Governor’s State of the State Address and Responsibility

Here is the text of the Governor’s State of the State Address.

You will note that the Governor did not call for restrictions on the right of patients to hold doctors and hospitals responsible for their negligence. This is a good sign. You can be assured that this was not missed by the doctors, hospitals and their insurers, and these special interest groups will be putting significant pressure on the Governor to get behind their efforts. And note that the Governor did say that he would be speaking with the Legislature “in a few weeks” about health care issues.

More specifically, he said this:

“But when we are number three in the country in obesity, as we are, and when we have the diabetes and heart disease statistics to go with being number three in obesity, there’s something needed beyond insurance. That something is personal responsibility-there’s no pill to make someone push their plate back or take a walk. We have had for a decade the most comprehensive health care program in the nation, and whatever the merits of TennCare — and there have been many — it has not succeeded in moving those public health indicators one notch. An insurance policy hasn’t worked, but a policy of responsibility can.

When I speak to you about health care in a few weeks, I am going to propose that we commit ourselves in a major way to combating obesity and the accompanying explosion of diabetes in our state. With diabetes, like so many chronic diseases, a patient’s lifestyle is in large part his treatment. Our state can’t solve this patient’s problems by taking responsibility for him; we can only help him take responsibility for himself.”

The same concept of responsibility goes for doctors and hospitals. We, the people of the State of Tennessee, are not in the position of preventing errors that injure and kill patients. We can encourage doctors and hospitals to prevent errors (and have, through the Peer Review Privilege, for example) but at the end of the day doctors and hospitals need to be accountable for their errors just like a diabetic needs to follow doctor’s orders in an effort to minimize the effects of this terrible disease on his or her life.

The Governor can help the health care industry prevent errors by forcing disclosure of those errors to regulators, therefore increasing public pressure on providers to have a good report card. The Governor can help the health care industry avoid excessive insurance costs by requiring insurers to justify their rate hikes. The Governor can help the health care providers by requiring the compilation and publication of data about the claims experiences of hospitals so that the Legislature and public can make informed decisions about the presence (or absence) of a problem.

But at the end of the day the industry – and the diabetic – have to be accountable for what they do. For the diabetic, the failure to act is can result in blindness, amputations, heart disease, even death. For the industry, accountablilty means the payment of compensatory damages for harm caused, determined by a jury, with appropriate supervision by a trial judge.

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