It is also estimated that 1.5 to 2 % of all cancers in the U.S. in the next few decades may be attributed to radiation from CAT scan studies.
It has been argued that the actual cost of medically unnecessary (but legally warranted) defensive medicine takes up to 9% of total health care spending. Others place that figure as high as 25%; most physicians tend to believe the latter. Our congressional leaders and the president claim that it is much lower than even the 9%. The problem is that the true costs have been so co-mingled into standards of practice that we may never know the true number.
The frightening thing is that if we use the 9% figure, then 198 billion dollars is wasted each year. If we use the 25% figure, 550 billion dollars is flushed down the toilet.
Let’s get back to the true cost and what a victim of malpractice can expect. Approximately 12.1 billion dollars is awarded to plaintiffs each year. Approximately 40% goes to the plaintiffs’ attorneys or court costs, leaving 7.2 billion dollars to the victims. If we then look at actual health care expenditures each year and use the 9% figure of defensive medicine and documentation, then $26 is being spent for every single dollar that actually reaches the malpractice victim. If we use the 25% figure, then $72 is thrown away for a single dollar to go to the victim. The truth is somewhere in between. I’ll leave you to make your own conclusions about the motives for the trial lawyers fighting against any true tort reform.
Unless we get real tort reform, nothing Congress does will help curtail the runaway costs of medicine. We must decouple malpractice determinations from malpractice awards. There are many ways to do this, but this will be fought tooth and nail by the trial lawyers association. Physicians should adjudicate with lawyers and judges overseeing. If lawyers can oversee lawyers, then physicians can surely oversee other physicians. The British system is also an acceptable manner to deal with malpractice cases. Loser pays the court costs.
The bottom line is that the real victims of the current medico-legal system are the American people, and its time to play Howard Beale and say: “We’re mad as hell, and we’re not gonna take it anymore!”
The solutions:
All civil lawsuits become automatic two way streets: the jury can find that the law suit was: bogus, an attempted shakedown, abuse of civil process or anything else the jury thinks; The higher the abuse of process the higher the judgement against the plaintiff lawyer/client; no need to counter sue, counter sue is automatic. I think the founders called it “checks and balance”!
Disclose: Let the Doctors recommend a course of treatment and let the doctors “disclose” the additional defensive medicine course of treat mandated by the trial lawyers; now let the patient pay 5% of the defensive price directly as an elective part of over the top treatment.” Disclose” and collect!
Post the price: It rises to the point of “malice fraud” that doctor’s prices are not posted clearly in the waiting room and on those forms you fill out upon arrival; certainly post prices for the procedures that are routine to that doctor.
Regulation: utilities are regulated, why not the insurance companies? If an American goes to Canada tomorrow to see a doctor, the total cash price of the doctor visit is the same or less than the deductable on the typical American individual policy. When an American goes to the hospital in the USA, if he pays cash for the doctor and the hospital his bill could be $40,000; but the doctors and hospital accept $3,500 for the exact same visit if an insurance company pays. Yes, if you think I am wrong you are misinformed.
That “State lines” define” health insurance protected territories” proves beyond a reasonable doubt that every member of congress must be voted out. Only elect local heroes like the guy who landed the plane in the Hudson or the guy that tackled the gunman in the high school parking lot or the person who saves a person from a burning building. Do not vote for any one that does not meet those criteria.
The author:
Delivered to congress the specific prediction in 1986 (wrote it by 1980): “ the downfall, by popular uprising of the government operating out of Moscow”…”just as we witnessed in the Philippines”.
1/1999: that the WTC would be hit; I refused to travel south of 40th St. Manhattan after 1/99.
1991: Copyright holder of: “Long lasting War” and sell lots of weapons; describing this war and the battle tactics that would be used against us; all delivered to every member of congress between 1989-1991.
1984 developed ethanol fuel and converted my car to ethanol (no gas). Desperately trying to keep us from funding the war against ourselves as we continue to do by allowing any mid east oil to be bought in the USA; or sold anywhere; we should today embargo all Mideast oil sales: war ends, we win. Yes they are “still” laughing at me for that one.
Assume that medical malpractice suits were outlawed tomorrow, what guaranty do we have that doctors will quit practicing “defensive medicine?” Answer: None at all. Doctors are accustomed to practice a certain way. It may be somewhat conditioned on the state of malpractice law but it is primarily conditioned on the 3rd party payer system, where someone other than the patient is responsible for paying the bills.
Further, if the statistics for death from malpractice are inflated, does that mean that victims of medical negligence (whatever their number) should not be compensated? The fact is that prosecution of a medical malpractice suit is expensive, so that attorneys already run a big risk in taking on “frivolous” cases. This is not to say reform may not be in order, but don’t throw out the valid claims in the process.
Some may still practice it, but likely only at the request of the patient. When doctors don’t have to fear that anything other of criminal negligence will result in a malpractice suite, they won’t have any reason to actively participate in these procedures to cover their asses from litigation.
I think the case for tort reform goes beyond even this. I recently asked a proponent of socialized medicine in the US why they are so concerned with health care costs to the exclusion of the flagrant abuses committed against the public by the legal profession. The average non-trivial occasion for being in court is as financially destructive as a non-catastrophic medical incident, and unlike the medical profession, those charges are artificially elevated by a grossly inefficient legal system and legal code, all of which most attorneys eagerly support.
I simply do not understand why the public is so outraged exclusively against the medical profession which at least has the legitimate excuse of its work being extremely scientifically rigorous (pharmaceutical research, device R&D and medical training) as opposed to the legal profession where most of the “rigor” comes from artificial complexity.
You don’t have to look much beyond the title here, Dr. Bones, to be appalled by yet another consequence of Party-’n’-Ideology wombschoolin’ and downdumbin’: Kiddie Selfservatives–the latest degeneration (or neogeneration) of ’em at least–simply cannot think ahead more than a couple of moves.
Allow me to support this gloomy diagnosis a little. Consider, sir, how you yourself would go about this initial-carryin’ neocomrade’s agitproppin’ business, were you (_mê genoito!_) self-corrupt enough to attempt such a thing:
(1) You would begin subjectively with a Miltonoid [0] sentiment of “injur’d merit,” whining and whimpering (but only behind closed doors) that the invaluable contributions of Progressive Assyriology [1] get no ghostly respect at all and far less material remuneration than they obviously ought to.
(2) So far, that’s no worse than Original Sin, and “everybody does it,” loosely speaking. You cross your first Rubicon only when you decide the matter must be addressed out in what the kiddies’ Neocomrade Presbyter R. J. Neuhaus was pleased to christen the N.P.S., “naked public square.” That’s the point at which you perceive the need to set up a Progressive Assyriology Anti-Defamation League, or P. A. Defense Fund, or . . . . [2]
(3) Lower and lower, worse and worse! Yet there is a second Rubicon to cross before one reaches the confines of Foxcuckooland, and that where M. Pascal and the Muses and you and I must draw our main line and try to keep Neocomrade Med. Dr. P. Weiss and all his neocomrades and merrylemmin’s on the far side. In the contrafactual scenario, it is where you decide that you yourself must head the P.A.A.D.L. and that membership in it should be, mostly or entirely, restricted to credentialed practitioners of Progressive Assyriology. Plus maybe advanced graduate students. Or maybe minus. [3]
(4) The fourth and foulest stage is not really a stage, but rather a perpetual ethical miasma and malaise that obtains throughout all stage, without which even the initial onset of self-corruption (_autoneophthisis saulweissiana_) would not be especially formidable. Though the point sounds so obvious as to approach tautology, yet it is crucial: the patient must at no point in her disease suspect that there could be any legitimate objection to shameless collective public self-puffery and self-servicin’.
Being in fact a decent political grown-up, Dr. Bones, I daresay you must find that condition almost incredible. How can even Wally Wingnut and Cindy from Wasilla not realize that the response to their piteous self-appealin’ from dupes and marks will be far better if they hire somebody who at least *looks* disinterested?
More specifically, if a Neocomrade Dr. P. W. Quack was clever enough to make it through medical school, ’twould not seem a great deal to expect her or him to perceive that in the case at hand the appeal ought ideally be made by a neocomrade with “Esq.” rather than “M. D.” after the surname. It is not exactly a secret that (the appearance of) “being forced to admit” moves more ideoproduct: “Though a shyster myself, I must agree that the quack community has a point when they bark ’n’ bellow things like ‘Unless we get real tort reform, nothing Congress does will help curtail the runaway costs of medicine’ . ”
Thus in short, sir, the neocomrades “simply cannot think ahead more than a couple of moves.” Q. E. D.
***
Though this morning’s particular application is a bit specialized, the infinite appetite of Party-’n’-Ideology neocomrades for tootin’ their own horns and servicin’ their “most esteemed and best belovèd” NeoSelves [4] is undoubtedly the ugliest thing about them, esthetically considered. When it comes to judgin’ themselves, the Kiddie Selfservative Movement evidently do not possess any standards, weekly or other; any criteria, new or old. None, at any rate, that are not instantly waivable upon self-request.
A proper *moral* evaluation of the _autoneophthisis weissiana_ infestation is trickier, however. For M. Pascal and you and me, Dr. Bones, everything depends on whether the individual moral agent is attempting to think well, _travaillons donc à bien penser!_ Hence one cannot pronounce without knowing exactly what thoughts each neokiddie is thinkin’.
Only the crudest suckers for Miss Rand of Petersburg and Mr. Nozick of H*rv*rd have ever worked their disease up into a clear-cut theory that allows condemnation _en masse_. Your run-of-the-mill Narcissus Dexter is inexpugnably, and quite sincerely, certain that _quod licet Iovi non licet bovi_, as Buckley Minor used to quote. Yet exactly what it is that makes Master Narky so sure that it and its team are much like Father Zeus [5] , and not at all like Bessy the Cow [6] , is not often guessable from outside the monkey house.
One obvious impediment to guesswork is the following: Master Narky is so in love with bein’ flattered that it very rarely objects, and perhaps it does not even notice, when the flattery contradicts itself. “It’s the thought that counts,” I guess, not the thinkin’ inside the thought, if any.
But G*re knows best.
Healthy days.
___
[0] _P. L._ I:97 f.
[1] I trust I have remembered correctly which of Mlle. Philosophia’s branches you hold teaching credentials for, sir? Not that it matters for the present argument.
[2] I can’t think of a suitable spoophonym off-hand, myself. Can you do better, Dr. Bones, either working backwards from PADDLE/PADDY or starting from scratch?
[3] If anybody’s listenin’ out in Rio Limbaugh, what the evil élitist is saying amounts to (1) Dr. Quack starts feelin’ very sorry for himself. (2) Dr. Quack decides “the American people” ought to share his noble self-sorrowin’. (3) Dr. Quack sets up a committee–a *committee of quacks*–to try to do somethin’ about it. (As opposed to hirin’ a P. R. agency that already exists, say, and lettin’ somebody else exalt the horn of quackery.)
[4] Marston, J., _The Scourge of Villainy, Three Books of Satires_, London, 1598. (the self-dedication)
[5] http://tinyurl.com/yzzll59
[6] http://tinyurl.com/ygf78xe
To my dilettante understanding of legal procedure, much of our problems stem from our rules of evidence which are ironically significantly more lax than those used by our ancient ancestors. Since our system of law is, like it or not, based on Christian traditions, we should consider replacing most of our rules of evidence with those used by the Mosaic Law. Ironically, that would actually largely put the Innocence Project out of business because most defendants could not be convicted under those rules of evidence, nor could most torts succeed because the burden of proof was not anything resembling a “preponderance of evidence” but actually making a positive, clear causal link between the defendant and the actionable offense.
testing…
Wonderful. There’s another half hour I won’t get back.
Any chance you folks can find and FIX whatever is sending comments into the ether, with no way to recall them by hitting the BACK button? Just curious.
In case anyone’s curious, the problem is mostly likely in this:
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jQuery(document).ready(function(){
jQuery.get(“http://pajamasmedia.com/comment-form/?postid=80701″, function(data){
jQuery(‘#comment-form’).append(data);
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As a result of our idiotic tort laws, each family of 4 pay a hidden tax of over $3000 per year on goods and services. Tort lawyers are leeches who are slowly strangling this country.
I agree wit bob Whos gonna make sure the doctores quit ordering all these extra procedures? nice job Dr weiss of cherry picking all your data
A government run by lawyers will never pursue tort reform.
Defensive medicine doesn’t just explode the absolute cost of health care, it artificially inflates demand for goods and services that drive up the price. This is actually the more serious side of this issue: it’s not the so-called “uninsured”, It’s The Skyrocketing Cost of Health Care, Stupid!!
Insurance is a tool for mitigating financial risk. We should NOT be using it to pay for every dollar of health care we consume. We do it because it results in effectively “free” health care (our employer pays the premium, we pay a “co-pay” that in no way reflects the cost of the care). By doing so, we help to destroy the free market in health care and drive up the cost. Insurance companies are only too happy to enable our addiction to ostensibly “free” health care, because it means nothing but high salaries and great profits for them.
Because we abuse insurance, using it to pay for ALL routine health care, we no longer have a direct economic relationship with the health care provider (e.g., doctor), and all downward pressure on health care costs is thus effectively neutralized – and this has been the result. No other commodity market has seen this kind of skyrocketing cost increase. That’s because no other commodity market is funded through abuse of insurance.
Other topics for this issue:
The skyrocketing proliferation of prescription drug consumption, driven primarily by psychiatrists who use them as a substitute for actual psychotherapy, has led to its own problems. Not the least of these is the damage many of these drugs do, even when “properly” prescribed, which in turn leads to more drugs, institutionalization and, ultimately, additional health care costs. All of this increased demand ultimately drives the cost of health care higher when there is no effective mechanism working to keep costs down.
Direct-to-consumer drug advertising artificially increases the demand for drugs completely out of proportion to the actual medical need. Again, this increased demand drives the price up disproportionately because there is NOTHING working to keep cost down in health care.
Tort reform would be nice, but it’s a drop in the bucket compared to what’s really driving skyrocketing health care costs. And EVERYONE is responsible.
“In March of this
year, San Diego County Superior Court evaluated our own
rates under both San Francisco and San Diego standards
and found the support staff rates to be reasonable (“even if
they are higher than the market rates for San Diego”).
Gober v. Ralphs Grocery Co., N72142 (Minute Order dated
March 20, 2007). The court approved an award of $160 per
hour for law-student clerks and $60 per hour for word
processors. Although none of these individuals is certified
by Section 6450, the court did not require that their work be
considered “overhead” expenses. It reached this conclusion
by applying the case law, which demands that California
courts follow market practice.” http://www.cel.sfsu.edu/paralegal/pdfs/paralegal-billing.pdf
Note to self: standard legal market practice puts billing for the services of word processors (fast typists) at $60 per hour.
“On average, the 2.4 million registered nurses in the U.S. earned $28.71 per hour in May 2006. Registered nurses in California were the highest paid among all of the States, with an average hourly wage of $36.12.” http://www.bls.gov/ted/2007/may/wk2/art05.htm.
Which market needs adjusting again?
Just for grins and giggles, can someone point to me in the US Constitution where the Federal Government is allowed to limit jury awards? Many of you will most likely be quick to argue that the individual mandate is unconstitutional, and I would agree with you. But so is the tort reform that you are advocating. When a jury awards a defendant a certain monetary amount, the federal government has no constitutional power to limit that amount.
What incentive do they have to order them in most cases? Most doctors outsource their testing to third parties. If they’re getting kickbacks for ordering unnecessary tests you could probably sue them for defrauding you.
I don’t think anyone really read what the good doctor wrote. He clearly states that true victims of malpractice must be compensated. What he was trying to say as well, is that the true cost of the current malpractice system is unsustainable and something must be done. Neither the house or senate bill came even remotely close to doing addressing this big issue.
Defensive medicine and documentation is the 800 pound gorilla in the room. I don’t get anymore money by ordering a CAT scan or an MRI. I dont make any more money by ordering extra blood work. I dont make anymore money by writing a 2 page dissertation in the patients chart to cover my ass. Tort reform is a must.
@16. in the trenches: – I don’t get anymore money by ordering a CAT scan or an MRI.
Right. But the point is, that CAT or MRI (1) artificially inflates the demand for care while at the same time (2) artificially inflating the cost of care. Both could be eliminated by reasonable tort reform, yes. But just because doctors aren’t necessarily benefiting from the defensive medicine they practice doesn’t mean it’s not a big part of the problem, right?
Tort reform remains elusive, IMHO, because BOTH the high cost of liability coverage AND the costs incurred by defensive medicine are so easily folded into the overall cost of health care. However high that cost ultimately goes, “insurance will cover it”. If we weren’t using a broken economic model to pay for health care, real competition and the subsequent need for efficiency would trail up the line and, ultimately, lead to a deafening clamor for tort reform rather than just the ‘oh yeah, that would be nice’ mindset most folks have.
If the republicans actually had any ideas, they’d run attack ads showing a “fat cat” lawyer smoking a cuban, drinking expensive scotch and thumbing through a brick of $100s laughing about how rich he got off medical malpractice suits.
The only downside is that John Edwards would probably sue them on the grounds that they can’t use his image and character in public without his approval…
I am still a Republican. The Dems betrayed us on the 9/11 crisis. You conservatives have a distinct pattern though, it is always someones else’s fault and usually someone with an income well below 40,000. You sound like Marxists. Just put us in charge and everything magically will have a solution. The doctors and hospitals have already found a solution. It is called ignore the poor and anyone who appears poor. Make them wait longer. Assure them there is nothing wrong. You all need to review the broken window fallacy. What we need is a National week long strike.
Defensive medicine is also a waste of the patients time and money. Not to mention that some procedures are uncomfortable or worse.
My only concern with loser pays is that sometimes you can lose even if you are right. Some people just don’t come across well in court. Maybe the jurors should have medical training such as retired doctors or nurses. That way they would have a better idea if malpractice occurred.
Mike T; Agreed, it would be great fun to socialize lawyers services. No… wait. Bad idea.
et al,
Might as well get over the fact that, in this benighted world, there is ALWAYS someone willing to take someone else’s property or life. It’s call evil and it permeates our very being, even the most spiritual member of Humanity.
The Tort Bar is, like the corporation, a creation of fallible Man, and thus possesses no soul. This leads the Tort Lawyer to the lowest common ethics denominator of their odious Ilk. They know no depth too low through which to crawl to make their millions. Doctors prescribe tests precisely because of the Tort Bar’s inherent ambulance chasing in search of ‘victims’ through which suit may be brought.
“Physicians alone pay some 19 billion dollars a year in malpractice premiums. The argument by the Obama administration and the leaders in Congress is that the U.S. malpractice system is only a small contributor to the high cost of health care.”
Where these figures appear to be only a small part of costs, they may well represent a much larger cost machination, like the proverbial tip of the ice berg.
If an Oby-Gyn like yourself pays 50% of gross into malpractice insurance, guess who actually pays that cost on their statement. The cost is rolled back to the patient care and then to the insurance company, and then held exemplary as rising health care costs. One estimate of cost per baby delivered is $14,000 whereas grandmother use to have babys for almost free.
Malpractice is different from malfeasance is occurance whereas both now have sky is the limit cost potentials. Malpractice costs can be capped and derived as a settlement, whereas malfeasance pushes into criminal activity.
Perhaps the real issue of costs is that the American people are an unhealthy lot and the supply/demand curve is accelerated by demand. The American people were a hardy rural folk in 1930 and are now obese urbanites who baby boomed in the 1950′s. The top ten disease killers are dietary related. It is estimated that reducing salt, for example, would save American health costs by $80 billion/yr. Who gets to pay the blame for fat, sugar sucking, hard drinking, nicotine fiend, junk food junkies?
JED, I think you have some valid points here, but ultimately it’s not that simple.
Americans aren’t all that conscientious about their health, but another major contributor is the medical profession’s unhealthy obsession with reducing cholesterol. My story is illustrative and, as I’ve discovered, not at all unique.
In my 30s I had genetically high cholesterol. Astronomical, actually – the overall number was something like 480+ at one time. I ate right, took megadoses of niacin, pounded down oat bran muffins, exercised and did all the right things, but it never budged. My doctor put me on a series of statins that never reduced my cholesterol by more than 10% but each one made me sicker than the last. I became not only irritable, but chronically angry. Ultimately I decided the whole thing was bunk and stopped taking the drugs.
I later learned that the “normal” level for cholesterol has dropped from around 200 to something like 120 or 110 in recent days – despite the fact that there is no statistical evidence of a causal relationship between cholesterol and heart disease (the Zetia debacle demonstrated that, and more – cholesterol can be reduced until the cows come home and STILL not have a positive effect on reducing the risk of heart disease). This change in “normal” has virtually guaranteed that almost every adult is prescribed some form of statin. And recently, adolescents and children are being prescribed them for off-label purposes.
I met a psychiatrist during that time who’d researched low and artificially-lowered cholesterol in men, and discovered that it leads to aggressive behavior (factor THAT into today’s headlines).
Fast-forward to ten years later and I discover that all that statin abuse has resulted in a gall bladder full of stones – a problem I never had when my naturally high cholesterol, which had caused no ill effects, was left unchecked. After two attacks I’m hospitalized and undergo laparoscopic cholecystectomy in ’94 – simple enough but I have nagging, chronic pain near my liver from then on. The next year my father-in-law has the same procedure for the same reason. He is left with the same nagging pain, but in his case it’s often debilitating. Doctors tell him everything from “it’s all in your head” to “you probably have an adhesion – just ignore it”. After four years of living with this constant pain – which of course exacerbates his already crippling COPD – he dies from a torn adhesion that had formed at the site of his gall bladder removal. He bled internally and the problem wasn’t discovered until long after he’d gone irretrievably septic. He died after 10 days in ICU and the effect on my wife, who had personally cared for him for twenty years and was forced to make the call ending his life support, was devastating. That was 1999. Since then I’ve discovered that this isn’t an uncommon occurrence.
Last year, while away for training, I awake in the middle of the night feeling something is desperately wrong. Without going into gory details, I discover that I’m hemorrhaging internally. To cut to the chase, after a two-hour drive back home (done in 84 minutes) and an hour in the ER, I learn that I have … a “bleeding duodenal ulcer” at exactly the point where my father-in-law experienced his torn adhesion. The last thing I hear before anesthesia kicks in is that my hematocrit is 10.
Fortunately, unlike my father-in-law, I bled into my gut. Ironically, I arrived at the hospital ten years to the day we’d brought him to the ER.
Yes, bad things happen to good people. But that doesn’t obviate the fact that much health care expense is caused by over-consumption and “defensive” medicine (like prescribing unnecessary drugs… just to say you did) – all because “insurance will cover it”.
And that phenomenon is amplified when you have a medical profession or a psychiatric profession obsessing over issues that are created by pharmaceutical company research aimed at increasing the demand for their product(s). It’s amplified when direct-to-consumer advertising artificially increases demand for barely-tested prescription medications far beyond the actual medical need. It’s amplified when the elderly are viewed and treated as whining complainers who don’t have long to live anyway, and whose quality of life therefore isn’t all that important – best to just write them another prescription for Haldol to shut them up. Please don’t try to tell me it doesn’t happen. On a regular basis. I’ve spent far too much time in elderly care facilities to fall for that line. And the attitude is reflected in the bills the Democrats have churned out in their attempts to seize control over the health care industry. The entire medical profession doesn’t conform to this stereotype, but unfortunately it’s far too pervasive too ignore. And it’s made worse by the profit-maximizing behavior of clinic, facility and hospital administrators and insurance company execs who have to generate a bottom line that justifies their six- or seven-figure salary.
ALL of this – ever bit of it – is made possible by the insane way we abuse insurance to pay for health care.
I would be content to see the Republicans use a little class warfare against the Democrats’ trial lawyer allies. You know, a little compare and contrast between the poor working guy whose family is crushed by increasing premiums while John Edwards plays tennis on his fancy compound he financed through malpractice lawsuits.
I am a physician. I thank God that I practice in the military where I am somewhat protected from frivolous malpractice lawsuits; but not freed from the responsibility to provide the best medical care in the world to our service members. Some, if not most, doctors really do care about providing the best care. Sometimes patients just have bad luck; believe it or not, nobody lives forever no matter how hard we try. Sometimes babies are born with impairments no matter how hard we try or how much money we spend; and John Edwards gets rich. Where would he be without doctors?
Unless we stop this legal freight train and adopt mechanisms such as loser pays as well as caps on awards, I will probably retire at 20 and become a greeter at Walmart.
Why Can’t Lawyers Be Sued for Malpractice?
What if your lawyer does everything right, but still doesn’t get the outcome you want? What if you have only vague, circumstantial evidence and a couple of anecdotes that imply that maybe your lawyer did something wrong? What if all you have is an emotional argument, but it’s a compelling emotional argument? Someone should be held accountable, right?
I can hear the commercials now: “Have you or someone you love been injured in a lawsuit? If you or someone you love has ever taken a settlement or a plea bargain you may be entitled to compensation. Call the law firm of Brown, Brown, and Brown now. The law firms have lawyers working hard on their side, and so should you!”
Democrats are in the pocket of Big Lawyah, and for that reason alone we will never have meaningful tort reform. But imagine if lawyers were subject to the same kind of frivolous lawsuits they bring against others; imagine if lawyers had to carry malpractice insurance; or if they had to higher extra office personnel just to keep up with the constantly changing regulations designed to come between them and their clients. If such were the case, I’m sure we would have tort reform by now.
There are some health care plans out there that seem to get at the problem identified by Goy and others. I don’t know all the details but under these programs your company gives you $2000 each year in a tax free account on which you draw to pay your health care costs. Anything left over you keep permanently like a 401k. If you use more than $2000 in one year, then you have to start paying until you reach $8000. Everything after that is paid by an insurance company based on premiums paid for each employee by the company.
Under this set up, the consumer is actively involved in shopping for health care, questioning prices, making his/her own decisions on what procedures to have – such that the Health Care industry would start to act like a free market and costs would seek their appropriate level. This is similar to what McCain proposed during his campaign but the idea was derided by the Democrats and BHO (his smarmy dismissal of really good ideas that don’t sound like socialism or that would be a problem for unions is becoming one of his signatures).
But, if the Democrats cannot bring themselves to believe that people can manage to cover their own care in the range of $2000 to $8000, then I suppose they could provide “gap” funds for the truly indigent. But then we all know that this would not be good enough for them. There is not enough vote buying potential in a scheme like that.
@27. Mike G: – There are some health care plans out there that seem to get at the problem identified by Goy and others.
Mike, if you remember the left’s “outrage” and boycott against Whole Foods last year, this is what that was all about. Mackey (WF’s CEO) made it clear that we do not need to implement socialized medicine in order to resolve the so-called health care “crisis”. He was pilloried by the left-o-sphere as a result.
Needless to say, WF employees prefer their plan. Getting the word out on success stories like Whole Foods scare the living crap out of the socialists – and especially the Unions – who have spent 50 years working to hand control of the health care industry over to the government. Note how the union mouthpieces in that video are pushing for more entitlement, not for controlling health care costs and not saving their employers’ money.
The Democrats’ B.S. plan is all about control, entitlement and federal revenue. It has nothing to do with giving everyone “access” to health care – health care is already universally accessible – all one has to do is take responsibility for paying for it, like they must with food, clothing, transportation, housing and all the other necessities of life. Rather, it has everything to do with creating a permanent, middle-class entitlement that will forever tie a pathologically dependent electorate to a therapeutic government. Like Europe.
@28 Goy: Yes your last paragraph is so painfully true – but not obvious to enough people. I know plenty of otherwise right thinking folks who listen to Democrat stories like the one about the women who had no choice but to wear her dead sister’s teeth – and just conclude that everything is awful with health care and the government needs to step in. Not sure who is dumber in this case, the teeth borrower or the person who comes to that conclusion.
One of the crazy making turns in how to control costs in the health care debate is the constant shifting of the subject between the macro-economics of health to the micro-management of patient studies.
23. goy: but ultimately it’s not that simple.
Pre-existing conditions leads that shift in the arguement. A child who needs ear implants is valued equally to a 4 pack a day, 5 DUI patient?
I am saying that good medicine is based on self reliance/discipline along with good advice at the doctor patient level. Expensive medicine comes when lawyers and politicians are adding their bills to both the individuals and the amazing $2.3 trillion American health care costs.
The fundamental problem is supply/demand. Politicians and insurance companies sell fear so that healthy people pay for those with unhealthy habits. The govt. spends 60% of the medical costs and needs to take over the other 40% to cover and pay for its mismanagement. We are looking at redistribution of both the health and the wealth. Self determination gets undermined to the nanny state, and the macro-health becomes weaker and the macro-economics soar.
The subject is tort reform, and in its lower percent way, is worth the experiment to bend the cost curve. Caps on malpractice at the state level please, with oversight of the casino insurance companies only at the state level.
We can tweak Tort Law without eliminating a person’s right to a day in court. One way to start would have the Court appoint the Experts to review the Medicine, not the dueling plaintiff and defendant experts presently used. Also, loser pays court costs would spur prompt settlement in obvious cases and dissuade “throwing stuff against the wall to see what sticks.” Finally, consider subspecialist Judges. Sports hires professional referees. Why not professional judges? Or Jurors for that matter?
The problem with these arguments is that if tort reform was enacted, it will save less than 1%! also, although the author says he wants true victims compensated, almost all reform efforts put in caps. Have you or someone you love been victims of a truly bad doctor? My sister was butchered after a double mastectomy, and if I showed you a photo of her body from her shoulders down to her knees, you would not be sure what you were looking at…she looked like a damn alien. She received the max of 250,000 which was no where near just compensation. How much do you think your wife or daughter would deserve? Agree that malingerers, fraud, frivolous cases need to be dealt with, but so do bad doctors!
@32. bobby: – The problem with these arguments is that if tort reform was enacted, it will save less than 1%!
There’s no rational basis on which to make this statement.
Various surveys have determined that as much as 40% of medical tests, procedures and prescriptions are consumed because of the defensive medicine physicians feel compelled to practice, since the government’s refusal to address tort reform leaves them with the worst of all possible liability choices. They feel no compunction in covering themselves in this way because “insurance will cover it”, that is, WE (the health care consumer) pay for – it in the form skyrocketing health care costs. And this doesn’t even begin to address the additional administrative and paperwork costs that are a direct result of reducing liability. Meanwhile, the useless federal HIPAA regulations are another cost-jacking issue altogether.
By reducing that 40% even by half, we will significantly reduce the over-consumption of health care and, thus, add one element of what’s needed to bring health care costs back into equilibrium with other commodities.
Another element required is to start applying some level of sanity to the way we pay for our health care. This means the complete elimination of comprehensive, group health care insurance, which gives every policyholder a NO-LIMIT HEALTH CARE CREDIT CARD that encourages them to consume health care at the slightest whim and, most importantly, oblivious to the cost. Such plans are also the heart of what justifies over-consumption (e.g., defensive medicine) in other areas.
Health Savings Accounts, decoupling of health care insurance and employment, tax incentives for high-deductible / low premium “catastrophic” insurance policies (to prevent financial ruin from medical costs) and direct, out-of-pocket payment for health care will bring the costs down. Prices for every other commodity are kept relatively affordable in this way.
Health care is the ONLY commodity we pay for through the abuse of insurance. Not only does this “spread the cost around” (sound familiar?), but most importantly it hides the cost from the consumer. Mysteriously, as a result, health care is the ONLY commodity that has seen skyrocketing cost increases for the last four decades.
“Physicians alone pay some 19 billion dollars a year in malpractice premiums.”
“Approximately 12.1 billion dollars is awarded to plaintiffs each year.”
if doctors pay $19B a year to have their insurance companies pay out $12B, why not cut out the middleman? by self-insuring themselves, they would save $7 billion a year.
saving $7B would allow them to lower prices.
the only thing that would make this plan better would be to figure out a way to cut out the trial lawyers too.
In the past it was looser pay, this along effectively regulates the predatory lawyers. Does not need anyone to make a decision, you loose you pay. Very simple and as it once was.
@34. stargirl: – if doctors pay $19B a year to have their insurance companies pay out $12B, why not cut out the middleman?
Note: this argument works just as well with health care in general.
In the aggregate, consumers pay $X Trillion per year on health care. On top of that we have the burden imposed by Medicare and the insurance companies: their facilities, employees’ salaries, stock options, benefits and bonuses, taxes, contractors, subcontractors, claims processors, equipment costs, utilities costs, etc. ALL of those expenses must be paid for over and above what actually gets spent on health care, proper.
By eliminating comprehensive, group health care insurance AND Medicare, and going back to direct, out-of-pocket payment, we would not only eliminate all THAT expense, but we would eliminate all the associated expense imposed on health care providers in order to deal with insurance companies as well. In total, we would reduce the combined overall cost of health care by enough, probably, to bring the cost of care down to the level where pretty much everyone could afford it. And the small percentage left could easily be supported by local charities and other NON-GOVERNMENT facilities.
I have a question. California some time back placed a cap on pain and suffering awards in malpractice lawsuites. Did this result in lower malpractice insurance rates? If not, why not? Did this reduce the cost of medical care?