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  1. #141  
    Not at all dramatic. With government involvement - who really makes the decision? Do you? Your doctor? NO - the government and its hacks.

    Quote Originally Posted by Iago View Post


    Seemed a weee bit dramatic to me. almost brought tears to my eyes.
  2. #142  
    Tort reform is an important element in the mix. With our SUE when you wanna fell good situation, bet that even an ICU nurse knows why the doctors she works with pay high insurance rates. Why hospitals pay high insurance rates. Take a guess.

    Quote Originally Posted by hypocaffeinemia View Post
    Anyone who thinks tort reform will magically fix or even make a significant dent into costs of the current system must have not spent any time in a hospital since 1960.


    /icu nurse
  3. #143  
    Quote Originally Posted by Iago View Post
    So highlighting is editing? I didn't know. I'm sorry.
    Uh.....
  4. #144  
    Quote Originally Posted by bclinger View Post
    Not at all dramatic. With government involvement - who really makes the decision? Do you? Your doctor? NO - the government and its hacks.
    -who really makes the decision? Do you? Your doctor? NO - the Insurance companies and its hacks.
    Iago

    "Good name in man and woman, dear my lord, Is the immediate jewel of their souls: Who steals my purse steals trash . . . But he that filches from me my good name Robs me of that which not enriches him
    And makes me poor indeed."


    Criminal: A person with predatory instincts who has not sufficient capital to form a corporation.
    - Howard Scott
  5. #145  
    Quote Originally Posted by bclinger View Post
    Tort reform is an important element in the mix. With our SUE when you wanna fell good situation, bet that even an ICU nurse knows why the doctors she works with pay high insurance rates. Why hospitals pay high insurance rates. Take a guess.
    Texas had tort reform a few years back. People that were behind the push, sold it as a much need reform that would lower costs. And Texans being well...Texans hahaha (trying to be diplomatic) fell for it hook line and sinker. Costs never came down, people with legitimate claims can't find attorneys to help them move forward because the damage caps make it a loosing proposition. So even when you win or could win, you loose. Good old frontier justice. I've read even Defense attorneys are closing up shop, since suits are dramatically down. It seems that committing malpractice is just the cost of doing business.
    Iago

    "Good name in man and woman, dear my lord, Is the immediate jewel of their souls: Who steals my purse steals trash . . . But he that filches from me my good name Robs me of that which not enriches him
    And makes me poor indeed."


    Criminal: A person with predatory instincts who has not sufficient capital to form a corporation.
    - Howard Scott
  6. #146  
    Quote Originally Posted by anthillmob View Post
    That the people claim to be happier with their health care (assuming the statistics you mention are any good) is not a reflection of a better system, but of people not knowing any better.
    Of course. We all know that those people in France, Germany, Sweden and others are just not as well informed as Americans. They can't possibly be trusted to know if they're health care system is any good, unless they are told so by the geniuses in the USA.

    The misplaced national pride that won't let us admit that maybe we can learn from other countries is what prevents any change in our system....luckily 72% of Americans now support a public option for insurance. But of course, they probably don't know any better either.

    A study in 2007 determined that 61% of home foreclosures were a direct result of medical costs. My own father lost his house when he became seriously ill. Our system is irrevocably broken - uninformed responses like "tort reform" are not an answer that will make any real improvements.
    Last edited by Bujin; 06/26/2009 at 06:26 AM.
    Everything's Amazing and Nobody's Happy

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  7. #147  
    Quote Originally Posted by Micael View Post
    who do you mean by "no one"? the politicians?
    Yes, and most of the population at large. I was being only a tad hyperbolous. I'm sure there are individuals here and there that might be capable and willing to actually discuss things without a pre-formed position, but they're rare enough to not be worth mentioning. Most people just resort to anecdotes, catch phrases, ad hominem, straw men, and/or sarcasm.
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  8. #148  
    Quote Originally Posted by Iago View Post
    Texas had tort reform a few years back.
    So, the question becomes, was its 'failure' the result of a problem with concept, or of execution? Much like 'campaign finance reform' and not ironically 'health care reform', getting people to agree that there are problems is not the issue.
    ‎"Is that suck and salvage the Kevin Costner method?" - Chris Matthews on Hardball, July 6, 2010. Wonder if he's talking about his oil device or his movie career...
  9. #149  
    your capitalism health care system isn't working, why do you think it need fix now? or you don't think its broken?
  10. #150  
    Quote Originally Posted by bclinger View Post
    I disagree. Why should I go to a doctor, take his/her time when nothing is wrong? Does not make sense at all.
    Quote Originally Posted by bclinger View Post
    Tort reform is an important element in the mix. With our SUE when you wanna fell good situation, bet that even an ICU nurse knows why the doctors she works with pay high insurance rates. Why hospitals pay high insurance rates. Take a guess.
    He.

    And I carry my own malpractice insurance, too, but here's the deal: lawsuits that are truly frivolous are thrown out nearly immediately. Nearly every lawsuit I've seen or had to witness at (anyone who put their signature anywhere in the chart was subpoenaed) had at least some element of truth to it. On top of that, they aren't anywhere as common as politicians or TV shows would like to pretend. It's a tiny, tiny drop in the bucket of costs. Really, it is.

    A whole year's worth of lawsuits doesn't come close to the cost of one patient that comes in three-quarters dead with ten different comorbidities that codes on you five times a shift, ends up in a combination of septic and cardiogenic shock requiring four different vasopressors and a balloon pump just to keep blood moving, and hangs on for a week before recovering or (more likely) dying.

    I know that sounds dramatic but patients as described above are status quo in ICUs across the country weekly if not daily. There are similar costly scenarios in trauma ICUs as well, but we were discussing the importance of preventive healthcare.

    These stays cost millions and hospitals lose money even on patients with insurance. These costs must be offset somehow if we wish to continue to have hospitals, and make up the bulk of why our healthcare is overly expensive compared to other first-world nations.
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    #151  
    Quote Originally Posted by hypocaffeinemia View Post
    A whole year's worth of lawsuits doesn't come close to the cost of one patient that comes in three-quarters dead with ten different comorbidities that codes on you five times a shift, ends up in a combination of septic and cardiogenic shock requiring four different vasopressors and a balloon pump just to keep blood moving, and hangs on for a week before recovering or (more likely) dying.
    I disagree. The cost of the lawsuits themselves - dramatically increasing - is only one factor. The other is the practice of defensive medicine that results from this out-of-control lawsuit situation. It leads to a standard of care that requires the level of intervention that you describe above. Every headache requires a head ct, because 1 in 1000 will have an intracranial bleed. If you see 1000 patients and neglect to order head CTs on all of them, guess what- you are being served papers and going to trial, taking you out of your practice for weeks and getting your name posted on your state medical board's malpractice website. Docs order millions of unnecessary expensive tests yearly due to the threat of malpractice. Personally, I benefit financially from these tests... But it is a shame and I would rather make less money and have less burden placed on payors and ultimately those who have to work to pay these medical bills.
  12. #152  
    I would like to see some evidence that the standard of care is dramatically different to countries with low malpractice suit rates.

    I'm not convinced increased diagnostics are necessarily defensive compared to an actual increase in standard of care. Every headache does not require a head CT, but I think you know that.

    We've had pretty strict tort reform here in Texas, yet I've not noticed any change in standard of care or reduction of supposedly defensive healthcare.
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       #153  
    Quote Originally Posted by Iago View Post
    -who really makes the decision? Do you? Your doctor? NO - the Insurance companies and its hacks.
    Well which is it? Either you want someone looking over the shoulder of the doctor and making decisions on whats wasteful or not, or you don't. Make a stand man! Make a stand!
    The Law of Logical Argument: Anything is possible if you don't know what you are talking about.
  14. JC Strat's Avatar
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    #154  
    Quote Originally Posted by Iago View Post
    Texas had tort reform a few years back. People that were behind the push, sold it as a much need reform that would lower costs. And Texans being well...Texans hahaha (trying to be diplomatic) fell for it hook line and sinker. Costs never came down, people with legitimate claims can't find attorneys to help them move forward because the damage caps make it a loosing proposition. So even when you win or could win, you loose. Good old frontier justice. I've read even Defense attorneys are closing up shop, since suits are dramatically down. It seems that committing malpractice is just the cost of doing business.
    Iago your words are as trustworthy as your Shakespearian namesake. Way to put down texans!

    Texas tort reform has significantly increased access to health care in texas by bringing in great numbers of physicians. What trial lawyers and their cronies try to show is that costs in texas have not been decreasing year to year since prop 12 passed in 2003. What they desperately don't want publicized is that, relative to other states and their population growth, texas costs are being contained well. Physicians are willing to see more complex patients instead of referring them off to specialists, improving access to care. Malpractice patients still get all expenses paid such as lost work and medical expenses present and future, but the cap on noneconomic "pain and suffering" was places at a quarter of a million dollars. Well this small change is not enough to fund the extravagant lifestyles of fatcat malpractice attorneys who strongly prefer the jackpot no-limits awards that fund their lucrative profession.

    Suddenly when there is a cap on lawyer fees, the "altruistic" trial attorneys are no longer so interested in pursuing frivolous cases... What a surprise.

    Unfortunately, instead of using common sense, for some reason the left has lined up with trial lawyers on this issue. We will not contain medical costs without some form of tort reform. Doctors live in terrible and justified fear of lawsuits as the see many of the best physicians they know sued. The test-happy, defensive medicine that results dramatically drives up costs.
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    #155  
    Quote Originally Posted by hypocaffeinemia View Post
    Every headache does not require a head CT, but I think you know that.
    It depends on if you are applying a medical standard or a legal standard. I guarantee that if you were to "fail" to get a head ct on a patient who sustained injury that might have been prevented, I can find physicians in your area who will testify against you (for anice hourly rate, of course). If only you had gotten that head ct, this terrible injury could have been prevented. Shame on you, doctor.

    We look at the evidence and play the odds on every patient we see. Rarely, the odds will be against us and our diagnosis will be wrong. It will look like a duck and quack like a duck and end up being s goose. If the punishment is harsh enough, we will treat it like a duck or a goose or likely waterfowl but possibly some other avian or maybe a bat, and will run all of the tests necessary to rule out all of the above. Your words are reasonble but they will not be reasoble in court. They will mislead and go for the jugular. No-limit on "pain" damages incentivizes jackpot lawsuits and defensive medicine... It is such a logical progression that I am surprised that you disagree.
  16. #156  
    Quote Originally Posted by JC Strat View Post
    It depends on if you are applying a medical standard or a legal standard. I guarantee that if you were to "fail" to get a head ct on a patient who sustained injury that might have been prevented, I can find physicians in your area who will testify against you (for anice hourly rate, of course). If only you had gotten that head ct, this terrible injury could have been prevented. Shame on you, doctor.

    We look at the evidence and play the odds on every patient we see. Rarely, the odds will be against us and our diagnosis will be wrong. It will look like a duck and quack like a duck and end up being s goose. If the punishment is harsh enough, we will treat it like a duck or a goose or likely waterfowl but possibly some other avian or maybe a bat, and will run all of the tests necessary to rule out all of the above. Your words are reasonble but they will not be reasoble in court. They will mislead and go for the jugular. No-limit on "pain" damages incentivizes jackpot lawsuits and defensive medicine... It is such a logical progression that I am surprised that you disagree.
    I disagree because I've been a witness to multiple malpractice suits and it just doesn't work that way. I mean, there's no doubt the plaintiff's expert witness might try that tact, but it doesn't necessarily hold water unless the standard of care is in his or her favor.

    And as has been previously mentioned, Texas has undergone significant tort reform. Yet, costs remain as a high as anywhere.
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    #157  
    Quote Originally Posted by hypocaffeinemia View Post
    I disagree because I've been a witness to multiple malpractice suits and it just doesn't work that way. I mean, there's no doubt the plaintiff's expert witness might try that tact, but it doesn't necessarily hold water unless the standard of care is in his or her favor.

    And as has been previously mentioned, Texas has undergone significant tort reform. Yet, costs remain as a high as anywhere.
    Well, I have never been a paid expert witness. I have been a material (unpaid) witness in a trial before. They tend to be like the John Ritter case, where the cardiologist who saw actor John Ritter in the ED was sued for not ordering a chest ct to rule out aortic dissection in the setting of classic heart attack symptoms. Of course the plaintiff attorney found numerous experts to testify that the cardiologist violated the standard of care, for $450 per four plus fees.

    Yes the cardiologist was eventually found not liable; after being crucufued in the press, taking weeks of unpaid time to defend himself, and after hundreds of thousands if not millions of dollars in wasted litigations costs. But the real cost is that every physician who hears of this case will now have a significantly lower threshold for ordering a chest ct in the setting of angina. Writing an order that costs the physician nothing can stave off accusations of incompetence and the threat of financial ruin. Most doctors cannot resist this, and those that do find themselves at risk of violating the "new" standard of care - because everyone else is ordering the test.

    Defensive medicine makes me a lot of money. I have every financial incentive to see it continue. But I see it all day and it is highly disappointing.

    Malpractice insurance rates in my state of North Carolina rose 67% in 2007. In one year. Those costs are passed on to patients. But they pale in comparison to the cost of defensive medicine. Malpractice insurance rates in texas have been declining. The number of per capita physicians in texas has risen dramatically compared to other states, resulting in improved access to care, particularly in underserved areas. Because of the quarter-million limit on "pain" claims, texas physicians no longer practice with the Sword of Damocles suspended above them. True malpractice cases still go through, and the medical profession is policed by the medical board. This is a good model for the rest of the nation. Arguing againt the quarter-million cap on arbitrary "pain" claims marks you as someone with a vested interest in maintaining the status quo in the health system. I also have a financial interest in seeing defensive medicine flourish, but I know it is wrong when I see it.
  18. #158  
    Quote Originally Posted by bclinger View Post
    I disagree. Why should I go to a doctor, take his/her time when nothing is wrong? Does not make sense at all.
    Ok, I'll give you a real world example. Uninsured person has a cold, which gets worse and worse and develops into pneumonia which they don't treat until it becomes so acute they HAVE to seek treatment. Not having insurance and allowing the symptoms to become so severe, the person presents to an ER for treatment.

    No insurance, No Money, but the ER has to treat them.

    Now who is going to absorb that cost? All of us. The hospital will pass it on to the insured through higher fees. ALL of which could have been avoided by making sure everyone has PREVENTATIVE healthcare available.

    This scenario is repeated constantly in the U.S.daily. Ask anyone that works in an ER.
  19. #159  
    Quote Originally Posted by Toby View Post
    You do realize that there are places where fire fighters are not government employees, right? Equipment, training, and maintenance are paid for by a taxing district (usually property-tax based), and the actual fire fighters are volunteers who live in the community.
    You do realize there are places in the U.S. that hire a doctor to serve their communities healthcare needs?

    Crazy concept!
  20. #160  
    Quote Originally Posted by zhackwyatt View Post
    Wait what? By encouraging people to eat better, drink less, smoke less, and exercise more will lead to more problems in the ER?
    All of what you just stated is part of what's known as "preventative care". And having a healthcare provider is part of getting that healthy information.

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