News Sicko is probably one of the most disturbing films

[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.

 

[adrenaline]

I think they have it exactly backwards:

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.

Obama believes investing in health informatin technology will help reduce errors. with that I agree after investing in one myself ( although it was very pricey.)

But you bring up the valid argument doctors and republicans bring up and that in this culture of fear of lawsuits, it becomes very hard for practioners and institutions to be transparent with their errors, which is the first step in tackeling and improving medical errors.
This is another benefit of tort reform.

 

[mheslep]

The Medical Malpractice Myth

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

The fact that the Slate piece doesn't address the cost of defensive medicine or how sky rocketing premiums have driven physicians out of practice, and then going to dismiss malpractice as 1% of healthcare, indicates to me it is not worth the electrons that drew it on my screen.


http://www.manhattan-institute.org/html/cjr_10.htm#02"
Figure 1 shows avg malpractice premiums up 64% in 2000-2005

 

[mheslep]

Baker's book makes a statement questioning the connection between medical error and malpractice here:

https://www.amazon.com/gp/product/0226036480/?tag=pfamazon01-20
Page 97

...We have stacks of books and reports.
In this mountain of paper there is no research testing the conventional wisdom that medical malpractice lawsuits drive medical mistakes underground. Could it be that the conventional wisdom is wrong?...

I think no its not wrong. Granted it is hard to prove the connection.

 

[Al68]

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?

Of course not. As an instrument of the people, legitimate gov't power is limited to that possessed by the people. People do not have a general right to use force to control the behavior of others. People have the right to use only defensive force against others.

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

That's not why the U.S. gov't was founded.

People don't have the right to force their neighbors to be "good neighbors". People have the right to use force to defend themselves from wrongful force used against them by their neighbor.

This is what liberty fundamentally means. That each person is free to make their own decisions as long as they don't infringe on the liberty of others.

Live and let live, not live and tell others how to live to please their neighbor. That's what the word oppression fundamentally means.

 

[ThomasT]

Originally Posted by ThomasT
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?

Of course not. As an instrument of the people, legitimate gov't power is limited to that possessed by the people.

The people, via their elected representatives, have the power to regulate industries that act contrary to the public good. Unfortunately, in many cases, the elected representatives are tools of the industries (whose primary motivation is profit) that need to be regulated.

Moore's contention (at least one of them), I think, is that adequate health care should be a public service, and not primarily motivated by financial gain. And I agree with that.

This is what liberty fundamentally means. That each person is free to make their own decisions as long as they don't infringe on the liberty of others.

The contention is that profit motivated enterprises are screwing up the healthcare industry (the insurance industry, the drug industry, the legal system vis lawyers, unwarranted lawsuits, inordinately high awards, etc.) -- so their freedoms need to be further limited.

History has taught us that if people are free to make their own decisions, then they will inevitably infringe on the liberty of others. This is especially true if the primary motivation of the people concerned is financial gain.

Left unregulated (or if regulations are poorly enforced), private enterprise has given us economic meltdowns,
inordinately high prices wrt certain essential commodities and services, inordinately low wages, sweatshops, child labor, slavery, etc.

But society is evolving. Increased socialization is inevitable. I think that a single-payer healthcare system (along with necessary reforms) that administers to everyone on an equal basis should be given a shot. But it doesn't seem like we're ready for that yet.

 

[ThomasT]

The fact that the Slate piece doesn't address the cost of defensive medicine or how sky rocketing premiums have driven physicians out of practice, and then going to dismiss malpractice as 1% of healthcare, indicates to me it is not worth the electrons that drew it on my screen.

With all the defensive medicine it would seem reasonable to expect malpractice, and malpractice lawsuits and awards and insurance premiums, to decline. But the trend is generally upward. Maybe the standard defensive medicine practices are superfluous to, not addressing, the actual causes of malpractice.

I thought this passage from that article was interesting:

Anesthesiologists used to get hit with the most malpractice lawsuits and some of the highest insurance premiums. Then in the late 1980s, the American Society of Anesthesiologists launched a project to analyze every claim ever brought against its members and develop new ways to reduce medical error. By 2002, the specialty had one of the highest safety ratings in the profession, and its average insurance premium plummeted to its 1985 level, bucking nationwide trends. Similarly, feeling embattled by a high rate of malpractice claims, the University of Michigan Medical System in 2002 analyzed all adverse claims and used the data to restructure procedures to guard against error. Since instituting the program, the number of suits has dropped by half, and the university's annual spending on malpractice litigation is down two-thirds. And at the Lexington, Ky., Veterans Affairs Medical Center, a program of early disclosure and settlement of malpractice claims lowered average settlement costs to $15,000, compared with $83,000 for other VA hospitals.

I don't know how to take the 1% thing:

After all, including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending. If anything, there are fewer lawsuits than would be expected, and far more injuries than we usually imagine.

http://www.manhattan-institute.org/html/cjr_10.htm#02"
Figure 1 shows avg malpractice premiums up 64% in 2000-2005

This link was informative, I think. Thanks.

 

[mheslep]

With all the defensive medicine it would seem reasonable to expect malpractice, and malpractice lawsuits and awards and insurance premiums, to decline. But the trend is generally upward. Maybe the standard defensive medicine practices are superfluous to, not addressing, the actual causes of malpractice.

I'm sure that's what the tort attorney's argue. The other argument is that many malpractice lawsuits are frivolous, or cast a wide net over anybody remotely connected to the case in search of deep pockets as adrenaline suggested above, because the laws in some states enable big awards for these attorneys, i.e. malpractice is big business for them. Ever hear of the phrase 'ambulance chaser'? I don't suggest most lawsuits are such, but it baffles me that just because there is a lawsuit people many people (apparently) consider the fault is with the medical profession.

 

[Al68]

History has taught us that if people are free to make their own decisions, then they will inevitably infringe on the liberty of others. This is especially true if the primary motivation of the people concerned is financial gain.

So, offering to sell me something (voluntarily) is an infringement of my liberties? But forcing me to pay for something against my will is not?