Sicko is probably one of the most disturbing films

[mheslep]

Here's my take on the way to fix US health care some time back.
https://www.physicsforums.com/showpost.php?p=1616345&postcount=114

McCain's adviser Douglas Holtz-Eakin had a good health plan proposal to reduce costs during the campaign. Obama-Biden distorted it during the campaign, particularly Biden who repeatedly made outright false statements about it. Anyway, the problem seems to be that politically people don't want to give up getting health care through their employers and the employee based tax deductions, instituted after WWII. Maybe a nationalized system is the only way to break free of the status quo.

 

[mheslep]

If you look at something like that you cannot possibly argue that the US has a healthcare system which serves its people better than a public healthcare system like, for example, the NHS...

I can and have. However, I'm more interested in improving the US system, rather than leading with the flaws in other countries. I increasingly note that it is most often not Americans who start this kind how-terrible-YOU-are kind of discussion, above post case in point.

 

[cristo]

I increasingly note that it is most often not Americans who start this kind how-terrible-YOU-are kind of discussion, above post case in point.

Ok, sorry. Please, feel free to put those rose-tinted glasses back on. If you don't want to listen to the truth that's being put out there, then fine, but you can't take away my right to talk about something just because you don't like to hear it!

 

[mheslep]

Ok, sorry. Please, feel free to put those rose-tinted glasses back on.

Please feel free to actually show where my statements are rose-tinted.

If you don't want to listen to the truth that's being put out there, then fine, but you can't take away my right to talk about something just because you don't like to hear it!

Obviously I can't take anyone's right to talk away. What I can do is point out obnoxious and self important posts.

 

[adrenaline]

It's interesting, contrary to urban myth most doctors in this country endorse a national health insurance since we are so fed up with the private carriers.

http://www.pnhp.org/news/2004/february/most_physicians_endo.php

Nearly two-thirds (64%) of physicians favor single-payer national health insurance, far more than support managed care (10%) or fee-for-service care (26%) according to a Harvard Medical School study published today in the Archives of Internal Medicine. National health insurance (NHI) received majority support from physicians of virtually every age, gender and medical specialty – even among surgeons, a plurality supported NHI.

( for the record we look things up all the time, I have at least 14 different journal subscriptions come every other week that i wade through between being on call, teaching etc.)

 

[adrenaline]

The U.S. a nation where the Elite free load off of the hard work and services of the lower and middle class. The Elite get top notch health care, but most hard working americans get poor quality health care. War vets for example get poor quality health care. Why should those who work hard and make huge sacrifices to defend the country get the short end of the stick? The least that congress could do is pass legislating cracking down on the shady practices of Insurance companies, and drug companies. If we are going to have a capitalist health care system, let's at least pass laws to protect the consumers.

agree, but let us not forget that even in the model of universal health care,( and I will use Britain since it is cited so much, )the elite have access to better and quicker care as well. In fact, the British NHS has a very active, healthy private indepedant sector that probably accounts for more than the socialized national health service

http://www.medrants.com/index.php/archives/1675

I was reminded just how significant the independent sector is. It provides 85 percent of the UK’s residential care beds, for example, and 20% of all acute elective surgery - that’s the stuff like hip replacements that isn’t exactly life-threatening, but which you want to get done fast anyway.

Indeed, the independent sector has more beds than the NHS and local-authority care homes put together!

It employs almost as many people - roughly 750,000 of them - and it accounts for a quarter of UK health and social care spending...

I suspect if we go to a more universal health care model, like Britain, this country will also (rightfully or wrongfully )have a very healthy two tiered system ( one private and one national) as it exists in Britain. That's why I feel many Americans who dread the "socialized medical system " and want to cling tenaciously to their "private insurance system" have nothing to fear.

Unfortunately, most opponents of univeral health care cite the dysfunctional veterans medical care example that you bought up as a reason for not transitioning to a national health care model. But like everything else in this country, those veterans with the financial means ( my father who is a commodity broker) can opt out of the veteran's system and choose their own medical care through private insurance...

 

[ThomasT]

What makes me comfortable is calling him a fraud. His documentaries are frauds. He was caught when his uncut tapes leaked out. He hires people to read from a script, then cuts and pastes to make his "documentary".

And it's just plain faulty logic to blame a provider of a service for their service not being good enough, if it's the same service they agreed to provide and you agreed to take.

Yes, I think Michael Moore is a bit of a hypocrite, and I'll be forever not like him and others for abandoning Ralph Nader. (I really like Nader -- well, most of his 'message' anyway.)

And of course Moore's 'documentaries' are biased (To a fault? I don't know -- maybe the bias serves to make his essential message more clear.) But he does, I think, depict some things accurately, and he is making films about important social issues. And I agree with what seems to be the essence of his 'message' -- that our social institutions are often driven by greed of one sort or another, and rife with corruption and dishonesty. I have to wonder if a single-payer nationalized healthcare system is necessarily immune to this.

I think the American people should be outraged about the behavior, the track record, of our government officials wrt many issues. But is the healthcare situation in the US really as bad as some people seem to think?

 

[adrenaline]

But is the healthcare situation in the US really as bad as some people seem to think?

Yes, as one of the richest country in the world we suck but I also want to point out how infant mortality is not a good measuring stick for compating us to nationalized health care which keeps coming up with intercountry comarisons.


The United States easily has the most intensive system of emergency intervention to keep low birth weight and premature infants alive in the world.

The US is only one of a handful countries that keeps detailed statistics on early fetal mortality -- the survival rate of infants who are born as early as the 20th week of gestation.

Thus, in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive -- and the mortality rate for such infants is in excess of 50 percent -- that sequence of events will be recorded as a live birth and then a death. In many countries (including many European countries) such severe medical intervention would not be attempted this would recorded as a fetal death rather than a live birth. That unfortunate infant would never show up in infant mortality statistics!

The above paraphrased from medical site discussion board.


Take Cuba (which has a better infant mortality)... they do not register births under 1000g. In fact, this is precisely what the World Health Organization itself recommends that for official record keeping purposes, only live births of greater than 1,000g should be included. But guess what, we do register live weights below 1000g!


Cuba looks better than the United States but in fact what is probably true is that the United States takes far more serious (and expensive) interventions among extremely low birth weight and extremely premature infants than Cuba (or much of the rest of the world for that matter) does.


I would not use our infant mortality data to show what a sucky job we are doing compared to the rest of the world. Data that show how countries with national health insurance kicks our butt in terms of managing chronic, long term diseases would have more solid ground to stand on...

 

[cristo]

Please feel free to actually show where my statements are rose-tinted.

It's rather rose tinted to say that your health service serves its people better than a nationalised health service. Did you watch the programme I linked to? If not, I think you should. If so, then perhaps you could point out somewhere in the UK where people are forced to bring out their children at 4am to be helped by a charity for third world countries because they cannot afford access to doctors.

Obviously I can't take anyone's right to talk away. What I can do is point out obnoxious and self important posts.

obnoxious

1 archaic : exposed to something unpleasant or harmful —used with to
2 archaic : deserving of censure
3: odiously or disgustingly objectionable : highly offensive

What definition of obnoxious do my comments fall under? If you feel the post you quoted falls under the latter definition, then it seems you find the truth offensive. I'm at odds to believe how you get through a day without being offended!

 

[cristo]

agree, but let us not forget that even in the model of universal health care,( and I will use Britain since it is cited so much, )the elite have access to better and quicker care as well.

Precisely: one can opt to go private and skip the waiting lists for procedures (to some extent). But, the fundamental difference is that there is still healthcare available to everyone that needs it: not just the people who can afford it.

 

[DrClapeyron]

What is so universal about universal health care? Sounds Orwellian to me. The healthcare bandwagon looks to be the new gravy train for the 2010's, just like technology was the bubble of the 1990's. The US Government entitlements over the next 10 years are going to nearly triple! Can you imagine the US Government handing out $2 trillion to citizens to pay premiums for their insurance? These insurance companies are going to make a bonanza and invest the money in financial, bond and stock markets.

 

[adrenaline]

Precisely: one can opt to go private and skip the waiting lists for procedures (to some extent). But, the fundamental difference is that there is still healthcare available to everyone that needs it: not just the people who can afford it.

I agree, I also must warn people who have "great insurance" to look at their lifetime limit for their plan.

For instance, a 42 year old patient of mine had aggressive subcutaneous T cell lymphoma which over the course of 8 years gobbled up her 3 million lifetime limit. ( Chemo, infectious complications,skin radiation etc.) At that point she had to foot 100% of any health care costs, as if she were uninsured. Because she now has a pre existing, it became impossible to switch to another insurance carrier. In her best interest, I told her I would put her on disability and now she has medicare part B that will at least pay 80% of her continual mounting medical care costs. It was hard since she had worked over 25 years as a quality control lab technician and now felt guilty using tax payers funds to pay her medical bills, I told her, the free market system of providing health insurance has failed her and she has paid into the tax system all this time. Still, it was very hard for her.

This is where our existing private health insurance system truley fails us. If a family were to have one family member with a catastrophic illness ( say leukemia that required at least two bone marrow transplants to cure it or a child with a rare congenital disease, etc). You can bet that family has used up their lifetime limit of health care dollars provided by their private carrier. ( Mine happens to be 7 million but I pay through the nose in yearly premiums). At least medicare and medicaid does not have such a lifetime capitated value. ( They are essentially national health insurance for the elderly and the poor.)

 

[mheslep]

I agree, I also must warn people who have "great insurance" to look at their lifetime limit for their plan.

For instance, a 42 year old patient of mine had aggressive subcutaneous T cell lymphoma which over the course of 8 years gobbled up her 3 million lifetime limit. ( Chemo, infectious complications,skin radiation etc.) At that point she had to foot 100% of any health care costs, as if she were uninsured. Because she now has a pre existing, it became impossible to switch to another insurance carrier. In her best interest, I told her I would put her on disability and now she has medicare part B that will at least pay 80% of her continual mounting medical care costs. It was hard since she had worked over 25 years as a quality control lab technician and now felt guilty using tax payers funds to pay her medical bills, I told her, the free market system of providing health insurance has failed her and she has paid into the tax system all this time. Still, it was very hard for her.

This is where our existing private health insurance system truley fails us.

I agree the existing system is seriously flawed. However, it seems to me the problem in this case is high cost - 8 years and $3 million dollars. The solution would then lie towards reducing those costs, and not just having someone else (the government) pay for them. The $3m mentioned here I assume went almost completely to hospitals, doctors, technicians, drugs; and very little to profits for insurers.

 

[adrenaline]

IHowever, it seems to me the problem in this case is high cost - 8 years and $3 million dollars. The solution would then lie towards reducing those costs, and not just having someone else (the government) pay for them. The $3m mentioned here I assume went almost completely to hospitals, doctors, technicians, drugs; and very little to profits for insurers.

Different issue, my point was to highlight the fact that if you get a rare, incurable or devastating disease , your "cadillac" insurance may not be there for you after a while.This is what most americans don't understand.

As for cost, this example can't be used to suggest how to cut costs. Subcutaneous t cell lymphoma is hard to cure, it requires a lifetime of treatments just to control the disease so it doesn't ravage her. The millions included radiation treatment,( the overhead for one radiation facility is in the millions) at least a month or so in the ICU due to sepsis yearly, ( at a cost of over 5,000 a day in the icu on vasopressors, ventilator etc.) , the exotic chemo that are not readily availabe or cheap , interminttent tube feeding through her stomach when she gets stomatitis etc I treated her for two years free until she got on disabilty ( that includes placing central lines at 2 in the morning etc.) Hard to condemn a 42 year old to death just because she was unlucky enought to get type of cancer that doesn't kill quickly nor cures easily.

The way we reduce costs in our system is not in treating these exotic diseases like hers but by providing good basic diabetes preventative care , hypertension care , good prenatal care etc., Tort reform, because you can't ask a doc to pay 6 figure malpractice premiums on a government paycheck , and it reduces the unnecessary testing to "cover your a$$" etc. These are things countries with universal health care do far better than us. ( By the way She was willing to keep working and supplement her employer's premiums by up to $1500 a month, but the insurance carrier would not let her.) So even when she was willing to pay, the system would not let her.

 

[mheslep]

Tort reform, because you can't ask a doc to pay 6 figure malpractice premiums on a government paycheck , and it reduces the unnecessary testing to "cover your a$$" etc. These are things countries with universal health care do far better than us...

What does national health care have to do with tort reform?

 

[adrenaline]

What does national health care have to do with tort reform?

If you look at my post it was regards to cutting costs in our inefficient health care system. Indirectly , on a practical level national health care will reduce payments to physicians, ( i look at what medicare and medicaid pay me) although most won't mind ( as I referranced earlier about the JAMA survey) but at the same time the overhead for such things as malpractice premiums need to come down. My profit margin is 5%, if my payments go down by 10% , I dont' have much room, can't cut my nurses salary, I've already cut my own for the last five years, I guess I could stop providing $10,000 a year medical insurance premiums for each of my 20 plus employees, but more practically, one of my biggest overheads malpractice premiums could also use a decrease. ( For the record I have never lost a suit) /Canadian physicians and Britsh physicians don't come close to what we pay.

Directly, tort reform will change the behavior of most doctors in this country which contribute to the overspending of health care dollars, which is "assurance behavior, " or over ordering of tests or speciality referall to avoid law suits:

[JAMA. 2005;293:2609-2617.

ABSTRACT

Context How often physicians alter their clinical behavior because of the threat of malpractice liability, termed defensive medicine, and the consequences of those changes, are central questions in the ongoing medical malpractice reform debate.

Objective To study the prevalence and characteristics of defensive medicine among physicians practicing in high-liability specialties during a period of substantial instability in the malpractice environment.

Design, Setting, and Participants Mail survey of physicians in 6 specialties at high risk of litigation (emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology) in Pennsylvania in May 2003.

Main Outcome Measures Number of physicians in each specialty reporting defensive medicine or changes in scope of practice and characteristics of defensive medicine (assurance and avoidance behavior).

Results A total of 824 physicians (65%) completed the survey. Nearly all (93%) reported practicing defensive medicine. "Assurance behavior" such as ordering tests, performing diagnostic procedures, and referring patients for consultation, was very common (92%). Among practitioners of defensive medicine who detailed their most recent defensive act,43% reported using imaging technology in clinically unnecessary circumstances.The incidence of procedures and patients that were perceived to elevate the probability of litigation was also widespread. Forty-two percent of respondents reported that they had taken steps to restrict their practice in the previous 3 years, including eliminating procedures prone to complications, such as trauma surgery, and avoiding patients who had complex medical problems or were perceived as litigious. Defensive practice correlated strongly with respondents’ lack of confidence in their liability insurance and perceived burden of insurance premiums.

Conclusion Defensive medicine is highly prevalent among physicians in Pennsylvania who pay the most for liability insurance, with potentially serious implications for cost, access, and both technical and interpersonal quality of care

So you see, tort reform will help bring down the cost of overall health care spending, which will expedite embracing a univesral health care model of some sort and contibute to its financial solvency. Right now the specialties leading the fight against universal health care model are not surprisingly the ones with the greatest malpractice premiums ( ob/gyn, neurosurgery ets.) Generalists llike internal medicine such as I are the ones leading the advocacy.

 

[mheslep]

So you see, tort reform will help bring down the cost of overall health care spending,

Yes, I agree. I think its widely known that malpractice suits drive up the cost of health care and, as your JAMA issue details, the threat of malpractice drives up the costs even more through defensive medicine. Thus I would hope to see tort reform tried first, before nationalizing the entire system. However, tort reform has been on the agenda for decades and it hasn't happened. It may be that it is politically impossible unless and until the health system is nationalized.

PS Quantifying the cost of defensive medicine is difficult. I posted this Doc's anecdote that's suggestive awhile back.
https://www.physicsforums.com/showpost.php?p=1635269&postcount=186

A male in his late 30's/early fortys comes to the ER complaining of chest pain. He has a cough or some other reason to have some chest pain (nothing points to cardiac disease) but since he said the magic words "chest pain", we now feel obliged to order the full workup to protect us from the 0.001% chance that this may represent heart disease.

He gets an EKG X 2 (probably $100)
He gets cardiac enzymes drawn X 3 (probably $150)
He gets other routine labs (maybe $150 total)
He gets a chest X-ray ($100)
He gets admitted to a medical/cardiac telemetry floor 24 hour observation ($1200)
He may get a stress test if he had any risk factor at all ($750)
He gets discharged with a follow up appointment with his PCP ($75)

So, about $2500 is spent when the only thing needed was $2 worth of Motrin. Happens every day unfortunately.

 

[Al68]

Hehehe...you make me laugh!

You will find out in time because it will be done (simply because it must be done).

If by "it", you mean the gov't taking over private companies, I can't argue, they've been doing it incrementally already.

My point was that they plan to do that instead of competing with them.

 

[Al68]

And I agree with what seems to be the essence of his 'message' -- that our social institutions are often driven by greed of one sort or another

I looks to me like Moore doesn't know the difference between a "social institution" and a private company. Of course private companies are driven by the profit motive. But they are not social institutions.

Moore seems to be so confused and delusional he thinks that the fact that a private company doesn't act like a social institution is due to corruption of the institution instead of the obvious fact that it was never a social institution in the first place, except in his mind.

Sad thing is, he is not alone.

 

[ThomasT]

I looks to me like Moore doesn't know the difference between a "social institution" and a private company. Of course private companies are driven by the profit motive. But they are not social institutions.

Moore seems to be so confused and delusional he thinks that the fact that a private company doesn't act like a social institution is due to corruption of the institution instead of the obvious fact that it was never a social institution in the first place, except in his mind.

Sad thing is, he is not alone.

I agree that it doesn't make much sense to expect private enterprises, especially very large ones, to behave in socially responsible ways so long as the behavior of social institutions or government officials is often, directly or indirectly, determined by the profit motives of private enterprises.

 

[ThomasT]

Directly, tort reform will change the behavior of most doctors in this country which contribute to the overspending of health care dollars, which is "assurance behavior, " or over ordering of tests or speciality referal to avoid law suits:

What exactly does 'tort reform', wrt medical malpractice suits, entail?

Would reform of the 'legal system', that is, how suits are dealt with rather than limiting the scope of suits, be a better approach?

 

[Alfi]

Originally Posted by ThomasT View Post

And I agree with what seems to be the essence of his 'message' -- that our social institutions are often driven by greed of one sort or another
I agree. between Medical Insurance,and malpractice insurance, the layers and insurance companies are main reasons why the whole medical social system is so expensive.

 

[Vanadium 50]

So you see, tort reform will help bring down the cost of overall health care spending

Of course.

which will expedite embracing a univesral health care model of some sort and contibute to its financial solvency.

Contribute to its solvency, of course. But why does this have anything to do with universal health care? I would argue that if you reduce health care costs via tort reform, it would lessen the pressure for some sort of nationalized health care, not increase the pressure.

Right now the specialties leading the fight against universal health care model are not surprisingly the ones with the greatest malpractice premiums ( ob/gyn, neurosurgery ets.) Generalists llike internal medicine such as I are the ones leading the advocacy.

But why is that? If tort reform and universal health care go hand in hand, wouldn't obstetricians be leading the charge?

 

[ThomasT]

The Medical Malpractice Myth

The Jury's Still Out: A Critical Look at Malpractice Reform

 

[adrenaline]

The Medical Malpractice Myth

The Jury's Still Out: A Critical Look at Malpractice Reform

both very good articles thankyou giving different sides of the issue.

The first article is not giving the whole story about republicans wanting to cap injury to $250,000 dollars. A victim can still get unlimited amounts for loss of wages. So if you are an artist who makes millions selling masterpieces per year and lose use of your painting arm then you are entitled to millions and millions of malpractice settlement for lost wages but your entitlement to " emotional pain and suffering" is to be capped at $250,000. I don't agree with the republicans on this because the emotional suffering of say losing an infant is beyond any measure of money we can subsribe. However, their reasoning is that this will limit frivolous lawsuits where no real harm or death happened but people can say they were emotionally traumatised. I use a real case where a woman sued a dermatologist for leaving a scar on their shoulder blade after excising a melanoma because it caused undo cosmetic pain and suffering . ( This is an actual case that went to court even though the patient signed consent stated she realized excision of a melanoma may leave a scar).

What exactly does 'tort reform', wrt medical malpractice suits, entail?

Many physicians feel there should be a health court set system set up with judges and lawyers who are experts on medical field, much like you have traffic court, immigration court etc.

This court would review cases and decide what was frivolous and what were true negligance. They could decide what goes to court. Our current system right now bogs down the court system with too many frivolous malpractice suits and allows true negligence to sometimes go unpunished. which the article correctly surmises.

For instance, I got dragged into a lawsuit where 8 weeks before a woman died I treated her for an allergic reaction to sulfa. ( had hives and wheezing). She died 8 weeks later due to complications of back surgery. The lawyers threw out a net to grab every doctor involved in her care ( wether we contributed to her death or not .) I spent $70,000 in legal fees extracting myself from the case. $70,000 to prove to the lawyers I was completely innocent of any complications suffered by her back surgery she had done 2 weeks after seeing me! Now a health court would have thrown my involvement right out from the get go.

As for reducing medical errors, I think the democrats are right to pursue that. I invested in a $150,000 electronic medical records system that warns me of drug interactions, when the person is due for a pap, prescriptions electronically etc. I also pay 15,000 a year for IT support, updates etc. However, a pediatrician in South Georgia who sees 90 percent medicaid and a take home salary of $58,000 or less can't afford such a high overhead investment. The democrats have not devised a solution to help that pediatrician obtain electronic medical records and embark on an important step in reducing medical errors.

 

[Al68]

I agree that it doesn't make much sense to expect private enterprises, especially very large ones, to behave in socially responsible ways so long as the behavior of social institutions or government officials is often, directly or indirectly, determined by the profit motives of private enterprises.

Or as long as the behavior of government officials is limited by the constitution or libertarian beliefs.

Private companies are NOT a part of the gov't or any gov't agency. Holding gov't responsible for their actions is illogical to say the least.

If Democrats think they can offer a better service and/or price than the private companies they should compete with them, not try to control them. If not, then they should shut up.

The truth is Democrats don't want to compete with them to offer a better service or price, they want a monopoly. They can achieve this by just controlling all the private companies.

Of course the people that desire a monopoly on the control of insurance companies will claim that the centrally controlled entity in charge will provide a better service/price than competing private companies, and they know with enough propaganda, people will actually believe such nonsense.

 

[adrenaline]

But why is that? If tort reform and universal health care go hand in hand, wouldn't obstetricians be leading the charge?

They feel that tort reform has to happen first. Medicare and medicaid pay doctors a dismal amount compared to private insurers ( which is why many doctors no longer see either) and going to universal health care will mean lower reimbursements for doctors as a whole ( which is probably why most people are surprised a majority of us still advocate a national health insurance policy. ) The anesthesiologist that pays $500,000 in malpractice premiums is not going to be able to pay their premiums when reimbursments are cut in half.


There is a ob/gyn who takes medicaid patients in Savanah,georga. She is the only ob/gyn left who takes medicaid in that area ( national health insurance for the poor), as a result, she cannot afford malpractice and practices without a malpractice policy. I myself have to limit medicaid to 15% of our patient volume because we don't even break even seeing them, we actually lose money with each one. I could not pay my $300,000 a year rent, malpractice premiums, workman's comp, health insurance, disbability, 401 etc. if I saw more than 15% imedicaid n my outpatient practice ( I can't control what I see in the hospital since I am also an intensivist).

 

[adrenaline]

By the way here is a link describing health courts and how it can benefit patients as well as doctors and actually provide a more consistent means of punishing the repeat offenders ( on both sides, victims and doctors.) and how it can help curb costs of medicine in general and malpractice costs.

http://www.medrants.com/index.php/archives/2956

This is my answer for tort reform, special health courts ( not the $250,000 dollar cap for emotional pain and suffering advocated by the republicans, something we cannot quantitate anyway.)

 

[Vanadium 50]

The anesthesiologist that pays $500,000 in malpractice premiums is not going to be able to pay their premiums when reimbursments are cut in half.

You look far too young to have been practicing in the 80's, but back then Massachusetts really got themselves into a bind. The state regulated what doctors could charge (via banning balance billing), and it also imposed minimum malpractice insurance (and even allowed retroactive premium increases!). When the premiums exceeded the income, a number of doctors -particularly obstetricians, who had relatively high insurance premiums and relatively low permitted income - simply closed up shop.

Women ended up driving to Rhode Island and New Hampshire to have babies.

 

[Art]

In a universal health care system such as in the UK the state takes on the fiscal responsibility of doctor's malpractice suits. The doctors are of course still held personally liable in terms of disciplinary procedures.

 

[ThomasT]

Many physicians feel there should be a health court set system set up with judges and lawyers who are experts on medical field, much like you have traffic court, immigration court etc.

This makes a lot of sense. The status quo that requires you to spend ridiculous amounts of money just to avoid frivolous or unwarranted lawsuits is unacceptable.

Capping awards for alleged emotional pain and suffering makes sense to me also.

There is the argument that even doing both wouldn't lower costs by much at all. But I agree with you that the special court thing should be done. It's a step in the right direction.

 

[mheslep]

As for reducing medical errors, I think the democrats are right to pursue that. ...

I think they have it exactly backwards:

Sens. Hillary Clinton and Barack Obama also want to save on health care. But rather than capping jury awards, they hope to cut the number of medical malpractice cases by reducing medical errors,

The material I read shows the principle cause of errors in the first instance to be the exploding malpractice suits. That is, progress in exchanging medical information, patient work-ups, etc is severely hampered by fear of liability. If this is the case, then the cost of unrestrained malpractice suits include:
- direct costs in damages paid ($29B)
- indirect costs imposed by defensive medicine
- some portion of medical errors.

 

[ThomasT]

Originally Posted by ThomasT
I agree that it doesn't make much sense to expect private enterprises, especially very large ones, to behave in socially responsible ways so long as the behavior of social institutions or government officials is often, directly or indirectly, determined by the profit motives of private enterprises.

Or as long as the behavior of government officials is limited by the constitution or libertarian beliefs.

Private companies are NOT a part of the gov't or any gov't agency. Holding gov't responsible for their actions is illogical to say the least.

Isn't it, ostensibly, the responsibility of the government, as an instrument of the people, to ensure that the people, in their individual and collective enterprises, behave in socially responsible ways?

We have governments because people can't be trusted to be good neighbors. We have a separation of governmental powers because governments are people.

If Democrats think they can offer a better service and/or price than the private companies they should compete with them, not try to control them. If not, then they should shut up.

The truth is Democrats don't want to compete with them to offer a better service or price, they want a monopoly. They can achieve this by just controlling all the private companies.

Of course the people that desire a monopoly on the control of insurance companies will claim that the centrally controlled entity in charge will provide a better service/price than competing private companies, and they know with enough propaganda, people will actually believe such nonsense.

You might be right about this. In any case, I don't like much of what either party is saying and doing. Imho, they're both irreparably fubar(ed).

I do like the idea of cutting out as many 'middle men' as possible. Then many of these insurance people can go do some real work. ( I'm just kidding ... really.)

 

[Vanadium 50]

In a universal health care system such as in the UK the state takes on the fiscal responsibility of doctor's malpractice suits. The doctors are of course still held personally liable in terms of disciplinary procedures.

But isn't that an argument for nationalizing malpractice insurance, thought, not one for nationalizing healthcare? The two are, at least in theory, separate issues.

 

[adrenaline]

But isn't that an argument for nationalizing malpractice insurance, thought, not one for nationalizing healthcare? The two are, at least in theory, separate issues.

yes they are, and unfortunately obama's health plan, though I like it better than mcain's, doesn't really address this.