We spend 3 trillion dollars a year on health care. As compared to other countries, 800 billion dollars per year is wasted. Yet Congress lacks the political will to address this issue. Is it any wonder that the Congressional approval rating is at 13%? A system overhaul is needed. First, start with areas where major cost savings can be obtained. For example, full cost transparency would lead to added marketplace competition. Tort reform would reduce the need for practitioners to practice defensive medicine by ordering extra medical procedures. The long process will lead to a comprehensive plan. Political will comes from large groups of people or Congressional action. Dont hold your breath waiting for Congressional action. Large groups start as small groups. Join me in a group with the specialized intention of reforming the health care system. Its a fledgling group called the American Freedom Party. You can find it under Facebook groups.
The key is tort reform. We need a major overhaul in civil law in this country in order to lower healthcare costs. The completely broken civil legal system in our country is directly responsible for the broken aspects of our healthcare system.
You state we spend 3 trillion dollars per year on health care. Can you break that down by who spends this? I would suggest that there are 3 groups. Federal Government, Medicare(spends a large percentage), State governments Medicaid(spend the next largest percentage) and businesses through Group health insurance spend the third largest percentage; leaving individual/families spending the lowest percentage. With the increase in numbers of individuals qualifying for Medicare, it is no wonder health care Medicare costs are rising at a fast pace. With the drastic increase in regulations passed by the Federal Government it is no wonder the cost of providing health care has continued to rise since the mid 1990's.
I am not so concerned as to who spends for health care. If a colonoscopy cost $7,000 but it should cost $4,000, someone is paying too much. The cost savings would benefit all of us with either reduction of personal health care cost or reduction of taxes needed to support government spending. The point is that there's $3,000,000,000 being spent and we are spending too much. Philosophically, the governments of other countries have more control over their health care delivery systems. In order to reduce costs, we will probably need to keep the government involved at a high level. It’s a gradient between pure capitalism and pure socialism. All of the other countries have moved the balance of the scale more toward socialism and have lower health care costs. It's not whether we like capitalism or like socialism, what we all like is lower costs. Keep in mind that pure capitalism allows monopolies to operate unhindered. Pure capitalism would allow each post office to set its own rates. Some of our health care delivery system may be too capitalistic. Having said that, I am not convinced that a single-payer system is necessary and I am not convinced that it is the best system. It may be possible to create a health care delivery system that keeps cost in line with other countries, is superior to systems in other countries, and allows an appropriate useful blend between capitalism and socialism. That's the goal.
Can you Actually document what the impact of tort reform would be on actual healthcare costs. Most data I have seem shows this to be a very small part of the total cost unless one makes Hugh assumptions about how much unnecessary testing is going on and then ascribes all of the estimated unnecessary testing to fear of being sued. Now if the AMA was actually self policing there might be a reduced number of malpractice cases.
"If a colonoscopy cost $7,000 but it should cost $4,000, someone is paying too much." The problem is that physicians do not work for the Federal government. They provide a service. They pay rent, salaries, buy supplies, pay utilities, pay to comply with Federal and State regulations; AND, like lawyers, accountants, electricians, plumbers and all other "service" providers can charge a fee for their service that they find reasonable and that covers their costs of providing care and provides them the profit they want. So who determines the cost of a colonoscopy? The surgeon. Just as a lawyer or accountant determines what they will charge for their services. If you think a surgeon or doctor or any other provider of health care is charging too much, then shop around. That is what should be happening. If it were, prices would go down, not up. If you and other dems and liberals want to "set" the fees doctors and hospitals and other medical care professionals can charge, then you would need to pass a law making them all federal employees. Should the Federal government be allowed to set the salaries of all workers? Set the fee a plumber, electrician, accountant, lawyer, waitress, school teacher and so on; can earn per hour?
Husband a surgeon and I have been a health care administrator for over 25 years. Tort reform helps lower the cost of providing health care as it lowers the Providers overhead. But, I agree it is a small part of lowering costs. Unfortunately, people fail to understand that the federal governments "cost" of medical care, primarily Medicare; is far different than the providers cost of providing medical care. Everything the Federal government has done and private insurance companies have done since the mid 90's has increased operating costs for providers. On top of the increased costs, reimbursements have steadily declined with the onset of PPO's, HMO's and managed care. You simply can't keep increasing the costs of providing health care and continually decreasing what you pay or allow physicians and other providers to charge for their services. One thing about malpractice is the truth in my years of experience; when lawyers are willing to take lawsuits on contingency, basically getting more money then their client if they win; the number of malpractice suits will remain high, whether they have merit or not. More malpractice companies are starting to defend their insured health care providers regardless that it costs 4x more than pay the defendant and their attorney off. Why? 1. more doctors and hospitals are demanding they be defended, 2. the insurance companies are finding that lawyers are less likely to file "frivolous" law suits. Texas reduced what patients can sue for. I am not sure I agree with this approach because where a patient was truly wronged, the jury should be able to determine the "award". I am more incline to support "medical grand juries" that decide whether a case has any merit before it can go forward. And, I also support the "plantif" and their "attorney" being responsible for legal and court fees of the "provider defendant" if it is found it was a frivolous law suit or the provider defendant is found not guilty. This will stop lawyers from taking cases that have no legal merit.
That failed to provide the cost impact of tort reform. If you are going to eliminate the ability of lawyers to take cases on contingency you will eliminate both the valid and the frivolous lawsuits and essential eliminate free enterprise in the legal arena. For that degree of government interference in the free enterprise system you are going to have to post some major justifications. And hey, if you are going to eliminate lawyers taking cases on contingency why just stop at medical cases. How about product liability cases, financial cases, accident cases, etc, etc.
Actually, the insurance companies pretty much determine the cost of medical procedures by setting reimbursement rates. Medicare and Medicade do the same. The only rate shopping and negotiating used to be by us uninsured people and believe me It is never a very successful process because individuals have nowhere near the clout that insurance companies posess.
Cost transparency is critical to reducing health care costs. Just try asking a physician how much a procedure will cost. They do not know. So how can we shop around if the provider does not disclose the cost while we are making the health care choice? When insurance companies determine compensation rates, that's a gravy train for every one except the person paying the bill. Is there not a built-in incentive to order additional test that may or may not be needed? The entire system needs to be overhauled. Its too easy to pick apart one aspect of the system and say 'that's not going to help much'. Effectively we are paying a 40% tax on every medical procedure because of the inefficiency of the system. We must focus on the enormous overall benefits of reducing health care costs. We have a do-nothing Congress with a 13% approval rating. They go to church every Sunday and bow down to worship the status quo. Why?, because they personally benefit from the 40% tax. So long as they can keep you and I arguing about reform methods and not focusing on ways to reduce the 40% tax, they are completely satisfied.
Still missing any actual data on savings from tort reform. Must be hard to document largely illusory savings.
It would save ten of billions, if not hundreds of billions, of dollars every year. I am a hospitalist, (e.g. internal medicine physician that works purely in a hospital setting). For the overwhelming majority of patients that I see, I am forced to order unnecessary tests for fear of absurd lawsuits, and I am certainly not alone in that practice. Every emergency room physician that I have encountered in my career (probably around 2 dozen) orders a plethora of unnecessary tests for the fear of lawsuits. Moreover, every internal medicine doctor or subspecialist who admits patients in every hospital that I have worked does the same thing. I have attended national meetings of physician organizations, and whenever this subject is brought up, their is a 100% consensus on this issue. It has been 5 years since I have completed residency, and without breaking a sweat I can estimate my unnecessary testing/admissions due to lawsuit fears to be at least several million dollars. Show me this "data" that you speak of. No doubt it came the American Association for Justice or some other corrupt trial lawyer lobbying firm. The real data is the following. The USA has the highest per-capital medical costs in the world. Our medical costs are significantly higher than countries in Europe with similar populations. The main difference between the USA and these European nations is that these countries in Europe have a more sane civil legal system. We pay $8,233 annually per person here in America. In Europe, depending on what country you are in, they are paying between $3,000-$5000 annual per person. Our obesity rate alone does not account for this difference nor does our more diverse population. Clearly our insane civil legal system, where a doctor can be sued for ANYTHING imaginable, is a major factor in this discrepancy in healthcare cost between the USA and Europe. http://www.pbs.org/newshour/rundown/health-costs-how-the-us-compares-with-other-countries/ The medical field is probably the most regulated field in the country. What in the world are you talking about with your AMA comment? Even if I disregard the fact that the AMA is the most impotent organization in the history of organizations, your statement still makes no sense. What does "self-policing" of the AMA have to do with frivolous lawsuits? On the same note, where is the "self-policing" from the American Bar Association on these ambulance chaser lawyers? G-d only know how many ethics violations these trial lawyer firms rack up on a daily basis.
So you have no actual source or data for your claim that tort reform will save considerable amounts of money. Just parroting the Republican party line with no backup
Post #12 doesn't have any actual data either. It is OK to have any opinion but even better to have facts.
I see your strategy: First, you ignore the evidence that I do present (e.g. the link that shows the per capita cost of healthcare in America is 2-3 times that of any country in Europe and 4 times that of Israel and some other countries). Next, you fail to address my logical argument that the average European is not 2-3 times healthier than the average American, the procedures and medications used in America are essentially identical to those of Europe, and the life expectancy is similar between the USA and European countries. Thus, there must be something else that accounts for the vast discrepancy in per capital cost between countries in Europe and America. The main thing that comes to mind that can account for this huge discrepancy is the fact that European society is not nearly as litigious because their civil legal system is very different than ours, and they are unable to sue their physician for looking at them the wrong way. You also ignore the fact that every physician that I have ever spoke to (dozens upon dozens) practices defensive medicine. Let's summarize. You ignore first-hand accounts from dozens of physicians that defensive medicine exists. You then ignore the data that I present. Then, after your ignore everything, you hilariously conclude that I "have no data." Funny stuff. No. I am actually relying on data in conjunction with logic and common sense (something you left-wing ideologues are incapable of). I guess you're adhering to the Democratic Party plan of sticking you head in the sand and hoping that nobody will call you out on your flagrant inaccuracies.
Logic dictates that it obviously will work. If the civil legal system was changed for the better and you actually forced ambulance chaser lawyers to find an actual reason to sue physicians (e.g. proving that a patient's bad outcome was due a physician failing to adhere to the "standard of care"), then physicians would stop practicing defensive medicine and tens or hundreds of billions of dollars would be saved. We unfortunately do not have such a system and lawyers can sue any doctor at any time for literally ANYTHING. If you do not think that this travesty of a civil legal system causes doctors to try to protect their own back as much as they possibly can (by ordering every test under the sun), then you are unable to apply logic appropriately.
One simple change will go a long way towards fixing this: LOSER PAYS. Bring a suit against me. If you lose, ALL COSTS of bringing that suit are on YOU, including compensation for MY TIME to defend myself.
so you fantasy is all you have. i have data. http://www.statesman.com/news/news/local/new-study-tort-reform-has-not-reduced-health-care-/nRpcp/ http://www.press.uchicago.edu/ucp/books/book/chicago/M/bo3662467.html Logic isn't logical when the facts are against you. So stop trying to sound like you know what you are talking about. Your insult not withstanding believing a fantasy without data isn't logical.
Of course that protects the wealthy and corporation and id based on the fantasy that there are too many frivolous lawsuits. There aren't and frankly this would go a long way to protect bad actors in these scenarios.
Actually you have provided Absolutly no data to back up your statement for savings from tort reform. Personal stories and logic and common sense are not an acceptable substitute for actual data. The fact that healthcare costs and results in the United States are inferior to most developed countries is not in dispute but is irrelevant to the issue of savings from tort reform. It is your leap of logic that assumes the discrepancy in costs and results is due to our tort system that needs actual documentation.
So, in your mind, firsthand accounts from dozens of doctors who have to deal with this nonsense every day is "fantasy?" Also, in your mind, actual data that shows the vast discrepancy in per capital medical costs between the USA and every other country in the world (despite similar populations and identical treatment methods) is "fantasy?" I think it's you who is living in a fantasy world. Are you kidding me. This, "study" of yours (and I use that term loosely) only looks at the extremely modest reforms passed in Texas (e.g. "Texas-style tort reform"). The real tort reform that doctors like myself are talking about are nothing like the laws passed in Texas. What we want is to pass common sense reforms of the civil legal system that force weasel lawyers to actually prove beyond a reasonable doubt (a foreign concept to these lawyers) that a patient's bad outcome was the direct cause of a specific physicians failure to adhere to the standard of care. There are no negative aspects of such proposals (besides limiting the ability of ambulance chasers to steal healthcare dollars), so I cannot fathom to understand why anyone who is not a greedy slip-and-fall lawyer would be against them. For example, if a hospitalized patient with a gangrenous right leg undergoes surgery, and the surgeon carelessly amputates the left leg, the patient should not be able to sue the internal medicine doctor that is ordering the antibiotics, nor the cardiologist who cleared him for the surgery, nor the ophthalmologist who was called to treat his pink eye, nor the gastroenterologist who treated his IBS, etc. However, with our crazy legal system, all of the aforementioned consulting physicians who had absolutely nothing to do with the surgeon's error, will be named in the lawsuit, and they have to waste their own time (not to mention their patients' time) and money to fight this absurd lawsuit. This is not even the link to a study. Rather, it is a link to a book written by a self-serving lawyer. It's hilarious that you dismiss the actual evidence and firsthand accounts that I have presented, and yet, when it's your turn to present evidence, you provide this biased nonsense. You are confusing biased nonsense, like that Tom Baker fantasy book, with actual facts. Try again. Let's recap: You are not a physician. You have no experience in the healthcare field regarding ordering tests for patients in a hospital setting or even an outpatient setting. You have provided absolutely no evidence to support your argument. I, on the other hand, am a physician. I admit around 1500 patients to hospitals annually and take care of thousands more on the hospital floors. I write tens of thousands of orders for these aforementioned patients annually. I have spoken to dozens of physicians regarding this topic of discussion and they agree that the civil legal system is broken a major cause of healthcare expenditure. Unlike you, I have presented statistical evidence should a vast discrepancy in per-capital healthcare costs between the USA and every other country in the world, and this discrepancy can be explained by our warped legal system. So, given the above information, you somehow have the audacity to state that I have no idea what I am talking about? Talk about keeping one's head in the sand. It's like having someone who never served in the military impugn a veteran's account of the existence of post traumatic stress syndrome. My insult? Where in the world did I insult you? I stated that anyone who believes that doctors not having to order tens or hundreds of billions of dollars in tests wouldn't save tens or hundreds of billions of dollars is not a logical person. The onus is on you to be a logical person or not. Then are you willing to change your viewpoint?
