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Thread: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386, 590]

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by washunut View Post
    Think it is due to two things. Some posters seem to do this as some type of job, not sure if they get paid or are just hyper partisans. Then there are some who have been here for a while, their arguments have been debunked and now they are left with personal attacks as their sole defense. Would appreciate hearing your thoughts.
    Either that, or they ignore the posts that refuted them, leave for awhile, then come back with the same tired arguments that were earlier refuted, seemingly pretending that the counter arguments were never brought up.

    It gets quickly tiring. It really makes me wonder if these people are getting paid. I see no reason to come onto a forum like this with absolutely no intention of doing anything but constantly repeating the same lines over and over.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    If I may, I'm really trying to learn here. New to this forum and enjoying the variety of opinions, crazy or not. The upcoming election is critical regardless of where you stand on the issues. That's why I'm here and hopefully, more will come. Maybe all you folks don't realize it, but speaking as someone with fresh eyes on this place, your words (meaning all the posters here) really have an effect when it comes to getting a clear picture of what is important to people. Plus, the humor is great too.

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Tort reform - A minor issue. In any case, this *was* offered as a bargaining chip to get Republicans on board. Obama said many times that he was willing to play ball on tort reform. No dice.
    Youre kidding. No I mean really, you have to be joking with that stance.


    The costs of defensive medicine
    In recent studies, more than 90 percent of physicians reported practicing positive defensive medicine in the past 12 months; unnecessary imaging tests accounted for 43 percent of these actions. More than 92 percent of surgeons reported ordering unnecessary tests to protect themselves.

    Another study found a direct relationship between higher malpractice awards and malpractice premiums and Medicare spending, especially with imaging services. The increased spending, however, had no measurable effects on mortality.

    In a recent Gallup survey, physicians attributed 34 percent of overall healthcare costs to defensive medicine and 21 percent of their practice to be defensive in nature. Specifically, they estimated that 35 percent of diagnostic tests, 29 percent of lab tests, 19 percent of hospitalizations, 14 percent of prescriptions, and 8 percent of surgeries were performed to avoid lawsuits.

    Liability reform has been estimated to result in anywhere from a 5 percent to a 34 percent reduction in medical expenditures by reducing defensive medicine practices, with estimates of savings from $54 billion to $650 billion.
    http://news.vanderbilt.edu/2012/02/d...edic-medicine/
    Vanderbilt University Medical Center researchers estimate that U.S. orthopaedic surgeons create approximately $2 billion per year in unnecessary health care costs associated with orthopaedic care due to the practice of defensive medicine. Defensive medicine adds billions to healthcare costs | Healthcare Finance News

    Defensive medicine adds billions to healthcare costs | Healthcare Finance News
    ATLANTA -- Physicians estimate the cost of defensive medicine to be between 26 and 34 percent of total annual healthcare costs, according to a recent report by Jackson Healthcare. At an estimated $2.5 trillion in annual spending, this means $650-850 billion is spent each year on medical orders intended to avoid lawsuits rather than treat patients.
    UConn Advance - February 23, 2009 - Study shows defensive medicine widespread
    The cost of ‘defensive’ medicine – tests, procedures, referrals, hospitalizations, or prescriptions ordered by physicians fearful of lawsuits – is huge and widespread, according to a study by the Massachusetts Medical Society and UConn Health Center researcher Robert Aseltine Jr.

    The study is based on a survey – believed to be the first of its kind – that was completed by more than 900 physicians in Massachusetts. It asked about their use of seven tests and procedures: plain film X-rays, CT scans, magnetic resonance imaging, ultrasounds, laboratory testing, specialty referrals and consultations, and hospital admissions.

    About 83 percent reported practicing defensive medicine, with an average of between 18 percent and 28 percent of tests, procedures, referrals, and consultations and 13 percent of hospitalizations ordered for defensive reasons.

    Such practices were estimated to cost a minimum of $1.4 billion per year in Massachusetts.
    Kandahar and liberals in this thread, do you really think its just insurance companies adding to the cost of health care? No one seemed to reply to this post and it seems to highlight that malpractice avoidance is contributing a hefty percentage to health care costs.

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    FactCheck.org : Summit Extras: Medical Malpractice

    As Republican Rep. Dave Camp correctly pointed out, the Congressional Budget Office estimated that limiting malpractice liability would "reduce the federal deficit by more than $50 billion." More precisely, that’s $54 billion over 10 years, according to the CBO. But CBO Director Douglas Elmendorf noted the savings would "reduce total U.S. health care spending by about 0.5 percent (about $11 billion in 2009)."
    I favor tort reform, but it is not going to have a huge impact.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by OpportunityCost View Post
    Kandahar and liberals in this thread, do you really think its just insurance companies adding to the cost of health care?
    No.

    No one seemed to reply to this post
    Because I don't disagree that tort reform is a worthy goal. Obama offered to work with Republicans to reform it too, and instead they gave him the finger.

    and it seems to highlight that malpractice avoidance is contributing a hefty percentage to health care costs.
    It's less than 2% of our health care costs. That isn't nothing, but there are much bigger problems to worry about.
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by Redress View Post
    FactCheck.org : Summit Extras: Medical Malpractice



    I favor tort reform, but it is not going to have a huge impact.
    No one can know for sure what the cost of defensive medicine is. I would be shocked if the figure above or $5 billion a year in a system of $2.7 trillion is accurate. Is there something that you have that breaks this into categories. For example the cost of medical insurance premiums, what percent of tests are done for defensive purposes, the cost of taking doctors out of hospitals because they have to appear in court, the cost of lawyers hired by hospitals, the amount of money paid out to settle claims. Just a list while typing so I am sure I am missing many other things.

    I understand that trial lawyers are a key donor base for the democratic party, but do really believe that health care spends only $ 5 billion in this area???

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    I don't favor tort reform. Basically, what a medical malpractice suit is is just a way to determine which insurance company should cover the cost of a medical mishap- the insurance of the patient or the insurance of the doctor. The optimal answer is for the doctor's insurance to cover it if there was a preventable mistake- even if it was a very understandable one- because you want doctors to have incentives to be very careful not to make mistakes. Malpractice suits don't create costs, they just decide which insurance company pays for them. If we stopped all malpractice suits, and nobody changed their behavior in any way, the cost of malpractice insurance would go down $x and the cost of health insurance would go up the same amount, so it would be a wash. But, people would change their behavior. Doctors wouldn't have as much incentive to be careful. So, then the total costs would increase.

    The legal standard for determining which insurance company should cover it is exactly what it should be. If there are precautions the doctor could have taken that would be cheaper to implement than the cost of the harm done by not taking it, then the doctor's insurance is liable. Otherwise, the patient's insurance is liable. What would be a better standard?
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

    Quote Originally Posted by Kandahar View Post
    It's less than 2% of our health care costs. That isn't nothing, but there are much bigger problems to worry about.
    Can you cite where you found this figure or how it's determined?

    How does one account for all the extra "just-in-case" screens/tests that might not be performed if doctor's didn't have to be so paranoid about liability? These are always billed with doctors asserting they are medically necessary, when many probably are not. Are these counted in this 2%?

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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by washunut View Post
    No one can know for sure what the cost of defensive medicine is. I would be shocked if the figure above or $5 billion a year in a system of $2.7 trillion is accurate. Is there something that you have that breaks this into categories. For example the cost of medical insurance premiums, what percent of tests are done for defensive purposes, the cost of taking doctors out of hospitals because they have to appear in court, the cost of lawyers hired by hospitals, the amount of money paid out to settle claims. Just a list while typing so I am sure I am missing many other things.

    I understand that trial lawyers are a key donor base for the democratic party, but do really believe that health care spends only $ 5 billion in this area???
    So if no one can know, why are you making assumptions? Why throw out the studies done on the subject then continue to act like it is a big cost saver?
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    Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386]

    Quote Originally Posted by washunut View Post
    No one can know for sure what the cost of defensive medicine is. I would be shocked if the figure above or $5 billion a year in a system of $2.7 trillion is accurate. Is there something that you have that breaks this into categories. For example the cost of medical insurance premiums, what percent of tests are done for defensive purposes, the cost of taking doctors out of hospitals because they have to appear in court, the cost of lawyers hired by hospitals, the amount of money paid out to settle claims. Just a list while typing so I am sure I am missing many other things.

    I understand that trial lawyers are a key donor base for the democratic party, but do really believe that health care spends only $ 5 billion in this area???
    The defensive medicine angle is pretty badly exaggerated. First off, some defensive medicine is a good thing. That's the whole point of having a system for torts- to remind sub-standard doctors to be more careful. When the tort reform advocates get those statistics about defensive medicine, what they're doing is just polling doctors and asking them what percentage of tests they order would they consider "defensive medicine". That doesn't tell you how many of those tests were wasteful. It could be that all of them are defensive medicine in the sense of doctors having their behavior corrected to become more efficient by avoiding careless mistakes. But, secondly, its also just something doctors like to gripe about. Nobody likes getting sued, so they ham it up like it is a bigger deal than it is. It's kind of like asking the fans of a baseball team whether the referees are biased against their team, 90% of them say "yes", and then publishing a statistic that 90% of the referees are biased against that team. When they actually compare, for example, the spending on tests between states with extremely plaintiff-friendly malpractice laws and states with extremely defendant-friendly malpractice laws, they actually find that the spending on tests doesn't really vary at all.
    Total tax rates- People living in poverty: 16.2%. The median American: 27%. Working people who make over $140k/year: 31%. The top 1%: 30%. Super rich investors: around 15%. Help the democrats retake the house.

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