[quote]hedo wrote:
How about if the lawsuit is found frivolous the person who filed it pays legal costs for both sides.
That way only the legitimate cases would get filed in theory since the lawyer is on contingency and will not put up his money on a whim
[/quote]
That would probably be the only way to stop this and bring it sufficient media attention.
[quote]Professor X wrote:
En Sabah Nur wrote:
I thought the number of minority physicians was on the rise in the U.S.? I thought about doing something medical related but Biology is tearing me all kinds of new assholes…
I would guess that depends on what you mean by “rise”. I was the only black guy in my class. There was one black girl, two latino girls, 5 native Indian girls (as in from India…one who was simply beautiful inside and out but that’s another story), about 10 asian girls (if you include the twins who were from Persia), and about 20 white girls. There were more women than men and the rest were white guys aside from 4 native Indian guys (which is who I generally hung out with simply because our cultures were pretty similar…ie, same music, basketball, weightlifting and other shit we just clicked on).
Yes, I suppose that is a rise from ZERO black and latino people in the classes previous.[/quote]
Yeah I see what you mean. I’m one of the few (as in 2 or 3) and sometimes the only black person in just about all of my classes and it’s been that way since I can remember. Probably could be attributed to the fact there aren’t many black people on this campus (or college for that matter), or maybe the ones that are here just don’t find the sciences that appealing, oh well…
Illegal immigration has not helped the cost of health insurance…
[quote]PantyPeePunch wrote:
Illegal immigration has not helped the cost of health insurance… [/quote]
Indigent (non-paying) patients are poor/uninsured. None of those folks I see here in Tally are illegals. I’m sure this is not the case elsewhere like in Texas, for example, but I’d like to point out that if these folks were legal immigrants, they would still be indigent. Hmmm… what do the numbers say?
http://www.libertypost.org/cgi-bin/readart.cgi?ArtNum=120151
Here’s a paper which cites a study done a couple of years back:
Uncompensated costs to hospitals and other healthcare providers run into the billions of dollars annually. States bordering Mexico take the biggest hits. The Federation for American Immigration Reform, or FAIR (fairus.org), estimates that last year, California lost $1.4 billion, Texas lost $850 million, and Arizona lost $400 million. Officials believe care to illegal immigrants make up 25 percent of those costs. If that is true, then hospitals serving the 24 US counties along the border ate $190 million in the year 2000, according to an oft-cited study by MGT of America (mgtamer.com) sponsored by the United States/Mexico Border Counties Coalition (bordercounties.org)
Now 25 percent sounds like a lot, and it is… but these are border states only. We are talking about 662 million dollars, by my calculations. In the context of the national health care expenditures, that isn’t shit. Sorry.
The real problem is real health care costs being falsely elevated (way, way elevated) due to the bullshit in the system eating up all the money. Plain and simple, it doesn’t really cost a hundred thousand dollars for bypass surgery. I’m sorry, it doesn’t. But when we fill in for all the liability, insurance overhead for the patient, the doctor, and the hospital, a hundred thousand dollars is a bargain!
If we could tame even some of the BS in the system, and have the costs of health care approach the numbers that they really are in terms of the consumption of materials and labor, then having health insurance wouldn’t be such a problem, and magically, the indigent population starts to decrease.
This is just like a hungry man being forced to steal bread. Hey, he doesn’t want to, but if the bread costs twenty dollars a loaf, he’s not going to be able to pay that. A man’s gotta eat. If you get all fucked up in a car wreck, you kinda need health care. Same thing.
[quote]doogie wrote:
hspder wrote:
Then again, it might just be another instance of the GOP selling their souls to the highest bidder.
DING DING DING
[/quote]
The Democrats have veto-proof majorities in both houses of the legislature in Massachusetts…
This is an excellent idea - it’s the British system. If we want to do it, the first thing that will be necessary is getting the Dems out from under the influence of the plaintiffs’ bar. We can’t even get a specific reform aimed at the asbestos trials, and they are so shady as to be almost criminal.
The argument the plaintiffs’ bar will raise is the classic line-drawing argument – if you design a system to eliminate one error, in this case get rid of frivolous suits, you almost necessarily increase another type of error, in this case making it more difficult for some legitimate cases to go to trial.
So you’d see a barrage of commercials from the trial lawyers claiming that “big business” was behind tort reform because they wanted to squelch lawsuits from “the little guys” who couldn’t afford to pay the retainers they would just have to pay to cover the insurance lawyers would just have to get in order to keep bringing crappy cases.
In reality, it would be the marginal cases – the ones that could have merit, but aren’t obviously right – that would be the “error” cases. Cases in which causation of harm is not obvious (or even likely) would do very poorly - bye-bye breast-implant lawsuits. That, I think, is generally a good thing, though you might lose some meritorious cases as well.
Cases in which it is clear one party in a set group of parties caused the harm would fare much better. And it would eliminate - or at least go a long way toward eliminating - the completely frivolous cases.
I think that generally it would be good to move toward the British system, with maybe a cap on the costs payable by the losing side (probably a sliding cap based on the amount of time involved), so that really rich defendants couldn’t just hire 500 lawyers to intimidate the other side to drop just based on the costs it would run up paying for the lawyers if they lost.
Another item to reform: cap contingency fees to some maximum hourly rate, to go along with the maximum percent of the award (which should be lowered from 30% down to 20% or 15%).
[quote]hspder wrote:
w/r/t medical school, the problem seems to be a combination of tuition and entrance requirements; there are many people who want to be doctors but cannot either because they cannot afford the tuition costs over such an extended period of time (first to meet the entrance requirements, then for the actual Med School). The length of the actual Med School part of things doesn’t make it easier.[/quote]
The AMA has artificially depressed the number of doctors for years, simply by refusing to accredit new medical schools. There are around 3-4 applications for every spot in an accredited U.S. med school. It’s a guild (just like the ABA).
And the schools don’t mind – I think they rather like being able to raise tuitions essentially at will due to demand.
[quote]hspder wrote:
Basically, my point is that there was a strong investment in this – by providing subsidies to colleges to teach more nurses, and cheaper and easier loans/scholarships to people who wanted to go into Med School, to sustain them for the long period of time – we would have many more nurses and doctors.
Would that, in your opinion, help? How? If not, why?
[/quote]
That would help a lot, but they could also encourage more state universities and colleges to establish med schools and nursing programs - more opportunities for students to get spots at schools in their own states and qualify for in-state tuition.
And they need to do something about the plaintiffs’ bar (see preceding post)…
Here’s an article by Arnold Kling criticizing the MA law:
Bill of Health
By ARNOLD KLING
April 7, 2006; Page A12
The elected leaders of Massachusetts have come up with a novel solution for the vexing problem of paying for health care: abolish the laws of arithmetic. Their new plan is a perfect illustration of what happens when politicians approach a problem unconstrained by reality.
The plan includes tax incentives and penalties for employers and individuals to get everyone covered by a health-care policy. It also promises affordable health insurance for people with modest incomes, under a program yet to be negotiated between the state and private insurance companies. Nevertheless, three numbers stand out: $295, the annual penalty per worker a company must pay to the state if it does not provide health insurance; $0, the deductible on the typical state-subsidized health-insurance policy under the plan; and $6,000, the average annual expenditure on health care for a Massachusetts resident. Each of these numbers represents one of the irreconcilable goals of health-care policy:
? $295 represents the goal of affordability. We would like to be able to purchase health-care coverage for $295 a year. If that’s what it actually cost, my guess is that the problem of the uninsured would pretty much disappear.
? $0 represents the goal of insulation. As individuals, we would like to be insulated from health-care costs. That is why, instead of real insurance – which would have us pay for at least the first $10,000 of health care out of pocket – most of us have health-care policies with much lower deductibles.
? $6,000 represents the goal of accessibility. We want access to the best care that modern medicine can provide, whatever the expense.
The question is this: What insurance company will provide coverage with $0 deductible, at an annual premium of $295, for someone whose health care costs on average $6,000 a year? The numbers imply losses of over $5,700, not counting administrative costs. To subsidize zero-deductible health insurance, state taxpayers might have to pay out about $6,000 per recipient.
There is no reason to expect firms to rush to offer a policy to uninsured employees. It makes more sense for them to pay their $295 penalty and hand the health-insurance problem back to the individual – and ultimately to the taxpayers of Massachusetts. Economically, consumers who face deductibles of $0 have no incentive to restrain health-care spending. They are only constrained by the time and discomfort involved in obtaining medical care.
If more Massachusetts consumers enjoy coverage without any deductible, then the average per-person expenditure on health care of $6,000 seems likely to go up. Health insurance companies will not write policies that lose them money. Policies with deductibles of $0 in a state where spending per person on health care is on average $6,000 a year will have very high annual premiums – presumably over $6,000 a year.
The Massachusetts health plan promises to provide health-insurance companies with subsidies in order to induce them to offer these low-deductible insurance plans. The arithmetic suggests that these subsidies will have to be large – thousands of dollars larger than the $295 per worker that the state plans to collect from employers that do not provide health insurance.
The problem of paying for health-care coverage, which politicians are declaring they have “solved,” is really just beginning. The only way to make zero-deductible health insurance available at low cost is with a large subsidy; how much will depend on negotiations with insurance companies. Only when the size of the necessary tax increase becomes clear will Massachusetts’s leaders learn the laws of arithmetic.
Mr. Kling, an adjunct scholar with the Cato Institute, is the author of “Crisis of Abundance: Rethinking How We Pay for Health Care,” forthcoming from Cato.
[quote]BostonBarrister wrote:
doogie wrote:
hspder wrote:
Then again, it might just be another instance of the GOP selling their souls to the highest bidder.
DING DING DING
The Democrats have veto-proof majorities in both houses of the legislature in Massachusetts…[/quote]
Is that an excuse to roll over and not vote your principles?
The vote was 154 to 2 in the House and 37 to 0 in the Senate.
The Republican governor supported and signed the bill.
No matter, the Red Sox will still be second place this year, again.
[quote]
hspder wrote:
Then again, it might just be another instance of the GOP selling their souls to the highest bidder.
doogie wrote:
DING DING DING
BostonBarrister wrote:
The Democrats have veto-proof majorities in both houses of the legislature in Massachusetts…
doogie wrote:
Is that an excuse to roll over and not vote your principles?
The vote was 154 to 2 in the House and 37 to 0 in the Senate.
The Republican governor supported and signed the bill.[/quote]
Not really, assuming that any actual conservatives exist in the legislature – actually, there are probably a few. But just because Republicans and Democrats vote for it, don’t assume conservatives/libertarians did so. I’m sure some of the Republicans in MA would be comfortably to the left of some of the Dems in Texas.
Anyway though, my points were these: 1) I don’t know how “bipartisan” legislation like this is when one side knows it can’t do anything to stop it – without knowing more (like specific votes). That may very well lead to their acting like politicians and just tacking their names on, figuring it didn’t matter.
Or maybe it got labeled “bipartisan” because a few of the minority Republican legislators supported it?
I don’t know without more – but I guess I’m not suprised this came from Massachusetts. They should call Tennessee and ask them how TennCare is doing…
I should add I’m more surprised Romney signed it than I am that the legislature passed it – he seems like he has presidential ambitions, and I don’t know how well endorsing a bill like this will sit with primary voters.
[quote]BostonBarrister wrote:
They should call Tennessee and ask them how TennCare is doing…[/quote]
What happened with TennCare?
The only thing I could easily find wasn’t very neutral:
[quote]grew7 wrote:
BostonBarrister wrote:
They should call Tennessee and ask them how TennCare is doing…
What happened with TennCare?
The only thing I could easily find wasn’t very neutral:
http://en.wikipedia.org/wiki/TennCare[/quote]
Excellent, non-biased view of TennCare:
From a 2005 paper on privatization of state government programs by the Institute for Public Policy:
Tennessee Comptroller of the Treasury
The most important duty of the Comptroller of the Treasury is to audit state and local government entities and their participation in the general financial and administrative management of state government, such as agency privatization efforts.
? In 1994, Tennessee created a $4.4 billion “semi-privatized” program, TennCare, to replace Medicaid in Tennessee with a managed careformat that “would curb the outrageous annual growth in costs and to expand health coverage to previously uninsured Tennesseans.”
The state contracted with private companies to oversee health care of enrollees (AP 2/4/00).
? Since its inception in 1994, TennCare has experienced numerous problems and cost overruns. TennCare consumes roughly one in three dollars in the state budget
(Tennessee.gov, Office of the Governor, 1/12/2005).
? In 2005, Governor Bredesen, in response to budget shortfalls decided to shift back to the traditional Medicaid. The new plan “preserves full coverage for all 612,000 children on the program and maintains areasonable level of benefits for 396,000 adults who are
eligible for Medicaid.” 323,000 adults, however, will be removed from the program because they are not eligible for Medicaid. The new changes to TennCare could generate at least $575 million in cost savings for the State. Gov. Bredesen argues that even with the
reductions in adult benefits and enrollment, Tennessee still provides more “extensive healthcare coverage
than nearly 40 other states.” (Tennessee.gov, Office of the Governor, 1/12/2005).
[quote]Anyway though, my points were these: 1) I don’t know how “bipartisan” legislation like this is when one side knows it can’t do anything to stop it – without knowing more (like specific votes). That may very well lead to their acting like politicians and just tacking their names on, figuring it didn’t matter.
Or maybe it got labeled “bipartisan” because a few of the minority Republican legislators supported it? [/quote]
Hey, don’t even think of going through voting records during the next election (e.g. Kerry during the last election) if you aren’t going to hold republicans to their voting records as well.
The damned thing was either bipartisan or it was not…
[quote]BostonBarrister wrote:
Anyway though, my points were these: 1) I don’t know how “bipartisan” legislation like this is when one side knows it can’t do anything to stop it – without knowing more (like specific votes). That may very well lead to their acting like politicians and just tacking their names on, figuring it didn’t matter.
Or maybe it got labeled “bipartisan” because a few of the minority Republican legislators supported it?
vroom wrote:
Hey, don’t even think of going through voting records during the next election (e.g. Kerry during the last election) if you aren’t going to hold republicans to their voting records as well.
The damned thing was either bipartisan or it was not…[/quote]
Yes vroom, I’m sure this will have a large impact on the next MA state election…
[quote]BostonBarrister wrote:
Nevertheless, three numbers stand out: $295, the annual penalty per worker a company must pay to the state if it does not provide health insurance; $0, the deductible on the typical state-subsidized health-insurance policy under the plan;[/quote]
That does sound unrealistic, but the author does not go into enough detail… There are many variables in here that would give a more accurate idea of how realistic this bill is.
Sure, the $295 penalty is ridiculous, but the fact remains that a lot of small companies cannot afford to pay more unless they reduce their employee’s salaries. Yes, a potential catastrophe can happen if companies that CAN afford the insurance – or, even, already provide one – start paying for the fine rather than for the insurance, but it still remains to be seen if that’s what’s going to happen. If it does, well, the bill will have to be changed.
As for the deductible, again, it has to do with what people can afford, and giving an incentive to people going to the doctor as the first symptoms appear rather than when it’s already an emergency.
Yes, this bill will be expensive, but the whole point is to save on Emergency healthcare.
Having said that, I believe that this bill does have a huge problem: it still relies on Insurance companies, when it’s been proven over and over again that Government is much more efficient at managing health insurance than any (private) insurance company. If the bill would have done away with (private) health insurance companies, it would have been much more realistic, since the cost savings would be enormous.
[quote]BostonBarrister wrote:
“semi-privatized” program, TennCare[/quote]
The key word here is “semi-privatized”. Do away with the privatized part – i.e., remove insurance companies from the equation – and then it would work…
[quote]hedo wrote:
How about if the lawsuit is found frivolous the person who filed it pays legal costs for both sides.
Professor X wrote:
That would probably be the only way to stop this and bring it sufficient media attention.
BostonBarrister wrote:
This is an excellent idea - it’s the British system. If we want to do it, the first thing that will be necessary is getting the Dems out from under the influence of the plaintiffs’ bar. We can’t even get a specific reform aimed at the asbestos trials, and they are so shady as to be almost criminal.[/quote]
Yup, it is indeed a great idea.
I’d like to note that the media has its share of responsibility for the current situation too – I believe they helped create a perception that the “bad doctor” problem is much more serious than it is in reality. Of course, the public shouldn’t fall for that, but, as I said before, people are stupid… there should be some kind of way to prevent the media from jumping all over the corner cases and make such a big deal out of them. The last thing we need is for people to fear doctors more than they already do.
One thing that can also be helpful, on the side, would be to have a compulsory, “customer satisfaction” survey system (at the Federal or State level for all doctors) and an independent board do random samples of cases that had poor ratings and review them. I know, it sounds useless, but, if properly designed and implemented, it could do wonders at weaning out the few bad seeds (they would have an overwhelming number of bad ratings and hence would have a high probability of being randomly picked up) and would give patients an outlet…