Question to those in favor of health care reform.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Liberals believe that capitalism can lead companies to focus overly on profits instead of doing the right thing by their customers, in some cases illegally. When that happens, those customers should have the right to legal remedies if the law has been violated resulting in some harm to them. I think you would find that many of the people who believe in health reform also believe that there should be no such thing as a for-profit hosptial.

So if it a government run health care system would the same thing apply? From what I know, if you are a patient at the VA, NIH, or military, you can't sue. So, if you get the "government option", should you still be able to sue.

10:08 here. I've never heard you can't sue these agencies. People sue the government all the time, and I do think you should continue to be able to under any such system.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Here's the thing about malpractice suits. You can change how it works, but malpractice is a very small fraction of our health care costs.

And even when you add in the costs of defensive medicine, it only adds up to a few more percentage points.

Sure, we'd all like to eliminate frivolous suits or unreasonable awards, but it is too small to make any difference. And people sue for good reasons, too. Somene's child may be permanently disabled, or someone's father or mother may have died at an early age. Do you want to prevent a family from getting adequate compensation for that?

Look, the sources of that info used very poor info for coming to those conclusions.

My question is, are American doctors that bad. Are we worse than say Greek doctors. Explain all the litigation. Who is getting injured by the big bad doctor. And, Greeks never have complications?

I disagree. I think the Hopkins research was very compelling.

As for the difference in malpractice claims, all I can say is that the average claim size is about the same as Britain, so the problem is the number of successful lawsuits. Is that the fault of the doctors or the law? Could be either.

Look, we like to believe that American health care is the best in the world. The fact is, it is not. Even for well-off people with good insurance, it is not better than most industrialized nations. So is it possible that there are more bad apples in the American medical pool? Yes, it's possible.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Here's the thing about malpractice suits. You can change how it works, but malpractice is a very small fraction of our health care costs.

And even when you add in the costs of defensive medicine, it only adds up to a few more percentage points.

Sure, we'd all like to eliminate frivolous suits or unreasonable awards, but it is too small to make any difference. And people sue for good reasons, too. Somene's child may be permanently disabled, or someone's father or mother may have died at an early age. Do you want to prevent a family from getting adequate compensation for that?

Look, the sources of that info used very poor info for coming to those conclusions.

My question is, are American doctors that bad. Are we worse than say Greek doctors. Explain all the litigation. Who is getting injured by the big bad doctor. And, Greeks never have complications?

I disagree. I think the Hopkins research was very compelling.

As for the difference in malpractice claims, all I can say is that the average claim size is about the same as Britain, so the problem is the number of successful lawsuits. Is that the fault of the doctors or the law? Could be either.

Look, we like to believe that American health care is the best in the world. The fact is, it is not. Even for well-off people with good insurance, it is not better than most industrialized nations. So is it possible that there are more bad apples in the American medical pool? Yes, it's possible.

Hopkins looked at direct costs. They did not go to Britain to ask those doctors how they would handle a particular problem. For example, British MDs would do a lumber puncture with out a CT scan (and we used to do the same), but US doctors will first get a CT scan. There is a push for Hopkins to do a slightly different analysis.
Their volume of claims is lower b/c they have to pay the lawyer up front. They also have to pay the legal costs of the doctor if they lose. So that slows them down considerably. They have the same number of mishaps, but their threshold is much higher to file a claim.
My question is what measurement are you using to describe "good care". If you get Pancreatic cancer in Britain, your prognosis is the same. If you are looking at longevity, that is determined by social status (education), not insurance coverage.

All that said, some suggest that to get US doctors to change their approach, the malpractice risk would have to be nearly zero. I am not in favor of that, so I am willing to live with our higher costs.

[Anonymous]

Anonymous wrote:Lawsuits allow the little man to sue Doctors and corporations. The democrats want to look out for the little man, not protect insurance companies/doctors.

Kind of funny that we want doctors to protect us, but we don't want to protect doctors?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Lawsuits allow the little man to sue Doctors and corporations. The democrats want to look out for the little man, not protect insurance companies/doctors.

Kind of funny that we want doctors to protect us, but we don't want to protect doctors?

You're looking at it backwards. We give doctors great power over us. With power comes accountability.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Here's the thing about malpractice suits. You can change how it works, but malpractice is a very small fraction of our health care costs.

And even when you add in the costs of defensive medicine, it only adds up to a few more percentage points.

Sure, we'd all like to eliminate frivolous suits or unreasonable awards, but it is too small to make any difference. And people sue for good reasons, too. Somene's child may be permanently disabled, or someone's father or mother may have died at an early age. Do you want to prevent a family from getting adequate compensation for that?

Look, the sources of that info used very poor info for coming to those conclusions.

My question is, are American doctors that bad. Are we worse than say Greek doctors. Explain all the litigation. Who is getting injured by the big bad doctor. And, Greeks never have complications?

I disagree. I think the Hopkins research was very compelling.

As for the difference in malpractice claims, all I can say is that the average claim size is about the same as Britain, so the problem is the number of successful lawsuits. Is that the fault of the doctors or the law? Could be either.

Look, we like to believe that American health care is the best in the world. The fact is, it is not. Even for well-off people with good insurance, it is not better than most industrialized nations. So is it possible that there are more bad apples in the American medical pool? Yes, it's possible.

Hopkins looked at direct costs. They did not go to Britain to ask those doctors how they would handle a particular problem. For example, British MDs would do a lumber puncture with out a CT scan (and we used to do the same), but US doctors will first get a CT scan. There is a push for Hopkins to do a slightly different analysis.
Their volume of claims is lower b/c they have to pay the lawyer up front. They also have to pay the legal costs of the doctor if they lose. So that slows them down considerably. They have the same number of mishaps, but their threshold is much higher to file a claim.
My question is what measurement are you using to describe "good care". If you get Pancreatic cancer in Britain, your prognosis is the same. If you are looking at longevity, that is determined by social status (education), not insurance coverage.

All that said, some suggest that to get US doctors to change their approach, the malpractice risk would have to be nearly zero. I am not in favor of that, so I am willing to live with our higher costs.

Are we talking about the same research? I'm talking about Gerard Anderson from the school of public health.

[Anonymous]

Why wouldn't you want everyone to have health insurance?

If you have it keep it, let those who don't get some. Have you ever tried to go to a doctor without it or money to pay for a sick visit? Have you ever had to decide between the drs office and paying the light bill? Guess what you keep the lights on and your body suffers in the end.

[Anonymous]

Anonymous wrote:Why wouldn't you want everyone to have health insurance?

If you have it keep it, let those who don't get some. Have you ever tried to go to a doctor without it or money to pay for a sick visit? Have you ever had to decide between the drs office and paying the light bill? Guess what you keep the lights on and your body suffers in the end.

I would see the doctor, skip the lights.
Back to the OP, why sue too if you get it for "free".

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why wouldn't you want everyone to have health insurance?

If you have it keep it, let those who don't get some. Have you ever tried to go to a doctor without it or money to pay for a sick visit? Have you ever had to decide between the drs office and paying the light bill? Guess what you keep the lights on and your body suffers in the end.

I would see the doctor, skip the lights.
Back to the OP, why sue too if you get it for "free".

Easy to say unless you have had it cut off.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Here's the thing about malpractice suits. You can change how it works, but malpractice is a very small fraction of our health care costs.

And even when you add in the costs of defensive medicine, it only adds up to a few more percentage points.

Sure, we'd all like to eliminate frivolous suits or unreasonable awards, but it is too small to make any difference. And people sue for good reasons, too. Somene's child may be permanently disabled, or someone's father or mother may have died at an early age. Do you want to prevent a family from getting adequate compensation for that?

Look, the sources of that info used very poor info for coming to those conclusions.

My question is, are American doctors that bad. Are we worse than say Greek doctors. Explain all the litigation. Who is getting injured by the big bad doctor. And, Greeks never have complications?

I disagree. I think the Hopkins research was very compelling.

As for the difference in malpractice claims, all I can say is that the average claim size is about the same as Britain, so the problem is the number of successful lawsuits. Is that the fault of the doctors or the law? Could be either.

Look, we like to believe that American health care is the best in the world. The fact is, it is not. Even for well-off people with good insurance, it is not better than most industrialized nations. So is it possible that there are more bad apples in the American medical pool? Yes, it's possible.

Hopkins looked at direct costs. They did not go to Britain to ask those doctors how they would handle a particular problem. For example, British MDs would do a lumber puncture with out a CT scan (and we used to do the same), but US doctors will first get a CT scan. There is a push for Hopkins to do a slightly different analysis.
Their volume of claims is lower b/c they have to pay the lawyer up front. They also have to pay the legal costs of the doctor if they lose. So that slows them down considerably. They have the same number of mishaps, but their threshold is much higher to file a claim.
My question is what measurement are you using to describe "good care". If you get Pancreatic cancer in Britain, your prognosis is the same. If you are looking at longevity, that is determined by social status (education), not insurance coverage.

All that said, some suggest that to get US doctors to change their approach, the malpractice risk would have to be nearly zero. I am not in favor of that, so I am willing to live with our higher costs.

Are we talking about the same research? I'm talking about Gerard Anderson from the school of public health.

Yes, that is the one everyone quotes. He did not do a walk through. He did not look at the thought processes of the WHOLE staff for a particular illness.
Some say that the true results will come when we take a set of patients and look very closely at why a foreign doctor would do this or that differently. That has yet to be studied.

[Anonymous]

I'm a liberal who favors health care reform, and I think the question posed by the OP is one of the most difficult to face.

In my personal experience, I would say that fear of lawsuits does cost money, I'm pretty sure I have had unnecessary scans and etc. b/c doctors are covering their asses. And, I'm pretty sure I have been told to "go to the emergency room" when a simple phone consultation would have been the right answer (and the answer I was looking for FWIW).

But, if you ask me to put some kind of cap on malpractice awards, I start to get a pit in my stomach. I think about that lady who was killed by the contaminated epidural at Sibley a few years ago. She died a few days after the baby was born from a brain infection. The doctors performed the epidural w/o proper set up and then failed to treat her in time. Can you say that the appropriate penalty/compensation for that is only $250K, or only $ 1 million. I can't.

So yes, I think there is over treatment due to malpractice, But I also think there is a lot of bad medicine practiced out there. In contrast to the overtreatment I have experiences, I have also been in situations were something fairly critical would have been dismissed if I had been a less educated healthcare consumer and had not pushed for a further test.

So, I'm not sure of the solution. Because of the way our system works, there are frivolous suits and they are generally settled for some fraction of the amount requested, but for enough to keep the suits coming. But, there are also horrible cases of malpractice (and I'm using that term purposely b/c I'm not talking about true accidents or cases where the doctor made a reasonable judgment and turned out to be wrong ie the headache was actually the 1 in a million brain cancer). And, the best check on true malpractice that occurs b/c of arrogance, sloppiness, inattention or just plain stupidity is malpractice suits (or if someone has a better idea, I'm willing to listen).

At some level, I think we need to pay doctors enough for them to be better practitioners. To get up to speed on treatments and tests. I should not have to be more educated on medical literature than my doctor, but I often find myself in that situation. And, I think that if we have tort reform it needs to be focuses on protecting doctors who do everything right but end up with a bad outcome, not on limiting damages for those who failed to practice good medicine. Caps on damages only do the latter.

This maybe a bad analogy, but I find malpractice reform to be an issue like abortion. I'm fundamentally against abortion, I think it is killing an unborn child, I wish it never happened. But, I'm not sure I can say I would force a raped teenager to carry the child of her rapist. And, once you are willing to kill that unborn child, how do you know where to draw the line. What about the child of a poor mother who was forced into sex by her abusive husband? College honor student with a birth control failure? I don't know. So the answer need to be something besides just banning abortion. Malpractice is similar. Are you willing to put a limit on damages for a stupid, arrogant, doctor who kills your child b/c he fails to do a test that all medical research says should be done? No? What about if the dead person was your mother and the error was just sloppy book keeping? Ok? What about a homeless person and the error is not taking their complaint seriously b/c the emergency room was really busy that night....

But, none of the malpractice issues change how I think about a process that reforms our health insurance system. It is a farce that the only way you can really get decent insurance is through your employer. That discriminates against the entreprenures, the freelancers, the mom's starting their own businesses at home, and the unemployed or underemployed. It is crazy that keeping health insurance should be a factor in your decision to change jobs or start your own business (or stay home with your kids). We need a system where everyone can get health insurance (and for that to work, everyone needs to get health insurance, you can't say the insurance companies must insure anyone and then allow people to wait until they are sick to get insurance. That is not how insurance works. And, either everyone gets to deduct health insurance costs from their taxes or no one does. The current system only allows a deduction if you get it from your job. That makes no sense.

Personally, I don't think any of the current plans really address the fundamental problems in our insurance system or our medical system.

Not really an answer to your question. But, I think its worth looking at these problems as more complicated than a Fox News v. Obamacare black and white. There is a lot of nuance to these issues that is getting lost in the shouting.

[Anonymous]

pp, (16:35) thanks for your honesty. I agree with much of what you said.
WRT that case at Sibley, I know some of the details. But you need to keep in mind, you can NEVER sterilize living skin, you can clean it, but not sterilize it. No matter what the set up. So if the set up was perfect, and she still got the infection, and they diagnosed and treated according, but still died, would the family still be entitled?

Since that case, many hospitals are no longer allowing fathers in the room while the epidurals are placed, for reasons of "sterility".

I do find it interesting why in the US support of malpractice suits comes from the liberal wing. Someone mentioned that the present system is to protect the little guy from the big wealthy corporations and doctors. Well, what happens when doctors and hospitals are not wealthy, will the lawsuits stop?

[Anonymous]

"But in Britain, doctors are free to use their judgment. Headache? Take an aspirin (which by the way costs more there than here).
But we here can not judge, every complaint has to be taken seriously.
Of course some British patients walk out of the office and go home to have a stroke. But does one or two bad outcomes justify hundreds of thousands of unnecessary imaging? "

Agree with this point. We should have medical norms in place aimed at the likely scenarios not the 1 in a million scenarios.

BUT...on tort reform, I'm all for reform as I think most medical mistakes are very inadvertent and nurses and doctors are trying to do a good job for their patients. But for the brain damaged baby caused by a mistake in delivery someone besides just the fmaily should help bear those MAJOR costs for the rest of the patient's life. As another thread pointed out, some people sue because they can't afford to take care of a terrible injured family member and so need to find some financial help from somewhere. If we set up a way to try to take care of those people in a more systematic way instead of making them feel they need to win the lawsuit lottery, that might alleviate some of the lawsuits. Also if tied into that hospitals more systemically investigated patient deaths/complications that were unanticipated to actually LEARN from those instances rather than try to cover them up to avoid a suit...that would probably help the overall picture too.
I strongly support health reform....I am not at all opposed to some reasonable form of tort reform (*not JUST dollar limits) accompanying that.

[Anonymous]

Brain damage can and does occur with or without doctors around. All developed countries have about the same incidence of cerebral palsy and so on. So to pick on one practitioner is just a blame game. That said, we do need a system in place to take care of children and adults with disabilities. I actually think we need that before health care reform. The problem has been that people with children with add want the same coverage as the severely autistic or CP child. Then it gets to be this selfish "equality" argument, then costs get out of control.
Things happen. That woman who died after giving birth might have developed meningitis without the epidural. But if it were the epidural, that would be one complication they see less of in Britain, 'cause women hardly get epidurals there.

Also, these countries that are getting cozy with the idea of malpractice suits are kinda twitchy about potential costs of defensive medicine creeping into the system.

[Anonymous]

Anonymous wrote:pp, (16:35) thanks for your honesty. I agree with much of what you said.
WRT that case at Sibley, I know some of the details. But you need to keep in mind, you can NEVER sterilize living skin, you can clean it, but not sterilize it. No matter what the set up. So if the set up was perfect, and she still got the infection, and they diagnosed and treated according, but still died, would the family still be entitled?

16:35 again:

I'm really not sure if they are entitled. That was my point. That is why we have the jury system, in which the jury gets to decide. However, the jury system seems so flawed, b/c many jury members seem to think of lawsuits like the lottery and figure "they have insurance" why not just award the pliantiff a millions of dollars. BUt, is there a better system? Government bureaucrats deciding the value of life? The system is not great... but I can't think of a better one. Its a hard question.