Malpractice Insurance- Who Cares?

[skiz knot]

Second, I'm pretty sure that undergraduate performance correlates poorly even with success in med school, ...

Is it a perfect correlation? No, but it is fairly good.
Is success on the MCAT a perfect correlation? No, but it is fairly good.
Is a combination of MCAT and GPA a perfect correlation? No, but it is the best one they have come up with yet for performance during the first two years of medical school.

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[mike3kgt]

Hello,

I was glad to happen upon this thread and it pleases me to see that students are taking an interest in their future careers and plan to fight for it!

Take a break from posting and please read a story.

My father was a surgeon in the South Florida region until he passed away 3 years ago. He graduated from U of Buffalo back in 1962, attended residency and fellowships at the Lahey clinic in Boston and came down to the south to set up his practice. He practice medicine with passion and vigor for 40 years. In the 1980s, he began to see a shift in the way medicine was being practiced. Throughout the decade and into the 90's he saw his practice and his colleague's practices become more regulated through health-care reform, the institution of HMOs, and rising costs of medical malpractice. Physicians often did not mind losing here or there because they often claimed 'I am doing well enough, let them have this one, besides I am too busy'. The patient-physician relationship began to degrade, he found himself being sued for frivolous reasons, and most importantly, while he never feigned in his dedication to his patients, he began to lose his zest for the institution of medicine. My father often told my sister (also a physician) and I that 'the pendulum will swing, keep your hopes up.' It has been over 25 years, and the pendulum has not swung...

Does this have any resemblance to today's healthcare climate? Do you keep telling yourself that 'the pendulum' is bound to swing?

Folks, while you have the right to say 'I will let somebody else deal with this' or 'By the time I graduate, everything will be fine' you have the DUTY as future physicians to take interest in your careers. I implore everyone to think strongly about what you CAN do and not what you CAN'T do.

This forum is a great medium for presenting great thoughts and intelligent viewpoints. I encourage discussion, dissent, but most of all diligence . Join your student organizations, talk amongst your families and friends, and be proactive.

Medical malpractice is a serious issue for physicians, dentists, and all healthcare professionals. While we could have several threads about how the VP candidate for the Democratic ticket is a malpractice attorney, how the State of Florida has a 3 strikes and you're out malpractice bill being voted on in November, or how some GPs pay over $80,000/year in malpractice insurance in South Florida, my intention for this post was only to tell a story.

I hope I did an okay job.

-Mike

 

[Leche]

It looks as if Citizens for a Fair Share has managed to get a proposal on the ballot to limit laywers' contingency fees on the Nov. ballot:

http://www.citizensforafairshare.org/release071504.html

"Under this proposed amendment, patients will receive 70% of the first $250,000 awarded, and 90% of the remainder of the award, minus the costs of bringing the lawsuit.

Example: under the proposal, the patient would receive $850,000 of a million dollar award (minus costs) while they currently receive only $600,000.

Example: under the proposal, trial attorneys would receive $150,000 of a million dollar award while they currently reap $400,000."

It's a start, so those of you who live in Florida, or have friends or family that live there, spread the word and let's get this passed!

 

[pseudoknot]

perhaps you were just using the term "the market" to mean "that which presently exists",

Yes, I meant this.

rather than the traditional economic conception of a "market" (i.e., essentially free, largely self-correcting etc.), so I don't know...

Not that.

 

[mdforme]

This is why doctors will lose any war they engage in. Half bury their head in the sand and say "everything will be fine" and the other half say crap like "It concerns me that you will be my collegues" and prevent any meaningfull common ground from forming between us so that we can stand some sort of chance in fight for our intrests and the intrests of society.

I don't consider personal attacks to be conducive to "meaningful common ground", or any sort of positive change. I just wish people could discuss serious problems like these in a mature manner. It is the rash personal attacks that make me worry.

 

[mike3kgt]

It looks as if Citizens for a Fair Share has managed to get a proposal on the ballot to limit laywers' contingency fees on the Nov. ballot:

http://www.citizensforafairshare.org/release071504.html

"Under this proposed amendment, patients will receive 70% of the first $250,000 awarded, and 90% of the remainder of the award, minus the costs of bringing the lawsuit.

Yes! You are correct. I read about the petition last week and I have already contacted Joyce about being apart of the effort in Ft. Lauderdale. I hope that this will make some sort of progress.

This.... however, makes me VERY nervous:

Physician Shall Charge the Same Fee for the Same Health Care Service to Every Patient

http://election.dos.state.fl.us/initiatives/initdetail.asp?account=35169&seqnum=11

or how about

Public Protection from Repeated Medical Malpractice

http://election.dos.state.fl.us/initiatives/initdetail.asp?account=35169&seqnum=8

These two ballot initiatives seek to run all doctors out of the State of Florida. This election will most likely be doctor vs. trial lawyer! If you are in Florida, this is the time to get involved.

It is sad when we come to situations like these

-Mike

 

[Leche]

Yes, unfortunately, the trial lawyers let it be known that if doctors pressed to get the contingency fee issue on the ballot, they would not hesitate to counter and go for the kill. Indeed, it has now become an us vs them standoff.
It's a shame they are trying to standardize fees like that. On more than one occassion, a sympathetic doc has charged me less for a service after finding out I was uninsured and paying out of pocket.

 

[CAGetaway]

This has been a really interesting thread to read, but how many of you really think that the tide of opinion (in Congress as well as as among the general public) has changed enough since the Clinton era to make socialized medicine a realistic possibility in the near future? Somehow I doubt this issue will be resolved very soon. Nevertheless, I'm one of those people (the minority among contributors here, it seems) who would, perhaps naively, like to see socialized medicine happen. People have mentioned the UK and Canada already. I'm wondering, does anyone know of a different model of socialized medicine that works better than these two- and by working better I mean it provides all patients with free care, provides them with better care than in the UK or Canada, and provides physicians with better compensation than in the UK or Canada?

I know there are different models out there. Maybe one is better. Maybe not.

 

[ZekeMD]

People here in the US fail to realize that if we adopt socialized medicine the cost of care may go down, but the quality of care will also decrease dramatically. Lets face it, money is still a draw to the medical profession...without the promise of monetary gains, many would-be doctors will instead opt for something else. Medical schools most likely will still be able to fill their classes, but the quality of applicants will definately go down.

Socialized medicine will also force doctors to specialize. That means fewer pediatricians, FP, IM, etc. Who's going to see all the patients for general things??? Specialists?!?! Right now we probably have the best healthcare system as far aw quality goes. We will lose that if the switch is made.

 

[Chemguync]

I plan on being involved to prevent my profession from failing, but if my government ends up taking control of healthcare and tries to force me to do its bidding for peanuts, that just won't fly. I've always wanted to travel the world, and there must be countries out there willing to pay for US trained physicians. I hear Singapore is nice..

 

[Daiphon]

People here in the US fail to realize that if we adopt socialized medicine the cost of care may go down, but the quality of care will also decrease dramatically... Right now we probably have the best healthcare system as far aw quality goes. We will lose that if the switch is made.

at the risk of getting flamed, i'm gonna add my $.02.

socialized medicine works in other countries for several reasons, but there are 2 big reasons why it won't work in the usa.

first, the citizens of my beloved country have a "i want my cake and to eat it too" attitude - e.g. they want all these expensive diagnostic tests and outstanding level of care - but do not wish to pay for it. other countries either have a HUGE tax on income, or they mandate that businesses and corporations provide either health benefits (they cannot opt out) or pay into a national "health care account" for every worker they employ, regardless of full-time, part-time, summer help, etc. (like germany). this would never fly in the usa because 1) everyone and their GI outlet wines and moans if taxes are raised by a scintilla of a point... much less if they were to be raised to the level required to fund a national health care program. and 2) americans with health insurance have lost the view of what insurance truly is - if you bring your car in for an oil change, do you file an auto insurance claim? of course not... so, why file a claim when you go in for your annual checkup, or some other "routine maintenance"? doing so simply insulates our patients from the true costs of medical care in this country, where Rochester MN can have more CT scanners than all of Canada, and makes them think that doctors are all rolling in the dough and that they can sue for the dumbest things.

aside: i support malpractice suits, but only TRUE malpractice suits - where there is a "Deriliction of Duty that Directly causes Damages" (go HY Psych!), not the "less than perfect outcome" that seems to have become our judicial standard.

back to my original point... secondly, this country is way too damn big to ever be able to pull off a national health care system. socialized medicine works in other countries because the populations are relatively small, and relatively homogeneic compared to the united states. i agree with Zeke in that the quality of care will go down... but not because lesser qualified applicants will get into medical school; but rather because the HMO model that would likely get used prefers quantity over quality, and in order to pay the bills, docs will see patients even faster than we currently do... not to mention that the PA's and NP's will likely continue to assume our responsibilities until the point where the only distinguishing features among these groups will be our level of debt incurred to reach our chosen profession.

I think some of these sentiments have been expressed already in this thread; but reading through it made me feel like venting...

like i said above, these are just my $.02... i know people will agree/disagree, and i can't wait to read the replies. =)

-tim

 

[Chemguync]

back to my original point... secondly, this country is way too damn big to ever be able to pull off a national health care system. socialized medicine works in other countries because the populations are relatively small, and relatively homogeneic compared to the united states.
-tim

Ohh, perhaps another secession on the horizon? Civil War II (AKA The Second War of Northern Aggression) will be fought over healthcare. Sounds fun

 

[mike3kgt]

Ohh, perhaps another secession on the horizon? Civil War II (AKA The Second War of Northern Aggression) will be fought over healthcare. Sounds fun

So you are proposing sending all of the trial attorneys to the south and docs to the north?

Haha, now that would be a walk-out. Maybe then they'd realize how important qualified practitioners are (as doctors, not sources of income)

-Mike

 

[Chemguync]

Oh my no. I like the south far too much. Lawyers to the north! Or put 'em all in Oregon. Nobody's using it anyway..

 

[mike3kgt]

at the risk of getting flamed, i'm gonna add my $.02.

socialized medicine works in other countries for several reasons

Tim,

No yelling here and no 'flaming messages,' you present a well-spoken argument.

I would, however, like to ask you if you have experienced socialized medicine? Have you ever worked in government, the VA prehaps? Ever had a long conversation with somebody who has?

Quick story:
A good friend of mine at NSU was born in Cuba and emigrated to the US in 1995 (after completing 1 year of medical school in Cuba) where in between 1995-2003 she learned English, worked for a biotech firm and is now in dental school. Her story represents the beginning of the American dream.

Her father, however, was not able to make the trip to Miami due to political reasons with the communist Castro gov't. He is a physician specializing in nephrology and was too valuable to let leave the country. The stories I hear from my friend are amazing. She explains that while the medical education in Cuba is decent, there are no supplies. There are no medications for the common people, techniques are outdated, supplies are thin, and people generally do not have the motivation to excel in medicine and care.

I know a communist government may have limited supplies due to embargos and such but this is an example, albeit extreme, of what one looks forward to in a socialized healthcare system.

Government regulation of healthcare, civil liberties, and the economic infrastructure is dangerous. I am, however, not implying that socialization of medicine is a segway into communism. I am implying that socialization of medicine will lead to the progression of substandard care for all.

What is government good for in healthcare? Well, NIH for example. Not only does the NIH produce great research, it houses and produces the best scientists in the field. Research + government = good.

What is the government terrible for in healthcare? My private practice. How much I charge for procedures, who I see as patients, and the way I operate my business is not the government's concern (as long as I am performing safely and ethically). Private practice + government = bad. They don't call it private for no apparent reason.

Like we have always said, it may not be the perfect system, but it is the best we have.

-Mike

 

[Daiphon]

mike...

i have had long discussions with people from standardized medicine (most notably several friends from canada), and have experienced it as well (in the UK)... that said, i know that the UK is an imperfect social system, in that if you have money, you have extra insurance... blah blah blah....

you make a good point, but my question is this: is the cuba situation due to social medicine, or because of the heavy restrictions on trade due to our embargo? i ask because i honestly don't know; and, uncharacteristically, don't have an opinion... medical supplies don't get embargoed, to my knowledge... but do you think the poor buying power of the country due to our restrictions might have something to do with it?

oh, and thanks for the compliment. d=)

-tim

 

[Daiphon]

Oh my no. I like the south far too much. Lawyers to the north! Or put 'em all in Oregon. Nobody's using it anyway..

i dunno, i kinda like the north (seeing as how i'm from that side of the mason-dixon)... how about bikini atoll? d=)

glow in the dark lawyers... so we can see the bloodsuckers coming!

 

[Chemguync]

i dunno, i kinda like the north (seeing as how i'm from that side of the mason-dixon)... how about bikini atoll? d=)

glow in the dark lawyers... so we can see the bloodsuckers coming!

I like where you're going with that one....

 

[Chemguync]

Anybody know why we even still have an embargo on Cuba? Seems silly to keep it up when most people don't even know about it. Communists need love, too

 

[chiron]

i dunno, i kinda like the north (seeing as how i'm from that side of the mason-dixon)... how about bikini atoll? d=)

glow in the dark lawyers... so we can see the bloodsuckers coming!

North or South it doesn't matter, the war would be short anyway. Why? 1.) Doctors are better fighters (talk about skill with a blade!)
2.) If the lawyers get hurt, they're screwed. "Medic! "

 

[Daiphon]

2.) If the lawyers get hurt, they're screwed. "Medic! "

wouldn't EMTALA technically apply? (just my future EM-ness flexing itself).

-t

 

[mike3kgt]

North or South it doesn't matter, the war would be short anyway. "

Isn't this what we have said about every war? If I am not mistaken, the Civil War was not supposed to last more than a month. Years later......

Why? 1.) Doctors are better fighters (talk about skill with a blade!) 2.) If the lawyers get hurt, they're screwed. "Medic!

1. Fortunately, doctors (as a whole) certainly are more venerated and respected. Unfortunately, med mal trial lawyers (as a whole) would put up a better fight... docs care too much to 'do no harm'.

2. That is, unless docs actually took the initiative to fight back. We know that a walk-out of trial lawyers for a week would not cause nearly as much of an effect as a walk-out of docs for the same period. It happened in FL for one day, but that was not as many docs as we had hoped and a period of only one day only sent a quiet message. Imagine the strong message the healthcare community would send to the public if it did happen. Do you think they would realize how important docs are?

Or do we all make too much $ (in their opinion)?

-Mike

 

[canuck MD]

Socialized medicine isn't so much a question of $ but more a question of values. It won't work in the US, not because of the financial burden, but because of the "rich-man's" mentality. Like it or not, the rich control the US (as in most countries)...like it or not, the rich don't really care about "equality of care" or low income families having access to prompt and appropriate medical treatment. Do you really think that a Fortune 500 company CEO is willing to wait in line to have a hip replacement done while a low income common folk is treated? Of course not. Those who have, want more. The presidential candidates are painting a really nice picture, however, the US, unlike Canada, will not stand for this type of social justice. A canadian GP who is making 100 000$ CDN (65K US) is going to have a very comfortable lifestyle. Of course, some canadian medical students want more...they'll move to the US to make more money...I've decided to stay in Canada because I can't stand the thought of only treating people who can pay...it just doesn't make sense! We all know that, in general, the lower income families have more health problems than higher income families yet the US makes sure that ressources are not available for the poor. Just isn't any logic to it; and I couldn't see myself working in that kind of system.

 

[flighterdoc]

Anybody know why we even still have an embargo on Cuba? Seems silly to keep it up when most people don't even know about it. Communists need love, too

There still is, but it's pretty much ONLY the US. There are LOTS of tourists from europe, candada, and other places. Medicine and medical equipment can be purchased from these locations without any limitations.

After the Soviet Union went down the tubes (they were Cuba's major source of hard money and oil), Castro started actively soliciting tourists from other countries. There are hotels, restaurants and bars that are strictly for tourists (called "investors"), the only cash allowed is dollars, and the only cubans there are servants. So much for the communist experiment.

If the embargo was lifted, the massive and rapid influx of hard cash (dollars), first from Cubanos in the US, Cigars flowing into the US (BTW, Cuban cigars aren't what they used to be, and aren't as good as a good dominican like a Fuente) then US tourists, then people buying working, stock '57 Chevy Bel Air autos would pretty much ruin what little economy there is.

 

[flighterdoc]

wouldn't EMTALA technically apply? (just my future EM-ness flexing itself).

-t

Just make sure they can't drag their worthless asses over the ED threshold

 

[chiron]

Isn't this what we have said about every war? If I am not mistaken, the Civil War was not supposed to last more than a month. Years later......




1. Fortunately, doctors (as a whole) certainly are more venerated and respected. Unfortunately, med mal trial lawyers (as a whole) would put up a better fight... docs care too much to 'do no harm'.

2. That is, unless docs actually took the initiative to fight back. We know that a walk-out of trial lawyers for a week would not cause nearly as much of an effect as a walk-out of docs for the same period. It happened in FL for one day, but that was not as many docs as we had hoped and a period of only one day only sent a quiet message. Imagine the strong message the healthcare community would send to the public if it did happen. Do you think they would realize how important docs are?

Or do we all make too much $ (in their opinion)?

-Mike

Mike, I can't believe you analyzed my post! It was a joke man!

 

[Chemguync]

Socialized medicine isn't so much a question of $ but more a question of values. It won't work in the US, not because of the financial burden, but because of the "rich-man's" mentality. Like it or not, the rich control the US (as in most countries)...like it or not, the rich don't really care about "equality of care" or low income families having access to prompt and appropriate medical treatment. Do you really think that a Fortune 500 company CEO is willing to wait in line to have a hip replacement done while a low income common folk is treated? Of course not. Those who have, want more. The presidential candidates are painting a really nice picture, however, the US, unlike Canada, will not stand for this type of social justice. A canadian GP who is making 100 000$ CDN (65K US) is going to have a very comfortable lifestyle. Of course, some canadian medical students want more...they'll move to the US to make more money...I've decided to stay in Canada because I can't stand the thought of only treating people who can pay...it just doesn't make sense! We all know that, in general, the lower income families have more health problems than higher income families yet the US makes sure that ressources are not available for the poor. Just isn't any logic to it; and I couldn't see myself working in that kind of system.

Kind of an unfair generalization from across the fence there, Dudly.

It's ok, though. We still like America Jr.

 

[IceKid]

Kind of an unfair generalization from across the fence there, Dudly.

It's ok, though. We still like America Jr.

everyone always wants to think their way is best, canada included (that is until you're a diabetic in canada, and it takes ages to see your doc and then you go into keto-acidosis. then they HAVE to admit you before you die- this happened to my friend's sister). not all canadians are completely enamored with their system, that's for sure.

sure it's true that the more affluent people in the states get better healthcare. but it is preferable for EVERYONE to have crap healthcare?

 

[shocker]

Just the rumors of how much medicine is changing has decreased applications and therefore probably decreased the quality of medicine.

It appears that historically when the economy goes down, people flock back to school to buffer against future problems.

So why have apps to med school decreased for the last 10 years? Look at the # of apps in 95', I can't remember exactly, but I think about 45,000. Now look at 03', about 32,000.

The answer is that a lot of highly motivated and intellectual people understand that medicine is taking a hit. These people understand that life will be easier in the business sector or as a malpractice attorney. Now, before you say "good riddens", even if their hearts were not in it 100% they could still provide excellent care. If I had the chance to choose who performed some new and complicated procedure on me, I would choose the guy with straight A's who didn't ask me all about my social life. I would not choose the person who wanted it so bad, but could only muster a 3.0 with C's in organic chemistry.

 

[Daiphon]

good point... but, (and i post this in jest, not seriously) what in the hell purpose does ochem as a "pre-med" course serve? i mean, other than the weeding out and reality check - e.g. "do i really want this enough to slog through ochem?"

d=)

-t

 

[rgporter]

...What are we going to do about it? The litigation lobby is so much bigger than our lobby. Doctors can be apathetic about politics. We need a call to action. What would happen if every doc paid 50% of their insurance premiums to their politician (cause money CAN get you anything in this world)? Just a thought.

Do you know what percentage of politicians are or used to be lawyers? I don't think they will turn on their own.
On a semi-related note I live in Utah, we had a big scandle a couple of months ago where one of the big HMO's was making their patients sign a mandatory arbitration agreement (courtesy of a new law passed here). People freaked out, more proof of money grubbers in the medical profession. Who stepped in to save the day? The association of trial lawyers, to preserve the rights of the downtrodden naturally. It made me sick to see people buying that crap wholesale, don't they realize the lawyers were just looking out for themselves? I think we are headed for rough times, people are just too stupid to believe anything dire until the $hit has hit the fan.

 

[jakekocz]

Trying from an outsider's perspective to get a grasp on why we as a nation would choose socialized medicine, I can't get past the idea that health and the amount of healthcare one requires correlates to certain lifestyle choices such as smoking, eating and other personal choices. Now if we went to socialized medicine, that means I would have to pay for others who consume more than their share of healthcare because of their personal choices. That doesn't seem right or fair to me, am I wrong in thinking this? What would be the alternative view?

 

[canuck MD]

Kind of an unfair generalization from across the fence there, Dudly.

It's ok, though. We still like America Jr.

Maybe unfair, but true.

 

[mike3kgt]

..that means I would have to pay for others who consume more than their share of healthcare because of their personal choices. That doesn't seem right or fair to me, am I wrong in thinking this?

Ahh, a future conservative.

-Mike

P.S. I was 1 out of 537 (if you know what I mean)

 

[Chemguync]

Maybe unfair, but true.

Well now if I thought it were true, I wouldn't call it unfair, would I? I'd say it's a fair generalization, then go on to make a snide comment about Canadia being America's dorky little brother, etc. etc.

 

[freaker]

I am personally okay with waiting 3 months to get a non-emergency procedure done as long as everyone in the US has access to FAIR healthcare.

What on earth do you mean by FAIR healtcare? Do you think this is fair?

Five Year survival rates for Colon Cancer and Breast Cancer, respectively:

USA 60% 82%
Germany 48% 68%
Switzerland 51% 76%
France 45% 72%
Netherlands 50% 72%
Spain 46% 64%
Sweden 47% 68%
UK 36% 63%
Denmark 38% 69%


Is it fair that people die because the poor need equal access? Let's not even get into the ethical dilemma of throwing people out on the streets after the inevitable rise in unemployment caused by higher taxes to support socialized medicine.

 

[freaker]

However, I am pretty disturbed by people saying that they hate Bush but plan to vote for him because of this one issue. First, I haven't seen him prioritizing malpractice reform yet, and I don't see why that would happen in a future administration either. More importantly, people need to realize that the president does not have that much power over this stuff. It's a legislative issue, not an executive one, so even if John Edwards wakes up and says doctors should be forced into slavery, that doesn't mean it'll happen. Also, this isn't really even a federal issue, it's a state one. If you care about tort reform, look closely at your state legislators, not the president.

Bush actually tried to push a bill through Congress in 2002. It got through the House, but it was blocked in the Senate--at the time controlled by Democrats. And yes, both Kerry and Edwards voted against malpractice reform.

http://www.cnn.com/2003/ALLPOLITICS/01/16/bush.malpractice/

And if you read the above link, there you go. The American Trial Lawyers Association has the Dems in their pocket, in part because they donate loads of cash their way.

Don't believe me? 1 in every 10 dollars received by the Kerry campaign in the months of March and April was from a lawyer.

the roughly $74 million Kerry raised in March and April, close to $1 in every $10 came from attorneys.

http://www.boston.com/news/politics...heney_slams_dem_ticket_on_malpractice?mode=PF

If you ask me, Bush's reforms are a good start. Seriously, read about what has happened in California as of late. Californians still pay 35% of their insurance premiums (!) to fend off lawsuits, but legislation has been successful in curbing the trend.

 

[flighterdoc]

What on earth do you mean by FAIR healtcare? Do you think this is fair?

Five Year survival rates for Colon Cancer and Breast Cancer, respectively:

USA 60% 82%
Germany 48% 68%
Switzerland 51% 76%
France 45% 72%
Netherlands 50% 72%
Spain 46% 64%
Sweden 47% 68%
UK 36% 63%
Denmark 38% 69%


Is it fair that people die because the poor need equal access? Let's not even get into the ethical dilemma of throwing people out on the streets after the inevitable rise in unemployment caused by higher taxes to support socialized medicine.

Hey, great numbers! Where did they come from?

 

[mike3kgt]

Bush actually tried to push a bill through Congress in 2002. It got through the House, but it was blocked in the Senate--at the time controlled by Democrats. And yes, both Kerry and Edwards voted against malpractice reform.

http://www.cnn.com/2003/ALLPOLITICS/01/16/bush.malpractice/

And if you read the above link, there you go. The American Trial Lawyers Association has the Dems in their pocket, in part because they donate loads of cash their way.

Don't believe me? 1 in every 10 dollars received by the Kerry campaign in the months of March and April was from a lawyer.



http://www.boston.com/news/politics...heney_slams_dem_ticket_on_malpractice?mode=PF

If you ask me, Bush's reforms are a good start. Seriously, read about what has happened in California as of late. Californians still pay 35% of their insurance premiums (!) to fend off lawsuits, but legislation has been successful in curbing the trend.

Thank you for the insightful information. I implore people who read this thread that we need more people like fighterdoc with similar drive and motivation. If every doctor spoke in this way and acted accordingly, we could possibly not be in the mess we are in. While many doctors love complaining about what's happening in medicine, only a few actually take proactive action. Altruism in medicine is critical, ignorance and inaction is not.

To follow up on your John Edwards post... I remembered reading in the Washington Post the day after Edwards was picked for VP that $7mil was donated to the Kerry/Edwards campaign from the trial lawyers fund raising associations. Read the following (from http://www.freerepublic.com/focus/f-news/1166693/posts):

But Rob Christensen of the Raleigh News & Observer reported, "Since withdrawing from the presidential race, Edwards has redirected his financial pipeline – much of it from plaintiffs attorneys – to Kerry. By some estimates, Edwards' donors have funneled $7 million into Kerry's coffers. Edwards' chief fund-raiser, Fred Baron, a Dallas trial lawyer, is working full-time to raise money for Kerry."

The media loves to point out Edward's boyish good looks and charisma as the reason why he was picked... sure, maybe that will help, but I'd say $7mil in the bank would sway any candidate in their direction. BTW, this is the same media that is bashing Schwarzenegger's "girlie men" comments about politicians being bought out by private interests (i.e. trial lawyers). Maybe we should spend less time talking about candidate's hair and petty political fights and actually talk about issues!

How about one of my previous posts about Florida's malpractice mess? Doing some research, I have found that Floridians for Patient Protection, a group in FL who brought bills seeking to restrict doctors' rights, has raised $12,817,568.13 to date! Looking closely at their contributors, one can see many are listed like Krutz, Sleeze, and Booze, P.A. As for Citizens For A Fair Share, Inc., a group in FL who brought a bill to limit trial lawyers who take a 50-90% cut of settlements and jury awards, has raised only $3,555,893.86.

As quoted on the news, "we are in the midst of a cultural civil war" of republican vs. democrat, conservative vs. liberal, doctor vs. trial lawyer.

The question is, will anybody stand up and make their voices heard?

-Mike

 

[CJMPre-Med]

Looking closely at their contributors, one can see many are listed like...Sleeze...

How apropos.

 

[evescadeceus]

Let's assume that Kerry/Edwards are elected. In a Congress dominated by the opposing party, health care legislation which significantly changes the status quo wouldn't pass. The Clintons learned it the hard way. They would as well.

If we get a Democratic congress in the next four years, you could possibly see the creation of some kind of a two-tiered system, with private practices moving increasingly to cash-pay only in order to protect themselves. This could mean less operating revenue for private practices, or it could mean roughly the same - its hard to tell.

At the same time, you might see the creation of a public system with many of the pitfalls mentioned in above posts. It would almost certainly be staffed by an influx of FMG willing to accept these positions. Ultimately, medicine could become far more cutthroat, as young American educated docs jockey for positions outside the public system.

Or you could see some form of tinkering. Coverage for uninsured patients who visit a hospital ER, surgery, chemotherapy performed at a hospital, etc, funded by the taxpayer (you'd probably see a new payroll deduction). This wouldn't encourage preventative care. It might reimburse hospital-based docs fairly. A general strike of hospital-based physicians might encourage fair reimbursement, I suspect.

Hospital charity programs currently cover the cost of emergency care to the uninsured based on their income in a lot of states. These programs usually cover a lot of things except the ER docs bill for those who are poor and uninsured. Those with some disposable income opt for the monthly payment plan if they feel the overall bill is managable. Those who don't or can't watch their credit go in the tank. Or course, the doc doesn't get paid either.

The poor and uninsured can now get some types of surgery through hospital programs specifically designed to provide and pay for these services (the docs get paid as part of the program). You could see an expansion of these programs.

What you'd have left is a patchwork system as complex as the tax code with as many loopholes (but not socialized medicine). You'd see an SS, Medicare, and health insurance payroll deduction (most likely without salary caps - everybody pays, even those who won't go near it). You could possibly see new "free" clinics sprouting next to hospitals. This whole scenario won't be cheap, but it would be paid for by everybody, and it would not be socialized medicine, which my gut tells me the vast majority of voters and docs can't stand the thought of.

 

[koma]

Doesn't Kerry have a daughter who is a rising M4 in Harvard?

 

[doctalaughs]

Let's assume that Kerry/Edwards are elected. In a Congress dominated by the opposing party, health care legislation which significantly changes the status quo wouldn't pass. The Clintons learned it the hard way. They would as well.

In the first 4 years of the Clinton Administration, the congress wasn't "dominated" by the Republicans. In fact, they only had a seat or two majority.

I think people underestimate how close the Clintons came to passing socialized medicine. True, the final vote was like 100-20 or something, but that was after a very expensive, clever, and persistent lobbying and organizing by the right. Insurance companies spent like $20 million in 6 months bringing the harry and lousie commercials to the public. Republicans organized protesters to swamp hillary at every stop she made to campaign for her healthcare plan. They convinced democrats to oppose the legislation by threatening to defeat other important issues.

Socialized medicine is a real threat to our professions. Don't take it lightly.