You may not have seen this gem on page 2 of Thursday's Business section in the O -- a quote from OHSU's always credible Steve Stadum: "We're not trying to game these numbers."
So what was he talking about? If you guessed the costs for the aerial tram, you'd be wrong. He was referring to OHSU's "study" on what it would cost them if they lose tort claims immunity. The estimated range was $8.7 - 43 million per year, plus $14 - 50 million in one-time costs. One would think that at a level of precision that low, they could have done the study for less than the $35K they spent.
But what is curious to me is that they seem to think that a high number is more compelling for their argument that they shouldn't lose their immunity. Without getting into the well-worn substantive arguments on OHSU's very low percentage of public funding and charitable service, it seems illogical to argue that if OHSU causes *that* much harm to people, it is *more* deserving of immunity from civil liability. If any institution causes the public persistent serious harm, doesn't it seem like it should be held up to higher scrutiny, not lower responsibility?
That's the same thought I had when I read that story. Instead of reading, "If its tort liability cap is lifted, OHSU wll have to pay millions in damages and insurance," it could have read, "If OHSU's tort liability cap is lifted, victims of malpractice on Pill Hill will no longer be subjected to millions of dollars' worth of harm, without any right to recover for it." (Could have, but never would.)
Yes, funny thing, Mr. Stadum, justice isn't free.
Comments (10)
Of all your many great posts, this is the subject that I think is most important. I feel as Portlanders we should make this right. How can we feel good about our city if a little kid can get screwed over this badly by the system? Free market values could take care of this eventually. I mean if enough people pass on getting care at OHSU because the patient could face financial ruin if something goes wrong, then OHSU will have to change. It's part of what they are selling, like a warranty on a new car, and right now the OHSU product can't compete with other hospitals in this area. So why haven't these free market values kicked in? Because the patients aren't advised when they seek help, of what could happen should something go wrong, according to the report I saw on local television. Instead of going out of their way to inform their patients of the catastrophic financial risk they are taking by seekiing surgery there, OHSU spends a ton of money on ads touting their Smart Healthcare. We'd be doing OHSU a favor to force them to change because they could then offer the public a better product. It's ridiculous.
This is the difference between doing what is right and the attorney driven mentality at City Hall and other government entitites.
I remember the Goldschmidt Quote when he said he did "it" because he could, a power thing.
Everything you read for the folks whose house was flooded by a sewer back-up caused by the City, to this poor kid, to all the money fighting those ladies Renee Mitchel wrote about in her column.
Why can't they just work out a reciprocity deal with another hospital to take care of this kid, as I am sure they probably don't want to go back to OHSU.
Why do our taxpayer dollars go to penalizing and punishing taxpayers and city employees.
It is sort of the same rationale for the Price-Anderson Act, which caps liability for nuclear accicents at commercial nuclear facilities. The potential damages are so horrendous that the corporations designing, building, owning, or operating nuclear plants must be shielded from liability. If the potential damages were not so big, no liability cap would be needed.
In addition, I wonder how the study accounted for the incentive effects of the liability cap. With a low limit on liability, medical negligence has little financial consequence for the hospital. Economics would predict that this would reduce the incentive to avoid negligence. So, imposing ordinary tort liability on the hospital would be expected to reduce the incidence of negligence and thus reduce both the harm to patients and the financial losses to the hospital from paying tort judgmentgs and settlements.
But what is curious to me is that they seem to think that a high number is more compelling for their argument that they shouldn't lose their immunity. Without getting into the well-worn substantive arguments on OHSU's very low percentage of public funding and charitable service, it seems illogical to argue that if OHSU causes *that* much harm to people, it is *more* deserving of immunity from civil liability.
You must admit that such terms is a bit of an unfair trickbag, damned if they do, damned if they don't. The quintessential double bind. If they didn't show that they stood to lose beaucoup bucks without immunity, then why have immunity at all? I mean, after all, that's one big reason immunity is there: because it would be financially perilous without it. But then on the other hand, if they showed that immunity could be done away with with minimal exposure, then what's the argument for keeping it?
Which essentially devolves to the propriety of a tort claims act at all. Why blanket immunity carte blanche for all public entities?
Or, another question, is OHSU public or private? Part both? Which part is public and which part is private?
A statutory scheme that divines these things may be due.
In this continuing saga of how OHSU still claims at their convenience that they are a "private institution" in some circumstances and in others they are "public", we must not forget that OHSU has recently benefited from over $200M of public money from the state cigarette settlement. This taxpayer money is being misused per settlement directives.
And in the North Macadam URA Amendment Agreement, soon to be before city council again, OHSU is being given over $26M of the Amendment $38 M total in "gimmies"-under the table benefits from the City of Portland general budget. The amount doesn't even include the interest on the $38M borrowed at market rate.
There are many more cases of public/taxpayer money given to OHSU, but they claim they are "private" when it is convenient. But when it comes to "liability" they claim they are "public".
I cannot defend OHSU in many of their antics, in particular the new "attraction" between the hill and SOWA, but I will defend them on the tort issue. I am not an OHSU attorney, not anyone in charge of running the hospital, but a humble health care practitioner. And no, I'm not a doc.
If you walked the halls of the floors and units, you would see that OHSU is different from any other hospital in Oregon. As a teaching hospital, OHSU gets the most serious of cases, the sickest of the sick, the population that comes in often as complete train wrecks with multiple issues and comorbities, and they do a pretty good darn job of taking care of these folks all the while training nursing, residents and medical students. Even more important, OHSU treats many uninsured and Medicaid patients, which doesn't cover costs. Watch the dollars circle the drain...
While patients who suffer damage need some sort of medical compensation, I do not think the answer is to eliminate the tort caps. There must be some sort of compromise that will allow OHSU to continue providing often risky complex care to the masses, while somehow fairly compensating the patient should they be damaged at OHSU.
I wish people could see for themselves the good work that goes on there. The bad press about the tram has made us forget what REALLY happens up on the hill.
There must be some sort of protection when they provide care to those that don't have other options. There should be some sort of protection for doing cutting edge procedures and treatments. Science isn't perfect. People are people, and that includes physicians.
There must be a balance to allow OHSU to continue to do what they do. And that's a lot of great stuff! And sometimes some silly stuff, too.
Cutting-edge, experimental procedures are one thing -- Dr. Death taking out your appendix is something else. But our "leaders" in the Legislature don't see a difference -- and the Dr. Deaths in their McMansions and Porsches like it that way.
Charamba, Douro 2008
Horse Heaven Hills, Cabernet 2010
Lorelle, Horse Heaven Hills Pinot Grigio 2011
Avignonesi, Montepulciano 2004
Lorelle, Willamette Valley Pinot Noir 2011
Villa Antinori, Toscana 2007
Mercedes Eguren, Cabernet Sauvignon 2009
Lorelle, Columbia Valley Cabernet 2011
Purple Moon, Merlot 2011
Purple Moon, Chardonnnay 2011
Abacela, Vintner's Blend No. 12
Opula Red Blend 2010
Liberte, Pinot Noir 2010
Chateau Ste. Michelle, Indian Wells Red Blend 2010
Woodbridge, Chardonnay 2011
King Estate, Pinot Noir 2011
Famille Perrin, Cotes du Rhone Villages 2010
Columbia Crest, Les Chevaux Red 2010
14 Hands, Hot to Trot White Blend
Familia Bianchi, Malbec 2009
Terrapin Cellars, Pinot Gris 2011
Columbia Crest, Walter Clore Private Reserve 2009
Campo Viejo, Rioja, Termpranillo 2010
Ravenswood, Cabernet Sauvignon 2009
Quinta das Amoras, Vinho Tinto 2010
Waterbrook, Reserve Merlot 2009
Lorelle, Horse Heaven Hills, Pinot Grigio 2011
Tarantas, Rose
Chateau Lajarre, Bordeaux 2009
La Vielle Ferme, Rose 2011
Benvolio, Pinot Grigio 2011
Nobilo Icon, Pinot Noir 2009
Lello, Douro Tinto 2009
Quinson Fils, Cotes de Provence Rose 2011
Anindor, Pinot Gris 2010
Buenas Ondas, Syrah Rose 2010
Les Fiefs d'Anglars, Malbec 2009
14 Hands, Pinot Gris 2011
Conundrum 2012
Condes de Albarei, Albariño 2011
Columbia Crest, Walter Clore Private Reserve 2007
Penelope Sanchez, Garnacha Syrah 2010
Canoe Ridge, Merlot 2007
Atalaya do Mar, Godello 2010
Vega Montan, Mencia
Benvolio, Pinot Grigio
Nobilo Icon, Pinot Noir, Marlborough 2009
Portuga, Rose 2011
Revelation, Chardonnay, Pays d'Oc 2010
Beaulieu, Cabernet, Rutherford 2005
Monte Alto, Tinto Reserva 2005
Chateau Ste. Michelle, Cabernet, Indian Wells 2009
Espiral, Vinho Rose
Vin-Koru, Pinot Gris 2011
14 Hands, Hot to Trot Red 2009
Rodney Strong, Cabernet, Sonoma 2009
Abacela, Vintner's Blend #11
Portuga, White 2010
La Bourgeoisie, Red 2009
Januik, Red 2009
Three Rivers, River's Red 2008
Kirkland, Alexander Valley Merlot 2008
Muga, Rioja Rose 2010
Quinta das Amoras, Vinho Tinto 2009
Mauro Molino, Barbera d'Alba 2009
Garda Chiaretto Rose
Columbia Crest, Two Vines Vineyard 10 White
Chateau Ste. Michelle, Pinot Gris, Columbia Valley 2009
L'Hortus, Rose de Saignee 2010
Maculan, Pino & Toi 2008
McKinley Springs, Bombing Range Red 2008
Trader Joe's Pinot Gris 2009
Montes Alpha, Cabernet 2007
Gran Sasso, Sangiovese, Terre di Chieti 2009
Garda, Classico Chiaretto Rose
Beaulieu, Cabernet, Rutherford 1999
Picos del Montgo, Tempranillo 2008
Chateau de Montmirail, Vacqueyras 2008
La Granja 360, Syrah 2009
Montgras, Carmenere Reserva 2009
Lange, Pinot Gris 2009
Columbia Crest, Horse Heaven Hills Cabernet 2008
Kirkland, Pinot Grigio 2010
Trader Joe's Coastal Syrah 2009
Columbia Crest, Horse Heaven Hills Merlot 2008
Trader Joe's Coastal Chardonnay 2009
Vieux Papes Red
Domaine de l'Aujardiere, Chardonnay 2009
Santa Rita, Cabernet, Medalla Real 2007
Penfold's, Koonunga Hill Shiraz Cabernet 2008
Guild, Red, Lot #02 2008
Dievole, Dievolino Sangiovese 2008
Laforet, Burgogne Chardonnay 2009
Columbia Winery, Merlot 2007
Bonterra, Cabernet 2008
Elk Cove, Pinot Gris 2009
Maquis Lien 2006
Scott Paul, Pinot Noir, Le Paulee 2007
The Occasional Book
Neil Young - Waging Heavy Peace
Mark Bego - Aretha Franklin, the Queen of Soul (2012 ed.)
Jenny Lawson - Let's Pretend This Never Happened
J.D. Salinger - Franny and Zooey
Charles Dickens - A Christmas Carol
Timothy Egan - The Big Burn
Deborah Eisenberg - Transactions in a Foreign Currency
Kurt Vonnegut Jr. - Slaughterhouse Five
Kathryn Lance - Pandora's Genes
Cheryl Strayed - Wild
Fyodor Dostoyevsky - The Brothers Karamazov
Jack London - The House of Pride, and Other Tales of Hawaii
Jack Walker - The Extraordinary Rendition of Vincent Dellamaria
Colum McCann - Let the Great World Spin
Niccolò Machiavelli - The Prince
Harper Lee - To Kill a Mockingbird
Emma McLaughlin & Nicola Kraus - The Nanny Diaries
Brian Selznick - The Invention of Hugo Cabret
Sharon Creech - Walk Two Moons
Keith Richards - Life
F. Sionil Jose - Dusk
Natalie Babbitt - Tuck Everlasting
Justin Halpern - S#*t My Dad Says
Mark Herrmann - The Curmudgeon's Guide to Practicing Law
Barry Glassner - The Gospel of Food
Phil Stanford - The Peyton-Allan Files
Jesse Katz - The Opposite Field
Evelyn Waugh - Brideshead Revisited
J.K. Rowling - Harry Potter and the Sorcerer's Stone
David Sedaris - Holidays on Ice
Donald Miller - A Million Miles in a Thousand Years
Mitch Albom - Have a Little Faith
C.S. Lewis - The Magician's Nephew
F. Scott Fitzgerald - The Great Gatsby
William Shakespeare - A Midsummer Night's Dream
Ivan Doig - Bucking the Sun
Penda Diakité - I Lost My Tooth in Africa
Grace Lin - The Year of the Rat
Oscar Hijuelos - Mr. Ives' Christmas
Madeline L'Engle - A Wrinkle in Time
Steven Hart - The Last Three Miles
David Sedaris - Me Talk Pretty One Day
Karen Armstrong - The Spiral Staircase
Charles Larson - The Portland Murders
Adrian Wojnarowski - The Miracle of St. Anthony
William H. Colby - Long Goodbye
Steven D. Stark - Meet the Beatles
Phil Stanford - Portland Confidential
Rick Moody - Garden State
Jonathan Schwartz - All in Good Time
David Sedaris - Dress Your Family in Corduroy and Denim
Anthony Holden - Big Deal
Robert J. Spitzer - The Spirit of Leadership
James McManus - Positively Fifth Street
Jeff Noon - Vurt
Road Work
Miles run year to date: 21
At this date last year: 52
Total run in 2012: 129
In 2011: 113
In 2010: 125
In 2009: 67
In 2008: 28
In 2007: 113
In 2006: 100
In 2005: 149
In 2004: 204
In 2003: 269
Comments (10)
Of all your many great posts, this is the subject that I think is most important. I feel as Portlanders we should make this right. How can we feel good about our city if a little kid can get screwed over this badly by the system? Free market values could take care of this eventually. I mean if enough people pass on getting care at OHSU because the patient could face financial ruin if something goes wrong, then OHSU will have to change. It's part of what they are selling, like a warranty on a new car, and right now the OHSU product can't compete with other hospitals in this area. So why haven't these free market values kicked in? Because the patients aren't advised when they seek help, of what could happen should something go wrong, according to the report I saw on local television. Instead of going out of their way to inform their patients of the catastrophic financial risk they are taking by seekiing surgery there, OHSU spends a ton of money on ads touting their Smart Healthcare. We'd be doing OHSU a favor to force them to change because they could then offer the public a better product. It's ridiculous.
Posted by Bill McDonald | June 23, 2006 11:19 AM
This is the difference between doing what is right and the attorney driven mentality at City Hall and other government entitites.
I remember the Goldschmidt Quote when he said he did "it" because he could, a power thing.
Everything you read for the folks whose house was flooded by a sewer back-up caused by the City, to this poor kid, to all the money fighting those ladies Renee Mitchel wrote about in her column.
Why can't they just work out a reciprocity deal with another hospital to take care of this kid, as I am sure they probably don't want to go back to OHSU.
Why do our taxpayer dollars go to penalizing and punishing taxpayers and city employees.
Posted by Swimmer | June 23, 2006 11:35 AM
"Why do our taxpayer dollars go to penalizing and punishing taxpayers and city employees."
To preserve precious resources for urban development and for our local government employees' retirement and disability.
Posted by Allan L. | June 23, 2006 11:42 AM
It is sort of the same rationale for the Price-Anderson Act, which caps liability for nuclear accicents at commercial nuclear facilities. The potential damages are so horrendous that the corporations designing, building, owning, or operating nuclear plants must be shielded from liability. If the potential damages were not so big, no liability cap would be needed.
In addition, I wonder how the study accounted for the incentive effects of the liability cap. With a low limit on liability, medical negligence has little financial consequence for the hospital. Economics would predict that this would reduce the incentive to avoid negligence. So, imposing ordinary tort liability on the hospital would be expected to reduce the incidence of negligence and thus reduce both the harm to patients and the financial losses to the hospital from paying tort judgmentgs and settlements.
Just a thought.
Posted by Dan Meek | June 23, 2006 4:01 PM
Which essentially devolves to the propriety of a tort claims act at all. Why blanket immunity carte blanche for all public entities?
Or, another question, is OHSU public or private? Part both? Which part is public and which part is private?
A statutory scheme that divines these things may be due.
Posted by Rusty | June 23, 2006 8:51 PM
Did you see where Media Insiders claims some hospital muzzled Lars in one of today's posts.
Claims it was confirmed by a second source.
Posted by Swimmer | June 23, 2006 9:06 PM
They are going to need to save every dollar they can to cover their 85% share of Tram operating costs.
Think of Pill Hill as Jackson Hole, and all the Doctors are ski bums. They need to economize if they are going to keep skiing the fresh powder.
Which would you rather the hospital purchase: malpractice insurance or lift tickets?
Posted by Mister T | June 24, 2006 1:35 AM
In this continuing saga of how OHSU still claims at their convenience that they are a "private institution" in some circumstances and in others they are "public", we must not forget that OHSU has recently benefited from over $200M of public money from the state cigarette settlement. This taxpayer money is being misused per settlement directives.
And in the North Macadam URA Amendment Agreement, soon to be before city council again, OHSU is being given over $26M of the Amendment $38 M total in "gimmies"-under the table benefits from the City of Portland general budget. The amount doesn't even include the interest on the $38M borrowed at market rate.
There are many more cases of public/taxpayer money given to OHSU, but they claim they are "private" when it is convenient. But when it comes to "liability" they claim they are "public".
It is fun to watch the games they play.
Posted by Jerry | June 24, 2006 10:54 PM
I cannot defend OHSU in many of their antics, in particular the new "attraction" between the hill and SOWA, but I will defend them on the tort issue. I am not an OHSU attorney, not anyone in charge of running the hospital, but a humble health care practitioner. And no, I'm not a doc.
If you walked the halls of the floors and units, you would see that OHSU is different from any other hospital in Oregon. As a teaching hospital, OHSU gets the most serious of cases, the sickest of the sick, the population that comes in often as complete train wrecks with multiple issues and comorbities, and they do a pretty good darn job of taking care of these folks all the while training nursing, residents and medical students. Even more important, OHSU treats many uninsured and Medicaid patients, which doesn't cover costs. Watch the dollars circle the drain...
While patients who suffer damage need some sort of medical compensation, I do not think the answer is to eliminate the tort caps. There must be some sort of compromise that will allow OHSU to continue providing often risky complex care to the masses, while somehow fairly compensating the patient should they be damaged at OHSU.
I wish people could see for themselves the good work that goes on there. The bad press about the tram has made us forget what REALLY happens up on the hill.
There must be some sort of protection when they provide care to those that don't have other options. There should be some sort of protection for doing cutting edge procedures and treatments. Science isn't perfect. People are people, and that includes physicians.
There must be a balance to allow OHSU to continue to do what they do. And that's a lot of great stuff! And sometimes some silly stuff, too.
Free tram rides for all!
Posted by Just Looking | June 25, 2006 3:37 PM
Cutting-edge, experimental procedures are one thing -- Dr. Death taking out your appendix is something else. But our "leaders" in the Legislature don't see a difference -- and the Dr. Deaths in their McMansions and Porsches like it that way.
Posted by Jack Bog | June 25, 2006 10:20 PM