RE: Health Care, the American way...

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Lucylastic -> RE: Health Care, the American way... (5/30/2013 8:46:18 AM)
quote: ORIGINAL: vincentML quote: That kind of case (I'm not doubting or disparaging but I'd like to see a link supporting it's happened recently) absolutely falls into the category of gross wrecklessness and dis-regard and I agree that such a person has some kind of claim. Michael, this 2010 article suggests that Operating Room errors are an ongoing problem. Over a period of 6.5 years, doctors in Colorado alone operated on the wrong patient at least 25 times and on the wrong part of the body in another 107 patients, according to the study, which appears in the Archives of Surgery. This article from December 2012 found that preventable Surgical Errors Occur More Than 4,000 Times A Year In The U.S. http://abcnews.go.com/WNT/video/mistakes-surgery-common-18031255 ABC news vid and article on the same subject as the last link

Zonie63 -> RE: Health Care, the American way... (5/30/2013 9:33:50 AM)
quote: ORIGINAL: tazzygirl How did medical problems propel so many middle-class, insured Americans toward bankruptcy? For 92% of the medically bankrupt, high medical bills directly contributed to their bankruptcy. Many families with continuous cover- age found themselves under-insured, responsible for thou- sands of dollars in out-of-pocket costs. Others had private coverage but lost it when they became too sick to work. Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter do so within a year. Income loss due to illness also was common, but nearly always coupled with high medical bills. http://www.dailykos.com/story/2012/01/05/1051848/-Medical-bills-cause-62-percent-of-nbsp-bankruptcies# Wow, I had no idea that the numbers were that high. One thing that struck me about all this healthcare debate is that I've encountered a lot of people over the course of my life who seem rather cold-blooded about illness. From one point of view, it seems all about dollars and cents, but then from the general public, some people just don't really care that much. I can see where some people might be squeamish and uncomfortable about it, but there are others who seem to think that people get sick because it's their own fault. My grandfather used to think like that. He was absolutely insufferable when my grandmother was dying of cancer. He seemed to think that all she had to do was get out of bed, move around, and take some vitamin C and she'd feel better. He thought the hospitals and the doctors were bilking him and didn't want to run a big bill with all that medical science hooey. Folk remedies and faith healers are a much cheaper option. I'd like to think that folks like my grandfather are/were the exception, but I'm not so sure now. But I wonder how much of it is due to ignorance about medicine? Or is it perhaps due to a callous attitude about sick people in general?

Aswad -> RE: Health Care, the American way... (5/30/2013 9:48:30 AM)
quote: ORIGINAL: DesideriScuri I honestly wonder what impact it would have if the only results of a successful malpractice suit were loss of license to practice and a cash penalty for each year of life "left" between current age and life expectancy. Don't think about penalties. Just solve the problem when someone isn't fit to practice. Penalties are redundant. Losing the licence means you have to build a new career, which is basically taking the consequences of your own mistakes. There is rarely malice involved in choosing to become a doctor, so any further punishment or penalties is uncalled-for. quote: Very interesting thing to ponder. I''m just glad someone is. Around here, we take it for granted. IWYW, — Aswad.

vincentML -> RE: Health Care, the American way... (5/30/2013 11:30:17 AM)
quote: I'd like to think that folks like my grandfather are/were the exception, but I'm not so sure now. But I wonder how much of it is due to ignorance about medicine? Or is it perhaps due to a callous attitude about sick people in general? I perceive there is a callousness built into the delusional superiority that is intrinsic to the anti-govenrment politics attached at the end of the OP. Randians think they are made of a special 'producer' grit that elevates them above that crowd of welfarians who try to exploit them and drag them down. They see no value in providing humane medical care for people like your grandmother who did not earn it. How do we know she did not earn it? Because she cannot afford it. Ipso facto.

DesideriScuri -> RE: Health Care, the American way... (5/30/2013 11:51:57 AM)
quote: ORIGINAL: Aswad quote: ORIGINAL: DesideriScuri I honestly wonder what impact it would have if the only results of a successful malpractice suit were loss of license to practice and a cash penalty for each year of life "left" between current age and life expectancy. Don't think about penalties. Just solve the problem when someone isn't fit to practice. Penalties are redundant. Losing the licence means you have to build a new career, which is basically taking the consequences of your own mistakes. There is rarely malice involved in choosing to become a doctor, so any further punishment or penalties is uncalled-for. quote: Very interesting thing to ponder. I''m just glad someone is. Around here, we take it for granted. IWYW, — Aswad. We don't have the social system set up to carry those patients, so that was the idea behind the inclusion of a monetary award. While it's a very good idea to remove the license of a physician that has acted criminally, it doesn't help the patient that has been fucked. Thus, the award. Would also like to see capping the way a lawyer gets paid for the suit, too. Keeping the award going to the victim without being unduly soaked up by the lawyer(s) is imperative, too.

tazzygirl -> RE: Health Care, the American way... (5/30/2013 12:03:08 PM)
quote: ORIGINAL: vincentML quote: That kind of case (I'm not doubting or disparaging but I'd like to see a link supporting it's happened recently) absolutely falls into the category of gross wrecklessness and dis-regard and I agree that such a person has some kind of claim. Michael, this 2010 article suggests that Operating Room errors are an ongoing problem. Over a period of 6.5 years, doctors in Colorado alone operated on the wrong patient at least 25 times and on the wrong part of the body in another 107 patients, according to the study, which appears in the Archives of Surgery. This article from December 2012 found that preventable Surgical Errors Occur More Than 4,000 Times A Year In The U.S. Which is why its standard procedure now for surgeons to mark, either by an x or their initials, the site they are going to operate on. With both my knee and my heel, the surgeon came in, talked to me, explained again what he was going to do, then asked which body part. At that time, they both initialed the area they were operating on. "One of the worst cases I saw in this study was two patients who had had prostate biopsies," Stahel says. "One had cancer and one did not. Clinicians mixed up the samples and the patient without cancer had a radical prostatectomy -- which is a huge surgery, removal of an organ for nothing -- while the patient with cancer [was] still walking out in the community, not knowing his true diagnosis." Overall, one-third of the mistakes led to long-term negative consequences for the patient. One patient even died of lung complications after an internist inserted a chest tube in the wrong side of his body. Only about 22 percent of the mistakes led to malpractice claims or lawsuits. The database is unusual in that it contains information on all incidents (not just those that resulted in a claim), and for that reason the rate of surgical mix-ups reported in the study is likely more accurate than those in previous studies, Stahel says. Makes me wonder what would happen had every incident ended up in a law suit. How many of you men would be so forgiving had your balls been cut off?

tazzygirl -> RE: Health Care, the American way... (5/30/2013 12:16:40 PM)
quote: The cost issue is a genuine problem. You cite malpractice insurance rates (in some states) upward of $50.000 per year on average, more than five typical households make in a year. The median was $12.500 per year. For comparison, a starting wage for general practicioners in Norway is- if memory serves- about $60.000 per year. Those $12.500 would be about equal to the total income tax here for someone making $60.000 per year. And yet those rates, as in Texas, didnt go down when the cap was placed. Which means insurance companies are using those states to pad the bottom line. Many medical malpractice cases are rejected Collins says he didn't hesitate to represent Jeffers, but not every case is as easy to decide. He and other experienced malpractice attorneys say they tend to be very judicious about what they pursue. According to the Kaiser Family Foundation, 10,739 medical malpractice claims were paid in 2009 out of the more than 85,000 suits filed annually. Statistics from the U.S. Bureau of Justice show that plaintiffs won less than a quarter of the trials, and on average plaintiffs received $400,000. "Some say there are lots of frivolous lawsuits, but lawyers would be fools to take on a frivolous case," says Barry Furrow, director of the Health Law Program at the Earle Mack School of Law at Drexel University. Furrow says attorneys can spend hundreds of thousands of dollars on discovery fees -- the costs of gathering facts and evidence to support claims -- but in the end, they earn only a percentage of the winnings. To make prudent investments, they tend to focus on cases with huge losses. http://www.cnn.com/2011/HEALTH/03/24/ep.malpractice.sue.or.not/index.html Lawyers usually dont file frivolous suits these days. Why waste their own time and money? The pay off for that time and money is a percentage of the award. The more they get the client, the more they get paid. This actually is beneficial to those who cant afford attorneys like hospitals and doctors can. And many times the awards can be reduced. Then comes something few nonlawyers know that a court can do. The trial judge reduced plaintiff's money damages from $10 Million (past pain and suffering) and $50 Million (future pain and suffering) to $1 Million (past pain and suffering) and $3 million (future pain and suffering); the appeals court further reduced plaintiff's damages to $300,000 (past pain and suffering) and $300,000 (future pain and suffering) http://www.garyrosenberg-law.com/Blog/2011/October/MONEY-DAMAGES-JURY-AWARD-REDUCED-MEDICAL-MALPRAC.aspx Yes, the headlines are sensational. But appeals and even filing bankruptcy, can net no actually payment.

cloudboy -> RE: Health Care, the American way... (5/30/2013 1:11:29 PM)
There's a great HBO documentary on this subject called HOT COFFEE. What's changed in the USA is how the little guy often buys the big-business spin on news and public policy issues. It's as if Joe the Plummer's body was snatched by the Chamber of Commerce.

Aswad -> RE: Health Care, the American way... (5/30/2013 1:13:31 PM)
quote: ORIGINAL: DesideriScuri Thus, the award. Thus, the insurance. Thus, the cost. Thus, welfare by the scenic route. If you have a problem in the system, fix that problem, rather than introducing a new one. [;)] quote: Would also like to see capping the way a lawyer gets paid for the suit, too. Keeping the award going to the victim without being unduly soaked up by the lawyer(s) is imperative, too. This will simply mean that the ones that need these awards can't afford to pay the lawyer, giving the opposite outcome of the intended one. Incidentally, if the Constitution poses an obstacle to introducing solutions at the Federal level, then fix these things at the State level instead. If memory serves, there are fewer restrictions on what States can do than on what the Federal level of government can do. And it's easier to sell a good idea at the State level than in Congress, presumably. Study the models in Europe, particularly in Germany (with 80 million people, they will give an indication of how this scales) and also in the three countries Norway, Denmark and Sweden (they're so comparable that it's easier to isolate factors, and all three have great historical records and statistics to go by), then formulate one that will work for your State. Slip it to the right person. If that doesn't work, start pushing the idea to people that will listen, build a movement, make your representatives listen. A good starting point is to visit one of these places, or ideally live there a while, get a feel for what works and what doesn't. IWYW, — Aswad.

Aswad -> RE: Health Care, the American way... (5/30/2013 1:20:44 PM)
quote: ORIGINAL: tazzygirl And yet those rates, as in Texas, didnt go down when the cap was placed. Which means insurance companies are using those states to pad the bottom line. Absolutely. And they probably don't require measures (e.g. checklists¹) to reduce malpractice, either. quote: Yes, the headlines are sensational. But appeals and even filing bankruptcy, can net no actually payment. Yup. But the headlines are what inform people that don't have the queen of citations on hand. [;)] In a culture of fear, the idea that you need protection can be more powerful than facts about your actual risks, hence malpractice insurance and clip hoarding. IWYW, — Aswad. ¹ Really, anyone can make a mistake. The solution isn't to crucify doctors, or to have ad hoc measures in place, but rather to have an eye to developing a robust methodology, and a robust metamethodology. This is how Lockheed-Martin makes solutions for NASA, for instance, with fewer mistakes than any other human endeavour. Checklists are just one of many such measures. This puts the focus on improving quality (don't say solving problems, as it gets hackles up; cf. how long it took to get it into docs' heads that "a gentleman's hands are always clean" just won't cut it, pun intended), rather than punishing mistakes, and achieves more good in the long run.

fucktoyprincess -> RE: Health Care, the American way... (5/30/2013 1:23:07 PM)
FR Okay, I just want to add one thing. In a one payer system, everyone (doctors and patients) are part of the same system. There are no insurance companies as we understand them in the U.S. So the combination of one payer AND malpractice cap helps keep costs down. If you just try to cap malpractice payments but don't change anything else in the system - obviously one will not get the same results. There are apples and oranges being compared here. When I speak of a one payer system - I mean a system like Canada or the U.K. To the extent that our system in the U.S. is vastly different - only changing the whole thing will give us the same results. The point about malpractice is that IF you truly have a one payer system (where all doctors and all patients are in one system) then you do need to come up with ways to keep costs down. These include (but are not limited to) capping payments for medical services, capping malpractice awards, negotiated rates for services, use of generic drugs, etc. etc. etc. Just to be clear, I'm not suggesting any one change will give us the same results.

tazzygirl -> RE: Health Care, the American way... (5/30/2013 3:00:43 PM)
quote: ¹ Really, anyone can make a mistake. The solution isn't to crucify doctors, or to have ad hoc measures in place, but rather to have an eye to developing a robust methodology, and a robust metamethodology. This is how Lockheed-Martin makes solutions for NASA, for instance, with fewer mistakes than any other human endeavour. Checklists are just one of many such measures. This puts the focus on improving quality (don't say solving problems, as it gets hackles up; cf. how long it took to get it into docs' heads that "a gentleman's hands are always clean" just won't cut it, pun intended), rather than punishing mistakes, and achieves more good in the long run. I agree. I cannot fathom a physician intentionally cutting off or operating on the wrong body part. Its become standard practice to mark a limb or area to be worked upon. Mistakes can happen. Its the safest way to ensure they dont. However, at least in the US, nothing changes without reason. Money is a great incentive to change.

dcnovice -> RE: Health Care, the American way... (5/30/2013 3:56:47 PM)
quote: Which is why its standard procedure now for surgeons to mark, either by an x or their initials, the site they are going to operate on. With both my knee and my heel, the surgeon came in, talked to me, explained again what he was going to do, then asked which body part. At that time, they both initialed the area they were operating on. This reminds me of a story. Some writer (I forget who, alas) was in the hospital, awaiting surgery. The doc came in and wrote on him in the same fashion. Once the surgeon had left, the patient got a visiting friend to add, "Store in a cool place until opened." [:)]

Lucylastic -> RE: Health Care, the American way... (5/30/2013 4:47:35 PM)
Some need so little help

cloudboy -> RE: Health Care, the American way... (5/30/2013 6:00:31 PM)
Get the facts. Don't be fact averse, unless you want to be a mouthpiece for the Chamber of Commerce masquerading as someone "concerned about the costs of healthcare." quote: Also, I never really got into tort reform (although I believe it's a necessity). I blamed American people who'd rather sue their way into the American dream than work for it. I think it's one of the reasons juries award such out-landish awards in court; a part of them hopes that some day they'll "strike it rich". Not sure why you hate the civil justice system. Is it your position that that a victim of medical malpractice shouldn't be able to sue and file a claim about it?

DaddySatyr -> RE: Health Care, the American way... (5/30/2013 7:56:27 PM)
quote: ORIGINAL: vincentML quote: That kind of case (I'm not doubting or disparaging but I'd like to see a link supporting it's happened recently) absolutely falls into the category of gross wrecklessness and dis-regard and I agree that such a person has some kind of claim. Michael, this 2010 article suggests that Operating Room errors are an ongoing problem. Over a period of 6.5 years, doctors in Colorado alone operated on the wrong patient at least 25 times and on the wrong part of the body in another 107 patients, according to the study, which appears in the Archives of Surgery. This article from December 2012 found that preventable Surgical Errors Occur More Than 4,000 Times A Year In The U.S. Thank you for the links. I never meant to imply that egregiously negligent errors should go un-noticed but, if you look back to the personal experiences I shared, I think you'll understand where I was coming from. If and when I tell those stories (the latter gets told more than the first because the first is what brought on my PTSD and makes the nightmares worse), there's always someone who says: "I'd have sued the crap outta him!" and I can't help thinking that the over-all attitude of the American people is part of the problem. I absolutely believe that we need healthcare reforms in this country. I just don't believe that we've had any real ones, yet. In order for there to be a system that really works, everyone is going to have to give a little (at least initially); not just one portion - who in my mind are already pretty put-upon - while the lawyers, doctors, insurance agents - and yes, even - dead-beats continue to enjoy the fruits of that small (by comparison) group's sacrifices. Peace and comfort, Michael

Aswad -> RE: Health Care, the American way... (5/30/2013 7:58:41 PM)
quote: ORIGINAL: tazzygirl However, at least in the US, nothing changes without reason. Isn't self realization and the continuous process of improvement that leads to excellence enough anymore? IWYW, — Aswad.

tazzygirl -> RE: Health Care, the American way... (5/30/2013 8:00:09 PM)
lol Not in the US. The status quo doesnt change unless forced. Its the American way [;)]

Aswad -> RE: Health Care, the American way... (5/30/2013 9:19:28 PM)
quote: ORIGINAL: tazzygirl lol Not in the US. The status quo doesnt change unless forced. Its the American way [;)] Feared as much. Been a while since I saw "Made in the USA" on any goods around here. These days, it's China and Germany, mostly, though also some Sweden (Electrolux, AEG, etc.) and UK. It's kind of odd that the small island I live on, with less than thirty thousand inhabitants, has fully half the international subsea market, when you'd expect the US to lead in that area, given their naval history and image as an industry and hitech powerhouse, and given Norway's tendency not to even try to lead in any field. IWYW, — Aswad.

tazzygirl -> RE: Health Care, the American way... (5/30/2013 9:23:53 PM)
Silicon Valley lead the way, with the emphasis on technology. Manufacturing fell by the wayside and went over seas. Just today the man commented on a China acquisition of Smithfield hams. I simply said... we send all our manufacturing jobs there, it seems. Why cant they invade the US market the same way we invaded their manufacturing one?

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