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Thread: Pawlenty: Let ER's turn away patients to cut costs

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Yes, it's true that medicare reimbursements are a problem, but so are insurance reimbursements. Take my recent colonoscopy. The procedure would be covered, as long as they didn't find anything. So, the doctor does it, and if he had found something, the cost would still be there, and it would be more than I could cough up, so he eats it because I need more care?

    Doctors also complain about insurance company for this.

    As for tort reform, haven't states already done this? And has tort reform actually not lowered costs? Doctors over test not just because of fear of being sued, but because we tend to want tests. I often tell the doctor no to tests I don't think are important, but he tells me most want the tests. Consumer based systems would tend to want to please the consumer.

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Boo Radley View Post
    Yes, it's true that medicare reimbursements are a problem, but so are insurance reimbursements. Take my recent colonoscopy. The procedure would be covered, as long as they didn't find anything. So, the doctor does it, and if he had found something, the cost would still be there, and it would be more than I could cough up, so he eats it because I need more care?

    Doctors also complain about insurance company for this.

    As for tort reform, haven't states already done this? And has tort reform actually not lowered costs? Doctors over test not just because of fear of being sued, but because we tend to want tests. I often tell the doctor no to tests I don't think are important, but he tells me most want the tests. Consumer based systems would tend to want to please the consumer.
    @ the inanity of the insurance companies and their nerve to continue their bull**** practices - claiming that their menial 3% profit is acceptable.

    What on EARTH is up with that crap? "We'll ONLY cover it if they don't find anything WRONG" - then what's the point of having the procedure done for assessment to begin with?

    If they are just going to stiff you with the bill then they should just stiff you with it rather than pretending they're going to cover you.
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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by danarhea View Post
    Before anybody starts making statements about Pawlenty being a heartless Conservative, let's set the ground rules for this discussion, and get it straight on what Pawlenty proposes. He is talking about minor medical conditions, which are not emergencies.

    1) In that context, I don't see Pawlenty's proposal as heartless, but as a realistic idea. Emergency room care for minor conditions is one of the things that his bankrupting our medical care system.

    2) But is Pawlenty's "realistic" idea actually realistic? I don't think so. Minor medical conditions frequently lead to major hospitalizations. So what is the better way to cut costs in the medical system? Turn away minor conditions, to have people admitted to hospitals for long and very expensive stays? Or to keep things as they are, and treat those minor conditions before they flare up and cost orders of magnitude more money? I believe that the second one is best, and ultimately more cost effective.

    In the end, I don't see Pawlenty's proposal to be heartless at all. But I do see it to be poorly thought out, from an economic standpoint. Is there a third solution somewhere out there that we haven't looked at? Some would say that a public option would be that third option, but I disagree. Whatever solution we come up with must not take money from peoples' pockets without their consent. Or should it? If it does, then do we slide down the slippery slope to Socialism? If we do, then is this still America, or do we begin to say goodbye to a system of government that has has worked for more than 2 centuries?

    These are all very perplexing questions, and I would like to hear some thought out answers from everybody on this issue. So, in regard to what I have posted, the discussion in this thread should be as follows:

    Our health care system - Where do we go from here?

    PLEASE - NO TROLLING. If you only come here to bash Bush, Obama, or anybody else, while not offering constructive ideas and / or constructive criticism, then please leave this thread, and do not post. I will be asking moderators to thread ban those who do not stick to the topic at hand, and the discussion on it, along with those who display disruptive behavior.

    Article is here.
    My $0.02

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Boo Radley View Post
    Take my recent colonoscopy. The procedure would be covered, as long as they didn't find anything.
    What? I've never heard of this and it doesn't seem to make much sense.
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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Boo Radley View Post


    As for tort reform, haven't states already done this? And has tort reform actually not lowered costs? Doctors over test not just because of fear of being sued, but because we tend to want tests. I often tell the doctor no to tests I don't think are important, but he tells me most want the tests. Consumer based systems would tend to want to please the consumer.
    Have states already do this? Well, that depends. Has there been meaningful reform with regards to malpractice litigation? I have yet to see a state take this reform seriously. While there have been "caps" placed on litigation claims falling under certain guidelines, there are enough loopholes in these caps that a motivated attorney can easily seek claims as if the tort reform had never been implemented. And why wouldn't an attorney be motivated when most insurance companies settle without trial regardless of the claim unless the policy includes "right to waive" on the physician's behalf (which the physician pays more for).
    As a physician, at the very least I would like to see legislation implemented allowing a physician to recover defense fees and claims in lost income due to defense against suit if he is found not guilty. Therefore, the physician is more inclined to defend himself, and less likely to face litigation due to a plaintiff whose out to take advantage of the fact that most insurance companies settle regardless of the validity of the claim being made against the physician. Thus, patients with unintended outcomes due to physician negligence do not have to battle a cap to recover losses for the wrong extremity being amputated. And on the flip side, the physician is less likely to face frivolous suit... and if he does, he/she has the means to recover loss funds due to defense and lost income.

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Boo Radley View Post
    Take my recent colonoscopy.
    No thanks, you keep it.

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Shadowfax8 View Post
    Have states already do this? Well, that depends. Has there been meaningful reform with regards to malpractice litigation? I have yet to see a state take this reform seriously. While there have been "caps" placed on litigation claims falling under certain guidelines, there are enough loopholes in these caps that a motivated attorney can easily seek claims as if the tort reform had never been implemented. And why wouldn't an attorney be motivated when most insurance companies settle without trial regardless of the claim unless the policy includes "right to waive" on the physician's behalf (which the physician pays more for).
    As a physician, at the very least I would like to see legislation implemented allowing a physician to recover defense fees and claims in lost income due to defense against suit if he is found not guilty. Therefore, the physician is more inclined to defend himself, and less likely to face litigation due to a plaintiff whose out to take advantage of the fact that most insurance companies settle regardless of the validity of the claim being made against the physician. Thus, patients with unintended outcomes due to physician negligence do not have to battle a cap to recover losses for the wrong extremity being amputated. And on the flip side, the physician is less likely to face frivolous suit... and if he does, he/she has the means to recover loss funds due to defense and lost income.
    While pundits and reform opponents rail against malpractice lawsuits, they are only a symptom of the illness: medical malpractice. According to the Institute of Medicine, as many as 98,000 patients die each year due to preventable medical errors, at a cost of $29 billion. And that doesn't include patients who are seriously injured by medical errors.

    The Congressional Budget Office has concluded that the most dramatic proposed changes to tort law would cut health-care costs by only 0.5 percent. Meanwhile, they could worsen care and patient outcomes.

    The savings would be paltry partly because medical negligence claims make up less than 1 percent of the nation's civil caseload. And researchers at Harvard found that 97 percent of cases involved verifiable medical injuries, debunking the idea that many suits are "frivolous." Restricting the rights of injured patients when medical negligence is so common would be at odds with the obvious need for higher-quality health care.

    Furthermore, the current health-care proposals already address medical malpractice. Both the House and Senate bills offer incentives to states to initiate pilot projects focusing on medical negligence and patient safety. President Obama has directed the Department of Health and Human Services to launch similar projects.

    Tort reform is a distraction | Philadelphia Inquirer | 03/04/2010

    Since the 2005 reforms in Missouri, malpractice premiums at Hagen's practice have fallen 24 percent -- a decline he attributes to the reforms. Reintjes said his premiums have declined 30 percent.

    But -- and here's where the debate gets sticky -- overall health care costs in Missouri continue to rise. The same is true in states that have enacted even more stringent tort reforms, such as Texas.

    Which suggests that a tort system run amok is, at best, only a small contributor to the nation's health care costs.

    Would tort reform make much difference in health care costs? Probably not: Analysis | National News - cleveland.com - cleveland.com

    So show where trot reform has actually lowered costs.

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by RightinNYC View Post
    What? I've never heard of this and it doesn't seem to make much sense.
    That's exactly what I said to them. When we met with a representative, one employee quipped, I get it. It's good insurance if we don't need. Not worth a crap if we do.

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    Re: Pawlenty: Let ER's turn away patients to cut costs

    Quote Originally Posted by Boo Radley View Post
    While pundits and reform opponents rail against malpractice lawsuits, they are only a symptom of the illness: medical malpractice. According to the Institute of Medicine, as many as 98,000 patients die each year due to preventable medical errors, at a cost of $29 billion. And that doesn't include patients who are seriously injured by medical errors.

    The Congressional Budget Office has concluded that the most dramatic proposed changes to tort law would cut health-care costs by only 0.5 percent. Meanwhile, they could worsen care and patient outcomes.
    First off, you're copy pasting from the president of the "American Association for Justice," which is a plaintiff lawyer's advocacy group. It's like relying on the head of Phillip Morris for info about tobacco.

    Second, 0.5 percent of $2.3 Trillion is a ****load of money.

    Third, it's only 0.5% becase the tort reform that the CBO is looking at only deals with caps on pain and suffering, which doesn't really deal with the underlying issue. A program that enacted comprehensive reform of the entire process by which medical malpractice is addressed would have far greater effects.

    http://perspectives.thirdway.org/?p=678

    On the policy, “defensive medicine” now consumes 4 percent to 9 percent of the nation’s total health care spending. That translates to between roughly $92 billion and $207 billion annually that is wasted on unnecessary tests and procedures that doctors perform simply to avoid the threat of a lawsuit. Eliminating just half of this waste would be enough to cover all uninsured Americans.

    ...

    By contrast, there is little about the current medical malpractice system that works. Only 2 percent of people injured by medical errors file a claim for compensation. The few winners must wait three to five years to see the money. More than half of it is siphoned off to attorney fees and court costs.

    Democrats, however, often raise one major objection: caps on awards to injured patients. But they need not, nor should they, support this conservative idea as studies show that caps do little to reduce defensive medicine in the states where they have been enacted, according to the Congressional Budget Office.

    Instead, Democrats should propose a health court, which can serve as the backbone for fundamental malpractice reform. A health court is a specialized system of courts similar to the workers’ compensation system that would handle only medical malpractice cases. Injured patients would simply fill out a form to receive compensation for common injuries. Disputes would be quickly handled in an administrative court run by medical experts, who would ensure that the same standards of practice are applied to all similarly situated patients. They would be able to reach many more patients who are deserving of compensation. And like workers’ compensation, the rewards would be fair and predictable.
    The savings would be paltry partly because medical negligence claims make up less than 1 percent of the nation's civil caseload.
    What does that have to do with anything? That's some of the worst logic I've ever heard, although it's fairly typical for a plaintiff's lawyer. That's like saying that murder isn't a big deal because it's only 1% of all crime.


    Furthermore, the current health-care proposals already address medical malpractice. Both the House and Senate bills offer incentives to states to initiate pilot projects focusing on medical negligence and patient safety. President Obama has directed the Department of Health and Human Services to launch similar projects.
    The proposals direct the states to institute pilot programs and then provide a whopping $25 million to do so. Yea, real reform there.


    Since the 2005 reforms in Missouri, malpractice premiums at Hagen's practice have fallen 24 percent -- a decline he attributes to the reforms. Reintjes said his premiums have declined 30 percent.

    But -- and here's where the debate gets sticky -- overall health care costs in Missouri continue to rise. The same is true in states that have enacted even more stringent tort reforms, such as Texas.

    Which suggests that a tort system run amok is, at best, only a small contributor to the nation's health care costs.
    That is just awful, awful logic. Wow. I just really don't know what to say about that.

    Quote Originally Posted by Boo Radley View Post
    That's exactly what I said to them. When we met with a representative, one employee quipped, I get it. It's good insurance if we don't need. Not worth a crap if we do.
    No, I'm saying that the idea that the coverage for the test itself is predicated on the result doesn't make sense at all. No doctor that I've ever heard of would consent to perform such a test, since their receipt of payment could be conditioned on the outcome. That doesn't sound right.
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    Re: Pawlenty: Let ER's turn away patients to cut costs

    On the site:
    http://www.injuryboard.com/help-cent...tice-caps.aspx

    I find this to be conflicting info...

    "According to a recent article in the New York Times, physicians are flooding into Texas because of the state’s recent approval of a constitutional amendment limiting medical malpractice awards. Further, physicians noticed that the state of Texas experienced an average 21.3% decrease in medical malpractice insurance premiums during the four years following the tort reform legislation. "

    Then on down the page it says...

    "One report reveals that limitations on medical malpractice awards produced payout averages 15.7% lower than those of states without caps between 1991 and 2002. This statistic is true despite the fact that many of the states did not institute the limitations until near the end of the reporting period. Meanwhile, the median annual premium in states with caps increased an alarming 48.2%. Surprisingly, the median annual premium in states without caps increased more slowly: by 35.9%. In other words, the median medical malpractice insurance premiums were actually higher in states with caps. This is contrary to the goal of the limitations on medical malpractice awards."
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