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Direct Link To This Post Posted: March 22 2010 at 05:50
Originally posted by Negoba Negoba wrote:

Originally posted by thellama73 thellama73 wrote:

Originally posted by Epignosis Epignosis wrote:


A basic localized health care system is,  I guess, a moderate view.  I swing hard right on most things, but I in earnest think our health care is too expensive, but it's not because of greedy doctors or evil corporations (that's one popular reductive fallacy).  We need a combination of tort reform (first), so that doctors can lower their fees (and afford to be competitive rather than hamstrung because of malpractice insurance), and then I think we could explore letting local governments manage a health care system that would benefit whomever needed basic care (instead of being told, "Your child just has a ______; it will go away in a few days on its own.  That will be $200").


That's why I think we should expand access to nurse practitioners. They charge a whole lot less and perfectly competent, especially for little things. Let the doctors worry about brain surgery and broken bones. Nurses can handle everyday illnesses for much less money. Unfortunately, there's a bit of a stigma against them. "I'm not taking my child to a nurse! I demand a real doctor!."
 
Oh my lord!!! Two people I'm usually opposed to making complete logical sense!


I always make complete logical sense.  Geek

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Direct Link To This Post Posted: March 22 2010 at 08:33
I've been saving this because I usually don't put personal information on the internet but, my step son served in Iraq, he enlisted out of a sense of patriotic duty after the 9-11 attacks. He received permanent injuries while para-trooping that restrict his body movements and create a lot of pain.

Getting the VA to pay for his needed surgeries has been a constant and ongoing battle in which we have had to appeal to politicians etc. His ability to work and pay for it himself are restricted by his lack of physical movement. My wife helps as much as she can but her funds are restricted, she has permanent restrictive injuries too (non-war related). Her Mom is staying with her and is on a respirator. There is no extended family on their side, they are all they have.



Edited by Easy Money - March 22 2010 at 08:44
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Direct Link To This Post Posted: March 22 2010 at 08:40
This country has a really bad record of helping out those who we ask to put their lives on line for us.
Released date are often when it it impacted you but recorded dates are when it really happened...

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Direct Link To This Post Posted: March 22 2010 at 09:00
Originally posted by Epignosis Epignosis wrote:


A basic localized health care system is,  I guess, a moderate view.  I swing hard right on most things, but I in earnest think our health care is too expensive, but it's not because of greedy doctors or evil corporations (that's one popular reductive fallacy).  We need a combination of tort reform (first), so that doctors can lower their fees (and afford to be competitive rather than hamstrung because of malpractice insurance), and then I think we could explore letting local governments manage a health care system that would benefit whomever needed basic care (instead of being told, "Your child just has a ______; it will go away in a few days on its own.  That will be $200").
 
Rob,
 
I hope you don't think I'm singling you out because I'm not, but I have to take exception to this argument as well.  The Federal Government, healthcare insurance companies, academic experts and even physicians themselves acknowledge that malpractice suits add very little to the overall cost of healthcare.  And many states have passed laws to limit compensatory damages due to medical negligence anyway.
 
WellPoint study on healthcare cost drivers (insurance company).  Says the top 5 reasons for increases are:
 
- Advances in technology and subsequent increased usage
- Price inflation (presumably WellPoint is suggesting providers are jacking up prices, not insurers)
- Cost-shifting from people who are uninsured and those receiving Medicare
- High cost of regulatory compliance
- Patient lifestyles, such as physical inactivity and increases in obesity.

Congressional Budget Office report on malpractice tort reform - shows cost of malpractice insurance is increasing but rate of lawsuits are not, and the rate of increase on overall healthcare costs is much higher than the rate of increase on malpractice damage awards.  Overall the CBO estimates malpractice claims and insurance add only about 2% to the overall cost of healthcare.
 
 
 
 
 
 
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Direct Link To This Post Posted: March 22 2010 at 09:07
The actual suits account for a small bit of the budget, but the insurance rates are considerable. Before I was absorbed into a public clinic, about 12% of what I brought in went to pay my malpractice insurance. I work in a high risk area, so that's not the norm, but it's also not uncommon.
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Direct Link To This Post Posted: March 22 2010 at 09:09
Originally posted by ClemofNazareth ClemofNazareth wrote:

Originally posted by Epignosis Epignosis wrote:


A basic localized health care system is,  I guess, a moderate view.  I swing hard right on most things, but I in earnest think our health care is too expensive, but it's not because of greedy doctors or evil corporations (that's one popular reductive fallacy).  We need a combination of tort reform (first), so that doctors can lower their fees (and afford to be competitive rather than hamstrung because of malpractice insurance), and then I think we could explore letting local governments manage a health care system that would benefit whomever needed basic care (instead of being told, "Your child just has a ______; it will go away in a few days on its own.  That will be $200").
 
Rob,
 
I hope you don't think I'm singling you out because I'm not, but I have to take exception to this argument as well.  The Federal Government, healthcare insurance companies, academic experts and even physicians themselves acknowledge that malpractice suits add very little to the overall cost of healthcare. 
 


With the one data point being my father who is an ex-OB/GYN, I assure you that malpractice suits have a unbelievable effect on the way medicine is practiced.  Malpractice insurance rates are a huge problem.  Practices in my state (Pennsylvania) often shut down completely because the malpractice insurance become unaffordable for the physicians, and it is illegal to practice without it.  This is especially true for the "high-risk" professions (obstetrics being the worst).

I'm not saying your studies are without merit, but I have first-hand accounting from the several physicians I know about how the threat of the lawsuit effects their practice of medicine.  And believe me, it is not insignificant.

But, I'm probably not changing anyone's mind, as usual.
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Direct Link To This Post Posted: March 22 2010 at 12:15
Why am I not surprised to see mostly talking points being regurgitated Confused
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Direct Link To This Post Posted: March 22 2010 at 12:16
Originally posted by Padraic Padraic wrote:



With the one data point being my father who is an ex-OB/GYN, I assure you that malpractice suits have a unbelievable effect on the way medicine is practiced.  Malpractice insurance rates are a huge problem.  Practices in my state (Pennsylvania) often shut down completely because the malpractice insurance become unaffordable for the physicians, and it is illegal to practice without it.  This is especially true for the "high-risk" professions (obstetrics being the worst).

I'm not saying your studies are without merit, but I have first-hand accounting from the several physicians I know about how the threat of the lawsuit effects their practice of medicine.  And believe me, it is not insignificant.

But, I'm probably not changing anyone's mind, as usual.
 
Don't be discouraged - I doubt if I'm changing anyone's mind either. Wink
 
I'm not arguing malpractice insurance rates aren't a problem; indeed I think rising rates for malpractice insurance are a huge problem.  But Epignosis is pitching for tort reform, which addresses limits on malpractice lawsuits, not insurance rates.  In reality 38 out of 50 states have adopted some type of reform, including at least 34 that limit punitive and/or compensatory damages for medical malpractice.  Yet rates continue to climb, including in those states where reforms have been enacted. 
 
In fact a study by Kenneth Thorpe of Emory University's School of Public Health showed that in many states where reform and caps had been enacted, insurance companies ended up reporting higher rates of profitability while the resulting reduction in premiums only averaged about 17%.  In other words the insurance companies benefited from tort reform, but they only passed part of that savings on to the physicians.  Even if this rate of decline were applied to the entire $3.6B spent on malpractice the resulting savings would only be about $600M, which is less than pennies for an industry that is measured in trillions of dollars.
 
Insurance rates for anything related to the healthcare industry are a problem, which just reinforces my argument a few pages back that we need to eliminate these profit-grabbing middlemen from the healthcare equation altogether.  Of course, the bill just passed by Congress doesn't go far enough to do that, but at least it's a start.
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Direct Link To This Post Posted: March 22 2010 at 12:53
Originally posted by ClemofNazareth ClemofNazareth wrote:

Originally posted by Padraic Padraic wrote:



With the one data point being my father who is an ex-OB/GYN, I assure you that malpractice suits have a unbelievable effect on the way medicine is practiced.  Malpractice insurance rates are a huge problem.  Practices in my state (Pennsylvania) often shut down completely because the malpractice insurance become unaffordable for the physicians, and it is illegal to practice without it.  This is especially true for the "high-risk" professions (obstetrics being the worst).

I'm not saying your studies are without merit, but I have first-hand accounting from the several physicians I know about how the threat of the lawsuit effects their practice of medicine.  And believe me, it is not insignificant.

But, I'm probably not changing anyone's mind, as usual.
 
Don't be discouraged - I doubt if I'm changing anyone's mind either. Wink
 
I'm not arguing malpractice insurance rates aren't a problem; indeed I think rising rates for malpractice insurance are a huge problem.  But Epignosis is pitching for tort reform, which addresses limits on malpractice lawsuits, not insurance rates.  In reality 38 out of 50 states have adopted some type of reform, including at least 34 that limit punitive and/or compensatory damages for medical malpractice.  Yet rates continue to climb, including in those states where reforms have been enacted. 
 
In fact a study by Kenneth Thorpe of Emory University's School of Public Health showed that in many states where reform and caps had been enacted, insurance companies ended up reporting higher rates of profitability while the resulting reduction in premiums only averaged about 17%.  In other words the insurance companies benefited from tort reform, but they only passed part of that savings on to the physicians.  Even if this rate of decline were applied to the entire $3.6B spent on malpractice the resulting savings would only be about $600M, which is less than pennies for an industry that is measured in trillions of dollars.
 
Insurance rates for anything related to the healthcare industry are a problem, which just reinforces my argument a few pages back that we need to eliminate these profit-grabbing middlemen from the healthcare equation altogether.  Of course, the bill just passed by Congress doesn't go far enough to do that, but at least it's a start.


I support tort reform for reasons other than cost - although I am honestly surprised at these studies.  The money spent on defensive medicine seems like it would not be insignificant.

And let me be clear - neither I nor certainly my father (obviously) are any fans of insurance companies.  The study you cited above I am sure is a direct result of what often is state-sanction collusion between various insurance companies.
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Direct Link To This Post Posted: March 22 2010 at 15:02
........a doctor in Manhattan  saved a dying man for free, a brazillian grew a tree ..........It's a miracle
...
By the graces of God Almighty, and the pressures of the marketplace, the human race has civilized itself, it's a miracle......
'
For Bill Hubbard, and a congratulatory salute to Barrack ObamaApprove
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Direct Link To This Post Posted: March 22 2010 at 15:19
Originally posted by Chris S Chris S wrote:

........a doctor in Manhattan  saved a dying man for free, a brazillian grew a tree ..........It's a miracle
...
By the graces of God Almighty, and the pressures of the marketplace, the human race has civilized itself, it's a miracle......
'
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haha, i was listening to that album earlier today Big smile
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Direct Link To This Post Posted: March 22 2010 at 15:31
How about tort reform coupled with single payer health insurance?  I'm game.
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Direct Link To This Post Posted: March 22 2010 at 15:51
I've been following the health care bill debate from this side of the pond with great interest, and all I can say is congratulations to the House for passing such a momentous and historic bill last night.

From my perspective over here, the election for Obama was a message that the majority of Americans had tired of the extreme neo-con ideals of Bush, Chaney, et al, so the passing of this bill would seem to accord with the wishes of the majority of ordinary people in USA.

Of course, I am leaving myself wide open here to charges of Limey ignorance, but what the hellLOL
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Direct Link To This Post Posted: March 22 2010 at 16:08
Originally posted by lazland lazland wrote:

I've been following the health care bill debate from this side of the pond with great interest, and all I can say is congratulations to the House for passing such a momentous and historic bill last night.

From my perspective over here, the election for Obama was a message that the majority of Americans had tired of the extreme neo-con ideals of Bush, Chaney, et al, so the passing of this bill would seem to accord with the wishes of the majority of ordinary people in USA.

Of course, I am leaving myself wide open here to charges of Limey ignorance, but what the hellLOL


I wouldn't say that...I'd say a lot of American voters don't know what the hell about much of anything, especially people under 27 (and also, I can tell you that a lot of conservatives were not particularly thrilled with the Republican nominee, so there was some vote splitting).

I can't tell you how many people I've encountered who had huge opinions either way about things but couldn't give good reasons for them.  It's just the way we are- concrete in our opinions, and paradoxically, easily swayed.

I have a litmus test that used to be kind of amusing:

"George W. Bush is the worst President we've ever had!"

"All right.  Could you name ten US Presidents for me?"

"Yeah.  Bill Clinton, George W. Bush, George W. Bush's daddy George Bush, George Washington...Abraham Lincoln, JFK...um....Roosevelt...um...some other George, I forget his name..."

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Direct Link To This Post Posted: March 22 2010 at 21:55
^ sad indictment that for the populace....however I do feel that the general public in USA DO know right from wrong,do have solid principles and do love their country, republica asideWink
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Direct Link To This Post Posted: March 22 2010 at 22:00
Originally posted by Epignosis Epignosis wrote:

Originally posted by lazland lazland wrote:

I've been following the health care bill debate from this side of the pond with great interest, and all I can say is congratulations to the House for passing such a momentous and historic bill last night.

From my perspective over here, the election for Obama was a message that the majority of Americans had tired of the extreme neo-con ideals of Bush, Chaney, et al, so the passing of this bill would seem to accord with the wishes of the majority of ordinary people in USA.

Of course, I am leaving myself wide open here to charges of Limey ignorance, but what the hellLOL


I wouldn't say that...I'd say a lot of American voters don't know what the hell about much of anything, especially people under 27 (and also, I can tell you that a lot of conservatives were not particularly thrilled with the Republican nominee, so there was some vote splitting).

I can't tell you how many people I've encountered who had huge opinions either way about things but couldn't give good reasons for them.  It's just the way we are- concrete in our opinions, and paradoxically, easily swayed.

I have a litmus test that used to be kind of amusing:

"George W. Bush is the worst President we've ever had!"

"All right.  Could you name ten US Presidents for me?"

"Yeah.  Bill Clinton, George W. Bush, George W. Bush's daddy George Bush, George Washington...Abraham Lincoln, JFK...um....Roosevelt...um...some other George, I forget his name..."

Ermm


I love naming the presidents! I know them all in order. My current favorite is Grover Cleveland, rainy day president #22 & 24
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Direct Link To This Post Posted: March 22 2010 at 22:03
 ^ ^ it's one of the reasons an Electoral College exists, to avoid mob rule .. that said, the US is way too diverse and large to buy into the impression that the vast majority are knuckle-dragging buffoons--  there are many of those, and they make a loud noise, but they are easily startled by the truth







Edited by Atavachron - March 22 2010 at 22:04
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Direct Link To This Post Posted: March 22 2010 at 22:09
Originally posted by Atavachron Atavachron wrote:

 ^ ^ it's one of the reasons an Electoral College exists, to avoid mob rule .. that said, the US is way too diverse and large to buy into the impression that the vast majority are knuckle-dragging buffoons--  there are many of those, and they make a loud noise, but they are easily startled by the truth




Not what I said at all.

I said strongly opinionated and easily swayed.  I did not imply barbarians (and how in the world does the Electoral College today prevent "mob rule?" Confused). 

And as for truth, that still exists here?
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Direct Link To This Post Posted: March 22 2010 at 22:14
^ When Man seeks out truth as a form of recreation then we might be savedHug
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Direct Link To This Post Posted: March 22 2010 at 22:21
Originally posted by Epignosis Epignosis wrote:

Originally posted by Atavachron Atavachron wrote:

 ^ ^ it's one of the reasons an Electoral College exists, to avoid mob rule .. that said, the US is way too diverse and large to buy into the impression that the vast majority are knuckle-dragging buffoons--  there are many of those, and they make a loud noise, but they are easily startled by the truth


Not what I said at all.
I said strongly opinionated and easily swayed.  I did not imply barbarians

  - didn't you ?

(and how in the world does the Electoral College today prevent "mob rule?" Confused). 

   - "Additionally, in the Federalist No. 10, James Madison argued against "an interested and overbearing majority" and the "mischiefs of faction" in an electoral system. He defined a faction as "a number of citizens whether amounting to a majority or minority of the whole, who are united and actuated by some common impulse of passion, or of interest, adverse to the rights of other citizens, or to the permanent and aggregate interests of the community."

And as for truth, that still exists here?

   - it's a glib question, and difficult to answer other than in philosophic terms, so I'll ignore it.








Edited by Atavachron - March 22 2010 at 22:24
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