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View Diary: The ACA and Our Doctor Shortage (149 comments)

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  •  but suing isn't increasing costs (3+ / 0-)
    Recommended by:
    VeloVixen, peregrine kate, slouchsock

    that, as I have pointed out repeatedly, is almost neglible in its number of occurences and neglible to the total costs.  Its is all built on lies,  repeating lies doesn't make them true.

    Now that you have defined waste to be profit taking without return of value, then yes,  there is waste in the system.

    Just because something is non-profit doesn't make it non-wasteful,  just because you don't pay money out to investors doesn't mean someone isn't pocketing a ton of money that could go to patient care, ie, the executives, administrative bureaucracies, etc. that stand between patients and actual health care providers, will take a split whether profit of non-profit.

    The ACA attempts to control that split and put the money back into patient care.

    Pharmaceuticals do need to be negotiated, but that isn't what you originally said,  you talked about frivolous suits.

    •  I want (1+ / 0-)
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      VeloVixen

      All areas of medicine to be more efficient so care for everyone becomes a reality - pharma, suing, insurance, tech, edu costs, fraud, more efficient records/communication, etc.

      And we're at odds on suing, but if it costs $200k for an OBGYN to pay malpractice then prices have to go up.

      To the extent that OBGYNs are still making a ton of cash then that's another issue.

      "And there are those who give and know not pain in giving, nor do they seek joy, nor give with mindfulness of virtue; They give as in yonder valley the myrtle breathes its fragrance into space" Khalil Gibran

      by bcdelta on Mon Sep 03, 2012 at 10:17:08 AM PDT

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    •  Ezra Klein has a great perspective about effects (4+ / 0-)
      Recommended by:
      peregrine kate, SoCalSal, TexDem, jfromga

      of malpractice lawsuits.The direct costs of malpractice lawsuits — jury awards, settlements and the like are a minuscule part of health spending:  the AMA and the trial lawyers’ association — say $60 billion a year, or about 3 percent of overall medical spending is a good estimate.  Only a small percentage of medmal cases are actually reported and litigated.

      The problem isn't in courtrooms so much as on the operating table. But because it's doctors who are angry about malpractice suits, most of the fixes are from their perspective. What we need is malpractice reform from the patient's perspective. That wouldn't be the system we have now, or mere caps on damages: It would be serious work, much more costly, and investment in better practices.

      •  What about (1+ / 0-)
        Recommended by:
        VeloVixen

        the cost of defensive medicine due to fear of lawsuits - is this included in Klein's #s?

        "And there are those who give and know not pain in giving, nor do they seek joy, nor give with mindfulness of virtue; They give as in yonder valley the myrtle breathes its fragrance into space" Khalil Gibran

        by bcdelta on Mon Sep 03, 2012 at 10:43:23 AM PDT

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        •  Doctors supposedly practice "defensive medicine" (3+ / 0-)
          Recommended by:
          bcdelta, VeloVixen, jfromga

          because they are afraid of lawsuits.  But they are afraid of lawsuits because the insurance industry told them to be afraid.

          At the root of it, doctors aren't really afraid of the lawsuits, they're afraid of their malpractice insurance premium going up.  

          Frivolity is in the eye of the beholder, or, as my father used to say, "It all depends on whose ox is gored."  It's really very difficult for a truly meritless lawsuit to get anywhere.  

          The "problem" -- if there actually is one -- is that the insurance companies encourage these so-called "frivolous lawsuits."  It's a much better business model to settle suits and raise premiums then it is to actually use the tools that already exist in the U.S. legal system to deal with meritless litigation.  

          The insurance industry's sole purpose is to increase its revenues, not to lower medical costs.

          We must drive the special interests out of politics.… There can be no effective control of corporations while their political activity remains. To put an end to it will neither be a short not an easy task, but it can be done. -- Teddy Roosevelt

          by NoMoJoe on Mon Sep 03, 2012 at 11:00:28 AM PDT

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          •  Sounds like (1+ / 0-)
            Recommended by:
            VeloVixen

            collusion between legal and insurance.  Nicely made point.

            "And there are those who give and know not pain in giving, nor do they seek joy, nor give with mindfulness of virtue; They give as in yonder valley the myrtle breathes its fragrance into space" Khalil Gibran

            by bcdelta on Mon Sep 03, 2012 at 11:04:07 AM PDT

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          •  In NYS, I'd beg to differ, certainly surgeons and (1+ / 0-)
            Recommended by:
            VeloVixen

            OBY/GYN practitioners. I'd love to believe it's insurance companies making them afraid, but it's more likely the pregnant mother who threatens her physician with a lawsuit "if something's wrong with her baby". Certainly most patients aren't like this woman, the problem is too many are. (I happened to be in a room when she took an urgent call from a patient.) We're also seeing OBY/GYNs refuse to take on obese patients for liability reasons.

            As far as insurance companies and payouts vs changing the medical system, sounds far too much like municipalities payout for trip and falls rather than fixing all sidewalks pre-emptively.

            Even if I knew that tomorrow the world would go to pieces, I would still plant my apple tree. -Martin Luther

            by the fan man on Mon Sep 03, 2012 at 01:05:39 PM PDT

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      •  and the cost actually paid out in suits (1+ / 0-)
        Recommended by:
        VeloVixen

        can be high, but generally don't come close to what it really costs to a person's life if a permanent injury has been done or death of a parent with children is the result, etc.

        It is hard to find a doctor who is an expert in the medical area being challenged by the patient,  to sign the expert affidavit required prior to filing suit down here.  There are few frivilous claims.  We already have tort reform that caps claims.   It just isn't saving money as they said it would on premiums, etc.

        It really is a scare tactic by the insurance companies.

        •  Is that in Texas? (2+ / 0-)
          Recommended by:
          VeloVixen, jfromga

          There was an article about the tort reform in Texas--I wish I could remember where--that says that claims are way down, awards are way down, but insurance premiums haven't budged. More manna for the insurance companies.

          I also read that something like 83% of all claims in TX are against something like 11% of doctors. And it's worse, the more you narrow it--45% of claims to 5% of doctors, or something similar (this is from memory!)  But TX won't take their damn licenses away. "Ambulance chasing-lawyers", another right-wing meme, are NOT the problem. Insurance vultures and a minority of bad doctors are.

          "Maybe: it's a vicious little word that could slay me"--Sara Bareilles

          by ChurchofBruce on Mon Sep 03, 2012 at 01:35:22 PM PDT

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