The Healthcare Thread

[Requiem]

Stop shitting up the Obama thread with health care for 10 pages at a time.

[Drave]

/recommend :

FRONTLINE: sick around the world | PBS

(Also on the Netflix stream.)

[Etoille]

Originally Posted by Requiem

Stop shitting up the Obama thread with health care for 10 pages at a time.

Because the whole thing isn't shitted up with 1000000000000000 tangents on policy initiatives hes proposing already?

[chaos]

I should get free healthcare, and AladainAF should have to pay. Also, I'm too fat to work.

[Phoenix]

Originally Posted by chaos

I should get free healthcare, and AladainAF should have to pay. Also, I'm too fat to work.

I second this notion.

[Mario Speedwagon]

I demand free pizza and tacos in lieu of medical care.

[Haus]

Originally Posted by Mario Speedwagon

I demand free pizza and tacos in lieu of medical care.

How about pizza and tacos laced with drugs we're going to make the pharmaceutical companies sell for less that will help you be less depressed about your weight?

[Mario Speedwagon]

Deal.



Edit: No wait can I just get weed instead of the pharmaceuticals?

[MrSpitz]

One of his biggest priorities is health care reform, and right now he is pushing it. Not trying to be rude but, why would you possibly want to separate a health care discussion from Obama right now when its going to be his priority for the next 2 months?

[Snugglebear]

Originally Posted by MrSpitz

I don't think you can squeeze enough cost savings out of a group that only pockets 10% of the total we spend. Sure, there are savings there, but to think that is the primary source of reducing costs is ignorant.

As for malpractice, it absolutely has to be reformed with a concurrent reduction in insurance rates to health providers as part of any cost saving measure. As your article links, the insurance premium paid by doctors has steadily increased. Incidentally, the 2% figure is an actuarial estimation. It's not a real number. If you are going to approach someone and ask them to reduce their salary, when they are supposed to give care and work a tough job, you should take some of the non-care related costs from off their neck. By the way, here are some of the premiums for malpractice insurance in my state:

" Medical Malpractice Insurance Rates for New York
Doctors in New York saw a 14% increase in rates in 2007. This followed increases of over 7% every year since 2003. The following are average representative figures that New York physicians paid in 2007 for medical malpractice insurance based on location ($1.3M / $3.9M limits).

General Area Internal Medicine || General Surgery|| OB \ GYN
New York City $25,300 || $84,000 || $152,100
Nassau County, Suffolk County $31,500 || $105,000 || $186,000
Upstate New York $10,750 || $36,000 || $65,300
Source: Above figures are approximations across various carriers serving the NY market. Underlying data taken from the Medical Liability Monitor 2007 Rate Survey. The rates shown above should not be interpreted as the actual premiums an individual New York physician pays for coverage."
New York Medical Malpractice Insurance - Free Quotes Money-Saving Rates on NY Medical Malpractice Insurance

But, because the CBO contracted an actuarial firm to propose a model, even though their own data showed malpractice insurance rates going drastically up, malpractice must be a small part of the problem. Somehow, those numbers don't look small to me. Without a cap in judgments, so called 'doom day' suits can drastically inflate premiums. And no, you don't know a thing about code of conduct or anything like that.

Surely a 100,000 malpractice insurance premium paid by your surgeon doesn't factor in to what a hospital has to pay to retain his services, or what he charges at his outpatient clinic, correct? And they haven't continued to go up, since the 2003/2004 report you linked, right? And the quote you have on malpractice doesn't flat out say there is no code of conduct, rather a fluid bar set by other members of the community, such that if any accident were to occur, even if the provider was following guidelines that were safe and effective, you could find a nurse consult under no situational duress (say ER or non-routine surgery) to 'advise' the court a different way to proceed, which may not be right or wrong but kicks open the door of negligence? What if the guidelines in different states are different (which they are) and then you pick and choose regional differences to define as your reference of conduct? What if you have no idea what you are talking about?

I look forward to your input. (btw, its not 2004 anymore)

My big problem with medical malpractice reform is that it is always tied to tort reform. It may be helpful to limit non-economic (pain and suffering) damages to $400,000 in cases where there is no permanent disfigurement. We did this in West Virginia because you couldn't find a neurosurgeon there, and it seems to have done some good. However, filing damaging lawsuits against corporations is one of the only ways to regulate them these days. Even the government does it. There's no fucking regulation - you have to hit their bottom lines to get them to stop dumping shit in the rivers, etc.

This article claims that medical malpractice payouts have remained steady for 2 years, so insurance rates shouldn't be going up in NY State (rates were also frozen last August by the governor):

Data show NY malpractice payouts steady -- Newsday.com

And yes there are bad doctors, and there need to be medical malpractice lawsuits. WV is the poster child. Check out this nut, John King, who racked up 124 lawsuits in less than 2 years:

A Chance to Cut is a Chance to Cure

Described by patients as affable, Dr. King allegedly told some that he had once worked at the prestigious Cleveland Clinic. He hadn't. Patient James Cable of Charleston said that Dr. King told him he had competed in the Olympics in "kung fu." The doctor hasn't been in the Olympics, and kung fu isn't an Olympic event.

Kung Fu master!

[AladainAF]

Originally Posted by chaos

I should get free healthcare, and AladainAF should have to pay. Also, I'm too fat to work.

lol@poor fat people who can't afford insurance.

[MrSpitz]

I just want a recognized, nationally, standard of care or standard operating procedures or protocol for X Y and Z and protection for things happening when those guidelines are followed. Unfortunately there are bad physicians, but unfortunately our malpractice system is ambiguous and costly to health care providers, which we then pay for.

In New York, yes the premiums should stay steady. But, they haven't. They have risen drastically. So if pay outs are steady and premiums rising drastically, wouldn't this be the perfect scenario for tort reform, ie you making my point for me? Do you see those figures? The quote I liked best from the article you posted in support of this:
"The report Friday urged an independent review of insurers' premium-setting practices."

New York Doctors Frustrated Over Malpractice Insurance Hike - ABC News
"New York State approved a 14 percent increase in the price of medical malpractice insurance Wednesday -- a step the state's government admits is aimed at temporarily fixing a broken system. " July 2007

New York Imposes Short-term Moratorium on Medical Malpractice Rate Hikes -- AAFP News Now -- American Academy of Family Physicians
"New York Gov. David Paterson recently signed into law a bill that freezes medical malpractice rates in the state until July 1, 2009, giving state officials and policy-makers more time to reach an agreement on how to reduce those rates."

They actually already signed a moratorium, for the last year in New York, because the malpractice insurance premiums were going to go up 9% more and physicians in my state by and large couldn't afford it. I doubt the temporary stop is going to change the trend.


So payouts stay the same (correlating to the level of malpractice awards staying flat, meaning physicians aren't doing a terrible job), yet premiums rise steadily, and all patient end up paying. So what is the case against tort reform, exactly?

[Haus]

Originally Posted by MrSpitz

One of his biggest priorities is health care reform, and right now he is pushing it. Not trying to be rude but, why would you possibly want to separate a health care discussion from Obama right now when its going to be his priority for the next 2 months?

Here is where I have a little problem. He is "pushing" health care reform by saying "OK congress.. come up with a health care reform package. I'm going to mention the good things I want in it, now you guys make that happen".

If he were serious about getting it done I'd think he would be more involved in the process of writing the thing. Instead I think he knows there's a good chance he won't have the democratic votes to put a public option though so he wants to have a safe distance if it fails to get through congress.

[Etoille]

Originally Posted by MrSpitz

I just want a recognized, nationally, standard of care or standard operating procedures or protocol for X Y and Z and protection for things happening when those guidelines are followed. Unfortunately there are bad physicians, but unfortunately our malpractice system is ambiguous and costly to health care providers, which we then pay for.

In New York, yes the premiums should stay steady. But, they haven't. They have risen drastically. So if pay outs are steady and premiums rising drastically, wouldn't this be the perfect scenario for tort reform, ie you making my point for me? Do you see those figures? The quote I liked best from the article you posted in support of this:
"The report Friday urged an independent review of insurers' premium-setting practices."

New York Doctors Frustrated Over Malpractice Insurance Hike - ABC News
"New York State approved a 14 percent increase in the price of medical malpractice insurance Wednesday -- a step the state's government admits is aimed at temporarily fixing a broken system. " July 2007

New York Imposes Short-term Moratorium on Medical Malpractice Rate Hikes -- AAFP News Now -- American Academy of Family Physicians
"New York Gov. David Paterson recently signed into law a bill that freezes medical malpractice rates in the state until July 1, 2009, giving state officials and policy-makers more time to reach an agreement on how to reduce those rates."

They actually already signed a moratorium, for the last year in New York, because the malpractice insurance premiums were going to go up 9% more and physicians in my state by and large couldn't afford it. I doubt the temporary stop is going to change the trend.


So payouts stay the same (correlating to the level of malpractice awards staying flat, meaning physicians aren't doing a terrible job), yet premiums rise steadily, and all patient end up paying. So what is the case against tort reform, exactly?

Ok you DO realize that standard of care is part of the prima facie case a plaintiff has to prove, right? That thing that you 'just keep wishing' for is already part of something plaintiffs have to plead in their complaint. With CRAZY amounts of specificity in fact pleading jurisdictions I might add. (ie Illinois).

There are general standards of care which are tweaked from case to case becuase the facts of each case actually matter. But over all there ARE standards of care which are established by expert witnesses which plaintiff must produce in order to win his case. I know you keep insisting that it doesn't exist but the fact of the matter is that it does. Do your own research, dont just repeat what you hear on Fox.

Like I know this will mean nothing to you but you do realize that the award amounts arent the problem, right?

Most money (remember, I worked in this industry - SPECIFICALLY in malpractice defense) spent on premiums goes to cover attorney costs/costs of defense, not award amounts. Little cases here or there wherein someone has to be paid to write the motion to dismiss or take depositions before a settlement is reached.

As I said the answer, ESPECIALLY if youre going to rail against market regulation/be full retard capitalism, is not to cap damages; the court awards are PART of a capitalistic system.

The answer is to penalize attorneys (and their clients) for filing claims which are complete bullshit - because thats what costs the real money. They DO have rules for 'bad faith claims' however such rules cost time and money to enforce which insurance companies dont want to spend either to do.

Do the homework, stop listening to sound bites.

[Sunder]

So payouts stay the same (correlating to the level of malpractice awards staying flat, meaning physicians aren't doing a terrible job), yet premiums rise steadily, and all patient end up paying. So what is the case against tort reform, exactly?

If payouts are the same (malpractice awards have NOT increased) and premiums are still rising what is the case FOR tort reform exactly? Isn't it MORE likely that the insurance companies are just greedy fucking bastards trying to squeeze the docs for every dime they can even tho they aren't actually paying out more? Maybe YOU need to some more thinking/research on this subject before spouting off again.