News What are the factors driving the rising costs of healthcare?

[Njorl]

This is a great thread :D!

I agree, but far too time consuming. I want ATLA to pay me!

Njorl

 

[loseyourname]

Since this thread was initially about John Edwards, and not tort reform, I'm reposting a link that phatmonky posted that everyone seemed to ignore:

http://www.cnsnews.com/ViewPolitics.asp?Page=%5CPolitics%5Carchive%5C200401%5CPOL20040120a.html

Edwards became one of America's wealthiest trial lawyers by winning record jury verdicts and settlements in cases alleging that the botched treatment of women in labor and their deliveries caused infants to develop cerebral palsy, a brain disorder that causes motor function impairment and lifelong disability.

The cause of cerebral palsy has been debated since the 19th century. Some medical studies dating back to at least the 1980s asserted that doctors could do very little to cause cerebral palsy during the birthing process. Two new studies in 2003 further undermined the scientific premise of the high profile court cases that helped Edwards become a multi-millionaire and finance his own successful campaign for the U.S. Senate.

Dr. Murray Goldstein, a neurologist and the medical director of the United Cerebral Palsy Research and Educational Foundation, said it is conceivable for a doctor's incompetence to cause cerebral palsy in an infant. "There are some cases where the brain damage did occur at the time of delivery. But it's really unusual. It's really quite unusual," Goldstein said.

"The overwhelming majority of children that are born with developmental brain damage, the ob/gyn could not have done anything about it, could not have, not at this stage of what we know," Goldstein added.

But some of Edwards' critics say that as a trial lawyer, he relied more on his verbal skills than the latest scientific evidence to persuade juries that the doctors' mistakes had been instrumental in causing the cerebral palsy in the infants.

Edwards' trial summaries "routinely went beyond a recitation of his case to a heart-wrenching plea to jurors to listen to the unspoken voices of injured children," according to a comprehensive analysis of Edwards' legal career by The Boston Globe in 2003.

The Globe cited an example of Edwards' oratorical skills from a medical malpractice trial in 1985. Edwards had alleged that a doctor and a hospital had been responsible for the cerebral palsy afflicting then-five-year-old Jennifer Campbell.

'I have to tell you right now -- I didn't plan to talk about this -- right now I feel her (Jennifer), I feel her presence,' Edwards told the jury according to court records. "[Jennifer's] inside me and she's talking to you ... And this is what she says to you. She says, 'I don't ask for your pity. What I ask for is your strength. And I don't ask for your sympathy, but I do ask for your courage.'"

Sounds like a real sleezeball to me. Njorl's attempts to justify this by saying that Edwards was simply doing his job and doing it well are sickening. Personally, I do not want a man that does an immoral and exploitative job very well running my country. Then again, Bush made his money by driving oil companies into the ground yet somehow always getting bailed out by Saudi billionaires, seemingly in return for favor by either the CIA or US foreign policy, depending on which the Bush family was in charge of at the time.

What a great election in which to be an American.

 

[JohnDubYa]

RE: "Then again, Bush made his money by driving oil companies into the ground yet somehow always getting bailed out by Saudi billionaires, seemingly in return for favor by either the CIA or US foreign policy, depending on which the Bush family was in charge of at the time."

Let me guess: You watched Fahrenheit 911?

 

[loseyourname]

If you want to go off on that tangent, start another thread. I did not see that movie, but the investments are all a matter of public record. I'm just trying to be fair here. It is clear, to me at least, that Edwards made his money in an unethical manner. If I'm going to publicize that, then I'm also going to bring up the source of the Bush fortune so as not to be overly partisan like every other poster on this forum.

 

[JohnDubYa]

Okay, so let me ask: Which Saudi billionaire gave the Bushes money, and how do you know it? Was this a legitimate loan?

And which oil companies did the Bushes drive into the ground? And was this just a matter of competition, or did the Bushes do something illegal?

 

[Njorl]

Since this thread was initially about John Edwards, and not tort reform, I'm reposting a link that phatmonky posted that everyone seemed to ignore:

http://www.cnsnews.com/ViewPolitics.asp?Page=%5CPolitics%5Carchive%5C200401%5CPOL20040120a.html



Sounds like a real sleezeball to me. Njorl's attempts to justify this by saying that Edwards was simply doing his job and doing it well are sickening. Personally, I do not want a man that does an immoral and exploitative job very well running my country. Then again, Bush made his money by driving oil companies into the ground yet somehow always getting bailed out by Saudi billionaires, seemingly in return for favor by either the CIA or US foreign policy, depending on which the Bush family was in charge of at the time.

What a great election in which to be an American.

You're taking it on faith that Edwards' critics are correct. Evidently, you believe a court of law finding for a plaintiff to be irrefutable evidence that the plaintiff was not justified in their suit. Do you have evidence that Edwards was doing "an immoral and exploitative job", or do you just hate lawyers so much you enjoy believing bad things about them.

Njorl

 

[member 5645]

You're taking it on faith that Edwards' critics are correct. Evidently, you believe a court of law finding for a plaintiff to be irrefutable evidence that the plaintiff was not justified in their suit. Do you have evidence that Edwards was doing "an immoral and exploitative job", or do you just hate lawyers so much you enjoy believing bad things about them.

Njorl

Did you read any of my links??

 

[loseyourname]

Okay, so let me ask: Which Saudi billionaire gave the Bushes money, and how do you know it? Was this a legitimate loan?

And which oil companies did the Bushes drive into the ground? And was this just a matter of competition, or did the Bushes do something illegal?

Look, this thread is not about George Bush. If you want to discuss this, start another thread. The only reason I brought it up was to be fair to both parties. Anybody that has a lot of money likely stepped on some toes to get it. I'm not condemning the man for it. There are a lot of reasons that I don't like Bush; his business dealings are not one of them.

 

[member 5645]

You're taking it on faith that Edwards' critics are correct.

And just for the record the statements of CP not being caused at delivery, thus not the OB's fault, were first really stated in the 1999 British Medicine e (article referencing it in plain English: http://news.bbc.co.uk/1/hi/health/475160.stm )
and the findings were echoed this year and last by an American government study (supported by several international ogranizations) and an American College of Obstetricians and Gynecologists .

I can pull links for all, but I'm sure you are capable of delving in as far as you'd like.

 

[loseyourname]

You're taking it on faith that Edwards' critics are correct. Evidently, you believe a court of law finding for a plaintiff to be irrefutable evidence that the plaintiff was not justified in their suit. Do you have evidence that Edwards was doing "an immoral and exploitative job", or do you just hate lawyers so much you enjoy believing bad things about them.

Njorl

Edwards' critics are correct. The science he cited in his cases was untrue and he used appeals to emotion largely in favor of a more reasoned argument. I will admit that I have no proof that Edwards knew the science he used was untrue, but it is clear that he did not look into as much as he should. Like any good lawyer - and you are certainly right to say that he was a great lawyer -he was more concerned with winning his cases than he was with uncovering the truth. It is my belief that placing any concern higher than the concern for truth is immoral. In particular, placing any concern higher than the concern for justice, as a member of the judiciary system, is immoral.

It is also my belief that if Edwards was a republican, you would be jumping on this bandwagon faster than Rosie O'Donnell on a hot dog.

 

[Njorl]

And just for the record the statements of CP not being caused at delivery, thus not the OB's fault, were first really stated in the 1999 British Medicine e (article referencing it in plain English: http://news.bbc.co.uk/1/hi/health/475160.stm )
and the findings were echoed this year and last by an American government study (supported by several international ogranizations) and an American College of Obstetricians and Gynecologists .

I can pull links for all, but I'm sure you are capable of delving in as far as you'd like.

Edwards gave up practicing law before this. So, evidently, he was using accepted science at the time. You seem to be demanding that he should have been prophetic.

Njorl

 

[Njorl]

Edwards' critics are correct. The science he cited in his cases was untrue and he used appeals to emotion largely in favor of a more reasoned argument. I will admit that I have no proof that Edwards knew the science he used was untrue, but it is clear that he did not look into as much as he should. Like any good lawyer - and you are certainly right to say that he was a great lawyer -he was more concerned with winning his cases than he was with uncovering the truth. It is my belief that placing any concern higher than the concern for truth is immoral. In particular, placing any concern higher than the concern for justice, as a member of the judiciary system, is immoral.

It is also my belief that if Edwards was a republican, you would be jumping on this bandwagon faster than Rosie O'Donnell on a hot dog.

As I stated before. Edwards was using the accepted science of the time. Should he have known the science better than the scientific community? That is absolutely outrageous.

Opposing counsel both have access to expert witnesses. They can cross examine each other's experts. They can request evidentiary hearings to exclude experts who are not genuine, so that the jury never hears them.

I can see why you expect Edwards should have been prophetic, you yourself claim to be a mindreader.


Njorl

 

[Njorl]

Let me just ask.

Has any child ever been afflicted with cerebral palsy due to a health care provider's avoidable error? Is it conceivable that John Edwards could have represented such children? The rest of you seem to be saying that, "In theory such an injury could occur, but we know John Edwards didn't represent such people."

Njorl

 

[JohnDubYa]

Has any child ever been afflicted with cerebral palsy due to a health care provider's avoidable error? Is it conceivable that John Edwards could have represented such children? The rest of you seem to be saying that, "In theory such an injury could occur, but we know John Edwards didn't represent such people.

He may well have represented such children. And I am sure John Gotti engaged in legitimate business practices at times. So what? (No, I am not equating the two men.)

As I stated before. Edwards was using the accepted science of the time. Should he have known the science better than the scientific community? That is absolutely outrageous.

If Edwards was using the accepted science at the time, it would have been the defendants who were interviewing one expert after another looking for someone to back their view.

 

[member 5645]

I will admit that I have no proof that Edwards knew the science he used was untrue, but it is clear that he did not look into as much as he should. Like any good lawyer - and you are certainly right to say that he was a great lawyer -he was more concerned with winning his cases than he was with uncovering the truth.

http://www.cnsnews.com/Culture/archive/200402/CUL20040202a.html
Well according to him he didn't just not go far enough:

I took very seriously our responsibility to determine if our cases were merited," Edwards told the New York Times in an interview on Friday, just days after refusing to answer CNSNews.com's questions on the same topic.

"Before I ever accepted a brain-injured child case, we would spend months investigating it," Edwards added.

Which means he spent the time to investigate the case, and then ignored the facts.

 

[member 5645]

Let me just ask.

Has any child ever been afflicted with cerebral palsy due to a health care provider's avoidable error? Is it conceivable that John Edwards could have represented such children? The rest of you seem to be saying that, "In theory such an injury could occur, but we know John Edwards didn't represent such people."

Njorl

Edwards claims were that the doctor did not do the C section soon enough, and therefore it was his fault that the baby had CP. There is NO evidence to back this up, and as we know the burden of proof lies on the PLAINTIFF.
In this case, both edwards, and his 42nd (if I'm remembering that number right) expert witness are both scum who look to abuse the system.

The point is a moral one. Edwards is NOT the kind of person I want leading my country and/or healthcare system and/or future profession.

 

[loseyourname]

Let me just ask.

Has any child ever been afflicted with cerebral palsy due to a health care provider's avoidable error? Is it conceivable that John Edwards could have represented such children? The rest of you seem to be saying that, "In theory such an injury could occur, but we know John Edwards didn't represent such people."

Njorl

No, what we're saying is that whether or not Edwards won a couple of legitimate cases (heck, even if most of them were legitimate), there is no doubt that he put doctors out of business that did nothing wrong, and that he made countless millions of dollars doing it.

 

[Njorl]

http://www.cnsnews.com/Culture/archive/200402/CUL20040202a.html
Well according to him he didn't just not go far enough:



Which means he spent the time to investigate the case, and then ignored the facts.

That is nonsense. When Edwards was practicing it was still accepted that 10-15% of palsy cases were caused by perinatal asphyxia. It was also assumed that many of those cases were avoidable.

Even using the most conservative estimates of the most modern data, you should expect 1 or 2 justified suits for cerebral palsy in N. Carolina per year. You would also expect to see more than this in which reasonable people disagree as to the justice of the situation. Given the accepted science of Edwards' day, you would expect at least 5 times this number of cases - 5 to 10 justified cases, per year, and more cases that experts would reasonably disagree upon. Edwards won fewer than 2 palsy cases per year early in his career, and about 3 per year later. He was aknowledged as the best attorney in the state for this kind of case. If you did have a legitimate case, why on Earth would you go to anyone else. Statistically, all of this is perfectly reasonble. If you want to discredit him, the statistics are just not there. You will have to do it with specifics.

Do you really find it unreasonable that the best tort lawyer in North Carolina, one of the 8 best in the country, who specialized in cerebral palsy malpractice cases, should win 2 or 3 of those cases per year?


Njorl

 

[JohnDubYa]

One fact that gets lost in this thread is that WE pay for this litigation. The doctors continue to work and make their money. No, WE pay for the damages. So every time you write a check for your health insurance (or wonder why your salary isn't as high as it could be), you can thank John Edwards.

 

[Njorl]

No, what we're saying is that whether or not Edwards won a couple of legitimate cases (heck, even if most of them were legitimate), there is no doubt that he put doctors out of business that did nothing wrong, and that he made countless millions of dollars doing it.

He made about 6-7 million a year in his best years, winning about 8 cases a year. That is not uncounted millions. Only about 1/4 of those were palsy cases. Not all of the others were medical malpractice.

Please list the name of a Dr. that Edwards put out of business.

For Edwards to do that, he would have to hit a doctor at least 3 times with an unjustified suit. With just 2 palsy cases per year I find it unlikely. I haven't seen any reason to believe any of his cases were not justified. Just a lot of hand-wringing.

Njorl

 

[Njorl]

Edwards claims were that the doctor did not do the C section soon enough, and therefore it was his fault that the baby had CP. There is NO evidence to back this up, and as we know the burden of proof lies on the PLAINTIFF.
In this case, both edwards, and his 42nd (if I'm remembering that number right) expert witness are both scum who look to abuse the system.

The point is a moral one. Edwards is NOT the kind of person I want leading my country and/or healthcare system and/or future profession.

What case? Please provide some reference. I did not notice one in the two links I followed up.

Njorl

 

[Njorl]

One fact that gets lost in this thread is that WE pay for this litigation. The doctors continue to work and make their money. No, WE pay for the damages. So every time you write a check for your health insurance (or wonder why your salary isn't as high as it could be), you can thank John Edwards.

None of this affects health insurance, it affects malpractice insurance. Of every $100.00 dollars you spend for health care, you spend fifty-six cents (cents, not dollars) on malpractice insurance. I can afford it.

Njorl

 

[member 5645]

What case? Please provide some reference. I did not notice one in the two links I followed up.

Njorl

First, there is no doubt of what the 'baby brain damage' cases were arguing, right?? I'll put that link I guess, but this far it seems you are aware of Edwards original accusation, RIGHT??

Secondly, when I said case, I didn't mean legal case - but that is an interesting double meaning, and one I will address later. I just need to pull the link, but am leaving work now. Let me know if you needed that link explaining what the cases were about too - I assume you already know though

 

[loseyourname]

He made about 6-7 million a year in his best years, winning about 8 cases a year. That is not uncounted millions. Only about 1/4 of those were palsy cases. Not all of the others were medical malpractice.

Please list the name of a Dr. that Edwards put out of business.

For Edwards to do that, he would have to hit a doctor at least 3 times with an unjustified suit. With just 2 palsy cases per year I find it unlikely. I haven't seen any reason to believe any of his cases were not justified. Just a lot of hand-wringing.

Njorl

I didn't mean to imply that Edwards directly took the license of any doctor. What he did is greatly raise malpractice insurance premiums, which makes it very difficult for a doctor-owned practice to get off the ground. Raise the expenses to the point where they can no longer afford to own a practice, and you have put them out of business. I'm not trying to say that Edwards alone is responsible for this, but the fact remains that he (along with a lot of other lawyers) forced insurance companies to pay huge awards when it was not warranted. It is highly doubtful that even half of the doctors filed against were in fact responsible for the injuries suffered (in particular with the cerebral palsy cases). Obviously, hindsight plays a factor here, and perhaps you are right. Perhaps Edwards honestly believed that he was doing the right thing, despite the fact that it is now clear he was not. But just by looking at some of the transcipts of his cases (selected, admittedly, by conservative websites), he comes across as a man appealing to emotion, far more concerned with winning the case than with finding the truth, and thereby serving the cause of justice, which I'm pretty sure is what a lawyer is supposed to do.

 

[JohnDubYa]

RE: "None of this affects health insurance, it affects malpractice insurance."

You see no connection between the two?

 

[Njorl]

RE: "None of this affects health insurance, it affects malpractice insurance."

You see no connection between the two?

There is the concept of the second order effect of defensive medicine; Doctors order more tests to prevent lawsuits.

First, defensive medicine is not necessarily a bad thing. I'm sure some of it is waste, but not all, not even most.

Second, it is not logical, economically speaking, that defensive medicine could have such great costs when malpractice premiums are at 0.56% of medical costs. Money is only spent on defensive medicine to the extent that it is marginally more profitable than spending it on malpractice premiums.

Njorl

 

[JohnDubYa]

There is the concept of the second order effect of defensive medicine; Doctors order more tests to prevent lawsuits.

And they also charge more to pay for their higher malpractice rates, right?

 

[adrenaline]

And they also charge more to pay for their higher malpractice rates, right?

No, not allowed to. Remember, third party payers, whether it is medicare, Hmos, medicaid etc. fix the prices for a doctor's services : physical exam= x amount, , ekg= x amount, , urinalysis, skin biopsey etc. The prices cannot be inflated to cover overhead costs such as malpractice ins.premiums, etc. The most a doc can do is try to see more patients which isn't the best option for either the doctor or the patient. There are quite a few docs pushing for liability surcharges in place of tort reform but some in the AMA argue that it would look as if docs are taking advantage of the medical malpractice insurance crisis and using it to raise their fees.

 

[JohnDubYa]

No, not allowed to. Remember, third party payers, whether it is medicare, Hmos, medicaid etc. fix the prices for a doctor's services :

And what is that price, and is subject to change?

I am not talking about a case where a single doctor increases his rates to overcome a loss in court. I am talking about the overall cost of health care. All of a sudden, the following year its physical exam = X + dX.