsuits would cause increased medical-related deaths, did they?


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