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 Universal Health Care 
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RIP Killer
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wjb21ndtown wrote:
Where is the line on what to cover/not cover? IMO expenses and finances should dictate that... I would say "as much as possible" without being overly burdensome, and AT LEAST as much as cost savings requires.


Bingo, I think that is a minimum... Who pays for all these expensive emergency room visits by those who cannot pay, you and I do. There is no question that a family practice could handle such things in a preventative manner that would result in less expensive care down the road.

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July 20th, 2009, 5:54 pm
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I don't think that everyone is entitled to transpants, cancer treatments, etc., but some basic form of care should be afforded to all, and, IMO it would be cheaper to afford them this basic care than to afford them all emergency care that they are getting now. Where is the line on what to cover/not cover? IMO expenses and finances should dictate that... I would say "as much as possible" without being overly burdensome, and AT LEAST as much as cost savings requires.


The argument to cover major things like transplants, cancer treatments, etc. is that these are the things that generally cause major problems in people's lives and lead to bankruptcy, which is the worst case scenario for everyone involved.

Steensn, earlier I thought of two simple examples of why insurance is bad for costs: Lasic eye surgery, and plastic surgery.

In general, medical costs have risen astronomically over the past few years. However, the cost of Lasic and plastic surgeries have not risen, and in fact have fallen significantly. Incidentally, plastic surgery and lasic are virtually never covered by insurance.

Hmm...isn't that interesting? When people have to pay the costs out of their own pocket, the price falls...

If I had to propose a solution it would be the following: the government would provide major medical coverage insurance to everyone. MM covers the big things that generally bankrupt people, and because it doesn't cover chronic and minor issues, its pretty cheap. Additionally, I would give a $1000-$2000 per year medical debit card to people living below the poverty line. All of this would paid for by taxing medical benefits at a rate equal to income, which would drive people away from their insurance and lead to cheaper costs in a true market environment.


July 21st, 2009, 1:16 pm
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So you would outlaw insurance as we see it now? Because in your plan that isn't going away and that certainly is a huge benefit companies offer.

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July 21st, 2009, 1:23 pm
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steensn wrote:
So you would outlaw insurance as we see it now? Because in your plan that isn't going away and that certainly is a huge benefit companies offer.


No, I would tax at a rate equal to income.

See, the only reason employers offer insurance is because its tax exempt.

Let's say I'm an employer and want to give my employee a $30k raise.

I can raise his salary by $30k. If I do that, he won't get a true raise of $30k. He'll have to pay income tax on that, lowering the value below $30k. Also, I, as an employer will have to pay payroll taxes on that raise, making the costs to me, as an employer, more than $30k.

Alternatively, I could give my employee a medical insurance plan worth $30k. There are no payroll taxes, so it doesn't hurt me as an employer, and there are no income taxes, so the employee gets the true value of the insurance plan added to his compensation.

Thus, I would tax medical insurance at a rate equal to income. Many employers/employees would then chose to simply raise the income of their employees rather than provide insurance. Some people would still have coverage, but the amount would fall significantly.


July 21st, 2009, 1:49 pm
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Blueskies wrote:
The argument to cover major things like transplants, cancer treatments, etc. is that these are the things that generally cause major problems in people's lives and lead to bankruptcy, which is the worst case scenario for everyone involved.

Steensn, earlier I thought of two simple examples of why insurance is bad for costs: Lasic eye surgery, and plastic surgery.

In general, medical costs have risen astronomically over the past few years. However, the cost of Lasic and plastic surgeries have not risen, and in fact have fallen significantly. Incidentally, plastic surgery and lasic are virtually never covered by insurance.

Hmm...isn't that interesting? When people have to pay the costs out of their own pocket, the price falls...

If I had to propose a solution it would be the following: the government would provide major medical coverage insurance to everyone. MM covers the big things that generally bankrupt people, and because it doesn't cover chronic and minor issues, its pretty cheap. Additionally, I would give a $1000-$2000 per year medical debit card to people living below the poverty line. All of this would paid for by taxing medical benefits at a rate equal to income, which would drive people away from their insurance and lead to cheaper costs in a true market environment.


The type of people you're talking about covering ARE bankrupt (or damn close to it)... I would contend that the "worst case scenario" is death, but that's just me... But I don't think that we have an affirmative duty to "save" everyone in society.

And again... I'm not a fan of the plan that we're "talking about." I'm 100% against that plan. I cannot stand the govt. insurance plan that is currently being discussed. As a result I don't care much for the "bankruptcy" argument. IMO it is a red harring and side-tracks the discussion. The discussion should be about improvement, and getting heath care for more people without overly burdening the system and society. We CAN do more. We SHOULD do more. And what's worse... We can do MORE for LESS money. That should always be done...

I would advocate implimenting something along the lines of what I asserted earlier (which most people would agree that it is an improvement), see what kind of "savings" there are, and see what kind of costs there are, and build from there.


July 21st, 2009, 7:17 pm
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Mmmm, smells like communism! Pretty soon we'll be lined up around the block waiting for approval to have our teeth cleaned. I bet it will be cheaper just to use the iron fist to knock our teeth out.

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July 22nd, 2009, 3:19 pm
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Mmmm, smells like communism


Thats exactly what universal health caresounds like to me as well.


Ok you guys seem educated (at least smarter than me on the subject) wouldn't cleaning up our legal system lower health care prices? I mean if we can eliminate the idea that simply going to a hospital does not guarentee you life and therefor the right to sue if someone dies. All the Doctors I know pay almost 1/2 of what they make Just to insurance. if you ask me THATS why medical costs are so dang high. that and lack of compatition in the perscrition market.

what do you guys think?

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July 22nd, 2009, 4:59 pm
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regularjoe12 wrote:
Quote:
Mmmm, smells like communism


Thats exactly what universal health caresounds like to me as well.


Ok you guys seem educated (at least smarter than me on the subject) wouldn't cleaning up our legal system lower health care prices? I mean if we can eliminate the idea that simply going to a hospital does not guarentee you life and therefor the right to sue if someone dies. All the Doctors I know pay almost 1/2 of what they make Just to insurance. if you ask me THATS why medical costs are so dang high. that and lack of compatition in the perscrition market.

what do you guys think?


Bingo!

Frivilous lawsuits are one of the big reasons heath care is so high. People sue for absolutly stupid reasons.

Yeah, this whole heathcare issue goin' on right now could be takin care of in much better ways. I really hope we don't go the social heathcare route.


July 22nd, 2009, 5:03 pm
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regularjoe12 wrote:
Thats exactly what universal health caresounds like to me as well.


Ok you guys seem educated (at least smarter than me on the subject) wouldn't cleaning up our legal system lower health care prices? I mean if we can eliminate the idea that simply going to a hospital does not guarentee you life and therefor the right to sue if someone dies. All the Doctors I know pay almost 1/2 of what they make Just to insurance. if you ask me THATS why medical costs are so dang high. that and lack of compatition in the perscrition market.

what do you guys think?


Joe, the problem is that the majority of medical malpractice lawsuits (especially in states like MI) aren't frivilous.

The problem is the medical profession, not the legal system. In our current system is isn't common for doctors or nurses to work 20 hour + shifts, taking nothing but small "naps" on their breaks. Mistakes are bound to happen, and someone should be responsible for those mistakes.

Medical malpractice is a "cost" on the heath care industry (but it is generally the cost of med. mal. insurance, not med. mal. claims that raises the price of heathcare... pure med. malpractice would more put bad doctors out of business than it would increase health care costs, but that isn't feasible either, because then docs would simply go out of business after they messed up), but med. mal. pals in comparison to emergency visits to the hospital room.

Look at it this way... Med. mal. effects private practioners (your family doctors) as much as anyone else and a normal doctors office visit WITHOUT insurance is around $65 as long as they don't have to do any tests (I know that for a fact because I've gone to a few over the last 3 years and I don't have any insurance). A regular hospital visit without health insurance, even a brief visit to the emergency room will cost $200 MINIMALLY, and that's if they simple send you home and tell you that you have a cold.


July 22nd, 2009, 5:53 pm
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wjb21ndtown wrote:
regularjoe12 wrote:
Thats exactly what universal health caresounds like to me as well.


Ok you guys seem educated (at least smarter than me on the subject) wouldn't cleaning up our legal system lower health care prices? I mean if we can eliminate the idea that simply going to a hospital does not guarentee you life and therefor the right to sue if someone dies. All the Doctors I know pay almost 1/2 of what they make Just to insurance. if you ask me THATS why medical costs are so dang high. that and lack of compatition in the perscrition market.

what do you guys think?


Joe, the problem is that the majority of medical malpractice lawsuits (especially in states like MI) aren't frivilous.

The problem is the medical profession, not the legal system. In our current system is isn't common for doctors or nurses to work 20 hour + shifts, taking nothing but small "naps" on their breaks. Mistakes are bound to happen, and someone should be responsible for those mistakes.

Medical malpractice is a "cost" on the heath care industry (but it is generally the cost of med. mal. insurance, not med. mal. claims that raises the price of heathcare... pure med. malpractice would more put bad doctors out of business than it would increase health care costs, but that isn't feasible either, because then docs would simply go out of business after they messed up), but med. mal. pals in comparison to emergency visits to the hospital room.

Look at it this way... Med. mal. effects private practioners (your family doctors) as much as anyone else and a normal doctors office visit WITHOUT insurance is around $65 as long as they don't have to do any tests (I know that for a fact because I've gone to a few over the last 3 years and I don't have any insurance). A regular hospital visit without health insurance, even a brief visit to the emergency room will cost $200 MINIMALLY, and that's if they simple send you home and tell you that you have a cold.



wjb, while I understand what you are saying, and agree with much of it, part of the issue IS the legal system. Mistakes are going to be made, that much is certain, when humans are involved. I don't believe that any individual, no matter how educated they are, should be held accountable for human error, regardless of the enormity of the outcome. The question is, what are the circumstances surrounding the error? The point you bring about those doctors in residency being forced to work extreme hours is a valid one. It is the HOSPITALS that are at fault for that, and the doctors should be cleared of any wrongdoing, unless it can be proven that their actions were reckless and/or willfully negligent, in which case the hospital should be cleared.

But part of the issue is that a jury or judge could be asked to put a value on human life. And while that life is priceless, too often the judicial value is just outrageous. If a doctor makes a mistake in the operating room and it forces a person to live without a kidney, or let's say they lose a limb, do they really deserve millions of dollars for that? Many times, that person wouldn't have earned as much as they have been awarded in ten lifetimes. Pain and suffering? Everybody experiences pain and everyone suffers in their own way, but not everybody gets a check for it.

Another issue is insurance companies. In my opinion, the insurance INDUSTRY, as a whole, should be a not-for-profit business. Insurance companies have more money than anyone, and that isn't how it should be. I personally think that the industry should be completely overhauled. If this administration is going to put their nose into various businesses, this is the one they need to fix.

My mother used to work for a doctor. He was good, a general surgeon, never had any legal issues. Then one day he is named is a malpractice suit. The patient was seen by this doctor on the initial visit to the emergency room of a hospital, where the doctor made a diagnosis, prescribed medication AND INSTRUCTED THE PARENTS OF THE PATIENT TO SEE THEIR FAMILY DOCTOR if the condition persisted. Well, the condition did persist, they never filled the prescription and they didn't follow up with the family doctor. The original diagnosis was that the child had flu like symptons, it was that time of the year......made sense. Turns out it was something else, and the parents didn't bring the child back to the hospital until the following week. The doctor in question only saw that child the one time. Unfortunately, through the inactions of the parents, the child suffered brain damage because he had some other virus, THAT LEFT UNATTENDED WOULD CAUSE LONG TERM ISSUES. The parents, not the medical community, were at fault. However, this doctor was named in a malpractice lawsuit, wrongfully, and his malpractice insurance DOUBLED. He sued the family, the lawyer and the Detroit News for defamation of character and slander, since he really SHOULD NOT have been so named. He settled with the News, won against the lawyer but the family was cleared of any wrong doing in the defamation case. Despite that, his malpractice insurance did not return to his original premiums. Though they reduced it from the doubled premium, he was still forced to pay about 20% higher, just for being falsely named in a lawsuit.

The family won their case against the hospital.....and I wonder aloud how. They are to blame for their lack of action, but too often when a group of people (jury) see someone like themselves fighting the "establishment", they too often favor the "victims" even if the "establishment" clearly didn't make any mistakes. I see it all the time in lawsuits against car companies.

The American judicial system is EXTREMELY flawed in this respect. I suspect, that as a person studying to be a lawyer, you will disagree. But like it or not, that is the absolute truth.


July 23rd, 2009, 8:40 am
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m2karateman wrote:
wjb, while I understand what you are saying, and agree with much of it, part of the issue IS the legal system. Mistakes are going to be made, that much is certain, when humans are involved. I don't believe that any individual, no matter how educated they are, should be held accountable for human error, regardless of the enormity of the outcome. The question is, what are the circumstances surrounding the error? The point you bring about those doctors in residency being forced to work extreme hours is a valid one. It is the HOSPITALS that are at fault for that, and the doctors should be cleared of any wrongdoing, unless it can be proven that their actions were reckless and/or willfully negligent, in which case the hospital should be cleared.

But part of the issue is that a jury or judge could be asked to put a value on human life. And while that life is priceless, too often the judicial value is just outrageous. If a doctor makes a mistake in the operating room and it forces a person to live without a kidney, or let's say they lose a limb, do they really deserve millions of dollars for that? Many times, that person wouldn't have earned as much as they have been awarded in ten lifetimes. Pain and suffering? Everybody experiences pain and everyone suffers in their own way, but not everybody gets a check for it.

Another issue is insurance companies. In my opinion, the insurance INDUSTRY, as a whole, should be a not-for-profit business. Insurance companies have more money than anyone, and that isn't how it should be. I personally think that the industry should be completely overhauled. If this administration is going to put their nose into various businesses, this is the one they need to fix.

My mother used to work for a doctor. He was good, a general surgeon, never had any legal issues. Then one day he is named is a malpractice suit. The patient was seen by this doctor on the initial visit to the emergency room of a hospital, where the doctor made a diagnosis, prescribed medication AND INSTRUCTED THE PARENTS OF THE PATIENT TO SEE THEIR FAMILY DOCTOR if the condition persisted. Well, the condition did persist, they never filled the prescription and they didn't follow up with the family doctor. The original diagnosis was that the child had flu like symptons, it was that time of the year......made sense. Turns out it was something else, and the parents didn't bring the child back to the hospital until the following week. The doctor in question only saw that child the one time. Unfortunately, through the inactions of the parents, the child suffered brain damage because he had some other virus, THAT LEFT UNATTENDED WOULD CAUSE LONG TERM ISSUES. The parents, not the medical community, were at fault. However, this doctor was named in a malpractice lawsuit, wrongfully, and his malpractice insurance DOUBLED. He sued the family, the lawyer and the Detroit News for defamation of character and slander, since he really SHOULD NOT have been so named. He settled with the News, won against the lawyer but the family was cleared of any wrong doing in the defamation case. Despite that, his malpractice insurance did not return to his original premiums. Though they reduced it from the doubled premium, he was still forced to pay about 20% higher, just for being falsely named in a lawsuit.

The family won their case against the hospital.....and I wonder aloud how. They are to blame for their lack of action, but too often when a group of people (jury) see someone like themselves fighting the "establishment", they too often favor the "victims" even if the "establishment" clearly didn't make any mistakes. I see it all the time in lawsuits against car companies.

The American judicial system is EXTREMELY flawed in this respect. I suspect, that as a person studying to be a lawyer, you will disagree. But like it or not, that is the absolute truth.


With all due respect... I don't think know what you're talking about when it comes to medical malpractice... it could be that you do and I'm just misapplying your knowledge, but then you'll have to answer the last hypo and make it jive with the med. industry.

1) It ultimately is the hospitals and not the doctors that are at fault for long hours and lawsuits. A doctor may have thier license suspended temporarily, or in a RARE case lose their license, but the financial resp. is generally on the hospital, and the punishment to the individual doctor is relatively small.

2) Med. mal. doesn't punish "human error," it only holds people to a standard of what a reasonable professional would do under the same circumstances. Human error is allowed to the extent that another reasonable professional could or would make the same mistake. Leaving your watch in someone's abdomen after a surgery (really happens), leaving a scalpul in someones abdomen after a surgery, failing to check whether or not someone is alergic to a medication before giving it to them, etc., IMO are not "human errors," they are negligent mistakes that often wind up in death and should be punished.

If you want to call those mistakes "human errors" then you have to make that jive with a trucker that has stayed up too long, falls asleep at the wheel and plows into someone at 65mph, and kills everyone in the car. Or the truck driver that is racing to pick up his next load while filling out his log-book and setting his GPS, and crashes his rig. It really is the same thing. Most hospital mistakes are from 1) being too tired, or 2) being too rushed.

3) Juries are, if anything, "fickel." They're unnaturally biased against criminal defendants (because, after all, if you've been accused of a crime you must be guilty, right???)... it is actually most common for charges looked at as "bad" by society (drinking and driving especially) for defense attorney's to request bench trials (trials held by a judge rather than a jury) because the jury blatantly refuses to apply the law, they simply feel the guy is an alcoholic drunk that must be guilty because the cop said so... They're also unnaturally biased against corporations, because, afterall, the liberal media has taught us that corporations are evil entities that control all of the weath in society at the expense of society, so why not punish them every chance you get???

Your doctor story is a valid one, but, IMO, it all worked out in the end. He likely got a money judgment against the Det News and Attorney that resulted in an amount much more than the 20% higher he paid in med. mal. insurance for the next three years (if you're claim free for 3 years your premiums come down). Surely its not right that the parents were at fault and he got blamed, but it was the DOCTOR that CHOSE to have his insurance company take the case and represent him. They likely settled the case due to the cost of litigation, and raised his rate to compensate or offset the settlement. That's what insurance companies do.

They did not, however, raise his rate because of "defamation" or the docs. reputation. Much like an auto policy they only raise your rate when you CHOOSE to make a claim. If your car gets stolen your rates don't increase... but if your car gets stolen and you make a claim your rates go up. Its the same thing in every insurance contract. Is it right that he didn't do anything wrong and he got punished? No, but it's also not right that the person that had their car stolen didn't do anything wrong either... The system isn't perfect, but it is about as good as it can get...

You can't preclude someone from filing a lawsuit and protecting their interests, which is what you would have to do here to protect the doctor in your story. Further, don't get your panties in a knot over those outrageous settlements you hear about on TV. It is true that those are the numbers that juries decide upon, but there are statutory limitations that are much much lower than the jury awards. The jury isn't told that because the law doesn't want them automatically assigning the limit for every case, but where they assign a rate higher it is later reduced by the judical process. If you remember right that one lady got something like $20 million dollars (or maybe even $300 million... something stupid anyhow) for spilling the hot coffee on her at McDonalds... Her award ended up getting reduced to something like $20K to $300K... That's still high, and perhaps even ridiculous, but its nothing like the sensationalized media makes it out to be... Remember... they're all about giving you shocking stories, often at the expense of the truth...


July 23rd, 2009, 4:56 pm
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There is an easy way to fix medical malpractice insurance costs: allow for the existence of at-your-own-risk hospitals/doctors.

Meaning, there would be certain offices or hospitals that, when you go in you would sign a wavier saying that no matter what happens during treatment, you will not sue.

Not every hospital would become one, as there would be many people opposed to being treated in such a hospital. Some hospitals would remain the same, wanting to give their patients the peace of mind, and they could charge more for the service.


July 24th, 2009, 7:55 am
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Blueskies wrote:
There is an easy way to fix medical malpractice insurance costs: allow for the existence of at-your-own-risk hospitals/doctors.

Meaning, there would be certain offices or hospitals that, when you go in you would sign a wavier saying that no matter what happens during treatment, you will not sue.

Not every hospital would become one, as there would be many people opposed to being treated in such a hospital. Some hospitals would remain the same, wanting to give their patients the peace of mind, and they could charge more for the service.


I don't think this is an "easy" or practical way of fixing anything. The only people that would go there are poor people, and then they would be barred from recovery if anything bad happened... And what type of doctors do you think would work in this exempt hospital? Probably not the best ones... I think this is a silly idea that is not well thought out, and would make the problem WORSE not BETTER.

Further... I've said it before and I'll say it again... Med. Mal. is NOT the biggest problem. The problem is that people get emergency care and do not pay for it, leaving everyong else to foot the bill for them. THAT is why hospital visits are so expensive, and that his why heathcare is so expensive. The "free" emergency care costs 10X's more than med. mal. suits.


July 25th, 2009, 1:41 pm
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wjb21ndtown wrote:
Blueskies wrote:
There is an easy way to fix medical malpractice insurance costs: allow for the existence of at-your-own-risk hospitals/doctors.

Meaning, there would be certain offices or hospitals that, when you go in you would sign a wavier saying that no matter what happens during treatment, you will not sue.

Not every hospital would become one, as there would be many people opposed to being treated in such a hospital. Some hospitals would remain the same, wanting to give their patients the peace of mind, and they could charge more for the service.


I don't think this is an "easy" or practical way of fixing anything. The only people that would go there are poor people, and then they would be barred from recovery if anything bad happened... And what type of doctors do you think would work in this exempt hospital? Probably not the best ones... I think this is a silly idea that is not well thought out, and would make the problem WORSE not BETTER.

Further... I've said it before and I'll say it again... Med. Mal. is NOT the biggest problem. The problem is that people get emergency care and do not pay for it, leaving everyong else to foot the bill for them. THAT is why hospital visits are so expensive, and that his why heathcare is so expensive. The "free" emergency care costs 10X's more than med. mal. suits.


It's a way of creating an alternative medical system with cheaper costs.

Obviously, the care would not be as great, the doctors would be of lesser quality, but they could still get the job done.

Let's assume you're poor. Would you rather have medical treatment from a lesser skilled doctor, or no medical treatment whatsoever? I think you'd opt for the treatment.

And medical malpractice insurance premiums do impact the medical industry. The cost varies from location to location and from one field of medicine to another, but it generally runs between 20k-200k, which is more than enough to influence the supply of doctors:

http://www.papillonsartpalace.com/malprDact.htm


July 25th, 2009, 6:39 pm
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I've got another easy way to fix malpractice insurance issues. STOP HIRING FOREIGN DOCTORS!

Anyone been to the VA Hospital lately? I'm not trying to sound like an UBER-NATIONALISTS, but come on already. You can barely understand some of them, and can't really count on their training. The government healthcare system, as seen by the VA HOSPITAL, is a Prime example of what NATIONALIZED healthcare will look like.

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July 27th, 2009, 9:30 am
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