Missouri Hospitals Seek Millions from Tobacco Companies for Treatment of Smoking-Related Diseases

A group of 37 Missouri hospitals had their first day in court yesterday in a lawsuit against the tobacco companies (City of St. Louis v. American Tobacco). The suit seeks $477 million in compensation for the treatment of smoking-related illnesses among patients who did not have medical insurance. The claims date back to 1993.

According to an article in the St. Louis Post-Dispatch: "A standing-room-only crowd in the gallery — and more than two dozen jurors and alternates spilling from the jury box — packed a courtroom here Monday to hear opening statements in a trial that pits regional and local medical providers against Big Tobacco. Everything about the case is large: • Big dollars: The plaintiffs had sought $1 billion for the cost of treating diseases of smokers, although the demand is down to less than $500 million in actual damages, one of the defendants says. • Big time commitment: If the trial ran six months, as estimated, it would presumably be the St. Louis Circuit Court's longest. • Big legal teams: More than a dozen lawyers sat at the plaintiff and defense tables, with legal consultants around the country receiving electronic real-time transcripts from court reporters. • Big effort: it has taken almost 13 years to get the case to trial." ...

"The suit, filed in 1998, is the City of St. Louis v. American Tobacco. It pits 37 plaintiffs, mainly local and regional hospitals in Missouri, against 11 tobacco manufacturers. At issue is reimbursement dating to 1993 for treating the smoking-related illnesses of patients who had no insurance and did not pay their bills. Ken Brostron, a lawyer representing the hospitals, argued that tobacco companies knew as far back as the 1950s that cigarettes were addictive and harmful, yet continued to manufacture and market them. "And they don't think for one minute about who should pay for it," he said." ...

"Diane Sullivan, a lawyer for Philip Morris, argued that 95 percent of all patients paid their hospital bills and that only one of every five others smoked. "The truth is, hospitals make money from our bad habits," she said. Sullivan predicted that the plaintiffs would do their best to get jurors angry at tobacco companies. But she said that hospitals have mounted advertising campaigns to get smokers to use their hospitals, have allowed smoking on their campuses, and have sold cigarettes in vending machines and gift shops."

The Rest of the Story

Although I agree that cigarette companies produce a deadly and addictive product, that they have historically lied about the health effects of the product, that they knew the product was addictive and harmful yet covered that information up, and that they continue to manufacture and market this deadly product, I do not believe that the Missouri hospitals are entitled to compensation from the tobacco companies for treatment of smoking-related illnesses.

The hospitals are not entitled to compensation from tobacco companies for treatment of smoking-related illnesses any more than they are entitled to:

• compensation from alcohol companies for treatment of alcohol-related diseases;
• compensation from fast food and soft drink companies for treatment of obesity-related diseases;
• compensation from motor vehicle companies for treatment of motor vehicle crash injuries caused by defective product designs;
• compensation from toy companies for treatment of child injuries caused by toys with safety flaws;
• compensation from lettuce manufacturers who produced E. coli-contaminated produce for treatment of infections among patients who consumed this produce; or
• compensation from pharmaceutical companies for treatment of illnesses related to side effects of medications.

I think you get the idea. Allowing hospitals to be compensated for treatment of smoking-related illnesses would open the flood gates for similar lawsuits to be brought against all sorts of manufacturers of products which cause human illness. Although I am obviously sympathetic to the desire to hold tobacco companies accountable for their actions, I do not believe that this case has any legal merit.

What disturbs me about the case, however, is the fact that it seems to undermine the mission of hospitals. It seems to me that hospitals are charged with treating all patients, regardless of the causes of their injuries and that it is not the hospital's prerogative to determine the causes of the illness and force the companies responsible to pay for the treatment.

These hospitals are themselves responsible for numerous deaths among their patients. The significant rates of hospital-acquired infections and other medical treatment-caused morbidity and mortality in Missouri hospitals has been documented. However, I don't see these hospitals arguing that they themselves should be held financially accountable for the treatment of those illnesses. I don't see these same Missouri hospitals offering to return the money paid to them for treatment of illnesses that were caused by these hospitals.

Philip Morris also points out that some of these same hospitals have profited from the sale of cigarettes at their facilities. Yet they are not holding themselves financially responsible for their own contributions to these patients' illnesses.

The day these hospitals admit that they have contributed to the illnesses and deaths of some of their patients and they agree to reimburse those patients for the costs of those mistakes is the day they can talk to me about seeking compensation from the tobacco companies. Until then, this is both a lawsuit without legal merit and an undermining of the mission of our hospitals.