Pelosi Healthcare Bill Blows a Kiss to Trial Lawyers

[Gary and Alla 3,696]

It is a big deal in a moral sense - it's not right that a doctor can be sued blind. The criteria that warrants a suit needs to be tightened and there should be a cap on damages. That said, from a cost perspective, it's not that big a deal as the COB numbers show.

Maybe in the grand scheme of US health care costs it's not, however, for the local doctor who has to buy litigation insurance it clearly is. I know for a fact that doctors in Aus pay nowhere near that for litigation insurance.

Sure but malpractice insurance premiums have continued to go up even when states raised the bar on malpractice law suits and malpractice awards have gone down as a result. There's more to the issue than what is being discussed.

This is wrong. It is also silly to assume that the cost of attorneys to the healthcare industry is limited to malpractice insurance. My brother is a family practioner ( I have two other brothers that are physicians also) He pays in excess of $50,000 per year in malpractice insurance, largely because he also delivers babies (he is in a rural area) So if he sees 100 patieints per week, $10 of their office visit fee is just to pay malpractice insurance. 20% or more of the fee charged for a simple office visit. Then, to keep his insurance, he is required to perform many tests and procedures not medically required, to cover the @ss of his insurance company. He is forbidden from certian procedures, medically approved, because his insurance company objects (ie. normal birth 5+ years after ceserean) His patient's insurance maybe doesn't cover this, too bad for them. Easily, 50-60% of what you pay for a simple office visit for a simple illness can be fees directly related to protecting the doctor and/or his insurance carrier from lawsuits. It is commonly called "defensive medicine" and YOU pay for it. The government will NOT do this.

The cost of medical treatment is deeply impacted by lawsuits. NO country that has social medicine allows the attorneys to do what they do here, and this country will not either, they simply cannot.

[I AM NOT THAT GUY 5,715]

So you could save 5 billion annually out of 2.5 trillion (to be almost 4 trillion in a decade). 2% to start and about 1% to finish. What a savings...

Ooops, I overstated the potential significantly - 0.5% is the number quoted by CBO. That's a huge deal. NOT.

Typical liberal....No regard for OTHER PEOPLES MONEY.....

Dude, 0.5% is 0.5% - it's a negligible amount any way you slice it. Reducing the cost of health care by 0.5% won't stop this system from going down the drain in the very near future. Plain and simple.

Well, a billion here, and a billion there, pretty soon you are talking real money.

"As I think of this bill, and the fact that the more progress we make the deeper we go into the hole, I am reminded of a group of men who were working on a street. They had dug quite a number of holes. When they got through, they failed to puddle or tamp the earth when it was returned to the hole, and they had a nice little mound, which was quite a traffic hazard.

"Not knowing what to do with it, they sat down on the curb and had a conference. After a while, one of the fellows snapped his fingers and said, 'I have it. I know how we will get rid of that overriding earth and remove the hazard. We will just dig the hole deeper.'" [Congressional Record, June 16, 1965, p. 13884]. Senator Dirksen

Edited October 31, 2009 by Lone Ranger

[Heracles 417]

Absolutely. But let us keep n ind that the only entities that fail to add any value to the system are the insurance companies. They merely take a cut off the top and do nothing to further the goal of affordable, quality care. Nothing whatsoever. So, why is anyone even listening to what they have to say in this debate? why are we honoring the pimps of the system with even a second of attention?

What value do lawyers add?

The cost of medical treatment is deeply impacted by lawsuits. NO country that has social medicine allows the attorneys to do what they do here, and this country will not either, they simply cannot.

Spot on there. It's disingenuous that no democrat mentions this.

[Heracles 417]

The insurance companies function as gatekeepers, which is why, with all the expectations of what meaningful healthcare has come to mean, single payer is the only practicable solution to the problem.

People are not suing the insurance companies, they are suing doctors and hospitals. Hence, why even a health care system funded by a bottomless pit of oil, diamonds and gold would go bankrupt paying out US lawyers. Figuring out the best approach and how to pay for it is only one aspect of universal coverage. If anyone thinks it's simply going to be a case of business as usual, just with everyone covered, they are severely delusional and mistaken.

The reality is that doctors will be under a huge amount of stress, once the system kicks in. To even suggest that they need not worry about litigation is just ridiculous. The doctor I spoke to was a oncologist. The only way he was able to pay for this was to go in business with other doctors. he also said rather than spend 2 hours consulting newly diagnosed cancer patients, he has now been told to limit it to 20 minutes max, to pay for all of these expenses.

Simple calculation

Litigation insurance: $200k per annum

Doctor works: 1,750 hours a year (which is pushing it)

That means $114 an hour goes towards litigation insurance alone. Now add in the cost of rent, paying staff, taxes etc and the doctors are left shortchanged, while lawyers win.

Is this health care reform going to pay for the doctors litigation insurance? We all know the answer to that.

Edited October 31, 2009 by Booyah!

[Mr. Big Dog 10,747]

It is a big deal in a moral sense - it's not right that a doctor can be sued blind. The criteria that warrants a suit needs to be tightened and there should be a cap on damages. That said, from a cost perspective, it's not that big a deal as the COB numbers show.

Maybe in the grand scheme of US health care costs it's not, however, for the local doctor who has to buy litigation insurance it clearly is. I know for a fact that doctors in Aus pay nowhere near that for litigation insurance.

Sure but malpractice insurance premiums have continued to go up even when states raised the bar on malpractice law suits and malpractice awards have gone down as a result. There's more to the issue than what is being discussed.

This is wrong. It is also silly to assume that the cost of attorneys to the healthcare industry is limited to malpractice insurance. My brother is a family practioner ( I have two other brothers that are physicians also) He pays in excess of $50,000 per year in malpractice insurance, largely because he also delivers babies (he is in a rural area) So if he sees 100 patieints per week, $10 of their office visit fee is just to pay malpractice insurance. 20% or more of the fee charged for a simple office visit. Then, to keep his insurance, he is required to perform many tests and procedures not medically required, to cover the @ss of his insurance company. He is forbidden from certian procedures, medically approved, because his insurance company objects (ie. normal birth 5+ years after ceserean) His patient's insurance maybe doesn't cover this, too bad for them. Easily, 50-60% of what you pay for a simple office visit for a simple illness can be fees directly related to protecting the doctor and/or his insurance carrier from lawsuits. It is commonly called "defensive medicine" and YOU pay for it. The government will NOT do this.

The cost of medical treatment is deeply impacted by lawsuits. NO country that has social medicine allows the attorneys to do what they do here, and this country will not either, they simply cannot.

It wuld be silly to make that assumption. Question is, who made that assumption? I think the CBO covers all angles of the issue when making their assessment. And that assessment is that limiting malpractice suits would yield about 50 billion dollars in savings over the next decade. Lot of money, for sue but a small amount relative to the 30+ trillion dollars health care will suck up over that same time span.

Look, I'm all for injecting sanity into the system and that includes a reform on the malpractice liability front. To pretend that this would be the solution to the ills of the system or that it should be front and center of the reform effort is misguided, however.

[Heracles 417]

It wuld be silly to make that assumption. Question is, who made that assumption? I think the CBO covers all angles of the issue when making their assessment. And that assessment is that limiting malpractice suits would yield about 50 billion dollars in savings over the next decade. Lot of money, for sue but a small amount relative to the 30+ trillion dollars health care will suck up over that same time span.

Look, I'm all for injecting sanity into the system and that includes a reform on the malpractice liability front. To pretend that this would be the solution to the ills of the system or that it should be front and center of the reform effort is misguided, however.

Hardly chump change considering Germany's health care and social security budget is $85 billion.

Personally, I am not a 'work out the details down the track' kind of guy. We need to fix this mess for doctors and fast. We need to stop lawyers sucking the country dry and exploiting those trying to help others for their own gain.

Edited October 31, 2009 by Booyah!

[I AM NOT THAT GUY 5,715]

It is a big deal in a moral sense - it's not right that a doctor can be sued blind. The criteria that warrants a suit needs to be tightened and there should be a cap on damages. That said, from a cost perspective, it's not that big a deal as the COB numbers show.

Maybe in the grand scheme of US health care costs it's not, however, for the local doctor who has to buy litigation insurance it clearly is. I know for a fact that doctors in Aus pay nowhere near that for litigation insurance.

Sure but malpractice insurance premiums have continued to go up even when states raised the bar on malpractice law suits and malpractice awards have gone down as a result. There's more to the issue than what is being discussed.

This is wrong. It is also silly to assume that the cost of attorneys to the healthcare industry is limited to malpractice insurance. My brother is a family practioner ( I have two other brothers that are physicians also) He pays in excess of $50,000 per year in malpractice insurance, largely because he also delivers babies (he is in a rural area) So if he sees 100 patieints per week, $10 of their office visit fee is just to pay malpractice insurance. 20% or more of the fee charged for a simple office visit. Then, to keep his insurance, he is required to perform many tests and procedures not medically required, to cover the @ss of his insurance company. He is forbidden from certian procedures, medically approved, because his insurance company objects (ie. normal birth 5+ years after ceserean) His patient's insurance maybe doesn't cover this, too bad for them. Easily, 50-60% of what you pay for a simple office visit for a simple illness can be fees directly related to protecting the doctor and/or his insurance carrier from lawsuits. It is commonly called "defensive medicine" and YOU pay for it. The government will NOT do this.

The cost of medical treatment is deeply impacted by lawsuits. NO country that has social medicine allows the attorneys to do what they do here, and this country will not either, they simply cannot.

It wuld be silly to make that assumption. Question is, who made that assumption? I think the CBO covers all angles of the issue when making their assessment. And that assessment is that limiting malpractice suits would yield about 50 billion dollars in savings over the next decade. Lot of money, for sue but a small amount relative to the 30+ trillion dollars health care will suck up over that same time span.

Look, I'm all for injecting sanity into the system and that includes a reform on the malpractice liability front. To pretend that this would be the solution to the ills of the system or that it should be front and center of the reform effort is misguided, however.

Seems the lawyers agree with Big Dog:

$3,000,000 Medical Malpractice Verdict Highlights MICRA Unfairness

The unfairness of MICRA's thirty year old $250,000 cap on non-economic damages was underscored recently in a case tried by Michael Kelly and Doris Cheng on behalf of the parents of a patient who died after his head injury went undetected by an emergency room physician. Ethier v. Poindexter, M.D., (S.F. Sup. Ct. CGC-05-437623). Although a unanimous jury awarded $3,000,000 in wrongful death damages for the loss of Charles and Shirley Ethier's 29-year-old son, the trial judge was compelled to immediately reduced the award to $250,000 (an 83% reduction of the jury's award) in accordance with MICRA's antiquated limits.

In Ethier, Plaintiffs' son presented to the defendant emergency room physician with a head laceration after being struck with a surfboard. Ignoring the possibility of a serious head injury, the defendant neglected to order a CT scan or palpate the wound, and merely sutured the laceration and discharged the patient with a prescription for Vicodin. Shortly after leaving the care of defendant, the patient fell unconscious in his living room and was emergently taken to San Francisco General Hospital where he underwent a CT scan and emergent craniotomy. The decedent suffered a comminuted depressed skull fracture, which lacerated the middle meningeal artery, thereby causing epidural, subdural and intraparenchymal bleeding. As a result of prolonged intracranial pressure, the patient sustained brain death.

The Ethiers filed suit against the emergency room physician for the wrongful death of their son. Knowing that MICRA prevented his liability from exceeding $250,000, the defendant (who had 8 prior claims against him) refused to settle the case because his insurance policy covered liability up to $1,000,000. In essence, MICRA gave him a risk-free trial. (The defendant actually made money sitting in court from the per diem paid by his policy.)

Mike and Doris convincingly argued that had the defendant palpated the wound he would have discovered a skull fracture. The doctor argued that even if he had correctly diagnosed the patient, there would not have been time to arrange an emergency transport to a level one trauma center for evaluation, CT scan and surgical evacuation of the expanding hematoma. However, the jury rejected this argument and awarded Charles and Shirley out of pocket expenses and $3,000,000 in general damages for the death of their son.

The Ethiers are just one of the many families and individuals who have been victimized by MICRA's unfair limits over the last thirty years. The most recent study conducted by the Rand Institute, examining data from actual medical malpractice trials, concluded that defendants' liability is reduced in almost 50% of cases tried in California courts.

For three decades malpractice insurance companies have misled the electorate into believing that medical malpractice cases are responsible for skyrocketing health care costs and driving qualified doctors out of California. In fact, studies show that less than a 1% of all healthcare costs are attributable to legal costs and there is no difference between capped and non-capped states in the ratio of physicians to populations.

It's time California modified its law to protect victims of medical malpractice. There is no justification for telling any parent that if his or her child were struck by a physician driving a car they would be entitled to full compensation, but if killed through the negligence of a physician in the operating room they are only entitled to a fraction of what they are owed.

http://www.walkuplawoffice.com/CM/HowWeHav...Malpractice.asp

Edited October 31, 2009 by Lone Ranger

[Mr. Big Dog 10,747]

Not just the lawyers:

Role of Malpractice Litigation

Another commonly cited contention is that medical malpractice litigation is driving up U.S. health spending. The authors compared malpractice claims data from the U.S., Australia, Canada, and the U.K., using information from national reports and databases. While the U.S. had 50 percent more malpractice claims filed per 1,000 population than the U.K. and Australia, and 350 percent more than Canada, payments were lower, on average, than those in Canada and the U.K. More important, average payments per capita were only $16 in the U.S. in 2001, compared with $12 in the U.K., $10 in Australia, and $4 in Canada. Including awards, legal fees, and underwriting costs, the total amount spent defending U.S. malpractice claims was an estimated $6.5 billion in 2001, or 0.46 percent of total health spending.

[Mr. Big Dog 10,747]

It wuld be silly to make that assumption. Question is, who made that assumption? I think the CBO covers all angles of the issue when making their assessment. And that assessment is that limiting malpractice suits would yield about 50 billion dollars in savings over the next decade. Lot of money, for sue but a small amount relative to the 30+ trillion dollars health care will suck up over that same time span.

Look, I'm all for injecting sanity into the system and that includes a reform on the malpractice liability front. To pretend that this would be the solution to the ills of the system or that it should be front and center of the reform effort is misguided, however.

Hardly chump change considering Germany's health care and social security budget is $85 billion.

Germany's GDP is roughly $2.8 trillion and Germany spends about 11% of GDP on health care - that's $300 billion. Germany also has only about 1/4 of the US population. The German health care system would then cost roughly $1.2 trillion - half of that in the US - if the population was 320 million i/o the 80 million they have. If you want to make a point, at least try and get yer figures right.

[I AM NOT THAT GUY 5,715]

What is really driving the cost of healthcare in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

[Mr. Big Dog 10,747]

What is really driving the cost of health care in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

There are too many services rendered in the US without producing better results. The rewards for health care providers need to be revised to steer the system towards better results rather than more procedures.

[I AM NOT THAT GUY 5,715]

What is really driving the cost of health care in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

There are too many services rendered in the US without producing better results. The rewards for health care providers need to be revised to steer the system towards better results rather than more procedures.

What the plan? How are you going to remove the profit incentive out of the healthcare providers and suppliers? We are back to assigning a gatekeeper that is willing, and capable, to open and close that gate to lower costs overall. That's rationing, and it is long overdue.

Edited October 31, 2009 by Lone Ranger

[Mr. Big Dog 10,747]

What is really driving the cost of health care in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

There are too many services rendered in the US without producing better results. The rewards for health care providers need to be revised to steer the system towards better results rather than more procedures.

What the plan? How are you going to remove the profit incentive out of the healthcare providers and suppliers? We are back to assigning a gatekeeper that is willing, and capable, to open and close that gate to lower costs overall. That's rationing, and it is long overdue.

It's not really rationing as long as medically necessary care is available and provided. That is all a public health system should ever cover. If you want more, pay for it out of your own pocket or buy additional insurance coverage that takes care of it.

[I AM NOT THAT GUY 5,715]

What is really driving the cost of health care in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

There are too many services rendered in the US without producing better results. The rewards for health care providers need to be revised to steer the system towards better results rather than more procedures.

What the plan? How are you going to remove the profit incentive out of the healthcare providers and suppliers? We are back to assigning a gatekeeper that is willing, and capable, to open and close that gate to lower costs overall. That's rationing, and it is long overdue.

It's not really rationing as long as medically necessary care is available and provided. That is all a public health system should ever cover. If you want more, pay for it out of your own pocket or buy additional insurance coverage that takes care of it.

But, who decides what is medically necessary, and what is not? We left that up to the insurance companies, HMO's, PPO's and whatever variety you want to call it. Healthcare costs (premiums) are still rising.

Medicare caps the increase in payments to providers, and that is how they try to manage costs. If not rationing, then do we do price controls? You see where this is going?

Edited October 31, 2009 by Lone Ranger

[Mr. Big Dog 10,747]

What is really driving the cost of health care in the long run is patients. Sooner, or later, patients are going to have to do with less, or continue paying the high premiums, to the insurance companies, or to some sort of government quasi-insurance fund.

There are too many services rendered in the US without producing better results. The rewards for health care providers need to be revised to steer the system towards better results rather than more procedures.

What the plan? How are you going to remove the profit incentive out of the healthcare providers and suppliers? We are back to assigning a gatekeeper that is willing, and capable, to open and close that gate to lower costs overall. That's rationing, and it is long overdue.

It's not really rationing as long as medically necessary care is available and provided. That is all a public health system should ever cover. If you want more, pay for it out of your own pocket or buy additional insurance coverage that takes care of it.

But, who decides what is medically necessary, and what is not? We left that up to the insurance companies, HMO's, PPO's and whatever variety you want to call it. Healthcare costs (premiums) are still rising.

Medicare caps the increase in payments to providers, and that is how they try to manage costs. If not rationing, then do we do price controls? You see where this is going?

The decision on what is medically necessary and what isn't needs to be with the doctor not with the payor for the service. The controls that the payor institutes should be remuneration based on best practices not on number of procedures. While not easy, this isn't rocket science either. All of the developed countries worldwide demonstrate that it can be done. They're doing it and we're failing miserably.