Ekpolk and everyone else.

[carrera79]

I'm posing a question for a legitimate and, hopefully, flame free thread on the board. I would like to hear all opinions regarding the current status of malpractice insurance, tort reform and the quality of medical care in this country. I name ekpolk because of his thoughtful and persuasive arguments.
I would like to hear ideas regarding improvements to our system that would:

1. Make our system more affordable
2. Increase the quality of care without a substantial increase in costs.
3. Reduce the cost of doing business for our doctors. It is one of very few high skill careers that has not even kept up with inflation in income.

I know that we're all capable of slamming each other, myself included, but let's keep this one intelligent and civil. Thanks all.

 

[XS650]

1. By far the most significant thing that could be done to improve health care and reduce costs is to get people to start taking better care of their health.

2. More of the medical $$$ should be spent on prevention and early detection of diseases, but thats closely tied to 1.

3. A reasonable level of tort reform is needed. Sloppy doctors still need to fear legal action. Penny pinching, corner cutting HMOs and insurance companies still need to fear legal action. But, awards get out of hand and are often handed out for unjustifiable reasons.

Perhaps something like mandatory arbitration with a professional board of arbitrators who have no ties to the insurance industry or hospitals. There still needs to be a way for an injured party to sue if the arbitration process gets broken, but suits shouldn't be allowed until after arbitration has run it's course.

 

[Pablo]

XS 650 wrote:

quote:

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1. By far the most significant thing that could be done to improve health care and reduce costs is to get people to start taking better care of their health.

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Without a doubt a huge issue.....and conversely one of the more scary things about federal health care....

Just limiting the silly lawyers in suits would make a dent.

I don't get what (exactly) in Kerry's proposal will save us all this money he is claiming....

 

[carrera79]

I am in complete agreement with some limited tort reform. My FEELINGS on this whole issue is that the threshold for viability, sorry for to knowing the correct legal term, of a case is ever becoming lower and lower due to a judiciary that is not vigilant enough. Unfortunately I feel that this is pushing us into a postion requiring some type of legislative solution which, again in my opionion, is usually the worst way to solve a problem. How do we decide what now merits legal action? I loathe the idea of having legitimate cases stopped at the door wihtout any review for legitimacy. I am also in agreement that the insurance companies need to be looked at. We cannot continue on our current course without a drastic drop in the quality of our care in the near future.

 

[Jimbo]

The health thing sounds good at an emotional level, but it wont work. We have legislated and sued the tobacco industry practically out of business. A fraction of us smoke compared to a couple of decades ago. This should have reduced health care costs, right? Wrong! Americans are on aveage living longer and consuming ever increasing amounts of drugs medical services as we age. We all eventially die, and more expensively than when a quick massive heart attack was it for many or most.

All countries with socialized medicine ration health care based on government budgets. Canadian hospitals are (or were) given a budget for so many surgical procedures of a given type per year, based on service area population. Americans only blame "evil" HMO's for trying to control costs just as any government system has to. Ask anyone you personally know that actually lives in the UK or Canada.

Real tort reform will never happen. Isnt out next VP a trial lawyer? Get rid of juries for civil cases. The Constitution only guarantees criminal defendants jury trials.

 

[Whimsey]

If you get the insurance companies, the government and the lawyers out of health care it could be affordable again. In the "bad" old days where my parents had to pay for doctor's visits the doctors actually came to your home and my p*ss poor parents could afford to pay for the doctor visit. And there was NO WELFARE ASSISTANCE involved. If you want to have catastrophic insurance then that's great. It's cheap and covers real disasters, not small stuff. Unfortunately in my case the NJ state government does not allow you to purchase this insurance. You have to purchase a "full medical" plan or be uninsured

.

Whimsey

 

[ekpolk]

On the legal side, I see a serious "throwing baby out with dirty bath water" problem. I hope that no one takes from my previous lengthy posts on the related threads that I mindless defend the system since I'm a vested participant. In fact, the system does have problems and imbalances.

Some interested groups would lay all the blame at the feet of "trial lawyers," which is where I really have a problem. Let me diffuse the angry responders first -- yes, we do have some problem lawyers, but again, not nearly as many as the propagandists want you to think. Believe it or not, lawyers have an code-based ethical obligation to put their clients first and, distilling about two dozed other rules to their essence, do what's right. I know, a bunch of you are choking on that, but the great majority of us take this stuff very seriously. The legal profession suffers a severe case of the "turd in the punchbowl" phenomena. Even one little turd in there, and all of the punch is considered tainted.

So what else is wrong if not just the lawyers. It is, IMO, the combination of a series of compromises that, while they have some tremendous costs, keep the system operating as intended and somewhat efficiently.

STOP -- I'm being called away, and don't want to just delete and start again later. A parting thought for now: we need refinements, not drastic, destabilizing structural changes. If we declare whole classes of claims off-limits because of a few cases of abuse, well, what do we say to those with legitimate claims? If we decide to limit ("cap") damages, at some level ($250,000 gets tossed around a lot in medical malp circles), what do we say to the young guy with a family who gets totally, permanently disabled because of a medical accident??? I'll put up some more about this later. Gotta go.

 

[sprintman]

Tax cigarettes till they become just too expensive and nobody smokes. Extra tax for the health system while smoking drops and massive savings when nobody does. They say smoking costs the Aussie health system over $A12 billion per annum, so that would be a lot more in the US. Just one to think about.

 

[Dan4510]

quote:

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Originally posted by sprintman:
Tax cigarettes till they become just too expensive and nobody smokes. Extra tax for the health system while smoking drops and massive savings when nobody does. They say smoking costs the Aussie health system over $A12 billion per annum, so that would be a lot more in the US. Just one to think about.

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One thing one must consider when advocating taxing cigarettes, alcohol, other substances, once a certain price point is hit, a black market is created. This eats up all the savings of slowing down the problem.

My take on the medical problem, a lot of it is driven by people getting cheap insurance thru employers, government, etc. If you dont have to pay the full cost, you will overuse, driving up the demand, and eventually driving up the cost for everyone.

That said, after having been a cancer patient with 13 1/2 years of survival, I doubt any other medical system would have allowed me to survive. Socializing medicine is the path to fixing cuts and broken limbs and the dumbing down of doctors.

One thing to consider, medical costs held quite steady until the government invaded it with regulation and other programs, then the cost of medical care took off.

Also, the fact that many people live longer costs tremendous amounts. The last few years of life are extremely costly medically. I expect to live to be 120 and will shift the cost of it off to whoever wont vote if I can....just like seniors do today!

Prevention is one good answer, but I dont think we need another government agency telling me I cant have a big mac today!

Just some thoughts.

Dan

 

[sbc350gearhead]

I think that we should require that drugs with U.S. patent, be sold to other countries, for the same price that they are sold to americans.

 

[XS650]

quote:

---

Originally posted by Jimbo:
The health thing sounds good at an emotional level, but it wont work. We have legislated and sued the tobacco industry practically out of business. A fraction of us smoke compared to a couple of decades ago. This should have reduced health care costs, right? Wrong!

---

Reducing smoking obviously won't reduce the effects of other health problems. Obesity, poor diet and lack of exercise appear to be a big part of our problem.

Your point is interesting though, in that I saw astudy that shoeed that during a smokers lifetime the consume fewer medical services than a non-smoker. That's because although they die uglier deaths, they die much sooner.

Americans are on aveage living longer and consuming ever increasing amounts of drugs medical services as we age. We all eventially die, and more expensively than when a quick massive heart attack was it for many or most.

All countries with socialized medicine ration health care based on government budgets. Canadian hospitals are (or were) given a budget for so many surgical procedures of a given type per year, based on service area population. [/QB][/QUOTE]

America has one of the shortest (if not the shortest) average lifespans of any modern industrialized nation. The other countries must be doing something right.

 

[GROUCHO MARX]

I wonder how young black men, dying in street violence, skews the lifespan number?

 

[Dan4510]

quote:

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Originally posted by XS650:

Your point is interesting though, in that I saw astudy that shoeed that during a smokers lifetime the consume fewer medical services than a non-smoker. That's because although they die uglier deaths, they die much sooner.

---

The study was done by an economist and it showed that smokers on average died much sooner than the rest of the population, thus they did not draw their social security, medicare, etc and when they did die they died quickly and usually had private insurance that picked up the cost.

I have always advocated smoking for everyone except me. That way I get the benefit of all the ones that die early, at least that was social security wouldn't be broke when I start drawing it.

Dan

 

[Dan4510]

quote:

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Originally posted by GROUCHO MARX:
I wonder how young black men, dying in street violence, skews the lifespan number?

---

Groucho,

Actually, it doesnt skew the total numbers that bad since that population is only 12% of the whole recorded. But it is causing a big problem for black women, there are no men for them to marry and have kids with. 75% of black men at age 30 have spent some time behind bars due to our lovely criminal justices system.

Dan

 

[GROUCHO MARX]

One of the by products of the "Great Society" Dan?

 

[Dan4510]

quote:

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Originally posted by GROUCHO MARX:

One of the by products of the "Great Society" Dan?

---

Groucho,

Now that you mention it, YES! The great society made no sense economically and failed in its evaluatoin of human behavior. In more basic terms, it provided a direct economic incentive for the worst among our population to breed unchecked resulting in the crime, gang, and other social problems we have now.

Dan

 

[Jimbo]

quote:

---

Originally posted by ekpolk:


Believe it or not, lawyers have an code-based ethical obligation to put their clients first and, distilling about two dozed other rules to their essence, do what's right.

If we declare whole classes of claims off-limits because of a few cases of abuse, well, what do we say to those with legitimate claims? If we decide to limit ("cap") damages, at some level ($250,000 gets tossed around a lot in medical malp circles), what do we say to the young guy with a family who gets totally, permanently disabled because of a medical accident???

---

The ethical obligation to do everything possible for the plaintiff client is somehow "honorable" while the ethical obligation to the "defendant" (doctor, hospital or insurer) is not? It is the jury system that allows the outrageous awards that cause the bad publicity. How about a three-judge panel instead. I would not advocate a cap on actual damages. CIvil cases should be all about redress of damages, not to "punish". That is one place where the systems has gone astray.