A simple idea about healthcare (Full Version)

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truckinslave -> A simple idea about healthcare (3/6/2010 6:45:06 AM)

Let's reduce the cost of healthcare. Doctors earnings are one key ingredient, no?

1. To the best of my knowledge, medical schools in America fill every year.
2. When demand for a service remains steady, and supply increases, the cost of that service drops.

Q.E.D. To reduce the cost of healthcare, and health insurance, increase the number of people graduating from med school.

The government could facilitate this in any number of ways- from direct funding to tax incentives for start-up schools to starting their own as adjuncts to the military academies.

(If we increased the capacity of the medical school system to the point that there were more slots than qualified applicants, the cost of medical education should drop as well, also helping us achieve our goal).




mnottertail -> RE: A simple idea about healthcare (3/6/2010 6:50:22 AM)

so...................lets keep that in our pocket for some 10-12 years down the road when they graduate, what you got for the current crisis?




eyesopened -> RE: A simple idea about healthcare (3/6/2010 7:12:44 AM)

One thing about the current crisis isn't the amount of money doctor's make... it's about how much doctors have to spend... especially in malpractice insurance.  Tort reform would be a more immediate part of the solution.

I posted about a doctor who donates his time and service.  One problem he's run into is hospitals unwilling to donate space anymore.  It's that hospitals are so afraid of lawsuits that they fear being humanitarian.  There really are doctors who do not charge much.  There really are doctors who donate their time and talents.  It's really isn't the doctors who are the problem... it is the lawyers and the people who feel that they are absolutely entitled to sue their way through life.

Of course no one is interested in doctors who donate time, obviously, but maybe we can address the real causes of the problem.




DomKen -> RE: A simple idea about healthcare (3/6/2010 7:32:31 AM)

From the studies I've seen their isn't really a shortage of most specialties. The shortage that affects access is primary care physicians which is usually blamed on the fact that primary care docs make less money that specialists and the huge debt load most people acquire in completeing med school encourages them to go into higher paid specialties. Finding ways to get more primary care doctors is already part of the bill the Senate passed.

Malpractice insurance isn't really much of an issue. We've already greatly reduce the number of cases brought and the amount of money won and spent under the guise of tort reform.




Sanity -> RE: A simple idea about healthcare (3/6/2010 7:33:08 AM)


That reminds me of the way X number of years ago Libs said we shouldn't try to develop Alaska's ANWR oil fields because it would take X years to develop.

I guess to a Lib, if its not IMMEDIATE gratification, its nothing.


quote:

ORIGINAL: mnottertail

so...................lets keep that in our pocket for some 10-12 years down the road when they graduate, what you got for the current crisis?




TheHeretic -> RE: A simple idea about healthcare (3/6/2010 7:39:30 AM)

quote:

ORIGINAL: DomKen

We've already greatly reduce the number of cases brought and the amount of money won and spent under the guise of tort reform.


Evidence to back this statement?




DomKen -> RE: A simple idea about healthcare (3/6/2010 7:48:08 AM)


quote:

ORIGINAL: TheHeretic

quote:

ORIGINAL: DomKen

We've already greatly reduce the number of cases brought and the amount of money won and spent under the guise of tort reform.


Evidence to back this statement?

http://www.cbo.gov/doc.cfm?index=5549&type=0
http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=103623715.html
http://www.centerjd.org/air/TrueRiskF.pdf




truckinslave -> RE: A simple idea about healthcare (3/6/2010 7:53:36 AM)

I've read several of your other posts on this subject, and you obviously know way more about healthcare than not just the vast majority of us, the general public, but also than, what?, maybe 520 of the 535 people voting on the issue?

Never meant to promote this as a "fix", just as one idea that might incrementally help. (And, btw, isn't the situation almost exactly the opposite for nurses? Don't "we" keep paying tham more, and there's still a shortage?)




truckinslave -> RE: A simple idea about healthcare (3/6/2010 7:58:53 AM)

quote:

Malpractice insurance isn't really much of an issue


Good to know. Then, no one will object to further, substantive tort reform?

Whether or not you think malpractice insurance is "much of an issue", I've heard many doctors say otherwise; and the real savings from substantive tort reform lies not so much in possible reductions in malpractice insurance but from reducing the perceived need for "defensive medicine", which is a huge, and hugely expensive issue.




Louve00 -> RE: A simple idea about healthcare (3/6/2010 8:00:20 AM)

And aside from the cost of malpractice insurance is the cost of technology.  The price of an x-ray machine, never mind an MRI machine, or a CT or ultrasound is outrageous.  And the cost of lab equipment to run your blood samples.  Back in the day when there was no insurance companies and you just paid your dr out of your pocket, as he was leaving your house and moving on to his next patient, medical care was completely affordable.  But we didn't have the technology to know we were getting or developing health issues so we didn't live as long in those days.  Once technology started to advance, the need for insurance to help pay for it all became needed.  But there's a well known quote that reads....."Absolute power corrupts absolutely".  It's true.

*Editted to add...after re-reading DK's thread (or maybe truckinslave), I realized I parrotted his remark with his mention of "defensive medicine"




DarkSteven -> RE: A simple idea about healthcare (3/6/2010 8:01:19 AM)

quote:

ORIGINAL: eyesopened

One thing about the current crisis isn't the amount of money doctor's make... it's about how much doctors have to spend... especially in malpractice insurance.  Tort reform would be a more immediate part of the solution.


I don't like the idea of tinkering with doctors' compensation.  After all, it's the doctors' and nurses' knowledge and skill that health care is supposed to be paying for.

Insurance, the HMOs, and the political systems to administer health care add money but add questionable value.  Let's chop there first.





mnottertail -> RE: A simple idea about healthcare (3/6/2010 8:02:47 AM)


quote:

ORIGINAL: truckinslave

quote:

Malpractice insurance isn't really much of an issue


Good to know. Then, no one will object to further, substantive tort reform?

Whether or not you think malpractice insurance is "much of an issue", I've heard many doctors say otherwise; and the real savings from substantive tort reform lies not so much in possible reductions in malpractice insurance but from reducing the perceived need for "defensive medicine", which is a huge, and hugely expensive issue.



I will. In terms of fixes, when there is a public option, then I will agree that tort reform is worth looking at. fix the big ones, then the little ones.




rulemylife -> RE: A simple idea about healthcare (3/6/2010 8:18:07 AM)

quote:

ORIGINAL: eyesopened

One thing about the current crisis isn't the amount of money doctor's make... it's about how much doctors have to spend... especially in malpractice insurance.  Tort reform would be a more immediate part of the solution.


Would Tort Reform Lower Costs?


...One critic is Tom Baker, a professor of law and health sciences at the University of Pennsylvania School of Law and author of “The Medical Malpractice Myth,” who believes that making the legal system less receptive to medical malpractice lawsuits will not significantly affect the costs of medical care. He spoke with the freelance writer Anne Underwood.


Q. A lot of people seem to have taken up the cause of tort reform. Why isn’t it included in the health care legislation pending on Capitol Hill?

A. Because it’s a red herring. It’s become a talking point for those who want to obstruct change. But [tort reform] doesn’t accomplish the goal of bringing down costs.


Q. Why not?

A. As the cost of health care goes up, the medical liability component of it has stayed fairly constant. That means it’s part of the medical price inflation system, but it’s not driving it. The number of claims is small relative to actual cases of medical malpractice.


Q. But critics of the current system say that 10 to 15 percent of medical costs are due to medical malpractice.

A. That’s wildly exaggerated. According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail.





Musicmystery -> RE: A simple idea about healthcare (3/6/2010 8:23:33 AM)

quote:

ORIGINAL: truckinslave

Let's reduce the cost of healthcare. Doctors earnings are one key ingredient, no?

1. To the best of my knowledge, medical schools in America fill every year.
2. When demand for a service remains steady, and supply increases, the cost of that service drops.

Q.E.D. To reduce the cost of healthcare, and health insurance, increase the number of people graduating from med school.

The government could facilitate this in any number of ways- from direct funding to tax incentives for start-up schools to starting their own as adjuncts to the military academies.

(If we increased the capacity of the medical school system to the point that there were more slots than qualified applicants, the cost of medical education should drop as well, also helping us achieve our goal).


We do need more primary care doctors.

But health care is not a simple market (one demand curve and one supply curve only) as you've described above--it's a complex one, and thus needs a far more far-reaching proposal than this one piece.

But the U.S. has one doctor for every 500 people. Not a shortage.






truckinslave -> RE: A simple idea about healthcare (3/6/2010 8:27:16 AM)

You know, I am shocked- shocked!!- that you could find a lawyer to say that malpractice insurance has nothing at all to do with the high cost of healthcare. I bet if you looked you could even find a lawyer, and possibly some lawyerly study, that says the cost of defensive medicine is equally insignificant.
I bet we could find:
1. A Saudi who says OPEC has nothing much to do with the price of gas at the pump, and,
2. Congressman who say that the spending they voted for had no real effect on the national debt.

But I wouldn't put too much weight in them either.




rulemylife -> RE: A simple idea about healthcare (3/6/2010 8:42:30 AM)

quote:

ORIGINAL: truckinslave

quote:

Malpractice insurance isn't really much of an issue


Good to know. Then, no one will object to further, substantive tort reform?


I'm sure you won't object, until you or your wife or your children become a victim of medical negligence and find your ability to recover appropriate damages capped.

quote:


Whether or not you think malpractice insurance is "much of an issue", I've heard many doctors say otherwise; and the real savings from substantive tort reform lies not so much in possible reductions in malpractice insurance but from reducing the perceived need for "defensive medicine", which is a huge, and hugely expensive issue.


Yes it is, but where does that perception that they need to practice defensive medicine come from?

A number of different studies have shown it does not come from any increase in malpractice litigation but from arbitrary increases in premiums by medical malpractice insurers.

The number of malpractice cases has not risen, the inflation-adjusted settlements and awards have not risen, so you have to ask yourself why those malpractice insurance premiums continue to skyrocket other than the profit motive for those companies by promoting a crisis that does not exist.






rulemylife -> RE: A simple idea about healthcare (3/6/2010 8:50:08 AM)

quote:

ORIGINAL: truckinslave

You know, I am shocked- shocked!!- that you could find a lawyer to say that malpractice insurance has nothing at all to do with the high cost of healthcare. I bet if you looked you could even find a lawyer, and possibly some lawyerly study, that says the cost of defensive medicine is equally insignificant.
I bet we could find:
1. A Saudi who says OPEC has nothing much to do with the price of gas at the pump, and,
2. Congressman who say that the spending they voted for had no real effect on the national debt.

But I wouldn't put too much weight in them either.


Then present some facts to counter it, not ridiculous analogies and what "you heard" from doctors.




Termyn8or -> RE: A simple idea about healthcare (3/6/2010 9:02:35 AM)

FR

Unfortunately agreeing with Ken, there has been some tort reform in the last years. Unfortunately it turned out bad. My ex boss died of lung cancer after never having smoked anything in his life, but it was after kidney cancer. Kidney cancer, once excised goes to the lung in many cases, a well known fact. They should have kept a watch out for that but they did not. He was a short guy, strong as a mule. Toted appliances up into his van like refrigerators etc. by himself and delivered them, upstairs or downstairs by hinself, even in his late fifties. About two years after the removal of one of his kidneys for cancer, he complained of shortness of breath. They found that one lung was down to 8% capacity and the other 12%. Shortly thereafter he died. I talked with his Wife and asked if they were considering suing and she said yes, but it doesn't look good. All the rigamaroll just wasn't worth it. This guy came from Bylorus, learned the language and was trilingual, worked all his life and paid taxes and his own health insurance. He also served in OUR army.

As far as I am concerned the family should have had the tools within the legal system to put that HMO completely out of business, but the golden rule applies. He who has the gold makes the rules.

The simple solution is this - educate yourself, take care of yourself. Don't trust anyone to be competent nor loyal to you.

And this was supposedly high end private health insurance. So much for that.

T




AnimusRex -> RE: A simple idea about healthcare (3/6/2010 9:04:10 AM)

I think increasing the number of doctors might be a good thing; but expecting the cost of medical care to drop significantly probably is not realistic.

No matter how many doctors we have, medical care will be fairly expensive, because it is a complex and risky thing. For example, treatment for cancer, involving diagnostic tests, expert opinions, laboratory procedures, followed by radiation, chemotherapy, physical therapy...only a tiny fraction of all this is compensation that goes into the doctor's pocket.

And the trend is going towards complexity, away from simplicity. A century ago, the treatment for most diseases was limited to a bottle of pain pills, followed by a pine box. As medical science finds new ways to treat disease and illness, the treatments become complex, and ever more expensive, generally speaking.

But to the OP- I applaud you for taking the position that government can have a beneficial and assertive role to play in controlling the marketplace; that point of view sees the government as a tool we use to our benefit as citizens, not an evil to be destroyed.




truckinslave -> RE: A simple idea about healthcare (3/6/2010 9:20:28 AM)

quote:

I'm sure you won't object, until you or your wife or your children become a victim of medical negligence and find your ability to recover appropriate damages capped.


No one that I know objects to appropriate damages. It's the lottery-size awards that bother most of us; let's start with those.

"A number of different studies have shown it does not come from any increase in malpractice litigation but from arbitrary increases in premiums by medical malpractice insurers."

There are studies, and there are studies, and, I'd bet, studies of studies. No shortage of studies proving opposing views.
But the one thing all sensible people agree stops "arbitrary increases" in any kind of pricing is: competition. Like, across state lines.....





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