Question to those in favor of health care reform.

[Anonymous]

I was at a get together the other night, and I spoke with a number of people who were in favor of health care reform. Most of them were very liberal. The thing that I found interesting was that there was only one couple who said that they thought that the malpractice habit in the US has gotten out of control.
Now zip back 10 years ago to when I lived in Scandinavia, most people that I spoke to there thought that the US needed a national health policy. Many of them, who were for the most part also liberal, believed that Americans were sue happy and they could not imagine that culture in their countries. They also felt that way for any type of law suit, not just malpractice.
Here is what I don't understand. It seems to me that a liberal position would be more along the lines of trust the system, restraint, less litigation. What surprises me is that the opposite position seems to be taken by many liberal Americans, that is, in favor of law suits.
Can someone help me to understand this please.

[Anonymous]

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.

[Anonymous]

Also, the costs associated with lawsuits are a very small part of the problem and difficult to pin down:

Defensive medicine is costly says a recent article in the Wall Street Journal. (http://online.wsj.com/article/SB125193312967181349.html)

"Calculating how much defensive medicine actually costs is extremely difficult, because medical professionals often have many motivations for ordering tests and other procedures. The U.S. spends a higher percentage of its gross domestic product on health care than any other nation in the industrialized world. Legal expenses contribute to the bill.

"Even so, health-care experts say the direct costs of medical malpractice -- the insurance premiums, claims paid and legal fees -- amount to a very small portion of overall health-care spending.

"Total spending on medical malpractice, including legal-defense costs and claims payments, was $30.41 billion in 2007, according to an estimate from consulting firm Towers Perrin. That is a significant figure, but it still amounts to a little more than 1% of total U.S. health-care spending, which the federal government estimates at $2.241 trillion for 2007.

"Art Ushijima, president and chief executive of the Queen's Medical Center, based in Honolulu, says legal concerns have become a bigger burden. He recalls that when he first came to the hospital -- Hawaii's largest -- about 20 years ago, there was one staff attorney. Now there are six. Salaries for staff, with the costs to support them, are "well into the seven figures," he says."

[Anonymous]

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.

[Anonymous]

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.

Non-profit hospitals are largely a legal fiction - they enjoy tax breaks not available to the 1 in 5 hospitals that are "for-profit" and yet there is no corresponding requirement for them to offer ANY charity care. Some do, some largely don't. They are completely unaccountable right now.

According to the Washington Post:

federal law requires charity care in exchange for tax-exempt status, a 37-year-old IRS rule implementing the law is so vague that nonprofit hospitals have been able to exploit it by offering some free services but often little aid to the poorest people in their communities.

http://www.washingtonpost.com/wp-dyn/content/article/2006/09/12/AR2006091201409.html

[Anonymous]

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.

[Anonymous]

Anonymous wrote:Also, the costs associated with lawsuits are a very small part of the problem and difficult to pin down:

Defensive medicine is costly says a recent article in the Wall Street Journal. (http://online.wsj.com/article/SB125193312967181349.html)

"Calculating how much defensive medicine actually costs is extremely difficult, because medical professionals often have many motivations for ordering tests and other procedures. The U.S. spends a higher percentage of its gross domestic product on health care than any other nation in the industrialized world. Legal expenses contribute to the bill.

"Even so, health-care experts say the direct costs of medical malpractice -- the insurance premiums, claims paid and legal fees -- amount to a very small portion of overall health-care spending.

"Total spending on medical malpractice, including legal-defense costs and claims payments, was $30.41 billion in 2007, according to an estimate from consulting firm Towers Perrin. That is a significant figure, but it still amounts to a little more than 1% of total U.S. health-care spending, which the federal government estimates at $2.241 trillion for 2007.

"Art Ushijima, president and chief executive of the Queen's Medical Center, based in Honolulu, says legal concerns have become a bigger burden. He recalls that when he first came to the hospital -- Hawaii's largest -- about 20 years ago, there was one staff attorney. Now there are six. Salaries for staff, with the costs to support them, are "well into the seven figures," he says."

The estimates are way off.
When I go to medical conferences offered by Canadian doctors, they are always telling us to do things this way or that, and we always tell them that we can't, because of fear of litigation. Then they say, "wow, well then, just do it your way". They don't understand why we are so nervous.
The frequent referrals have to do with our high costs here. Referrals are a way of "spreading the blame around". It is a tactic that is not spoken about too often in the medical community. A young adult comes in complaining of headache, you would have to have balls not to get at least a CT scan, maybe a neurology consult, so you can say you did something. People have to believe this. We do not refer to make our friends rich, but rather to minimize risk.

[Anonymous]

Anonymous wrote:... We do not refer to make our friends rich, but rather to minimize risk.

If I may play devil's advocate: A lawsuit would only be a threat if the headache turned out to be something serious. In that case, the threat of it being serious should be sufficient motivation. In sum, the threat of a suit serves the purpose of causing the physician to have as much motivation to care for the patient as the patient does.

[Anonymous]

That's a bit simplistic. It is, in fact, a big part of the way we practice.

In all likelihood, the standard headache is just a migraine. It really doesn't need a CT scan, which will expose you to unneeded radiation, or an MRI, which is amazingly expensive. But if you ask for one or seem excessively worried, you're going to get that scan.

Most of the CT scans I get are done to convince people they don't have what they think they have, so they will get on board with exploring the other possibilities and treatments that are more likely to help them.

Democrats don't do tort reform because the trial lawyers give them huge amounts of money, and the doctors and big corporations don't. Simple as that.

[Anonymous]

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?

[Anonymous]

Anonymous wrote:That's a bit simplistic. It is, in fact, a big part of the way we practice.

In all likelihood, the standard headache is just a migraine. It really doesn't need a CT scan, which will expose you to unneeded radiation, or an MRI, which is amazingly expensive. But if you ask for one or seem excessively worried, you're going to get that scan.

Most of the CT scans I get are done to convince people they don't have what they think they have, so they will get on board with exploring the other possibilities and treatments that are more likely to help them.

Democrats don't do tort reform because the trial lawyers give them huge amounts of money, and the doctors and big corporations don't. Simple as that.

No, trial lawyers give them money because they protect victim's rights better than Republicans, who are cozy with doctors.

[Anonymous]

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?

[Anonymous]

Anonymous wrote:

Anonymous wrote:... We do not refer to make our friends rich, but rather to minimize risk.

If I may play devil's advocate: A lawsuit would only be a threat if the headache turned out to be something serious. In that case, the threat of it being serious should be sufficient motivation. In sum, the threat of a suit serves the purpose of causing the physician to have as much motivation to care for the patient as the patient does.

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?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:... We do not refer to make our friends rich, but rather to minimize risk.

If I may play devil's advocate: A lawsuit would only be a threat if the headache turned out to be something serious. In that case, the threat of it being serious should be sufficient motivation. In sum, the threat of a suit serves the purpose of causing the physician to have as much motivation to care for the patient as the patient does.

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?

Are all situations really like that though? Are there millions of people going to doctors for just a headache? I can't imagine my doctor ordering a scan because I have a headache. Am I wrong?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:... We do not refer to make our friends rich, but rather to minimize risk.

If I may play devil's advocate: A lawsuit would only be a threat if the headache turned out to be something serious. In that case, the threat of it being serious should be sufficient motivation. In sum, the threat of a suit serves the purpose of causing the physician to have as much motivation to care for the patient as the patient does.

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?

Are all situations really like that though? Are there millions of people going to doctors for just a headache? I can't imagine my doctor ordering a scan because I have a headache. Am I wrong?

If you go to the ER, you stand a 50% chance of getting one. If you are crying in pain, you'll get one. If you complain on more than a few visits you'll get one.