Any chance that litigation and our health care system will improve?

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BACMEDIC

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One common question I get from my colleagues, family, and friends is why I want to go into medicine when litigation and the state of health care are in such dire straights. In fact, many will recount recent events of doctors going on strike, or worse, leaving a particular field. We all have heard the flight from OB/GYN, or at least from delivering babies due to the cost of malpractice insurance and the high incidence of being dragged into court for things out of your control ? things that have been happening to the human race since the beginning of dawn.

One response I have, specifically to the litigation and the insurance questions, is that things are so bad that it can only improve. I based this on my gut feeling that patients would revolt once doctors became scarce or refused certain services or whatever.

Now I?m not so sure that things will ever improve if Kerry and Edwards get in. As many of you know, Edwards was a personal injury trial lawyer who went after many doctors. Of course, he is supported by trial lawyers. What are the chances that tort reform or any change will happen with these guys in office?

http://www.nytimes.com/2004/01/31/p...fb3eb4e4f1&ei=5070&pagewanted=print&position=
 
BACMEDIC said:
One common question I get from my colleagues, family, and friends is why I want to go into medicine when litigation and the state of health care are in such dire straights. In fact, many will recount recent events of doctors going on strike, or worse, leaving a particular field. We all have heard the flight from OB/GYN, or at least from delivering babies due to the cost of malpractice insurance and the high incidence of being dragged into court for things out of your control ? things that have been happening to the human race since the beginning of dawn.

One response I have, specifically to the litigation and the insurance questions, is that things are so bad that it can only improve. I based this on my gut feeling that patients would revolt once doctors became scarce or refused certain services or whatever.

Now I?m not so sure that things will ever improve if Kerry and Edwards get in. As many of you know, Edwards was a personal injury trial lawyer who went after many doctors. Of course, he is supported by trial lawyers. What are the chances that tort reform or any change will happen with these guys in office?

http://www.nytimes.com/2004/01/31/p...fb3eb4e4f1&ei=5070&pagewanted=print&position=


If Kerry gets elected, things will get far, far worse - even if the Congress remains in republican control.

The best solution for the health care system would be a Bush re-election and a 60+ republican majority in the Senate. Then, tort reform will happen.
 
It won't! Dare I say it may get worse? Edwards made a career out of extorting money from docs simply by playing on the emotions of sympathetic juries - including acting out births of children with cerebral palsy. He also received >90% of his primary campaign money from trial lawyers. I'm sure some people will say, "at least he's not beholden to oil companies", or some other garbage. From a future-physicians perspective (who already plans on paying 25%+ of my salary to malpractice insurance) Johnny be bad.
 
Dubbya said:
It won't! Dare I say it may get worse? Edwards made a career out of extorting money from docs simply by playing on the emotions of sympathetic juries - including acting out births of children with cerebral palsy. He also received >90% of his primary campaign money from trial lawyers. I'm sure some people will say, "at least he's not beholden to oil companies", or some other garbage. From a future-physicians perspective (who already plans on paying 25%+ of my salary to malpractice insurance) Johnny be bad.


And, despite all the claims little johns "expert witnesses" made in those trials, the incidence of CP hasn't gone down a bit, but the incidents of C-section have gone up tremendously.

Some fing expert - sees a blip (an artifact) somewhere on 30+ minutes of fetal monitor recording and claims "THATS when it happened, right THERE!!"

No wonder the trial lawyer a-holes don't want tort reform. Science would kill their livelihoods
 
i doubt it will get better at all. i'm not happy with edwards even though i'm a died-in-the-wool dem. he's just an a$$ and like dubya and flighterdoc said- he's all about sticking it to docs using less than honest tactics. wow, what a time to become a doc!
 
that dr. jack said:
i doubt it will get better at all. i'm not happy with edwards even though i'm a died-in-the-wool dem. he's just an a$$ and like dubya and flighterdoc said- he's all about sticking it to docs using less than honest tactics. wow, what a time to become a doc!


So, you going to vote for the Dem ticket? Vote against your future livelihood?
 
Guys, the malpractice crisis is not caused by malpractice suits - it is caused by price gouging by insurance companies. Do you realize that all the insurance companies which are hiking their rates up annually are turning record profits? Do you realize that it is to their advantage to settle claims rather than fight them, thereby hurting doctors? (they can settle 10 for $100,000 each or fight them and lose one for $2 million. guess which they choose).
It is the greedy insurance industry which is to blame for the crisis - these things come in cycles, not because trials are brought in cycles but because the market goes in cycles and the insurance industry's money is tied up in it.
Trial lawyers generally may be supporters of the democratic party, but republicans are the ones whom the insurance industry has in their pocket.

The answer to the original question is "yes": force the insurance industry to open their books and show that their rates are justified. I guarantee that a republican administration/congress will never do that.
 
Nice Dreams (what an appropriate name),
You claim , "The reason insurance rates are so high is because docs fight cases (many ridiculous) brought against them instead of settling"? HaHa. Yeah, maybe we should just give $100,000 to every person files a suit - that will surely fix the problem! WHAT LOGIC!
 
Dubbya said:
Nice Dreams (what an appropriate name),
You claim , "The reason insurance rates are so high is because docs fight cases (many ridiculous) brought against them instead of settling"? HaHa. Yeah, maybe we should just give $100,000 to every person files a suit - that will surely fix the problem! WHAT LOGIC!

Dubbya, what an appropriate name for you, because you completely misunderstood what I said and took it in the opposite direction! What I said is that the insurance companies settle claims INSTEAD of fighting them! This is the way they make money at doctors' expense! Yes, doctors should fight claims, but guess what? They don't have a choice. The vast majority are settled by insurance companies. This is one reason for the crisis.
 
Maybe trial lawyers should not promote the idea of getting rich off suing docs!
 
Dubbya said:
Maybe trial lawyers should not promote the idea of getting rich off suing docs!

Of course they shouldn't, and at least openly don't. The idea of malpractice is based on the fact that doctors make mistakes and people who are victims of mistakes due to negligence are entitled to compensation. Of course this can get out of hand. I support caps on awards. But caps will not solve the crisis. There has not been a great increase in malpractice suits or awards - the crisis is thanks to insurance corporations. If you fight for caps and ignore the greed of the insurance companies you will be playing into their hands. We need to fight on both fronts, and frankly the insurance side is much more to blame.
 
Nicedream,
No offense should be taken, but your post makes no sense, shows a misunderstanding of the dynamics of the situation, and sounds more like a political platform more than it does a logical stance on the issue.

I have spent the last two years as a graduate student working on my MHA. I've met everyone on every side of the fence on this issue from the presidents of insurance companies, physicians, administrators, all the way down to trial lawyers and combinations of the above.

It is ridiculous to say that insurance companies alone are the problem, what do you expect to happen when health expenditures continue to rise?(research of new technologies, marketing, pharmaceuticals, malpractice insurance, decreased state Medicaid budgets, Medicare capitations and decreased reimbursements, decreased employer contributions toward health care, etc etc etc, I could go on for hours). Obviously as health expenditures increase health insurance and malpractice insurance increase! Do you expect them to just go bankrupt? Also remember, the Blue's (Cross/Shield) are 501-c-4's, so they aren't really making money for stockholders, no one's pockets are getting lined (the profits they make sit in escrow), and I could also give you a laundry list of things in the community's benefit that the Blue's do for disadvantaged people here in my home state of Pennsylvania. Sure insurance is expensive and it's a problem, but it certainly isn't the root of all evil as you are trying to pretend it is.

One other thing everyone may find interesting, I read four years ago during the last political election that the "average lawyer" gave more than $2,000 in political contributions, where as the "average physician" gave $5 to political campaigns. I wonder who has the greater power of lobby in Washington??? Lawyers or Physicians?
 
(nicedream) said:
Guys, the malpractice crisis is not caused by malpractice suits - it is caused by price gouging by insurance companies. Do you realize that all the insurance companies which are hiking their rates up annually are turning record profits? Do you realize that it is to their advantage to settle claims rather than fight them, thereby hurting doctors? (they can settle 10 for $100,000 each or fight them and lose one for $2 million. guess which they choose).
It is the greedy insurance industry which is to blame for the crisis - these things come in cycles, not because trials are brought in cycles but because the market goes in cycles and the insurance industry's money is tied up in it.
Trial lawyers generally may be supporters of the democratic party, but republicans are the ones whom the insurance industry has in their pocket.

The answer to the original question is "yes": force the insurance industry to open their books and show that their rates are justified. I guarantee that a republican administration/congress will never do that.

Oh, now that is complete bull****, and that is exactly what the trial lawyers want you to believe. The only reason that malpractice rates are up, especially in the more litigious specialties such as obstetrics, are the exhorbitant awards that have been given in frivilous cases. Especially in my home state of Mississippi.

Fix the civil justice system, and then mandate that the insurance companies decrease their rates. Their risk decreases, so naturally, the rates will as well.

What is the incentive to go into OB/GYN at this time? You are going to work your ass off in this speciality, staying up all night long at times. You have to deal with a lot of medicaid, which will be a pain in the ass. Then, if one thing goes wrong, you get your pants sued off. It isn't worth it.
 
Guys, the malpractice crisis is not caused by malpractice suits - it is caused by price gouging by insurance companies. Do you realize that all the insurance companies which are hiking their rates up annually are turning record profits? Do you realize that it is to their advantage to settle claims rather than fight them, thereby hurting doctors? (they can settle 10 for $100,000 each or fight them and lose one for $2 million. guess which they choose).

I agree and have heard this theory more than once and it was not on these message boards. Blaming lawyers for high malpractice is like blaming doctors for high healthcare costs. The real bandits are those running FOR PROFIT insurance companies. Price gauging is real. Unfortunately I can not blame insurance companies, they exist to make a profit in their business. Every solution holds advantages and disadvantages and unfortunately a solution like tort reform is anti-democratic and goverment managed (state-run) insurance companies is anti-republican. I do not believe insurance subsidies fix the problem but rather delay dealing with it and tort reforms depending on how serious could hurt the legal system worse than it already is. But seriously, politicians debate these issues back and forth and really no one person knows the answer but what I do know is that something change.
Obviously I am just voicing my opinion.

http://www.nga.org/cda/files/1102MEDMALPRACTICE.pdf
 
Fix the civil justice system, and then mandate that the insurance companies decrease their rates. Their risk decreases, so naturally, the rates will as well.

How do you fix the justice system for doctors without impacting other parties? I don't know the answer. Also, you can not mandate insurance companies to decrease their rates. Price ceilings do not work. It will force a shortage of insurance carriers and may lead physicians going to foreign carriers. Just a thought. Obviously it could not force a black market but could may entice physicians or some other entity to start a non-profit malpractice company, which is obviously a step in the right direction as long as it is managed efficiently.
 
(Dubbya) said:
Maybe trial lawyers should not promote the idea of getting rich off suing docs!

(nicedream) said:
Of course they shouldn't, and at least openly don't. The idea of malpractice is based on the fact that doctors make mistakes and people who are victims of mistakes due to negligence are entitled to compensation.

I'm going to say this in the nicest way I can: ARE YOU COMPLETELY OBLIVIOUS!!!!!!

Open a phone book, look at some billboards, watch TV for a few minutes.

I'm not saying the insurance industry is perfect but it's crystal clear that greedy trial lawyers are breaking the back of our profession.
 
I don't have time right now, but do some searches on malpractice awards the past couple decades.
 
flighterdoc said:
So, you going to vote for the Dem ticket? Vote against your future livelihood?

i sure am- edwards may be a c$%ksucker, but bush/cheney go against EVERYTHING i believe in. i am perfectly ok with voting against my future livelihood if the alternative is voting against my conscience.

...and i just realized i made a huge typing mistake in my previous- "died in the wool". how embarassing. just as bad as "your" vs. "you're".
 
Sinnman said:
I'm going to say this in the nicest way I can: ARE YOU COMPLETELY OBLIVIOUS!!!!!!

Open a phone book, look at some billboards, watch TV for a few minutes.

I'm not saying the insurance industry is perfect but it's crystal clear that greedy trial lawyers are breaking the back of our profession.

You are the one who is completely oblivious. There are hundreds of examples where insurance companies are exponentially raising malpractice premiums despite DECREASES in malpractice jury awards.

You are the one who needs to pull your head out of your a$$.
 
I remember reading about a case that happened in the early 80's in my home state of OK, in which an OB/GYN was sued by a couple because their baby was born WITHOUT the nerve (can't remember the name, sorry) that controls diaphramatic movement, and therefore respiration. The malpractice lawyer for the prosecution brought a camera team to the Neo-natal unit, and filmed a "day in the life" documentary on the now critically ill baby. Thanks to the "sad story" presented at the trial, the parents of the baby received around $10,000,000 in damages FOR A CONGENITAL DEFECT. To make matters worse, the parents took the money, and then abandoned the child to the state.

That's the problem with our health care system - cases that have no medical backing win in court, and therefore cause insurance rates to skyrocket. It makes me sick thinking about it.
 
DrCoreyOSU said:
I remember reading about a case that happened in the early 80's in my home state of OK, in which an OB/GYN was sued by a couple because their baby was born WITHOUT the nerve (can't remember the name, sorry) that controls diaphramatic movement, and therefore respiration. The malpractice lawyer for the prosecution brought a camera team to the Neo-natal unit, and filmed a "day in the life" documentary on the now critically ill baby. Thanks to the "sad story" presented at the trial, the parents of the baby received around $10,000,000 in damages FOR A CONGENITAL DEFECT. To make matters worse, the parents took the money, and then abandoned the child to the state.

That's the problem with our health care system - cases that have no medical backing win in court, and therefore cause insurance rates to skyrocket. It makes me sick thinking about it.

Oh, but it isn't the lawyers that propagate this. It is the insurance companies fault.

At least, that is what the bleeding heart liberals want you to believe.
 
Cases like this $10 million one are the exception, not the rule, and they are like a mosquito bite to insurance companies.

I'll use Florida as an example, because it is the state I am in and am most familiar with. It should be a good example because Florida is one of the worst states in the crisis.

According to the Florida Department of Financial Services, malpractice awards the past five years have been at the lowest levels since the mid-1980s. According to the Gannett News Service, that's true across the nation.
The number of claims filed nationwide has decreased steadily since 1995, and is at the lowest level since 1984.
2% of claims filed result in jury awards! The rest are settled by insurance companies, at the expense of doctors' reputations and premiums.
The average jury award in Florida has gone down every year since 1999 - it is currently about $325,000.

Despite all this, insurance premiums have been increasing 20-25% per year. Despite the fact that the average malpractice payment in Florida is about $220,000, the average premium for an OB-GYN is $200,000! That means OB-GYN's are paying more PER YEAR for their insurance than they are likely to EVER cost the insurance company. That data comes from the National Practictioners Databank.

As I said in another post, these things come in cycles. In the 1970s and 80s doctors adjusted their rates to compensate for the high premiums they were paying. Now, in the age of Medicaid and HMO's, that's no longer an option.

Bush has promised to "whack the trial lawyers" - is it a coincidence that some of his biggest supporters are those in the insurance industry?

The CEO of FPIC Insurance Co. told stock analysts on Feb. 20, 2003 that he was "confident that the highest premiums in the nation would ensure continued profitability, with or without a cap on jury awards." Does that signal an intent to lower premiums after a cap to you? Here's Bob White, president of FPIC, the largest insurer in Florida: "There is no way we can voluntarily cut our rates."
 
What I can't understand is why the medical profession is required to carry insurance in case we mess up, while other professions requre laymen to purchase "malpractice" insurance in case of professional neglect. For example, I recently bought a house and was told that I should buy (at the low cost of $300, mind you) insurance in case the lawyer reviewing my loan and title "messed up."
"No way!" I said. If the lawyer messes up, I'll just see him/her in court.
"On what grounds?" The mortage broker asked.
"Why, malpractice, of course." I replied.
You can imagine the looks I received from my mortage broker, as well as the realtor. Needless to say, that wasn't a response they were used to.
 
"No way!" I said. If the lawyer messes up, I'll just see him/her in court."Why, malpractice, of course." I replied.

That would be some sweet revenge. It's an interesting point though. Why does a consumer need to buy insurance just in case the lawyer screws up 😕 . Why can't you sue a lawyer for malpractice 😕
 
(nicedream) said:
Cases like this $10 million one are the exception, not the rule, and they are like a mosquito bite to insurance companies.
"


That may be true, but cases like that change the bar (no pun intended) for the next case that comes along. It doesn't even have to be a "published" case (one that is written up to be used as a precident later on), it just lowers the standards expected for every trial that comes later.
 
flighterdoc said:
That may be true, but cases like that change the bar (no pun intended) for the next case that comes along. It doesn't even have to be a "published" case (one that is written up to be used as a precident later on), it just lowers the standards expected for every trial that comes later.

It still doesn't effect anything. See my above post.
 
daisygirl said:
That would be some sweet revenge. It's an interesting point though. Why does a consumer need to buy insurance just in case the lawyer screws up 😕 . Why can't you sue a lawyer for malpractice 😕

Lawyers are sued for malpractice and do carry malpractice insurance.
 
How much are lawyers paying for their malpractice insurance?
 
(nicedream) said:
It still doesn't effect anything. See my above post.


Then you're a fool. Lowering the bar makes the standard of proof lower the next time out. That makes it easier for BS decisions to be made. Judges especially will go outside the envelope a little on a trial, they don't want to go far afield because then there is a good chance they would get overturned on appeal.
 
flighterdoc said:
Then you're a fool. Lowering the bar makes the standard of proof lower the next time out. That makes it easier for BS decisions to be made. Judges especially will go outside the envelope a little on a trial, they don't want to go far afield because then there is a good chance they would get overturned on appeal.

You're ignoring the facts that were in my earlier post. Claims are continually down, payouts are low, and insurance companies are raking it in.
 
Dubbya said:
How much are lawyers paying for their malpractice insurance?

Yes lawyers pay a lot less in malpractice - I was just responding to someone asking why they don't pay any. They do. Why is it lower? Because when they make a mistake it's not someone's life on the line.
 
(nicedream) said:
Yes lawyers pay a lot less in malpractice - I was just responding to someone asking why they don't pay any. They do. Why is it lower? Because when they make a mistake it's not someone's life on the line.

maybe you should have been a lawyer?
 
Blaming the cause of such a mess on one entity will not solve the problem, nor will it even help in serious discussions.

Relief from raising cost of insurance, along with medical decisions taken away from insurance companies and placed back into the hands of physicians must be fought on a number of fronts. First, insurance companies must be prohibited from recouping their investments losses through increases in insurance premiums. Secondly, a cap on attorney fees would curtail the push for frivolous lawsuits in the hope of a huge settlement. Next, setting up an arbitration panel of experts that would determine the legitimacy of each case. This panel would have the power to dismiss a case, allow it to proceed, or arbitrate. Finally, a question of marketing must be addressed by the medical society and congress. The publics? perception that nothing should ever go wrong, and when something does go wrong, then it must be the fault of the doctors in charge. We must sow the seed of change in the way people think about where responsibility rightly belongs. A holistic marking strategy must be implemented that emphasizes nature?s power over man and modern medicine role. This, backed up with strong legislation, would dilute the current climate, changing it back into a society that is more practical and common sense based. As a physician, I will support all actions that benefit and advance the profession to these ends. However, my dismay found in my original post is that if Kerry with Edwards gets into the White House, I fear no change will occur, except those changes that will support the system that made him wealthy ? the personal injury trial lawyers. We will never get over the blame game of the insurance companies blaming the lawyers and the lawyers blaming the insurance companies, where in reality, there is considerable blame on both sides.
 
(nicedream) said:
Yes lawyers pay a lot less in malpractice - I was just responding to someone asking why they don't pay any. They do. Why is it lower? Because when they make a mistake it's not someone's life on the line.

If I am the person you were responding to (regarding asking why they don't pay any), then I think you may need to read my post again. I didn't ask that.

You are also making a sweeping generalization stating that people's lives are not on the line when an attorney represents them- i.e. think of defense attorneys. There are also plenty of other instances where a person's life can be destroyed by inadequate representation.
 
(nicedream) said:
Yes lawyers pay a lot less in malpractice - I was just responding to someone asking why they don't pay any. They do. Why is it lower? Because when they make a mistake it's not someone's life on the line.

I tell you what. The next time you get sick, go see your family lawyer. Don't bother going to see a doctor.
 
Did anyone go to DO Day on the Hill in April?
 
Insurance companies are in a perfectly competitive field. The prices they charge are at zero ECONOMIC profit. That is the way it is. If you don't believe me, then why aren't there a plethora of new companies vying for these so called economic profits? Why doesn't some group of doctors provide insurance? It just isn't feasible cause profits for the insurance market are zero. Forcing these companies to keep their rates low will only drive them out of business. The insurance companies are not the devil. They entered a market that was created by bad docs and lawyers. A better solution must be reached. If we force them to do this or that, we have cut the "invisible hand." Poor Adam Smith is cringing over this forum. I think that arbitration is the way to go.
 
<scratches head>

Errm, haven't most major malpractice insurance providers posted record profits in recent years? I can't be arsed to go look it up, but I'm 99% certain that that's the case; so your post makes absolutely no sense whatsoever. I'm with the poster above who said that ample culpability is to be found on all sides (lawyers, insurance co's) in this issue.
 
1viking said:
Insurance companies are in a perfectly competitive field. The prices they charge are at zero ECONOMIC profit. That is the way it is. If you don't believe me, then why aren't there a plethora of new companies vying for these so called economic profits? Why doesn't some group of doctors provide insurance? It just isn't feasible cause profits for the insurance market are zero. Forcing these companies to keep their rates low will only drive them out of business. The insurance companies are not the devil. They entered a market that was created by bad docs and lawyers. A better solution must be reached. If we force them to do this or that, we have cut the "invisible hand." Poor Adam Smith is cringing over this forum. I think that arbitration is the way to go.

I have no clue where you get this idea about insurance companies not making profit from...it's absolutely wrong. They are making huge profits, as is evident in my long post above.
 
(nicedream) said:
I have no clue where you get this idea about insurance companies not making profit from...it's absolutely wrong. They are making huge profits, as is evident in my long post above.

for someone who didn't start med school yet, you sure do know everything.

if you can solve the health care crisis, why don't you draft a solution to the problem? in the meantime, you've already stated your inaccurate views, we got them already! the more you post, the more you look like a complete simpleton and lose credibility.
 
1viking said:
Insurance companies are in a perfectly competitive field. The prices they charge are at zero ECONOMIC profit. That is the way it is. If you don't believe me, then why aren't there a plethora of new companies vying for these so called economic profits? Why doesn't some group of doctors provide insurance? It just isn't feasible cause profits for the insurance market are zero. Forcing these companies to keep their rates low will only drive them out of business. The insurance companies are not the devil. They entered a market that was created by bad docs and lawyers. A better solution must be reached. If we force them to do this or that, we have cut the "invisible hand." Poor Adam Smith is cringing over this forum. I think that arbitration is the way to go.

http://www.ismie.com/about/history.html

The above link is to an insurance company that provides malpractice insurance to physicians, and this company was founded BY physicians. After reading your post, I did a google search since I remembered watching a segment on some news magazine show (maybe 60 minutes?) and the segment happened to be on physicians who had started their own malpractice insurance company since they were sick of being financially strangled by the current insurance provider in their state. I'm pretty sure the segment that I've spoken about was NOT regarding the physicians who started the insurance company in the above link. For some reason I believe the physicians in the news segment were from a North Eastern state- but I may be wrong since I watched this news segment awhile ago (at least a year or two ago).
 
DrRichardKimble said:
for someone who didn't start med school yet, you sure do know everything.

if you can solve the health care crisis, why don't you draft a solution to the problem? in the meantime, you've already stated your inaccurate views, we got them already! the more you post, the more you look like a complete simpleton and lose credibility.

Well this complete simpleton has in fact worked extensively with his state senate on the problem, and has drafted a solution to the problem which was presented, considered, and rejected because of people such as yourself who can only see one side of the problem (the main opponent happened to be the brother of the President).
 
(nicedream) said:
Well this complete simpleton has in fact worked extensively with his state senate on the problem, and has drafted a solution to the problem which was presented, considered, and rejected because of people such as yourself who can only see one side of the problem (the main opponent happened to be the brother of the President).

forgive me, then you are not a simpleton, just a partisan choosing to see only part of a much bigger problem.
 
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