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I read your doctoral thesis two weeks ago - Very impressive.At what income level for each region do you draw a line between having enough money with poor financial management and vice versa? How does one know that better money management is more needed than more cash flow? How do we know that our "spending money responsibly" is better than their "spending money responsibly?" The poor knows they have less money to work with, and I think their financial decisions are simply as good (and bad) as ours.
I understand your point, however. Even some doctors often don't know how to manage financially. But in the context of the poor, I am not sure how much their lives will improve simply by managing their money better. How much money do we need to invest in order to educate them on this? How much return will we have if we spend the same amount of money by simply distributing them to each household? Even if we can make them spend money on whatever we want them to, how do we guarantee that their quality of life and life satisfaction will improve? An interesting area to investigate, but this has to be done after understanding why certain people spend their money in a certain way. The book, "Poor Economics," discusses this aspect, and you might find this book very intriguing.
Do you know any unbiased, non-liberal sources you recommend?
I have to agree with you that just because something does not cost much, it does not mean that it is not important. Although litigation costs are not a large pie of healthcare costs, malpractice reform has influences beyond the cost management. Dr. Gawande's "Better" has a chapter about this, and the current malpractice system is so inefficient that it also heavily affects physicians' satisfaction in their practices, among many other areas. It is lucky if they did not lose their licenses. However, when for-profit corporations get sued, they can pay billions of dollars for their penalty, because they can easily recover that cost in a month and keep doing whatever they were doing without ever apologizing to anyone. The negative effect of this inefficient litigation system is much greater on physicians than on institutions.
I can see that hospitals would use that model as another layer of control, taking away more autonomy from physicians. So the people who don't understand medicine (hospital administrations) enact such payment model (as suggested by PPACA) simply in order to maximize the reimbursement rates? Insurance companies work on the other side in order to minimize the reimbursements and maximize the amount of money that they can keep? And physicians are in between dealing with both worlds?
Is there any positive change that we can expect from this current PPACA? It sounds like things will get worse for physicians.
The implementation will be nearly impossible.
As I said before, many presidents advocated universal healthcare for nearly 100 years. It took this long to get to PPACA and Medicare/Medicaid. Republicans will lose a large chunk of middle-class families' supports to Democrats, private insurance companies will heavily lobby against that universal healthcare notion even before being brought up for the potential agenda, and raising tax rates will be a concern (although some people would rather pay much higher taxes if they don't have to pay premiums). Our ideals have almost zero power in the eyes of politicians and corporations.
What would you suggest to change the system as a whole? Who are major participants within political and social movements?
Dr. Gawande's "Better" will be something you might find interesting to read.
Our current legal system is very inefficient, time-consuming, emotionally exhausting, and costly for medical cases. If there is even a formal/informal appealing process, prior to lawsuits, that patients don't necessarily need to find lawyers to understand what happened and why something happened, we can still preserve that protection of patient rights without always relying on courts. But realistically, I am not sure if any malpractice reform will take place anytime soon.