America as a society can be lawsuit-happy, going to court over the slightest affront. But anyone who is familiar with the excesses of the legal system would find it hard to view litigation as the preferred approach to resolving problems of denial of patient care by managed care organizations.
Yet that's the implication of a recent study performed by the California Research Bureau, a state agency that provides nonpartisan research to the governor and legislators.
The news media jumped all over the bureau's conclusion that health plans weren't complying with state law and that patients were losing out financially because of requirements they settle disputes through arbitration. That's because the data ran counter to the view that arbitration generally is a way to avoid knockdown, drag-out legal bouts. Along with mediation, it has been the preferred approach to solving diverse problems. Litigation, while as American as apple pie, usually is the expensive alternative of last resort.
But there's more to this study than meets the eye.
First of all, researchers used the number of arbitration cases reported by one health plan to estimate how many cases all California health plans should have had. Although extrapolation is sometimes used for research purposes, such a limited sample doesn't make for the most statistically valid results.
While that fact alone is cause for concern, the research was weakened on a second count: The main researcher has acknowledged that he looked at only one of the two agencies to which health plans could send arbitration data.
Marcus Nieto, the senior health policy researcher for the research bureau, acknowledged that getting the correct data was an insurmountable problem. But researchers didn't go back to refine their work. They simply went ahead and reported what shoddy information they had.
Most members of the media bought the findings hook, line and sinker. Now a public interest group is using the report to demand that complete
arbitration records, with all patient information, be made public.
We're also concerned with the fact that the study was requested by a state legislator who received almost $175,000 in campaign contributions from trial lawyers. But there's no evidence that the support swayed the findings so we'll give the researchers the benefit of the doubt on this one.
Given the pressing need to find cost-effective methods of resolving care denials, this episode is worrisome. If tainted data begins to color the debate, every American will be the loser.