Profits Before Patients - A PBS Interview w/Bill Moyers

[Lastchance09]

What really gets me are these senior citizens holding up signs at these townhall meetings that demand that the govt. keep its hands off medicare. Who do they think runs medicare? The public option being proposed now in congress is just that, a public option. If you have health insurance, keep it. If you don't have health insurance, why wouldn't you want an option that would lower tje premium? I think people are getting so ginned up they really don't stop and think about what congress and the president are trying to do. Morever, even for those who have insurance provided by their employer (which I do), the current system cannot be sustained and sooner rather than later, your employer will no longer be able to offer you health insurance. There has to be a way to get all or most people covered so that those of us who are insured are not footing the bill for the uninsured that show up at the ER. Somebody is paying for the uninsured and that somebody looks alot like the rest of us.

Exactly! What ever happened to their belief that they want to leave their grandchildren a better America.

 

[Lastchance09]

I hate discussing this because we're going through this right now. DH left clinical medicine because of two BS lawsuits (neither of which have gone to trial yet, and it's been over 6 years). It changed the way he practiced medicine so much, he felt it was more ethical for him to get out than to practice defensive medicine.

Anyway, I just wanted to pop up and say...yep, malpractice is a part of the problem. You all pay one way or another. Defensive medicine and the loss of good physicians does affect you.

I hope this all gets hammered out soon.

I hate to break it you guys, but tort reform will not lower health care costs. Here is a snippet from an article on Salon magazines website:

Since 1986 more than half of the 50 states have enacted some kind of tort reform. For example, 34 states have legal limits on punitive damages, and 23 states have capped “non-economic” damages. By now we should be able to measure the real impact of tort reform.

We find in several states that tort reform has significantly reduced rates of medical malpractice insurance paid by physicians. This in turn has helped some states attract more physicians, especially physicians in high-risk practices, such as surgery.

However, we also find, in state after state, that the passage of tort reform laws does nothing to reduce overall health care costs. Health care costs and patient insurance premiums continue to increase at the same rate as before, if not faster. And the promised cost reductions from less “defensive medicine” never materialize.

Further, tort reform does nothing to make medical care safer. And patients whose lives have been devastated by malpractice find it much more difficult after “tort reform” to seek justice in courts.

You can read the rest of the article here:

http://open.salon.com/blog/mahabarbara/2009/05/04/the_truth_about_health_care_and_tort_reform_part_i

 

[DDRdiva]

Don't call them dumb! they are good hardworking Americans who have different opinions, that's all.

Seriously, it's very disturbing to hear what these people believe. Even when told the facts, they call you a liar.

The anti-health-care geniuses also came up with this nugget
http://scienceblogs.com/dispatches/2009/08/dumbass_quote_of_the_day_47.php

 

[Lastchance09]

Tort Reform Won't Help Lower Health Care Costs

From Slate Magazine:

After all, including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending.

The most impressive and comprehensive study is by the Harvard Medical Practice released in 1990. The Harvard researchers took a huge sample of 31,000 medical records, dating from the mid-1980s, and had them evaluated by practicing doctors and nurses, the professionals most likely to be sympathetic to the demands of the doctor's office and operating room. The records went through multiple rounds of evaluation, and a finding of negligence was made only if two doctors, working independently, separately reached that conclusion. Even with this conservative methodology, the study found that doctors were injuring one out of every 25 patients—and that only 4 percent of these injured patients sued.

And from a study done in May 2006 on whether these lawsuits are mostly frivolous:

But a new study, released in May, demolishes that possibility. Dr. David Studdert led a team of eight researchers from Harvard School of Public Health, Brigham and Women's Hospital, and the Harvard Risk Management Foundation* who examined 1,452 medical malpractice lawsuits. They found that more than 90 percent of the claims showed evidence of medical injury, which means they weren't frivolous. In 60 percent of these cases, the injury resulted from physician wrongdoing. In a quarter of the claims, the patient died.

Nor is there evidence to show that the level of jury awards has shot up. A recent RAND study looked at the growth in malpractice awards between 1960 and 1999. "Our results are striking," the research team concluded. "Not only do we show that real average awards have grown by less than real income over the 40 years in our sample, we also find that essentially all of this growth can be explained by changes in observable case characteristics and claimed economic losses."

You can read the article here: http://www.slate.com/id/2145400/#Return

And this is what then Senators Hillary Clinton and Barack Obama recommended in 2006 in an interview with the New England Journal of Medicine. They want to focus on medical errors.

We all know the statistic from the landmark 1999 Institute of Medicine (IOM) report that as many as 98,000 deaths in the United States each year result from medical errors.1 But the IOM also found that more than 90 percent of these deaths are the result of failed systems and procedures, not the negligence of physicians. Given this finding, we need to shift our response from placing blame on individual providers or health care organizations to developing systems for improving the quality of our patient-safety practices.2

To improve both patient safety and the medical liability climate, the tort system must achieve four goals: reduce the rates of preventable patient injuries, promote open communication between physicians and patients, ensure patients access to fair compensation for legitimate medical injuries, and reduce liability insurance premiums for health care providers. Addressing just one of these issues is not sufficient. Capping malpractice payments may ameliorate rising premium rates, but it would do nothing to prevent unsafe practices or ensure the provision of fair compensation to patients.3

Studies show that the most important factor in people's decisions to file lawsuits is not negligence, but ineffective communication between patients and providers.4 Malpractice suits often result when an unexpected adverse outcome is met with a lack of empathy from physicians and a perceived or actual withholding of essential information.4 Stemming the causes of medical errors requires disclosure and analysis, which create tension in the current liability climate.

The current tort system does not promote open communication to improve patient safety. On the contrary, it jeopardizes patient safety by creating an intimidating liability environment. Studies consistently show that health care providers are understandably reticent about discussing errors, because they believe that they have no appropriate assurance of legal protection.5 This reticence, in turn, impedes systemic and programmatic efforts to prevent medical errors.

To overcome the impasse in the debate on medical liability, we have introduced legislation, the National Medical Error Disclosure and Compensation (MEDiC) Bill (S. 1784), to direct reform toward the improvement of patient safety. Our proposed MEDiC program provides grant money and technical assistance to doctors, hospitals, insurers, and health care systems to implement programs for disclosure and compensation. The MEDiC model promotes the confidential disclosure to patients of medical errors in an effort to improve patient-safety systems. At the time of disclosure, compensation for the patient or family would be negotiated, and procedures would be implemented to prevent a recurrence of the problem that led to the patient's injury.

You can read the article here: http://http://content.nejm.org/cgi/content/full/354/21/2205




I know most people won't click on the links and will stick with what they believe, but I believe strongly that conventional wisdom should be challenged and the conventional wisdom is that tort reform would help lower health care costs. I do believe however, that the threat of lawsuits scares good doctors away.

 

[LaughingWater]

Aaaaand this is why I hate discussing this.

Sounds like a biased article to me, only because of the "tort reform" and "defensive medicine" quotes.

I clicked on her bio but didn't get anything. Is the author a physician or a nurse? Does the author have any experience whatsoever with how medicine is practiced? Has she had the kind of pressure physicians and nurses have on their shoulders every single day? Has she had to make split-second decisions with someone's life hanging in the balance? And after making those decisions, has she had them second-guessed by untrained individuals who seem to think that bad outcomes should never happen...ever...in medicine. (Which means you technically should never get old, your heart should never give out, and we should all live forever.)

I'm not being snarky with you personally, LastChance. I just need to know if this author, who obviously has a very strong opinion about tort reform, has any experience at all with the practice of medicine. And if so, how much?

 

[LaughingWater]

I do believe however, that the threat of lawsuits scares good doctors away.

That's my point.

You have no idea how many talented doctors have thrown in the towel. I'm not just talking about my husband. We've seen countless good physicians leave our hospitals, and because we know them personally, we know why they are leaving.

In the end, it won't hurt me as long as I have DH and our social circle of good docs. But other people have lost access to them, and that's a shame.

 

[LauraMax]

There is only a discussion of a co-op in the final bill. The co-op is being suggested by a Senator Wyden and he would also make it mandatory for everyone to purchase health insurance. Its critics say it would not keep the private insurers honest but a ton of money because we would be required to purchase insurance through private companies. If there is a co-op option there is no public option - which I prefer.

Also, please remember that there is no bill, yet. there are 3 completed proposals, 1 still has not left the finance committee - that would make 4 proposals being sent to Obama. Then he will negotiate with all the committees, come to agreement and then the final bill still has to go through mark-up and even more negotiations.

Basically it's going to be a long year.

Well, this is the first time I'm hearing about THREE bills (yes, they are bills, not "proposals" AKA proposed laws--once approved by Congress bills become laws or acts). And collective purchasing is part of Obama's bill. I can't speak to the other two, not knowing they existed (wonder why CNN, NYT & the local news never mentioned them? ).

I just watched part of a town hall mtg on my lunch hour, & they really are getting ugly. Why would someone go to a town hall mtg where stakeholders/taxpayers want to ask questions/obtain information & try to shout a legislator off the stage? It's just nonsensical to me. The senator almost gave up & walked off the stage a few times, & I can't say I blame her.

 

[sparrow13]

I just watched part of a town hall mtg on my lunch hour, & they really are getting ugly. Why would someone go to a town hall mtg where stakeholders/taxpayers want to ask questions/obtain information & try to shout a legislator off the stage? It's just nonsensical to me. The senator almost gave up & walked off the stage a few times, & I can't say I blame her.

They've confused being loud with being right.

These people are just stupid. I have no problem with passionate opinions on this or any other issue but their behavior makes it clear they are not interested in hearing what anyone has to say or even making their own points of view heard and understood. I know I'm never more interested in learning where someone is coming from than when they are screaming in my face or trying to hit me over the head with their purse.

 

[LauraMax]

I know I'm never more interested in learning where someone is coming from than when they are screaming in my face or trying to hit me over the head with their purse.

Holy crap Sparrow, she said almost the exact same thing! Something like "do you think you're going to change anyone's mind by shouting at them?"

And how did they respond? They shouted louder.

 

[kathryn]

Why would someone go to a town hall mtg where stakeholders/taxpayers want to ask questions/obtain information & try to shout a legislator off the stage? It's just nonsensical to me. The senator almost gave up & walked off the stage a few times, & I can't say I blame her.

I guess when you can't win an argument through reason and discussion, you try to shout down the opposition (bully tactics).

They are being fueled by Republicans, the pharmaceutical industry and insurance industry spouting their lies about the HC proposals, and it doesn't seem like they're open to hearing the truth.

 

[PhyllisG]

I had to shut off the TV and stop listening to the news on four different channels. I just felt so discouraged listening to these people yelling and screaming. I heard one man who brought a gun to a meeting! I saw another young woman in PA almost in tears worrying over the dismantling of the Constitution thru health care reform. What is really going on here? It just really started to sound dangerous and whoever is stirring this pot is really playing with fire.

 

[baylian]

There is no friggin money left in the government for this . . it will be a behemoth anchor that sinks this country.

And who is going to run it - ACORN??????????????

The reason they are in such a yank to push this through is that the Dems know that their proverbial goose could be cooked with the 2010 elections.

And Cash for Clunkers was a HUGE mistake. Do you know that the majority of the cars bought were foreign??? Living in MI I can hardly stand to see a picture of that cow Debbie Stabenow.

Yeah - I'm gonna get flamed but so what . . have been off the boards for a while. It's football time again!

BTW - nice avatar LauraMax, I shot by one of your posts because I didn't see Cookie!

Speaking of which - is it true (seriously) that Cookie Monster doesn't sing his song anymore or profess his love of cookies because it's considered not PC for health reasons?? Honestly someone told me that the other day. And that Oscar the Grouch is no longer "grouchy" . . . If this is true - good grief! What's next? Lucy can no longer swipe the football from the incoming Charlie Brown or take away her brother Linus's blanket????? And I am sure Pig Pen has been cleaned up as well . .

Gotta hit the shower . . nice long run tonight with no hip pain!

Let's talk about something more engaging - like - The Housewives of Hotlanta!!!

 

[PhyllisG]

Yes health care will be the anchor that sinks this country if we don't find a way to reform it. These industry bureaucrats are stuffing your dollars into their pockets. Every health care nickel they pay to themselves is care denied to a patient. One hundred thousand dollars an hour?! Whose money do you think that is? No senior is giving up medicare, no veteran is giving up VA benefits, and no congressman is giving up their benefits. All of these are govt run programs.

 

[hiitdogs]

What does ACORN have to do with health care, for crying out loud? And why do you always have to resort namecalling?

It will only cost money if we pay for the premiums for those millions of uninsured people, otherwise insurance premiums will pay for it. How do you think insurance companies are making such huge profits that they can pay their CEOs over $ 700 Mio in stock option on top of a $ 3 Mio salary.

 

[LaughingWater]

Has anyone actually read the plan?

The reason I ask is that I heard that it prohibits the creation of any new private plans once the law goes into effect.

I'm not entirely sure what that means, or why that stipulation would be in there in the first place. I may actually look this darn thing up and read it this weekend. (In shifts. )

 

[LauraMax]

Lori, I might just join you, but I have no intention of reading it in a single w/e. I'm actually considering about 10-20 pages a day, & maybe blogging about it (if I can figure out how & where LOL). Granted the blog would be subjective, but probably no more so than news reporters.

I'm gonna call my congressman's office. Probably will have to do a FOIA request, maybe through OMB, & pay for the copying & delivery. I'll let you know what I find out.

 

[LaughingWater]

I've got it online in front of me, and it ain't pretty:

http://patientsunitednow.com/files/full-bill-searchable.pdf

I haven't found anything that prohibits new private plans yet, but I just started looking. Plus I don't speak legalese, which is making this all the more painful.

Your idea for a blog sounds great. It would be wonderful to hear someone's interpretation of it in plain English. Check out https://www.blogger.com/start for a possible blog site.

 

[LauraMax]

Girl, if I tried to download that at work I think I'd crash our network! LOL! Even if I could I wouldn't be able to print it here, & I don't have a computer at home.

You're right about the legalese though--I work a lot w/ordinances & statutes, so I'm hoping I'll be able to get through all the whereases, therefores, herebys, we hold these truths to be self evident...........anyway, hoping there are a lot of pictures & bullet points.

OK, my congressman's office is going to send it to me. There is just to much info out there, & I'm having trouble separating fact from fiction coming from both supporters & opposition. I feel like I need to get a handle on it myself, esp. if I'm gonna argue for its adoption.

And just to clear up some confusion, here's where we stand right now:

--there is only one bill, not 3.
--the bill has been approved by the house & is now being reviewed by 3 committees in the senate:
1) Ways & Means
2) Education & Labor
3) Energy & Commerce
--unlike most bills, this legislation does not have a single sponsor. It's introduced by the committees, not by a single elected official.
--Once committee review is complete, it will go to the senate floor for a full vote.
--If the senate approves, it will be referred to conference committee.
--If conference committee refers its adoption, it will be voted on by house & senate together.

 

[sparrow13]

Has anyone actually read the plan?

The reason I ask is that I heard that it prohibits the creation of any new private plans once the law goes into effect.

I'm not entirely sure what that means, or why that stipulation would be in there in the first place. I may actually look this darn thing up and read it this weekend. (In shifts. )

I've been reading in shifts and had a similar question. In one section it seemed to say that people can remain on their current plans if they are on them when the legislation goes into effect but that they can't leave that plan and go to another private plan after the legislation goes into effect - a grandfather clause of sorts - and also that private insurers can't create any new plans after the fact either. But then later it seemed to contradict that. Maybe I just am processing it incorrectly. At this point I have no freaking idea and am considering a cave in Tibet.

 

[sparrow13]

Hey maybe this should be our new book club choice! Catheites read the health bill with 15 minute breaks to discuss the hotness that is Christian Bale. Heh.