OHSU and the Trampoline Effect

The Sunday Oregonian has a detailed financial analysis of OHSU compared to other local hospitals, but it completely leaves out one main difference: OHSU is protected from malpractice lawsuits with a limit in the range of damages to a few hundred grand. That's not much if negligent care leaves a boy with a permanently damaged brain - a case winding through the courts right now. This could be an example of what I call the Trampoline Effect. Have you ever stood on a trampoline and lifted one foot up? Instead of getting anywhere, the other foot just sinks further down. Here's how it works with OHSU: They thought that if they got protection in the event of malpractice, it would put them in a favorable position to compete with hospitals that haven't got it. That's the leg up part. However, the article mentions that Providence St. Vincent Medical Center performs 10 times as many heart-bypass operations, and 8 times the number of balloon angioplasties as OHSU. Could this be the part where the other leg sinks down? If you were going to have a serious operation would you go someplace that places the burden on your family if something goes wrong? I wouldn't even buy a new car under those conditions. I don't think you could buy a new car under those conditions. OHSU's best hope is that most patients don't realize this part of the deal, till it's too late. And KATU's piece on the brain-damaged boy revealed the hospital doesn't exactly rush to explain these conditions to new patients. Apparently, the Oregonian is in no hurry to explore that part of the story, either. Now OHSU is going after the high-end patients, patients with tremendous coverage. But my guess is that these patients didn't do better in life without knowing what is going on. They are better equipped to find out the best course of action. They're the ones most likely to ask, "Why would anyone want to put themselves in a hospital that isn't willing to stand behind its work financially in the event of a big problem?" So, instead of OHSU making itself more competitive by getting this protection, they've actually made their product much less attractive. They thought they had a leg up but the other one sank back down. And that's the Trampoline Effect.