Griping about healthcare? Do something about it.

[kc2lvh]

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I've seen way too many threads complaining about the health care reform, and what it's going to do to the medical profession. As I see it, there are two simple things that can be done to alleviate the problems inherent in our health care system, that should be done before passing any sort of blanket national health coverage:

1. This is the big one... tort reform. I won't try to get into the specifics because I'm neither a lawyer nor a politician. You guys all know the deal though - if you have to pay a ton of malpractice insurance, you're going to have to charge somebody. If every patient is a liability, then you are going to watch your own ass before you take care of them. This is driving up health care costs, so stop making it so easy to sue frivolously and get away with it.

2. Allow people to purchase health care across state lines. This is sort of obvious - competition means lower prices for the consumer.

I sent an email to representative this evening outlining these points. Say what you will about the ineffectiveness of political participation, but it only takes a few minutes, and it only takes one email to change a politician's mind. So if you've got the time to come here and read and post, take 5 minutes and look up your rep and email them.

 

[Cleavername]

I've seen way too many threads complaining about the health care reform, and what it's going to do to the medical profession. As I see it, there are two simple things that can be done to alleviate the problems inherent in our health care system, that should be done before passing any sort of blanket national health coverage:

1. This is the big one... tort reform. I won't try to get into the specifics because I'm neither a lawyer nor a politician. You guys all know the deal though - if you have to pay a ton of malpractice insurance, you're going to have to charge somebody. If every patient is a liability, then you are going to watch your own ass before you take care of them. This is driving up health care costs, so stop making it so easy to sue frivolously and get away with it.

2. Allow people to purchase health care across state lines. This is sort of obvious - competition means lower prices for the consumer.

I sent an email to representative this evening outlining these points. Say what you will about the ineffectiveness of political participation, but it only takes a few minutes, and it only takes one email to change a politician's mind. So if you've got the time to come here and read and post, take 5 minutes and look up your rep and email them.

lol yea dude, i just read this. suppousely there is like no neuro-surgeons in wyoming or something. if you experienced a head trauma and need a surgery, you would have to get bounced to another place real far from there.

read this for your self guys...enjoy🙂.
http://findarticles.com/p/articles/mi_m0843/is_2_28/ai_84236557/

 

[mwalker394]

I've seen way too many threads complaining about the health care reform, and what it's going to do to the medical profession. As I see it, there are two simple things that can be done to alleviate the problems inherent in our health care system, that should be done before passing any sort of blanket national health coverage:

1. This is the big one... tort reform. I won't try to get into the specifics because I'm neither a lawyer nor a politician. You guys all know the deal though - if you have to pay a ton of malpractice insurance, you're going to have to charge somebody. If every patient is a liability, then you are going to watch your own ass before you take care of them. This is driving up health care costs, so stop making it so easy to sue frivolously and get away with it.

2. Allow people to purchase health care across state lines. This is sort of obvious - competition means lower prices for the consumer.

I sent an email to representative this evening outlining these points. Say what you will about the ineffectiveness of political participation, but it only takes a few minutes, and it only takes one email to change a politician's mind. So if you've got the time to come here and read and post, take 5 minutes and look up your rep and email them.

I completely agree. I honestly know little about law, so I don't exactly how the reform would work (what exactly it would stipulate), but the situation is out of control. Any mistake doctors make is basically a way of winning the lottery, but it ends up costing everyone. Yes, doctors sometimes make mistakes they could have avoided and yes, they need to be held accountable when they are caring for others' lives, but it's medicine. As much as the media likes to paint it as black and white, really good physicians can make mistakes and suing them for all they're worth helps no one.

 

[kc2lvh]

another point I forgot about before... people on welfare and medicaid qualify for fertility treatments... what part of "taxpayers supporting octo-mom" makes sense?

 

[yeastfan21]

2. Allow people to purchase health care across state lines. This is sort of obvious - competition means lower prices for the consumer.

FYI, this is in the current health care legislation. States are given the option to link up so that insurance from one state can be sold in another. This is a far superior method to simply eliminating all interstate barriers by federal mandate. The reason is that different states have very different regulations for what treatments insurers cover. Some states require insurers to cover things like psychiatric treatment and certain kinds of cancer screenings; others don't. If you just suddenly force states to permit the sale of insurance from all other states, that will create a "race-to-the-bottom" in terms of the breadth of coverage. By putting the decision in the hands of individual states, you get the benefit of increased competition (like you described), but you preserve the states' right to place common-sense regulations on insurance.

 

[ARK013]

lol yea dude, i just read this. suppousely there is like no neuro-surgeons in wyoming or something. if you experienced a head trauma and need a surgery, you would have to get bounced to another place real far from there.

read this for your self guys...enjoy🙂.
http://findarticles.com/p/articles/mi_m0843/is_2_28/ai_84236557/

Haha this is very true....they come to Colorado! I live in Fort Collins and I work at three of the hospitals in surrounding cities, and we get a lot a lot a lot of people from wyoming, especially anywhere within like a hundred miles of Cheyenne, coming down for our surgeons!

Also I completely agree with the tort reform. A lady I work with used to work in a medical insurance company and she said that when all was said and done, the reason people wanted so much was because the lawyers took like 60-70 percent of the amount awarded through their fees and such. I don't know if that is the real amount, but either way it stinks and something should be done. Good thing Colorado is one of the states with a cap already.

 

[yeastfan21]

1. This is the big one... tort reform. I won't try to get into the specifics because I'm neither a lawyer nor a politician. You guys all know the deal though - if you have to pay a ton of malpractice insurance, you're going to have to charge somebody. If every patient is a liability, then you are going to watch your own ass before you take care of them. This is driving up health care costs, so stop making it so easy to sue frivolously and get away with it.

I'm open to certain kinds of tort reform, but it has to be done extremely carefully so as to not infringe on rights of patients who, due to doctor error, are subjected to serious pain and suffering. There's a real cost to simply capping jury awards, as nicely articulated here by Sen. Durbin:

http://www.youtube.com/watch?v=uHqhCbxu2wk&feature=related

Also, if we want to stop "frivolous" law suits, what better method is there than a jury to decide what is frivolous and what isn't?

 

[JokerMD]

the problem with Americans is this: we are too afraid to say "too bad, so sad" to people begging to pull themselves up at the expense of the rest.

what we need is for doctors to wage a COORDINATED "assult" on the healthcare industry to make big corporations and big government realize that at the end of the day, doctors are the ones holding the scalpel and busting their asses. it is shocking that doctors take so much abuse from insurance companies, lawyers, and patients and yet all they do is keep giving more.

also, writing to your congressman wont do much. congressmen are MUCH more likely to side with a gushy soap story from one of his/her uninsured constituents than a medical student/doctor.

 

[kc2lvh]

also, writing to your congressman wont do much. congressmen are MUCH more likely to side with a gushy soap story from one of his/her uninsured constituents than a medical student/doctor.

My point was that it's all nice to sit here and debate the finer points of health care, but it doesn't get anything done. You may have misgivings about what things our representatives listen to, but it takes 5 or 10 minutes of your time to write an email or make a phone call, and it doesn't matter who it's from, as long as you're one of their constituents. Do SOMETHING, if not that.

When it comes down to it, what will you say when someone asks you "well what did you do about it?" If you sat there and complained while the whole system went to ****, you're just as much at fault than the misguided legislators who messed it up.

 

[rockaction]

the problem with Americans is this: we are too afraid to say "too bad, so sad" to people begging to pull themselves up at the expense of the rest.

what we need is for doctors to wage a COORDINATED "assult" on the healthcare industry to make big corporations and big government realize that at the end of the day, doctors are the ones holding the scalpel and busting their asses. it is shocking that doctors take so much abuse from insurance companies, lawyers, and patients and yet all they do is keep giving more.

so doctors on strike? really?

i'd love to see how your "altruism" essays turn out on your secondaries.

 

[Parts Unknown]

1. This is the big one... tort reform. I won't try to get into the specifics because I'm neither a lawyer nor a politician. You guys all know the deal though - if you have to pay a ton of malpractice insurance, you're going to have to charge somebody. If every patient is a liability, then you are going to watch your own ass before you take care of them. This is driving up health care costs, so stop making it so easy to sue frivolously and get away with it.

Tort reform is a state issue, and many states already have it. If the issue is of serious import to you, simply practice in a state with a favorable tort environment. Somewhat ironically, tort reform coming down from the Federal level would require a larger government intervention in the health system than anything currently proposed, and it would likely have to survive challenges of constitutionality.

Interestingly, just this month Obama sent a letter to Congressional leaders endorsing $50 million for state level demonstration projects aimed at establishing and testing health courts.

Second:

"The conventional wisdom is that malpractice premiums have steadily risen and now constitute a crisis for medical practice. The best available data suggest otherwise. American Medical Association (AMA) surveys of self-employed physicians from 1970 to 2000 indicate that premiums rose until 1986, then declined until 1996, rose thereafter, but were lower in 2000 than in 1986. Other items represented a much greater share of total practice expenses in 1970 yet increased rapidly until 1996 and moderately thereafter, while spending on premiums fell during 1986–2000. National trends were reflected with variations in obstetrics/gynecology, surgery, and anesthesiology and in nine regions surveyed."

Rodwin MA, Chang HK, Clausen J. Malpractice Premiums and Physicians' Income: Perceptions of a Crisis Conflict with Empirical Evidence. Health Affairs 25:750-8, 2006.

2. Allow people to purchase health care across state lines. This is sort of obvious - competition means lower prices for the consumer.

I sent an email to representative this evening outlining these points.

As mentioned above, part of the current reform proposal is to allow the purchase of health insurance across state lines. That you does not know this, or seem to be aware of the health court endorsement, suggests that you have not been watching the debate very closely.

 

[7starmantis]

I'm open to certain kinds of tort reform, but it has to be done extremely carefully so as to not infringe on rights of patients who, due to doctor error, are subjected to serious pain and suffering. There's a real cost to simply capping jury awards, as nicely articulated here by Sen. Durbin:

http://www.youtube.com/watch?v=uHqhCbxu2wk&feature=related

Also, if we want to stop "frivolous" law suits, what better method is there than a jury to decide what is frivolous and what isn't?

I agree with you for the most part. Also, I dont think anyone is saying to "simply" cap jury awards. There is however, inherent in your statement, a philosophical discussion. We suppose that doctors have somehow become non-human and will from now on be perfect? We have "trained the humanity out of them and made them something better...doctors". I'm not sure that human error apart from malice or intent supports uncapped "pain and suffering". Certainly every case is different, but doctor error is always going to happen. Keeping the awards within reason is only responsible.

Now I'm not saying doctor error cases should be capped or thrown out or anything like that, thats ridiculous. What I am saying is that there is a difference between "honest" human error and drunken stupor mistakes. These need to be separated in the courts. Why we feel a person should be awarded ridiculous sums of money and the doctor destroyed because of the doctors humanity is beyond me. There are risks involved with letting humans cut you open, we take those risks to try and save lives. Sometimes things will go wrong and errors will be made, those should result in taking care of the patient in a reasonable manner. I guess I'm saying that human error does not malpractice make.

That being said, I'm not sure how or why you think a jury is the best at deciding what is "frivolous" or not. Thats not the duty of a jury, never has been, thats the duty of the judge. A jury is to determine guilt alone. Our system was never set up for juries to be deciding "frivolousness" and if it was, would be terrible at doing so! I can't think of anything worse at it actually.

 

[Dial71]

the problem with Americans is this: we are too afraid to say "too bad, so sad" to people begging to pull themselves up at the expense of the rest.

Really? Wanting to live a productive, healthy life is an unreasonable expectation?

This is the real problem with America in my opinion. We see too many issues colored by class conflict. This isn't about "wealth-redistribution" or punishing the rich. Rather, it is about insuring that every citizen has the opportunity to pursue life, liberty, and happiness.

Do you realize that one illness can completely ruin a family's finances, even for the insured middle-class? My mother's cancer forced my family to take out a second mortage on our house after her insurer droped her coverage. With all our savings obliterated, my father will probably not be able to ever save enough for his retirement. It is absurd to expect private citizens to finance their medical bills; how do you expect an average person to pay for a $250,000 surgery?

I agree that welfare spending should be carefully contained. However, access to healthcare should not be a privillage that only the wealthy can afford, but rather a public service provided by a central agency. Healthcare safeguards the public interest in the same way as police, fire, or rescue services, which are also government administered.

Could you really look into the eyes of the man who cuts your lawn and tell him that he doesn't deserve treatment for his pancreatic cancer because he didn't work hard enough for it? How about the cleaning lady? Would you tell her that if she wanted treatment for asthma bad enough that she should have chose a higher-paying career? How will you feel when you have to wait hours in th ER for your abdominal pain, because people like them are seeking care when their unmanaged conditions finally deteriorate with catastrophic results?

 

[minicow]

i think in texas they put a cap on the amount that can be claimed for "mental anguish" or whatever.

still get paid for damages or whatever. just not the tears.

 

[Parts Unknown]

I agree with you for the most part. Also, I dont think anyone is saying to "simply" cap jury awards. There is however, inherent in your statement, a philosophical discussion. We suppose that doctors have somehow become non-human and will from now on be perfect? We have "trained the humanity out of them and made them something better...doctors". I'm not sure that human error apart from malice or intent supports uncapped "pain and suffering". Certainly every case is different, but doctor error is always going to happen. Keeping the awards within reason is only responsible.

Now I'm not saying doctor error cases should be capped or thrown out or anything like that, thats ridiculous. What I am saying is that there is a difference between "honest" human error and drunken stupor mistakes. These need to be separated in the courts. Why we feel a person should be awarded ridiculous sums of money and the doctor destroyed because of the doctors humanity is beyond me. There are risks involved with letting humans cut you open, we take those risks to try and save lives. Sometimes things will go wrong and errors will be made, those should result in taking care of the patient in a reasonable manner. I guess I'm saying that human error does not malpractice make.

That being said, I'm not sure how or why you think a jury is the best at deciding what is "frivolous" or not. Thats not the duty of a jury, never has been, thats the duty of the judge. A jury is to determine guilt alone. Our system was never set up for juries to be deciding "frivolousness" and if it was, would be terrible at doing so! I can't think of anything worse at it actually.

During my residency orientation we had a lengthy presentation on medmal, with abundant input from our institution's office of risk management. Very illuminating, however, was a segment by a local attorney who actually did medmal cases. This state had enacted signficant tort reform a few years prior, and he was able to give us the before and after.

Prior to tort reform, he said he would disregard about 97% of the medmal consultations he did as being insufficient to bring a case. After tort reform that number went to about 98-99%. You see, medmal cases are expensive and lengthy to prepare, and if it goes to jury the defendants usually win, so it's not a good career strategy to file frivolous cases.

Of the cases that are brought, they fall broadly into ones that are medically defensible and medically indefensible. Indefensible cases get settled out of court. The large majority (don't have the exact stat anymore, but will look for it) of medically defensible cases are thrown out before trial. Most trial cases are settled in favor of the physician(s)/hospital.

This all means that, fortunately, a world where any patient who feels wronged can simply call up a lawyer and sue for millions simply doesn't exist. That does not mean that stupid lawsuits don't exist, or that jackpot jury awards are never handed out, just that the reality of medmal doesn't quite match the hype generated within our profession. You should be more worried about making honest mistakes than getting sued over imaginary ones.

You can find an interesting tidbit on some medmal stats here.

 

[TooMuchResearch]

i think in texas they put a cap on the amount that can be claimed for "mental anguish" or whatever.

still get paid for damages or whatever. just not the tears.

The only three emotions are happy, angry, and hungry, so the Texas cap makes sense.

 

[JokerMD]

so doctors on strike? really?

i'd love to see how your "altruism" essays turn out on your secondaries.

lol, no I do NOT mean doctors go on strike or form a union. By "assult" I mean that doctors begin to lobby congress and get more involved in the healthcare reform efforts like how big HMO's and pharma companies are doing. And by doctors I mean physicians who are actively practicing clinical medicine.

edit: by the way, it is unbelievable how quickly you guys judge other posters based on a few lines of text which obviously you guys misinterpreted.

i hope you're not like that in real-life because ill likely be your classmate at Case...

 

[JokerMD]

I agree that welfare spending should be carefully contained. However, access to healthcare should not be a privillage that only the wealthy can afford, but rather a public service provided by a central agency. Healthcare safeguards the public interest in the same way as police, fire, or rescue services, which are also government administered.

so basically you support a socialized system, am I right? I'm not saying it's a bad idea, I just want to get to the bottom line because reading through that post just wasted a good two minutes of my life.

Also, please don't guilt trip me because I would never deny healthcare to anyone, regardless of the circumstance. The reason why I said that Americans are too scared of saying "too bad, so sad" is because its a true observation ive made not just about the country but even about myself. Its one of those cultural attributes of an American that no matter how much harm and injustice you may have to suffer for general welfare, Americans will still do anything to please the less fortunate. You won't find that in other parts of the world.

Also, I come from a family of physicians, and almost all of them have become super-cynical towards every aspect of the healthcare system, not because they are making less money than they should be, but because there are middle-men HMOs and malpractice firms getting SUPER-RICH off both patients and doctors. That is what makes me angry.

I realize that the AMA probably has a lot of legislative pull in congress, but I feel as though it is not enough. I am upset because I don't see physicians actively participating in the committees and forums which are drafting the future of healthcare care. All I hear on the news is "HMO's feel that the new plan will do X" or "patients will by affected by the new plan in Y way." It seems that people just don't care what will happen to doctors...🙁

 

[Dial71]

My apologies for the emotional argument; this is an issue that incites me.

Yes, I support a single-payer system. The way I see it is this: we all want modern medicine, but it's going to cost us and we need some way to pay for it.

If insurance is a tool for distributing the cost of medical care over a large group, then why do we need a system in which our money must flow through wasteful middle-men? Why are insurers entitled a cut of the cash?

I agree with you that doctors deserve to be adequately compensated for their services and that the insurers and HMO's are taking more than their fair share of the healthcare dollars.

It is very frustrating that so few are willing to take the insurance industry to task for its predatory practices.

 

[KeyzerSoze]

another point I forgot about before... people on welfare and medicaid qualify for fertility treatments... what part of "taxpayers supporting octo-mom" makes sense?

Cool. Are there any other essential human biological functions which you'd like to withhold from medicaid patients?

 

[Morsetlis]

I'm not sure why you think "fertility treatment" should be free...

 

[KeyzerSoze]

I'm not sure why you think "fertility treatment" should be free...

I don't think it should be freer than any other health care. As I understand it, Medicaid recipients receive government insurance because they have low incomes and can't afford other insurance. I'm not sure why you think it shouldn't include "fertility treatments".

 

[JokerMD]

If insurance is a tool for distributing the cost of medical care over a large group, then why do we need a system in which our money must flow through wasteful middle-men? Why are insurers entitled a cut of the cash?

i 100% agree with this. the way I see it, there are two potential solutions which are both extremes. Either we have a completely "socialized" system or patients pay doctors directly for service like they did in the old days before managed healthcare. of course for the later, costs would need to be SIGNIFICANTLY controlled.

i too am pretty passionate about this topic because i HATE it when middle-men are making millions of dollars when they are doing more harm than good.

 

[Parts Unknown]

Cool. Are there any other essential human biological functions which you'd like to withhold from medicaid patients?

At the individual level, reproduction is not an essential biological function, it's a biologically driven goal that not everyone will attain.