EM salary and Obama's plan

[Birdstrike]

4. Malpractice reform... please, please, pretty please.

No, no, no. I appreciate the sentiment but:

Malpractice reform is not enough. Many states have this "reform" now and guess what, the lawyers just keep suing. The outrageous $20,000,000 awards may be limited, but these always were the exception anyway. My state is one of the best "A-rated" tort reform states, and the suits keep coming. There is still nothing, absolutely nothing, to stop a lawyer from slapping bogus, frivolous lawsuits on docs, one after the other. In fact, if I was a lawyer, all tort reform would do for me is make me file more suits. I can't hit the big jackpot award, so I need more frequent smaller awards: file a bogus suit, and the docs have to pay $100,000 to defend themselves when they did nothing wrong the vast majority of the time. So, what do we do? Settle for $20,000 to make it go away. Its like when a mugger holds a gun to your head...you gladly give him the $100, not because you want him to be able to put food on his kids table, but because the alternative is much worse. So, what does the lawyer do? He says, "Wow, that was easy", and he files another bogus lawsuit. So what's the solution (other than the ultimate solution, which is all of us leaving medicine, a la Atlas Shrugged)?

...a no-fault malpractice insurance system. Just like in states that have no-fault divorce, no-fault car insurance, or...

..."loser pays" everyone's legal fees, which is the only thing that will discourage bogus, baseless lawsuits.


But....since the lawyers make the rules (congress), enforce the rules (executive branch), and interpret the rules (judges) they allow their shark-lawyer friends to feed on the easy-bait doctors who refuse to stand up for themselves because they inherently want to help people and are afraid to be called "greedy", and....who suffers?

...you, the patient, by paying outrageous health care costs to pay for the outrageously expensive tests we have to order to find the 1 out of a million rare diagnosis we can't afford to miss, because we are tired of feeding lawyers and tired of spending out days off in court, meeting with our lawyers and doing depositions instead of being at the beach. Also, by being subjected to every test know to man, many of which have complications and side effects.

The sacrifices we make as docs are not worth it, when the patients, with the help of their lawyers just keep attacking us when we've dedicated our lives to helping people and when we're just trying to do our best 99.9% of the time, at all hours of the night and day, on nights, weekends, and holidays when we could otherwise be at home with our families.

---

Members don't see this ad.

 

[alexmtr]

The republicans constantly argue (and the democrats ignore them constantly) that we should let insurance companies provide insurance accross state lines. Sounds reasonable to me.

Agree. However, I think there also should be regulations on the minimal care the insurance companies must cover. Health care is a complicated matter and most people can't tell exactly what they need in an insurance plan and what they are getting when purchasing one. It is a matter of consumer protection - it needs to be there if we are to allow insurance companies to compete to sell the lowest priced product.

Physicians should be able to see patients for free and deduct the services on their taxes....

.....Welfare needs to be one agency, rather than splintered into medicare, medicaid, food stamps, WIC, etc. There are a lot of families who are double dipping, with multiple family members on medicaid/ food stamps, all living under the same, government subsidized housing. When the government has numerous agencies, one hand doesn't know what the other does.

Absolutely! That is a huge part of 'fixing the system'. There should be one agency that provides a safety net without allowing the system to get abused.
It would be great if doctors could do what we love and provide free care, however seeing the patient is the cheap part, what about all the tests and procedures they would need? But, perhaps all the money the 'unified' efficiently run welfare system can help us save will contribute to that 'free MRIs/elective surgeries/colonoscopies for the patients who can't afford it and do not qualify for welfare' fund...

I believe that there are a lot of responsible people out there who choose not to buy insurance. Just like some people gamble with the stock market or literally in Las Vegas, some people gamble that they won't have significant medical bills and don't get insurance. I think that is their right. When you are a generally healthy person, paying the occasional PCP bill out of pocket or prescription is much cheaper than paying for insurance.

I do disagree with you here. Health insurance mandate is often compared to car insurance, pointing out that one doesn't have to have a car in the first place. However, health is like the car of your childhood - you need if for survival, it is not the same as choosing to have a car in New York City.
Healthy people are only healthy until they are no longer are. Good drivers get into accidents - young healthy people get 'expensive' diseases/injuries. The whole point of any insurance is to pay it while you don't need it because one day you might. Insurance industry can't exist in any other way. Therefore, young healthy people need to contribute their share.

Anyhow, now all we need is a politician (of any persuasion) who can look beyond the short election cycle and is actually interested in making all/any of this happen.... (sigh...)

 

[GeneralVeers]

There are a few "easy" changes that would drastically reduce healthcare costs as well as the cost of insurance:

1. Have actual insurance that covers catastrophic medical costs. You pay out of pocket expenses up to $10,000 or some set amount. This would have the effect of decreasing utilization of services, and decreasing testing. For legitimately poor people who cannot afford even basic out of pocket costs there would be a subsidy, though they would still have to pay something.

2. Post price lists. Hospitals, clinics, and labs should all post pricing. That was consumers can shop around for quality, and price like with any other commodity. Since they are paying more out of pocket this is necessary. It would also have the effect of driving down costs further.

3. Loser pays malpractice reform. This would largely eliminate nuisance suits, and already is effective in Britain and other countries.

 

[WilcoWorld]

There are a few "easy" changes that would drastically reduce healthcare costs as well as the cost of insurance:

1. Have actual insurance that covers catastrophic medical costs. You pay out of pocket expenses up to $10,000 or some set amount. This would have the effect of decreasing utilization of services, and decreasing testing. For legitimately poor people who cannot afford even basic out of pocket costs there would be a subsidy, though they would still have to pay something.

2. Post price lists. Hospitals, clinics, and labs should all post pricing. That was consumers can shop around for quality, and price like with any other commodity. Since they are paying more out of pocket this is necessary. It would also have the effect of driving down costs further.

3. Loser pays malpractice reform. This would largely eliminate nuisance suits, and already is effective in Britain and other countries.

Hey! Between the above list and Dr. Strangelove, that makes at least four things that GV & I agree on.

 

[deleted65604]

1. Have actual insurance that covers catastrophic medical costs. You pay out of pocket expenses up to $10,000 or some set amount. This would have the effect of decreasing utilization of services, and decreasing testing. For legitimately poor people who cannot afford even basic out of pocket costs there would be a subsidy, though they would still have to pay something.

2. Post price lists. Hospitals, clinics, and labs should all post pricing. That was consumers can shop around for quality, and price like with any other commodity. Since they are paying more out of pocket this is necessary. It would also have the effect of driving down costs further.

I love these concepts. John Stossel said it well I believe:

http://www.youtube.com/watch?v=xLT00Ew78_M

 

[deleted109597]

 

[GeneralVeers]

The above would actually work.

 

[WilcoWorld]

It's called "self-triaging" and it happens.

 

[deleted65604]

A right to healthcare? Watch this...
[YOUTUBE]http://www.youtube.com/watch?v=u_HVyoT2PgM&feature=player_embedded[/YOUTUBE]
I agree. What do you think?

 

[Dwindlin]

I agree. What do you think?

Agree with the message. Though it is unfortunate the way in which he presented it. I have a feeling that because he used slavery as a comparison this is going to get torn apart by hyperbolic pundits, and the ultimate message lost because of it.

 

[ccfccp]

I completely agree with the sentiment in the abstract form, but at the same time, this is going to get some terrible airtime. I've discussed this before on this forum that the "right" to "free" healthcare is taking the works of someone else's labor by force. It would be like walking into a restaurant and demanding food or drink or service for free.

However, try convincing someone who's been out of work for 2 years that "those rich greedy doctors" aren't doing well enough making their cool 250K. They want more of my... MY money!

And on top of that, comparing the average doctor lifestyle to that of the average slave (which I understand was not the point of the statement, but believe me that's how this will be spun) is going to make us look like fools. I'm not sure how many people are sports fans, but it reminds me of a couple of years ago when several players (most notably Browns (at the time) tight end Kellen Winslow) made disparaging remarks including the line, "I'm an *** Soldier!" When compared with an actual soldier, he ended up looking ridiculous.

 

[deleted65604]

Good point. He did talk about nurses, techs, assistants, etc. I guess when I use that argument, I will emphasize those professions in addition to my own.

 

[GeneralVeers]

Good point. He did talk about nurses, techs, assistants, etc. I guess when I use that argument, I will emphasize those professions in addition to my own.

This is why FDR and the "Progressives" have talked about a "Second Bill of Rights". Whereas the first Bill of Rights defines what government may not do to you, the second would define what free goodies the government must provide to you. Those include healthcare, a job, a home, food, clothing, vacation etc.

I think healthcare for all would be great if we could afford it, but it is by no means a "right".

In the next 50 years the Federal Government of this country will have only one function: the care of the elderly. The expenses from the care of the elderly will eat up every single dollar of the budget and most of our economy. Unless we start saying "no" to people, this is our future.

 

[deleted109597]

I'm not sure how many people are sports fans, but it reminds me of a couple of years ago when several players (most notably Browns (at the time) tight end Kellen Winslow) made disparaging remarks including the line, "I'm an *** Soldier!" When compared with an actual soldier, he ended up looking ridiculous.

Point of personal priviledge:
He said it when he was a Miami Hurricane after a loss to the University of Tennessee.
That is all.