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Ralph welcomes Michael Saks and Stephan Landsman, authors of “Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm” about what can be done about the third leading cause of death in America, medical error. And America’s #1 Populist, Jim Hightower stops by to give us the breaking news on Exxon-Mobil’s attempt to break the union movement.

Michael Saks is Regents’ Professor in the College of Law, and the Department of Psychology at Arizona State University.  He is the co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm.

The healthcare industry causes more serious accidental injuries and deaths than all of the other human activities combined. So, there’s this huge disconnect between the amount of harm done, compared to the amount of money made, compared to the amount of insurance expenditures it takes to cover the costs of the harm.

Michael Saks, co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm

Redesigning the system is what the corporate managers are needed to do [to prevent errors]. But the financial incentives work completely against doing that. They would have to invest a lot of money, like bringing in systems engineers. They would have to invest a lot of money to fix these problems. And their reward for doing so would be to watch their revenue drop. Because when patients are harmed, the patients need additional care, and that additional care is additional revenue to the healthcare system.

Michael Saks, co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm

Stephan Landsman is Emeritus Professor of Law, and Organizer and Director of the Clifford Symposium on Tort Law and Social Policy at the DePaul University College of Law. He is the co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm.

It’s certainly been a focus of ours, that the $250,000 cap on non-out-of-pocket damages is a gross sort of harm to specific groups of patients… If you’re a working person and you have a clear income stream that’s interfered with, you’re going to be able to recover if you are harmed in ways that take you out of the workforce. If you are elderly, if you work at home and take care of your children, if you are indeed a child, you don’t have a stream of income. Therefore, the only kinds of claims you’re going to be able to make are claims for the actual treatment costs and for pain and suffering. If you make that limited to $250,000– and that was in the early 1970s, so you can imagine what inflation has done to it– you don’t have a claim that is worth litigating with respect to the perspective of almost any lawyer. So, what you’re saying is, if you’re elderly, if you’re a child, if you’re a work at home mom or dad, you are not going to be able to go to court. No matter how bad a job was done in treating you.

Stephan Landsman, co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm

[Our take is] that doctors face a very challenging sort of job. And that our own appraisal of where the damage often arises from is not because of the individual doctor so much. It is because of the system. That they’re tied into a system that doesn’t take care, doesn’t gather data, doesn’t share problems, doesn’t honestly discuss. And that, then, if there is a problem, and if it becomes salient, then the doctor has to stand alone. She’s going to be blamed in a medical malpractice suit. When the reality is that with better support, with better feedback, with better training, with more decency, you would not have those kinds of errors, but a system that was striving to correct itself. But the doctors have created a culture– a system– where now they are exposed and not effectively supported.

Stephan Landsman, co-author of Closing Death’s Door: Legal Innovations to End the Epidemic of Healthcare Harm

Jim Hightower is a syndicated columnist, national radio commentator, and America’s Number One populist.  He has written many books including Swim Against the Current: Even a Dead Fish Can Go With The Flow. Mr. Hightower is a board member of Public Citizen. He is also a founding member of Our Revolution, an organization inspired by the issues brought up in the Bernie Sanders campaign. Along with that, he writes a monthly newsletter called the Hightower Lowdown.

[The ExxonMobil lockout’s] impact is so humongous that you can’t imagine that we’re not standing up to this. Because it goes way beyond Beaumont, way beyond Exxon, and way beyond the union movement, even. This is about the middle class. If they can bust this union and good paying jobs, like Exxon Mobil has had… then that’s where inequality comes from. It’s not by accident. It didn’t come in on the breeze. It comes from actions by CEOs like Darren Woods, who said we’re going to bust the union.

Jim Hightower, writer of The Hightower Lowdown

The comment line for the White House is 202-456-1111… and just ask Joe Biden to brief himself on the Beaumont lockout by ExxonMobil that affects unions and the middle class all over the country and take a stand. After all, he calls himself –quote– a Union guy — end quote.

Ralph Nader

Ralph Nader Radio Hour Ep 385 Transcript (Right click to download)


  1. Evelyn says:

    Hi Ralph, was hospital after my brother passed on. Antibiotics liver failure in hospital you think they exam the pills as well spooky and footage as well, hearing law suit, Antibiotics induced Lupus and hospital the nurse was foreign called me and insurance. Was spooky! And was be view, chip hand? All around after 2015. Also hacked in literary sense, computer in what was typed into comp context. Handling all myself! Thank Evelyn Ramos love hear from you

  2. Don R. says:

    As mentioned, bring up a medical problem at a party that resulted from a botched procedure and many will augment your example with variations of their own. Then ask how many complained to their physician and you’ll likely find that no one spoke up.

    Most feel intimidated by those professionals assigned to help them manage their health issues, with good reason. I sought help for unexpected problems that occurred after a medical (or dental) procedure only to be disparaged, if not labeled as an unappreciative or recalcitrant patient. The lengths taken to avoid a discussion about my problems bewildered me.

    Part of the problem eminates from the expectation of physicians. Not all, but a good manye expect to be venerated by society, seeing themselves as something above the common citizen. Because of this high self-esteem, they get away with poor service delivery that other non-professional industries would be castigated for such unaccountability.

    The medical industry changed drastically from the days of the town doctor who regularly made house calls. In those days the the medical system existed to service the patients. In today’s world of for profit medicine, the patients exist to service the system.

    The experience often feels degrading, but what alternative do people have when they are at their most vunerable, when they feel I’ll?

    It’s a sad state I need of drastic change.

  3. Holls says:

    In support of the over prescription of antibiotics: About seven years ago, I went into my former doc (an independent practitioner) for a flu test as I was working with kids at the time. I was negative and they thought I just had a cold then offered me antibiotics. I said, “didn’t you just say it was viral, don’t you think that’s irresponsible?” and the smirked and handed me a prescription I never filled.

  4. RJ Haney says:

    Here’s recent (15 July 2021) information about the actions in Beaumont by Exxon Mobil and unions…

    • Susan P. says:

      Hospitals assign too many patients to doctors and too many to nurses and techs. THIS IS ONE OF THE BIGGEST ISSUES—LACK OF ADEQUATE STAFF. The same doctor should follow a patient through their hospital stay until that doctor rotates off. There is never enough stuffing at night or on weekends. THIS IS A HUGE ISSUE. A HOSPITAL SHOULD ALWAYS HAVE CONSIDERABLE EXTRA STAFF AND MUCH MORE APPROPRIATELY SMALLER STAFF TO PATIENT RATIOS. Some hospitals are sweatshops for nurses and techs. Some doctors should not be doctors at all. There is tremendous influence by drug and procedure reps like mesh nets for blood clots, etc. and doctors feel liability pressure to pressure patients instead of taking the time consider on a case by case basis is this really best. They seem to be unaware of lawsuits regarding certain products and they don’t take the time to look deeper even when 40 minutes of actual medical journal studies available on the internet would greatly enlighten them. I know this because I took care of my mother and ended up enlightening doctors on numerous occasions and fighting for her life repeatedly due to medical errors. NURSING HOMES ARE LARGELY PLACES ONLY SLIGHTLY BETTER THAN HELL. Medicare and Medicaid have no minimum doctor, nurse, or tech to patient ratios. Patients should be rated according to the amount of care needed including 24/7 care and staff should be assigned accordingly. This does not happen. Nursing homes were horrible and HORRIFIC before COVID—at least in Georgia which ranks about 45 out of 50. I don’t believe that nursing homes should exist in their current form. All hospitals and all medical care should be nonprofit and/or government funded in my opinion with minimum staffing requirements and ratios. Managed care has helped destroy the practice of medicine because it doesn’t allow doctors to go outside rigid guidelines on a case by case basis. Medicare for all should eliminate private insurance which doesn’t want to pay for anything and sets deductibles so high that it’s almost worthless unless there’s a catastrophe yet premiums are exhirbitant. I could write a book about all the medical errors I saw taking care of my mother. In one hospital there were 34 medical errors in four days. No exaggeration. I had to fight for my mother’s life repeatedly. The medical system is dysfunctional. Too many doctors are arrogant and don’t listen and don’t explain things that are crucial for patients and caregivers to understand. Their arrogance endangers their patients because the doctors don’t spend enough time with their patients and they misunderstand symptoms and then they screw up and won’t deal with their own errors because they are so arrogant and in a hurry because they have too many patients. I started writing case notes and putting them in my Mom’s chart whenever she was denied a test or medication that was of extreme importance and I gave the doctor a copy. That worked almost all the time—and I was almost always right—because I knew my Mom and understood her medically because I was her primary caregiver and I recognized the patterns when she became ill. It was a joy taking care of my Mom and a nightmare much of the time dealing with the medical system.

  5. Afdal Shahanshah says:

    Bellingcat doesn’t do journalism, Steve. They are a CIA/MI6 cutout for peddling NATO propaganda. I hope you haven’t been relying on them for any claims lately. They’ve been involved in a big scandal over the last couple years over their shoddy/fraudulent analyses related to the Syrian civil war.