But if you think it’s good enough for your family, shouldn’t our health insurance be good enough for the rest of America?

Way too reality-based.

“That trick never works!”

Why did O say 30 million were without med insurance? I thought the figure was 47 million.

I pointed out yesterday;

I see no reason the ama doesn’t self insure, that would be a win win for everyone, they would self police and their profit model would be lower then an insurances companies, forcing competition and performance from both the doctor and the insurance system

I was informed that major institutes DO self insure, well then, the ama is an institution, they should insure themselves

as far as law suites, for the most part they save us money, forcing doctors to be diligent, forcing drug companies into being responsible

I don’t know why more politicians don’t make that point

you guys know, it’s a losing strategy to have republicans vote down their own health care

they make enough and will get far more insurance contributions then health care will cost them if they vote down their own insurance

They’ll never do it — it’s a smart play.

Lotta WATB at the summit. Democracynow just played a clip of Alexander moaning that the country was too big & too complicated. Geez. If your job is beyond your capability level, quit already.

Durbin lickened our troops to Nazis, voted against defunding ACORN, and after a meeting with Paulson and Bernanke divested his funds in the stock market. This was just before the crash.

I’m just saying, pick your heros with care.

“But if you think it’s good enough for your family, shouldn’t our health insurance be good enough for the rest of America? That’s what it gets down to. Why have this double standard?”

Same goes for your base pay! At $165,200.

If you think it’s good enough for your family, shouldn’t our minimum wage be good enough for the rest of America? Why have this double standard?

ItS so clear.

Mornin’, BT, pups

The Rethugs didn’t do themselves any favours yesterday.

Get your facts straight before you shoot off your mouth.

Firstly, less than one in five doctors belong to the AMA. They haven’t spoken for physicians since the late sixties.

Secondly, lawsuits COST money; they do not SAVE money. No physician has the slightest interest in a) not being accountable or b) hurting patients, but they make mistakes, just like YOU do. Medicine is complex – more art than science, and requires making judgment calls every day – some of which will be wrong. The question is, do you compensate patients for medical mistakes or not? All doctors I know believe you do. Having said that, then the question becomes, how? Do you go to a compensation system, an insurance system, or do you keep the current adversarial system where the trial lawyers walk away with the money that should have gone to help the patient?

Doctors and patients are natural allies, not enemies. A no-fault system has done wonders for the divorce industry, auto insurance industry, and others. Do we go to something like that, or do you listen to the trial lawyers who have a vested interest in making us slice each others’ throats?

Warren Buffett said that if you have been in a poker game for a half hour and you still don’t know who’s the patsy, you are the patsy. The next time you get a little time, google up a list of billionaire lawyers and billionaire doctors. You will find many of the former and almost none of the latter, and most of the lawyers will be liability lawyers. Then look in the mirror for the patsy – it’s you – in the final analysis you are paying for it all.

hell yes!

Did the Ds?

I agree. As a retired civil servant, and beneficiary of the Federal Employee Health Benefit program, I can attest that Barrasso’s contention that selection of health savings schemes over insurance policies would be wise, and is done by thousands of civil servants, is utter bullshit. Those who used the health savings options did it in addition to insurance selections, had disposable income, and frequently dropped it the next year, after learning that they lost any unspent annual savings. They used the plans to pay for glasses, dental implants, and other things not covered in their selected insurance plans.

The shit about being wiser consumers is the same old Republican crap that any difficulties people have are their own fault and they will never get smart unless they suffer the consequences. Like Obama pointed out, we’d all be much more careful grocery shoppers if there were no FDA.

you can get your facts straight topdoc

it doesn’t matter how many docs are in the AMA, they are still an institution who can insure themselves

doctors and patients should indeed be partners however you really don’t believe that do you

there is no doubt, law suits save the populace money, this you can bet your license on

if not for medical lawsuits they wouldn’t give a flying hoot if they did something wrong, they would do things according to their own protocol rather then accepted protocol

now to doc, why don’t you try a different attitude, your’s shows your bedside manner and I really don’t think with a bed side manner like that you are any partner of any of your patients

I listened to NPR on the drive home last night and the commentary had a distinct Republican lean. DeCamp of MI was interviewed and most if not all of the sound bites were by Republicans. The frames and memes were distinctly right wing.

If you think it’s a socialist plot and it’s wrong, for goodness sakes drop out of the Federal Employees Health Benefit Program. But if you think it’s good enough for your family, shouldn’t our health insurance be good enough for the rest of America? That’s what it gets down to. Why have this double standard?

The whole fucking health care “reform” debate captured as eloquently as it is ever likely to be.

But again, it is not just the GOP this applies to, is it?

Is not the Democratic leadership in both the Congress and the White House also complicit in this healthcare industrial complex charade?

This is not a Democrat v. Republican issue. This is a Wall Street v. Main Street issue.

In fact, if the Democrats do manage to pass health care “reform” I suspect it will have less to do with the puny public option and more to do with the insurance industry chaffing, champing and/or chomping at the bit for those millions and millions of mandated insurance purchasers.

Also, why not extent this critique. If the folks in Congress and the White House are so gung ho about the “war on terror” why are they and their family members not volunteering in droves to go over there and fight it?

This isn’t just about hypocrisy either; it is snapshot of the ruling class itself.

But all too often the folks least apprised of [or opposed to] this are the very folks being shit on by the rich and powerful who own the stacked decks they distribute to “the voters” every election cycle.

No, but they’re weren’t as pitiful as the Rethugs.

ok to doc jim, now that addressing your incredibly unprofessional bedside manner is out of the way, let’s have a real discussion;

I agree some settlements are out of hand and give a measure that’s not justifiable

however you have to agree, some doctors shouldn’t be practicing and all doctors make mistakes

the the detriment of patients who can sometims never recover their previousl health

and sometimes there is indeed pain and suffering that cannot be measured, yet sometimes pain and suffering is overblown and over compensated

so I am pretty sure we agree on just about everything I just posted

I have no problem with a legitimate tort reform that keeps the medical profession from being irresponsible however my tort reform would look completely differant then the republican tort reform

rather then awarding the patient with a settlement that does not represent reality I would set a fund for those who also suffered but could not win their settllment, or some other fund that benefit health and health care costs

that’s the kind of tort reform I support, I know as just about everyone does there is fraud in some lawsuits, you know as just about everyone does, some law suits are not settled to the patients benefit at all

My impression too.

My Q about tort reform is: would you voluntarily accept the injury in exchange for the amount of the award?

States with caps on awards don’t have lower medical costs.

In fact, if the Democrats do manage to pass health care “reform” I suspect it will have less to do with the puny public option and more to do with the insurance industry chaffing, champing and/or chomping at the bit for those millions and millions of mandated insurance purchasers.

yup

the bill the president got rammed through the senate was a corporate gift, I am amazed a few republicans weren’t instructed to “fall on the sword” and vote for it “in the interest of bi particentism”

then the bill the republicans did submit was surprisingly similar to the senate versio

I agree with your point echan

and I know that contrary to “top doc’s” opinion, tort reform does not save money and law suits do save money

however a real social or ecnonomic progressive never put together a real tort reform package

I know you’ve seen some abuse of the court system, we all have, is that obuse profound enough to affect cost?…I don’t think so but never the less a progressive proposal for tort reform might be well placed

I think you yourself might be able to put together such a proposal that might stem some fraud yet protect us from irresponsible medical incidents

off to work, will read your response later this morning

The Rs will get elected by saying no to everything. The insurance corps may be counting on that and hoping to get a better deal in the future.

GDP revised up to 5.9% on slower inventory cuts

The Republicans don’t care about people who don’t make enough money to afford health care because to them, the amount of money one makes is the only standard by which they judge people, their blather about “morals” and “family values” notwithstanding.

Well played indeed. The fact that Obama is even considering tort reform, while at the same time referring to the public option in past tense is in itself a telling point.

I’d add that there was really only one perspective locked out of the summit, and that was the liberal voice. Thank God Durbin spoke up, eloquently.

But also, listen to Obama’s response to Durbin. Durbin was the very last speaker in his segment, and Obama’s terse, one word reply was troubling.

Obama “troubling.” Seems like a mild & polite way to speak about him.

BT,

Thank you from the bottom of my heart for posting this. I sit here in tears.

Durbin’s words moved me to tears. To. Tears.

Jane, play this over and over. Jane, get this played in full on as many venues as possible. And as many times here today.

Then, Mr. President, do not even worry about moving forward boldly with what progressives have been fighting for in regards to health care.

But I have to tell you, Mr. President, Durbin should consider running for the highest office if you cannot do this right. I believe that he could do health care correctly after that speech.

Boehner. I am from Ohio. I have two words for you. Zip it.

The Rethugs, and the corporations, want all forms of liability removed. Monsanto has shown them the way. An organic farmer cannot sue Monsanto because their frankenpollen contaminated the farmer’s crops; Monsanto will sue that same farmer for patent infringement, however, because traces of their frankendna showed up in the guy’s produce.

I missed Durbin yesterday and Obama’s response because I had to go to work. The clip above did not play Obama’s response. What was the “one word”?

Last time I bothered to show up for jury duty, I wrote on my form that, since money & power determine the outcome all too often, I would automatically vote against the party with the most power & money. As it was federal court, that meant I would vote against the govt. Needless to say I didn’t get selected for a jury but they made me go thru voir dire 4 times before I was excused.

I watched yesterdays summit , I didn’t hear anything new or different from the Rs.
I don’t know why Obama even bothered , the Rs have no interest in health reform.
Let’s just pass the bill with a PO through reconciliation ,and get it over with.
What the are they waiting for ?

Republicans keep telling the American people how they feel and think

I would be really surprised if there had been absolutely no prior understanding between Democratic Party participants and the White House as to what points of view were going to be expressed. No one played a greater role in convincing Obama to run for the White House than Dick Durbin.

If I were moderating, and wanted to give the appearance of open mindedness, I wouldn’t vehemently endorse every comment by people on my side. Obama made his own responses to Republicans, which seemed to me to have been aimed at educating those who have only followed the issues vaguely and have latched on to Republican fear mongering.

This idea is something that grew out of the Reagan years , the decade of greed some have called it.
It does not matter how you make your money as long as you make it.
And we base a persons worth as a member of the human race on how much money that person has ,with no consideration of how they made it.

Off to swim in the great capitalist cesspool.

US KIA Irak: 4,379

US KIA Afghanistan: 1,007 – includes those who were killed, or died as a result of wounds, in and around Afghanistan. For a more detailed breakdown go to icasualties.

Iraki and Afghan casualties: estimates vary to over 1.5M

US MBS 2010: 6,944

Be good to yourselves, and all other living things

Namaste

ok to doc jim, now that addressing your incredibly unprofessional bedside manner is out of the way, let’s have a real discussion;

>Bedside manner is irrelevant; I’m not talking to a patient; I’m talking to YOU.

I agree some settlements are out of hand and give a measure that’s not justifiable

however you have to agree, some doctors shouldn’t be practicing and all doctors make mistakes

>Some engineers, cops, journalists should not be practicing; your point is?

the the detriment of patients who can sometims never recover their previousl health

>I said that; everybody makes mistakes. Some serious. That was not the point.

and sometimes there is indeed pain and suffering that cannot be measured, yet sometimes pain and suffering is overblown and over compensated

>I’m sorry; I really can’t follow you.

so I am pretty sure we agree on just about everything I just posted

>Um, no.

I have no problem with a legitimate tort reform that keeps the medical profession from being irresponsible however my tort reform would look completely differant then the republican tort reform

>Do tell. Would you care to elaborate? Specifics, please.

rather then awarding the patient with a settlement that does not represent reality I would set a fund for those who also suffered but could not win their settllment, or some other fund that benefit health and health care costs

that’s the kind of tort reform I support, I know as just about everyone does there is fraud in some lawsuits, you know as just about everyone does, some law suits are not settled to the patients benefit at all

>I really don’t know where you’re going here. I don’t know what you mean by “reality.” “suffered, but can’t win their settlement”???? No, there is almost no fraud in lawsuits; some may not be justified, but they are not illegal.

I’m sorry; I can’t even respond any more; it’s like trying to discuss politics with Sarah Palin. Look, take some time, talk to people who are involved in medicine, law – patients who have been injured. Then pull your thoughts together in a coherent way and try again.

“A no-fault system has done wonders for the divorce industry, auto insurance industry, and others.”

I am not a car, nor a marriage, or other. I am a human being, and you, sir, will respect me as such.

If you fuck me up in your negligence or otherwise, then you should and will pay, and there is no room for a “no-fault system” in this regard, TopDoc. I will make you pay and you will pay handsomely. I will not accept you making mistakes that hinder or cost peoples’ lives because you wish to make medical practice an “artform”, as you so elequently stated.

TopDoc says: “Warren Buffett said that if you have been in a poker game for a half hour and you still don’t know who’s the patsy, you are the patsy.”

Do you know who the patsy is? Who’s the patsy, TopDoc? Is it the insurers?

A portion of it dates back to Calvinism and the Puritan work ethic. If you’re not prospering, it’s because your paying for some moral defect.

New post up top…

30 million seems to be the new 40 million which they were repeating six months ago.

#33 Mentioned that several times yesterday. That was the Republicans theme song along with “go back to the beginning” and “wipe the slate clean” “rip up those papers” and “let’s start over.

As I looked through my notes after the summit I was amazed that not one of the talking heads last night picked up on OBama’s statement at the end about “SIGNIFICANT MOVEMENT” by the Republicans. He threw that line in with the you have 2-6 weeks before we start moving forward to reach the goal.

How many chances have the Republicans been given to put their suggestions, changes in before we witness the touch down for the American people?

When OR staff have to mark legs or arms so the surgeon knows which to operate on I’d say that surgeon has way too many patients. Rep Murtha’s death was caused by a medical mistake. If somebody fucks me up, doctor, drunk driver, whatever, they are liable.

Same thing this morning on Morning Edition, lots of Republican sound bites.

Reading this post brought back a memory of something I had almost forgotten, about how it was before the Federal Health Benefits programme was in place. My father worked in a federal shipyard, which means my mother still benefits from it. But it wasn’t always in place. In the late 40′s, when I was 6 or 7, my brother and I were playing in the street, and I was hit by a car, and (luckily in the event) suffered a compound fracture in my thigh. The driver had no insurance, and as I was hospitalized for at least 10 days, the bill (even in 1948) came to around $2,000, which was roughly my father’s annual salary. Unlike today, he didn’t have to pay up all at once, but for the next eight years we lived on the margin, with no fire insurance, no car, and pretty basic food. That’s how it was before the insurance programme, and that’s how it still is for tens of millions of people today. I forgot.

Yes ,so true !
I live in the heart of Puritan Country , central Mass.,and I can say ,from the attitudes of some of the people around here Puritanism still exists ! LOL

So that’s what’s wrong with the Republicans .
They think poor people are poor, because of some moral shortcomings .

What was Mr. Bipartisan’s one word response to Dick Durban?

And then remembered.

Thanks for sharing.

I agree with you on this, there’s no reason for you to respond anymore, you can’t even correlate a bedside manner to what migh have been civilized discussion, as you prove not only once but even after it’s pointed out to you…great comprehension skills you have there “top” doc

anyway, none of your statements addressed anything I said in the first place, responding more would simply indicate your (obviously) subjective point of view in spite of the facts before your very eyes

time to move on “top doc”, your reference to Sarah palin is a look in your own mirror

Do ya think the main stream media will play Dick Durbin’s speech – I seriously doubt it – they’ll just continue with the misinformation of Repug’s talking points.

Exactly. That is my memory of our family during my childhood, during which my dad paid off several operations my mother had. He told me that, when I was born in a Catholic Hospital, they were not going to let him check my mother and I out of the hospital unless he paid cash. He told them that they would have to keep us, then, until he was able to pay it out. They reluctantly agreed to let us out on bail.

We’re in favor of defunding ACORN now?

Do ya think the main stream media will play Dick Durbin’s speech

They may pick up on the question of whether the Senate bill, as amended by Obama, would actually deliver for an affordable premium the kind of health insurance that FEHB provides to federal workers.

I’m just saying, pick your heros with care.

I don’t disagree, but let’s not get into purity tests. We disparage the conservatives when they do that.

No physician has the slightest interest in a) not being accountable or b) hurting patients, but they make mistakes.

Bullshit. There are some doctors that have a very big interest in not being accountable, and frankly, this crap about not suing doctors is also bullshit. Families who suffer because of the doctor’s negligence should get all the compensation the jury–a jury of his peers–will allow. And the insurance company that has to pay out (with the best lawyers around) can go to hell. The doctor who was negligent can pay higher premiums and deal with the insurance company. Screw them instead of the grieving family.
My brother’s funeral was yesterday after a long, lingering, horrible illness, and I am so glad he had good insurance and the doctors did everything they could.
Tort reform, my left cheek. It’s just the insurance company lobbyists fighting to make sure the insurance corporation doesn’t have to pay more than $250,000 and doctors don’t not having to worry about their premiums going up.

Dagnabit,

Now we’ll never know who TopDoc thought the patsy was. I was sooooo ready for his explanation. Oh well…

So much for the tort reform argument.

And hey, many actual doctors out there understand that health insurance reform is needed, and that a public option is a good way to go.

One fifth of one percent of healthcare costs

That should have been the end of the discussion.

Basically there’s no real savings here.

Americans pay twice the costs of other industrialized nations for medical care and receive no better outcomes. We certainly do have parasites in our healthcare system but the patients, lawyers, doctors and nurses are not the parasites.

For parasites in the healthcare system I’d look more toward insurance and finance.

As a member of the other side, I couldn’t agree more. In Cincinnati, we’ve lost many of the brightest in the medical arena who helped make our city world renown for it’s medical innovations and treatment – tired of the incessant lawsuits. As a builder, I got out after 20 years of adding $25,000 to every contract just to cover legal expenses to keep me out of court. As a LEED AP, I am seeing more and more attorneys becoming LEED accredited so they can jump on the ‘lets sue green buildings” bandwagon. LEED APs only design and construct per the rules and regulations as established and imposed by the U.S. Green Building Council. Go sue USBGC, or the clients who can’t control their employees work habits to turn off lights and faucets or turn down the thermostats – or God because the weather doesn’t play to a predescribed model. Although I will continue to teach sustainability, I refuse to be involved with any LEED certified buildings for this very reason.

Tort Reform = Racism

Mark. My. Words.

I couldn’t agree more. In Cincinnati, we’ve lost many of the brightest in the medical arena who helped make our city world renown for it’s medical innovations and treatment – tired of the incessant lawsuits.

1. Well, if they were so “bright,” why were they getting sued?
2. They couldn’t have been very dedicated doctors.
3. I don’t believe bright, dedicated doctors are quitting because of lawsuits. Bad doctors, maybe.
Look, some doctors cram patients through their offices and operating rooms like it’s McDonald’s during lunch hour. What’s going to keep them honest and thorough? If there’s a limit on lawsuits, they aren’t going to worry about missing the small stuff. Doctors are human, and many are greedy. people have a right to sue for shoddy work, and that goes beyond doctors to the building trades and any other service. You put yourself out there and offer your services, do it right or don’t do it at all.

As far as I could tell, there was zero discussion yesterday about reining in health care costs – not insurance costs, but the actual cost of doctor bills, hospital bills, medical device costs, costs of high-tech tests and lab work – all those costs that cause insurance rates to skyrocket as well as the costs to the patient of co-pays, deductables and other out-of-pocket expenses. Without something done about the actual costs of providing health care (and spare me the discussion about “tort reform”), costs are going to continue to rise – whether those costs are covered by for-profit insurance, non-profit insurance, medical savings accounts or a government program. Fee-for-service is a racket, and the sooner something is done about that payment mechanism, the sooner we’ll see health care costs come down (or at least not rise at the rate it is currently).

HEALTH CARE SUMMIT

Republicans and Democrats met yesterday at Blair House and discussed health care reform for over 7 hours. I watched most of it, which I guess shows that I have no life. All those hours of politicians with their talking points – but it was surprisingly interesting.

Republicans were respectful in their opposition to the health care reform bill even though their main point was the Congress should start over- from scratch after almost a year of legislative work. Then, they also asked that the Democrats forswear the use a majority vote to pass the bill. This strategy seems like the Bush diplomacy tactic of demanding that the other country give up its positions before we’ll negotiate with it.

Again and again, the Republicans said that the American people oppose this huge bill. Some polls do show this, but, no wonder, after Republicans and Teabaggers havemisled the public, with talkof government takeover and death panels.

The Democrats were moderate in defending the proposed bills, with many pointing out that the legislation includes many provisions that Republicans had favored. President Obama presided, sometimes conceding value in a Republican point, sometimes explaining part of the bill and its rationale, sometimes correcting Republican misstatements. At all times, he demonstrated command of the issues and command of the room.

The meeting was a positive event and somehat instructive. No significant positions were changed; the Republicans really offered nothin to cover most of the uninsured and rally want just to kill the bill. The Democrats showed no inclination to include the logical and clearly popular public option, but seemed resolved to get this job done.

Interestingly, after months of Republicans complaints that Obama did not live up to his campaign promise of transparent negotiations broadcast by C-Span, this event was not covered by C-Span.

homer http://www.altara.blogspot.com

A no-fault system hasn’t done shit for the auto-insurance buyer, and if you are one (as you likely are) then you know you’re full of crap.

Racism:

That’s right, I said it. If THEY want to fuck you up, then THEY do not want to be held responsible for it (especially in monetary terms). See how that works?

Fuck you, fascism.

Look, we have to talk carefully about tort reform. Acting as though unlimited pain and suffering is some boon to the “little guy” is a crock. In fact, the no-cap on P&S payouts is part of the reason that it’s so hard to find a general practitioner these days; once you factor in the malpractice insurance, it simply doesn’t make sense to be a generalist. As a result, we’re ending up with more and more plastic surgeons and fewer and fewer GP’s. And mark my words, at least a portion of genuine medical error is due to doctors having to see caseloads of sometimes a hundred or so patients a day. Could you juggle a hundred complex cases per day without making a single mistake?

On the flip side, nobody wants to let the truly horrible docs off the hook. Those who are sloppy, those who refuse to keep their knowledge and skills up to date, those who due to fraud or true negligence harm patients, they must have repercussions to their actions. But is medical malpractice law and unlimited payouts really the best solution we can come up with? How about raising the standard of proof so that unlimited payouts require proving true negligence or fraudulent intent — IE proving fault, not just a mistake — before we force the doc to write a check for a million dollars?

“topdocjim” was, yes, a little Republican in his presentation of the case for tort reform. And yes, we need to make sure that the true purpose of malpractice law — to provide a powerful incentive for doctors to do good work — remains. But simply allowing trial lawyers to consider doctors as giant ATM’s every time the patient isn’t happy with the look of their nose job, is killing the practice of medicine.

“topdocjim” is right about one thing: doctors and patients SHOULD be natural allies. The trial lawyer industry has very successfully injected into our minds the image of the irresponsible, reckless, arrogant doctor, and the reality is that this is at best a tiny, tiny fraction of the doctors in the world (and truth be told, these doctors tend not to flourish as word gets around of their assholishness). The real enemies are not the doctors! The enemies aren’t even completely the trial lawyers — at least, not the ethical ones who don’t just chase frivolous lawsuit dollars but actually defend the folks who are truly victims. The closes thing to a natural enemy we have is the insurance industry, so wasting our energy lambasting doctors who, for the most part, are just trying to do as much good as they can in an increasingly hostile system is a losing proposition.

TLDR: we DO need medical tort reform. Listen to Durbin’s words; he does not say it isn’t needed. What he says is (1) we should be careful about the reform to make sure that those who are truly victims (as opposed to those with an axe to grind) can still find relief, and (2) why on earth are Republicans bringing up tort reform as a silver bullet, when it’s 1/5 of one percent of the total budget for health care?

topdoc, we have many terrific physicians at FDL.

Your opening statement about most physicians not belonging to the AMA, while technically accurate, was disingenuous, and you know it. A lot of physicians pay into their specialty which then coordinates strategy with the AMA. AFAIK, general practitioners, aka family care, aka, primary care, and internists all understand that the health insurance cartel does no longer provides any value to patients. Physicians, nurses, hospitals, Big Pharma, medical device makers, and allied health professionals do. We need the specialists to climb on board with single payer.

Are you a specialist?

AFAIK, the AMA through the Liasion Committee on Medical School Education keeps the supply of physicians short, so as to maintain a floor underneath your wages. If you disagree with the LCMSE on this, please by all means let us know.

As far as I know Medicare subsidize your medical school education.

Physicians have to do a better job of policing their own. If you did that, we would not need to file law suits.

topdoc, one of the last strongholds of the health insurance cartel is statements like this from Tom Colburn (Wingnut OK)

“Medicare has at least $80 billion worth of fraud a year. That’s a full 20 percent of every dollar that’s spent on Medicare goes to fraud.”

How does all the fraud get committed without the physician knowing? I am very concerned that there are a lot of kickbacks.

topdoc, I look forward to your responses.

Psychiatrists, Children and Drug Industry’s Role

Prosecutors seek records in Medtronic fraud probe: The company faces a subpoena in a federal fraud investigation involving surgeon and former consultant Dr. Timothy Kuklo.

Not all physicians are white collar thugs. Unfortunately, without trial lawyers, the situation would be even worse than it already is.

Thank you for a balanced statement.

Do you have a link to something that shows the success of trial lawyers in medical malpractice? AFAIK, it is very difficult to find an attorney to file against a physician. The odds of winning in court and not being overturned, are so small, they do not want the risk. As a consequence, medical practice firms have no interest in settling.

topdoc, physicians are among the absolute smartest people in America, as far as test scores and grades are concerned.

Can you please explain why Medical School education is so expensive? I have to assume that there is immense graft, because it should not be so expensive to educate the best and the brightest.

I’m sorry – I don’t want to get into a long-winded discussion of tort reform here. People say it is complex – it is not complex, but it is a very broad area and you can’t summarize all the points in this kind of space. What I WOULD say is that just repeating old saws about how lawyers keep the doctors honest, docs are defrauding Medicare and whatever other you just want to believe, without checking your facts, are the very kinds of things the trial lawyers depend on while the pick YOUR pockets. When my malpractice insurance goes up, I just pass it on to you; I don’t pay it. You are the patsy in this game, not I; wise up.

Let me address a couple of points: firstly, you can’t have it both ways – all doctors being GPs AND have advanced medicine. When my cousin graduated from medical school in the thirties, he was licensed in medicine and surgery and could do it all – because “it all” wasn’t much. I am a subspecialist and I can’t keep up with even my narrow field, because medicine now knows so much, and is learning all the time. People hearken to the “good old days” of all generalists; yep, we docs can all go into general practice, but the advanced medicine we all want won’t be there, because nobody can know it all or even a small percentage. So when you need a heart transplant, it’s simple: you die.

Secondly, why is medical school expensive? It’s not. It is just that while you are studying round the clock in undergrad, taking 30 credit hours – that’s not a typo – in med school, and working 80 hours at slave wages in a seven-year residency, you must have $ to live on, so you take out loans. Those loans have interest and it compounds to amazing levels in those 15 years. So you are fifteen years older, with no assets and huge debt.

Someone always drags out that old chestnut about doctors policing their own. I am on the executive committee at my hospital and believe me, doctors who are not getting the job done are weeded out viciously. Medical licensing boards are very strong in every state about following up complaints. The fact is, however, that everybody makes mistakes, even GREAT doctors. If you don’t want to expose yourself to that, don’t get sick. The lawyers have insinuated themselves in the doctor-patient relationship because, like Willie Sutton, they know that’s where the money is. We need to get them out of that relationship and start putting our efforts toward taking care of patients we hurt.

Sorry, that probably doesn’t fit what you want to hear; but better the uncomfortable truth than the comfortable lie.

The law is clear as to the principle that someone sustaining an injury as a result of negligence of a provider of any service or product ought ot be made whole.

This principle should apply across the board to physicians the same as to anyone else. There is no need to have an extended discussion as to the way the medical profession is teated according to this principle, they should be treated the same as anyone else.

What effect this principle has on health related costs, if any, is totally beside the point. Since the cost that results from medical negligence has to be borne by the provider alone and should have no impact on other aspects of health costs. This is because the crucial element is negligence on the part of the provider and that is totally independent of the expense he accrues in poviding his care.

Where did you get the idea that my premiums go up?

I don’t pay increased premiums; you do. When my premiums go up, my fees go up. You really don’t get how this game is played, do you?

Doctors are all very happy to do whatever is necessary to take care of patients who are injured during medical care; for the most part physicians want to do their jobs, take care of sick people and do the right thing. Being attacked in court, having your competency questioned, having a lawyer paint you as an incompetent hack and attack your very soul does nothing but make doctors long for the day they can retire. A malpractice trial is a demeaning, devastating thing for a physician, who thinks of himself as one of the “good guys.”

This can be solved, but playing patsy to the trial lawyers, parroting their talking points may appeal to your sense of class warfare, but all you are doing is assuring that you will not get the healthcare you need when you are sick.

The one point that’s left out of the malpractice equation is that if a patient gets hurt by a doctor’s negligence they are much more likely to sue with the current insurance system we have because otherwise they are going to pay out of the nose to get that problem fixed or have huge additional medical bills that have to be paid, and the real problems from such negligence might not show up for years. If we had true single payer insurance or a system like in Canada or Great Britain, most patients would have little reason to sue because they know they wouldn’t be shackled with medical costs that would force them into bankruptcy for medical debt for life or continuing medical bills that might last a lifetime and that are often unknown and unpredictable. The unknown and unpredictable isn’t recoverable at all with the system we have in place and sometimes for instance, in an automobile accident, a person doesn’t know what the effects are going to be in 20 years. So I understand people wanting to sue to make sure that they aren’t financially ruined by a slip of the knife (or a car wreck, or whatever).

Malpractice awards would be reduced to practically nothing if we’d adopt a program that allows everyone guaranteed care, except in the case of horrid disfiguring injuries, the loss of a hand, or a foot or a leg or the death of a family wage earner.