Which Health Insurance Reforms?

Zyphlin · Sep 9, 2009

Redress said:
I am missing something here. How would tort reform reduce the use of needless tests?

I'm going to guess but, right now Doctors need to do just about any test they can to cover their ass, even if its exceedingly expensive and the benefit of it compared to the cost isn't really realistic, because if something should go wrong in the procedure they end up recommending they need to be able to say "see, we did everything we could to check". If they're not worried non-stop about covering their ass they may pass on a multi-thousand dollar test that is just going to verify what 2 other tests they already did says.

Redress · Sep 9, 2009

Zyphlin said:
I'm going to guess but, right now Doctors need to do just about any test they can to cover their ass, even if its exceedingly expensive and the benefit of it compared to the cost isn't really realistic, because if something should go wrong in the procedure they end up recommending they need to be able to say "see, we did everything we could to check". If they're not worried non-stop about covering their ass they may pass on a multi-thousand dollar test that is just going to verify what 2 other tests they already did says.

Thanks, I figured I was missing something.

Kandahar · Sep 9, 2009

Redress said:
I am missing something here. How would tort reform reduce the use of needless tests?

Many doctors order needless tests for their patients so that they can prove they did everything they possibly could if the patient comes back and sues the doctor for malpractice for not detecting something.

Tort reform would mitigate that problem by alleviating doctors' fears of malpractice lawsuits. I think it's very rare that pain and suffering should be worth more than $500K (unless it's chronic, incurable, and severe). And a wrongful death should usually not be worth more than 2 or 3 million.

Redress · Sep 9, 2009

Zyphlin said:
28k was for me. 34k when it was me and my girlfriend.

And sorry, I don't believe its the government...and thus the tax payers...job to subsidize you if you decide you want a family of 4. That's your choice.

I am not going to argue this point, it's not really the point I was going for.

Goobieman · Sep 9, 2009

The only way to reduce health care costs is to expose the health care industry - those that provide the goods and services to the patients - to competition and free market forces.

To do this, we must eliminate the third-party payer system that insulates the consumer from the actual cost of the health care he receives.

Zyphlin · Sep 9, 2009

Redress said:
I am not going to argue this point, it's not really the point I was going for.

I get what you're saying, and having a slight sliding scale based on spouse, number of children, possibly location would be understandable. However, I think it should be for those that are legitimatelly pretty "poor". Not people that are "just getting by" with their broadband, DVR, weekly dinner night at TGI Fridays, and a seat at the bar every saturday that's molded to the shape of their ass cheeks.

RightinNYC · Sep 9, 2009

Agent_Grey said:
Unbelievable.

Do any of you voting for Tort reform understand what a tiny piece of the pie it makes up?

Texas demolished malpractice lawsuits, decreasing the time people have to sue, eliminating punitive damages, and stiffly capping the amount people are allowed to get for injuries sustained due to medical negligance.

Did it bring their costs down? Not a jot. Whatever benefits tort reform might have brought to the system, those were swallowed by the astronomical rise in cost due to issues other than tort reform.

Knowing this do you still think tort reform is the most important issue facing medicine today? If so, why?

This is a significantly skewed version of the facts.

Texas's experience with tort reform is far different from the way you're portraying it. Here are some of the immediate results:

Four years after Texas voters approved a constitutional amendment limiting awards in medical malpractice lawsuits, doctors are responding as supporters predicted, arriving from all parts of the country to swell the ranks of specialists at Texas hospitals and bring professional health care to some long-underserved rural areas.

The influx, raising the state’s abysmally low ranking in physicians per capita, has flooded the medical board’s offices in Austin with applications for licenses, close to 2,500 at last count.

“It was hard to believe at first; we thought it was a spike,” said Dr. Donald W. Patrick, executive director of the medical board and a neurosurgeon and lawyer. But Dr. Patrick said the trend — licenses up 18 percent since 2003, when the damage caps were enacted — has held, with an even sharper jump of 30 percent in the last fiscal year, compared with the year before.

http://www.nytimes.com/2007/10/05/us/05doctors.html?pagewanted=1&_r=2

In 2003 and in 2005, Texas enacted a series of reforms to the state's civil justice system. They are stunning in their success. Texas Medical Liability Trust, one of the largest malpractice insurance companies in the state, has slashed its premiums by 35%, saving doctors some $217 million over four years.

This has allowed doctors and hospitals to cut costs and even increase the resources devoted to charity care. Take Christus Health, a nonprofit Catholic health system across the state. Thanks to tort reform, over the past four years Christus saved $100 million that it otherwise would have spent fending off bogus lawsuits or paying higher insurance premiums. Every dollar saved was reinvested in helping poor patients.

Why Doctors Are Heading for Texas - WSJ.com

The law has cut the average malpractice award by one-fourth, according to research by Bernard Black, a law and finance professor at the University of Texas. Before the caps, the average award was $1.21 million; it's been $880,000 since. "That's a real effect from the caps," Mr. Black said.

TORT REFORM | News for Dallas, Texas | Dallas Morning News | Dallas Business News

It's not simply a "how much is being spent on health care" question, as there are more facets than that. You have to consider other things, such as the availability of doctors in underserved areas, the amount of money that would be spent on healthcare which is being funneled to lawyers, etc.

Redress said:
I am missing something here. How would tort reform reduce the use of needless tests?

When a patient shows up at a doctor's office with a bruise after falling and bumping his head, the physician might order a CT scan even if she believes the injury is superficial.

Worries about a malpractice lawsuit might prompt her to take steps that aren't medically necessary. "If I don't get a CAT scan, this is that one case where I'll end up in court," the doctor might think, says Cecil Wilson, a physician who is president-elect of the American Medical Association.

This is defensive medicine -- a careful, fretful approach to treating patients, in which doctors authorize tests in part to reduce the risk that they will be sued. In the national debate over health care, doctors and policy makers often point to spending on defensive medicine as a key driver of soaring costs.

In a survey of Pennsylvania doctors in high-liability specialties such as obstetrics, 59% of respondents said they often ordered more tests than were medically necessary. The survey, conducted in 2003 when malpractice premiums were rising sharply in the state, was published in the Journal of the American Medical Association.

Tangible and Unseen Health-Care Costs - WSJ.com

Obstetricians are particularly ****ed by things like this. The average obstetrician in NYC pays around $115k for malpractice insurance each year. Hospitals are closing entire obstetrics wards due to the price. It's absolutely absurd.

Redress · Sep 9, 2009

I kinda held off from expressing what I think on this to see the results. For me, I think for the short run, we should focus on low cost reforms. Until we have the economy on the right track, and are not facing record deficits, we should not be spending alot of extra money, even if we can raise the revenue to pay for it.

What I would like to see in the short run is some tort reform, allowing insurance to be sold across state lines(why is this limit in place?), and insurance regulations, including requiring coverage for existing conditions. Everything else should wait awhile, both to be better able to afford the cost, and to see what effects those changes have.

rathi · Sep 10, 2009

including requiring coverage for existing conditions.

Assuming that you do the responsible thing and have a risk equalization program to handle the requirement, that is going to cost quite a bit of money.

However, if done correctly, healthcare reform will save the country quite a bit of money. Consider these two facts :47% of our healthcare costs are already shouldered by the government and we have by far the worst administrative overhead. Assuming we can reach the same level of efficiency of Europe and Canada with our reforms, the overall savings to the nation will be huge. While it may result in increased government spending, that could be recouped by taxes, or we could just call the savings a stimulus to the American tax payer. Either way, somebody comes out ahead.

However, given the fact that change doesn't happen overnight, caution would be prudent. Reaching the competitive equilibrium may take some time. in a new system.

Which Health Insurance Reforms?

Which health care reforms would you like to see before end of 2010?

Deregulate the insurance industry, let pure capitalism work

Tort Reform

Allow selling of insurance across state lines

Insurance regulations and enforcement to protect the insured

Financial aid to poor people/families to afford insurance

Creating a "public option"

Convert our health care to a socialized system ala Canada or UK

No reform

Other

More options

Zyphlin

Redress

Liberal Fascist For Life!

Kandahar

Enemy Combatant

Redress

Liberal Fascist For Life!

Goobieman

Zyphlin

RightinNYC

Girthless

Redress

Liberal Fascist For Life!

rathi

Count Smackula