Anita L. Riddle, RN
190 E. Michigan Avenue
Battle Creek, Michigan 49014
October 13, 2011
Governor Rick Snyder
P.O. Box 30013
Lansing, Michigan 48909
PHONE: (517) 373-3400
PHONE: (517) 335-7858 - Constituent Services
FAX :( 517) 335-6863
E-MAIL:
Dear Governor Snyder,
I am writing to you as a Registered Nurse, a health care consumer and a constituent. As governor you have indicated your concern and interest in the health of “Michiganders”. You are currently working on passing and implementing the MI Health Marketplace, a competitively priced marketplace to shop online for health insurance and services. I believe I have a health care concept that will fill a gap in access to health care and complement your MI Health Marketplace.
Even with the implementation of the new Health Care Reform Act in its early stages, there are still many people without health insurance. In August, Michigan’s unemployment rate was 11.2%. As you are aware, this contributes to an increase in health care disparities related to the access of care.The high cost of health care is also impacted by a patient’s ability to sue, and the physician’s need to carry malpractice insurance. What about a compromise that would benefit the health care consumer, the health care provider and the taxpayer?
On your website under health care proposals you reference:
“Pursuing additional Federally Qualified Health Centers (FQHCs) for Michigan. FQHCs are federally funded community organizations that offer care to people of all ages, regardless of their ability to pay. Only 29 of the total 1,048 FQHCs are in Michigan”.
With this in mind I have a proposal to increase asses to healthcare for Medicaid, MI Child and underinsured or uninsured consumers. While providing access to a vulnerable population, it would also help to decrease the cost of malpractice insurance for physicians.
A recent study determined in 2009, the average payment amount of a malpractice claim, in an outpatient setting, was 300,000, with a total of $1.3 billion paid out in the US (JAMA, 2011, June, p. 2429). Not only is this a waste of our health care dollars, it makes physicians reluctant
to stick their neck out to help someone. The following is a proposal, removing the risk of malpractice from the physician and increasing access to health care to those in need.
The proposal is for health care provided in the outpatient setting. Each health care provider will have the option to participate. Those who choose to participate will be required to designate 2 hours, 5 days per week, to provide care at no cost to Medicaid, MI Child, the uninsured and the underinsured. The hours of service to this population would be determined by each provider. During these designated hours only patients meeting the above criteria would be seen. Each patient would be allotted 2 well visits and 12 additional visits for acute and chronic illnesses annually. Any visits beyond this would be assessed a co-pay.
Services included would be examinations, lab draws, consultations, follow-ups, health prevention and health promoting measures. The providers would also cover the cost of any medications administered during the visit. All ages in this population are included, dependent on the specialty area of the provider. What do the health care providers get for their generous efforts? They receive immunity from any malpractice suits involving these patients and their families. The patients prior to being seen on their first visit must sign a waiver. The must know up front they cannot (by law to be determined), sue their health care providers. Since their care is being provided to them at no cost, they do not have the right to pursue any malpractice suits against their physicians, nurses or anyone employed by their treating office. Also with proper documentation of treatment the physician would receive 10% of their malpractice insurance premium back at the end of each fiscal year.
There are other benefits of instituting this proposal. It will encourage those patients who in the pastdid not have the means to obtain healthcare to seek it. This process will focus on prevention and promotion. I believe it will help to diagnosis and treat patients early, decreasing the chance the illness will become chronic, thus saving health care spending. As a previous emergency room (ER) nurse I have seen firsthand the misuse of the ER setting for ear infections, minor injuries and pregnancy tests. All of these issues could have been addressed in a less costly outpatient setting. By patients being seen and treated in the right setting it will decrease expenses to hospitals, and consumers. It will also keep ER beds open for true emergencies and increase patient and nurse satisfaction. An increase in nurse satisfaction will retain nurses during an impending shortage. It is a win-win situation for all.
The implementation of this proposal could begin in one Michigan county. I propose Lake County, as this county has the highest unemployment rate and Medicaid recipients in Michigan. The trial would take place for a period of 1 year. After the trial period, the plan would be evaluated looking at the number of patients served, cost per patient, savings to the provider and decrease in inappropriate ER visits. If found to be successful it could then be extended to other counties, in the order of need.
As mentioned earlier, you are an advocate of increasing Federally Qualified Health Centers (FQHCs) in Michigan. This proposal could supplement these Health Centers, increasing the number of patients served. Although this proposal is only a rough draft, I believe it is a viable solution to meet the needs of an underserved population. A population crying out for help. Please take time to consider the possibilities this proposal offers. As a member of the largest
health care profession, nursing, I feel this a workable solution in decreasing malpractice suits, decreasing the cost of health care and serving a population in need. Thank you for your time and consideration. If you have any questions or thoughts please contact me.
Sincerely,
Anita L. Riddle, RN
School Nurse
Calhoun County Public Health Department
269-986-0316
cc: Senator Carl Levin
Senator Debbie Stabenow
Bishop, T., Ryan, A., & Casalino, L. (2011, June). Paid malpractice claims for adverse events in inpatient and outpatient settings. Journal of American Medical Association, 305(23), 2427-2432.