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View Diary: Why healthcare costs so much in the U.S. (181 comments)

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  •  colonoscopies (3+ / 0-)
    Recommended by:
    denise b, RJDixon74135, mamamedusa

    If your doctor didn't push you to get that colonoscopy and in the end you turned out to have colon CA, you could sue him and probably win millions. Clinical guidelines essentially mandate it at age 50- any Dr. who DIDN'T push you to get it would be grossly negligent and expose himself to liability.  Further, even if you chose not to have it, and the Dr. documented your refusal, and did everything right, and you subsequently had a bad outcome, you could STILL win millions, because the outcome of that trial is up to the jury.  Even if you got the colonoscopy and it showed cancer, and the doctor tried to contact you in any way possible, up to and including sending certified letters and asking the police to check on your whereabouts, you could sue him and STILL win millions, because the outcome of the trial is up to the jury.  See the problem?

    That being said, I totally agree that all medically indicated screening should have ZERO out of pocket cost for patients.  It's a win-win-win for Drs-pts-insurance companies because a colonoscopy is way cheaper than a colon resection and all the possible complications thereof. Not to mention the effects on the patient.  

    •  Are you sure about this? (3+ / 0-)
      Recommended by:
      mamamedusa, samddobermann, BYw
      Further, even if you chose not to have it, and the Dr. documented your refusal, and did everything right, and you subsequently had a bad outcome, you could STILL win millions, because the outcome of that trial is up to the jury.  Even if you got the colonoscopy and it showed cancer, and the doctor tried to contact you in any way possible, up to and including sending certified letters and asking the police to check on your whereabouts, you could sue him and STILL win millions, because the outcome of the trial is up to the jury

      I thought medical malpractice requires a physician to be negligent. Judges do instruct juries. Can you cite cases in which physicians performed well and still lost big amounts?

      Men never do evil so completely and cheerfully as when they do it from a religious conviction. -- Blaise Pascal

      by RJDixon74135 on Fri May 13, 2011 at 09:32:54 PM PDT

      [ Parent ]

      •  Here's what I found (4+ / 0-)
        Recommended by:
        Matt Z, mamamedusa, elfling, BYw

        at "Debunking the Top 5 Myths about Medical Malpractice" by US Action

        MYTH: Debate over malpractice compensation is just about frivolous lawsuits.
        FACT: The proposed limits on damages would apply to ALL CASES, no matter how serious the injury or how egregious the malpractice by the doctor, hospital, nursing home or drug manufacturer.

        MYTH: Medical malpractice claims are driving up the cost of health care for everyone.
        FACT: The Congressional Budget Office (CBO) reports that all costs related to medical malpractice account for less than 2% of total health care costs. (1)

        (1)Malpractice costs amounted to "less than 2 percent of overall health care spending. Thus, even a reduction of 25 percent to 30 percent in malpractice costs would lower health care costs by only about 0.4 percent to 0.5 percent, and the likely effect on health insurance premiums would be comparably small." [Congressional Budget Office, "Limiting Tort Liability for Medical Malpractice," 1/08/04]

        Men never do evil so completely and cheerfully as when they do it from a religious conviction. -- Blaise Pascal

        by RJDixon74135 on Fri May 13, 2011 at 09:44:17 PM PDT

        [ Parent ]

        •  And the corollary is that (1+ / 0-)
          Recommended by:
          BYw

          medical malpractice suits as currently practiced are more about a bad outcome than about the severity of the error.

          Better to have a system where people's care is 100% paid regardless of fault and then mistakes can be dealt with by disciplinary commissions of doctors than our current system, where someone with a bad outcome has to hope that someone can be found at fault to pay for the care they need but can't afford.

          Fry, don't be a hero! It's not covered by our health plan!

          by elfling on Sat May 14, 2011 at 10:31:44 AM PDT

          [ Parent ]

          •  You have fallen for the medical (0+ / 0-)

            propaganda.

            Why should a doctor (or hospital's etc) sloppy care be encouraged? That leads to more sloppy care.

            What if someone's life is ruined because of the mistakes? What if a whole family suffers and has high expenses for things not designated medical or health care?

            The tale of woe described above is short of a lot of pertinent detail but it sounds like at least one thing that went wrong was a massive horrible hospital acquired infection. Most hospital acquired infections are preventable. It is sloppiness within the health care system that allows those infections to kill and torment patients.

            I'm asking you to believe. Not in my ability to bring about real change in Washington ... I'm asking you to believe in yours. Barack Obama

            by samddobermann on Sat May 14, 2011 at 03:13:52 PM PDT

            [ Parent ]

            •  Lawsuits don't solve those problems (0+ / 0-)

              Lawsuits are expensive and thus they're only pursued when damages are high. Many horrible errors are made that are never corrected, not by torts and not administratively. Many families have expenses that are high because of mistakes but not high enough to get an attorney - and it happens regardless of cause. That is, a minor or barely mistake can cause high expenses just as a major one can.

              When you're in the throes of a medical crisis, the last thing you want to do is take on a lawsuit, anyway.

              Single payer eliminates medical damages: the person gets the care she needs to recover regardless of fault or cause. This is a good thing. The person will be made as medically whole as possible, no questions asked, no need to find anyone at fault. Sometimes no one is.

              If there are high non-medical expenses, lawsuits could still be an option.

              Then, separately, medical boards at the local level can investigate the incident and take corrective action if need be. It might be that a doctor needs a reprimand or some remedial training. It might be that a procedure needs to be changed. It might be that someone needs to lose a license.

              Under the current scenario, if you sue, any winnings you get are first claimed by your lawyer and then by your health insurance company. Very few people have damages high enough to exceed these two takes, and then they obviously still end up with less cash than their actual total damages.

              Fry, don't be a hero! It's not covered by our health plan!

              by elfling on Sun May 15, 2011 at 09:05:56 AM PDT

              [ Parent ]

    •  And that age is too high (1+ / 0-)
      Recommended by:
      TrueBlueMajority

      Darrel Strawberry had full blown colon CA at 34. I had a precancerous polyp at 37. And i had been screened just two year earlier and was clear...but I pushed for another. Had i waited til 50...

    •  This is total bullshit Dr DZ (1+ / 0-)
      Recommended by:
      BYw

      And it may be that other doctors lied to you.

      Find me one case that fits what you described and I will check it out.

      The problem is with most screening tests for rare problems are so poor you have more FALSE NEGATIVES than you have cases found. And way more FALSE POSITIVES that scare the hell out of patients and their families.

      I'm asking you to believe. Not in my ability to bring about real change in Washington ... I'm asking you to believe in yours. Barack Obama

      by samddobermann on Sat May 14, 2011 at 01:36:33 PM PDT

      [ Parent ]

      •  re false negative/positive (0+ / 0-)

        the key part of your comment is rare problems. Prior probability is key. You don't look routinely for heart disease in kids because it is rare. You do look in overweight, sedentary smokers in their 60s because it isn't rare. The National Preventative Care Task Force that makes these recommendations takes prior probability into account. Actually they tend to get criticized more for recommending against screening because it isn't cost effective, but plenty of people know someone who wouldn't have been treated in a timely fashion without going against the screening recommendations.

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