Some questions for Republicans

[Huckleman2000]

Is the healthcare third rate or is the cost out of control? I still content that the healthcare here is better than anywhere else in the world. It's the access and the cost of that healthcare that is the causative factor. The doctor's and hospitals I have known and been to were excellent. They knew what they were doing and did it professionally and quickly. I never had to wait to see a doctor or a specialist nor did I have to wait for a procedure to be performed for more than a few days.

Costs are driven in part by law suits people bring against doctors, hospital and manufacturers of health care equipment and devices. Tort reform would lower the cost of healthcare drastically. Thus lowering costs of health insurance.

How'd that tort reform work in Texas, Zeb?

WASHINGTON, D.C. - Medical malpractice liability caps instituted in Texas in 2003 have failed to improve the state’s health care system, a Public Citizen report released today reveals.

These findings are crucial because the Texas experiment has been held up as a model by proponents of proposals now pending in Congress to limit patients’ rights. In spite of rhetoric to the contrary, the data show that the health care system in Texas has grown worse since 2003 by nearly every measure. For example:

• The percentage of uninsured people in Texas has increased, remaining the highest in the country with a quarter of Texans now uninsured;
• The cost of health insurance in the state has more than doubled;
• The cost of health care in Texas (measured by per patient Medicare reimbursements) has increased at nearly double the national average; and
• Spending increases for diagnostic testing (measured by per patient Medicare reimbursements) have far exceeded the national average.

“Members of Congress have conjured the supposed benefits of the Texas law out of thin air,” said David Arkush, director of Public Citizen’s Congress Watch division. “The only winners have been the insurance companies and, to a lesser extent, doctors.”

 

[rgraham666]

An interesting article on tort reform and health care.

The important point.

Annual jury awards and legal settlements involving doctors amounts to “a drop in the bucket” in a country that spends $2.3 trillion annually on health care, Amitabh Chandra, another Harvard University economist, recently told Bloomberg News. Chandra estimated the cost of jury awards at about $12 per person in the U.S., or about $3.6 billion. Insurer WellPoint Inc. has also said that liability awards are not what’s driving premiums.

And a 2004 report by the Congressional Budget Office said medical malpractice makes up only 2 percent of U.S. health spending. Even “significant reductions” would do little to curb health-care expenses, it concluded.

 

[trysail]

Denis Cortese, M.D., President and CEO of the Mayo Clinic ( an organization lauded for its control of healthcare costs ):

http://www.www.cspan.org/Watch/Medi...ress+by+Mayo+Clinic+CEO+Dr+Denis+Cortese.aspx

The tort bar always trots out the completely bogus claim that the social cost of ambulance chasing is equivalent to the premiums paid for malpractice insurance. This is, of course, both a canard and patently false.

In his address, Dr. Cortese makes a very credible and compelling case that the combination of the cost of practicing defensive medicine and the difficult-to-quantify social cost of professional paranoia are both SUBSTANTIAL and MATERIAL components of healthcare costs.

The only people who benefit from the insane American system of medical torts are the practitioners of legalized extortion and those who believe they hold a ticket in the lottery/theatre of a jury trial. If you believe otherwise, you either have no experience of healthcare or never had any contact with those connected with the field.


http://www.www.cspan.org/search.aspx?For=cortese

 

[jeninflorida]

An interesting article on tort reform and health care.

The important point.

Have you ever been in a lawsuit? Having to defend yourself in court (business or personal)?

One thing about reform that never is discussed is that for a doctor once he or she is taken to court that doctor will never practice medicine the same way. In the back of his or her mind, the thought of CYA will run ramped.

Also, for a smaller enterprise a lawsuit is very stressful and takes one’s focus away from business and focus onto defending oneself.

This topic has been brought up before and in a lot of cases most of the frivolous lawsuits do get dropped, but the doctor (enterprise) being sewed is out of luck for legal fees and the stress of being taken to court.

So the cost the actual cost is very much understated

Also to address the GE issue, wouldn’t it be a good thing if the government was able to terminate the bottom 10% of the employee base?

 

[Guest]

Have you ever been in a lawsuit? Having to defend yourself in court (business or personal)?

One thing about reform that never is discussed is that for a doctor once he or she is taken to court that doctor will never practice medicine the same way. In the back of his or her mind, the thought of CYA will run ramped.

Also, for a smaller enterprise a lawsuit is very stressful and takes one’s focus away from business and focus onto defending oneself.

This topic has been brought up before and in a lot of cases most of the frivolous lawsuits do get dropped, but the doctor (enterprise) being sewed is out of luck for legal fees and the stress of being taken to court.

So the cost the actual cost is very much understated

Also to address the GE issue, wouldn’t it be a good thing if the government was able to terminate the bottom 10% of the employee base?

I believe you missed the point of Rob's post.

This wasn't information about the mental welfare of physicians following lawsuits, the discussion centered on negating the argument presented by some of those against organized healthcare that it was malpractice awards that were causing insurance costs to rise.

It isn't.

The cost of malpractice insurance is also rising.

Sewed doctors? Do you mean sued? As in, bringing a lawsuit against?

Jesus. I had to read that twice before I could even figure out what you were trying to say.

 

[Stella_Omega]

Also to address the GE issue, wouldn’t it be a good thing if the government was able to terminate the bottom 10% of the employee base?

How about the top 1% instead? Save more money.

 

[rgraham666]

Have you ever been in a lawsuit? Having to defend yourself in court (business or personal)?

One thing about reform that never is discussed is that for a doctor once he or she is taken to court that doctor will never practice medicine the same way. In the back of his or her mind, the thought of CYA will run ramped.

Also, for a smaller enterprise a lawsuit is very stressful and takes one’s focus away from business and focus onto defending oneself.

This topic has been brought up before and in a lot of cases most of the frivolous lawsuits do get dropped, but the doctor (enterprise) being sewed is out of luck for legal fees and the stress of being taken to court.

So the cost the actual cost is very much understated

Also to address the GE issue, wouldn’t it be a good thing if the government was able to terminate the bottom 10% of the employee base?

So, Soviet management methods work? They were fond of decimating their workforce.

What happens to the 90% left behind? They'll now have 10% more work for the same pay. Would you blame them if they resent that?

What happens next year? Another 10% increase in work for no increase in pay? How long before they reach the point that there isn't enough time in the day to get all the work done? What happens to a company, or government, where the people are too busy to do accomplish anything?

None of this addresses my original point though. Is there some essential difference between governments and corporations that ensure one is always managed badly and one is managed well?

 

[JAMESBJOHNSON]

ROB

The essential difference twixt guvmint and business is: when guvmint blunders they get more money from taxpayers; when business blunders they have to find some other solution.

 

[sr71plt]

ROB

The essential difference twixt guvmint and business is: when guvmint blunders they get more money from taxpayers; when business blunders they have to find some other solution.

Well, no. When business blunders it gets more money too. Where have you been the last two years, James?

 

[stephen55]

Denis Cortese, M.D., President and CEO of the Mayo Clinic ( an organization lauded for its control of healthcare costs ):

http://www.www.cspan.org/Watch/Medi...ress+by+Mayo+Clinic+CEO+Dr+Denis+Cortese.aspx

The tort bar always trots out the completely bogus claim that the social cost of ambulance chasing is equivalent to the premiums paid for malpractice insurance. This is, of course, both a canard and patently false.

In his address, Dr. Cortese makes a very credible and compelling case that the combination of the cost of practicing defensive medicine and the difficult-to-quantify social cost of professional paranoia are both SUBSTANTIAL and MATERIAL components of healthcare costs.

The only people who benefit from the insane American system of medical torts are the practitioners of legalized extortion and those who believe they hold a ticket in the lottery/theatre of a jury trial. If you believe otherwise, you either have no experience of healthcare or never had any contact with those connected with the field.

http://www.www.cspan.org/search.aspx?For=cortese

No he didn't. I watched both of those videos and Dr. Cortese, who is head the the Mayo Clinic, gave a very good talk on why the clinic and others, can provide quality health care for a reasonable price. Anyone who is serious about getting American health care back on track should take the time to hear the guy out. He makes one point that so far from my observation of this debate, has been missing. He makes a clear distinction between health care reform and health insurance reform. He feels that both need attention but that they are two separate, but related, issues.

Now, on to his comments about the cost of practicing defensive medicine and the difficult-to-quantify social cost of professional paranoia are both SUBSTANTIAL and MATERIAL components of healthcare (sic) costs.

trysail's statement is not even wrong. It's fiction.

Dr. Cortese's only comments about medical malpractice suits are that they can destroy careers and are a lost source of learning capability. He stated (correctly) that when someone gets sued, "everyone goes to ground", thus knowledge of what went wrong is covered up. He contrasted this to the airline industry. When something goes wrong there, a near miss for example, it's reported quickly, experts investigate quickly, then the problem and it's solution are passed on to everyone in the industry, so it hopefully won't happen again. He does mention doctors ordering extra tests which adds to costs (negligibly) and I didn't hear anything about the social cost of professional paranoia whether difficult or easy to quantify.

So, I'm calling bullshit on that one.

His main point was that the airline industry has passenger safety at the top of it's agenda and so it should. He feels that the practice of medicine in the US, both in health care delivery and in health care insurance, has lost the notion that the patient comes first.

He listed the qualities that make the Mayo Clinic and many others, some of which he named, do a better job of keeping the patient's interests first.

i) Creating and maintaining a culture of keeping the focus on patient care and the patient's interests
ii) Increasing and maintaining the role of doctors engagement in management. (Bean counters care about beans, not patients.)
iii) A focus on teamwork, co-operation and collaboration between all care providers (not just the doctors)
iv) Creating a system of easy and rapid sharing of medical records
v) Above all, an increased use of the science of health care delivery.

The last point involves having systems engineers looking at the overall way things get done to redesign methods and plans for patient care to insure...
- better patient care
- better patient safety
- better patient outcomes, both short and long term
- better patient satisfaction
- better value for money spent (which always ends up costing less in the long run)

As for health insurance reform....

He feels strongly that everyone should have good health insurance. He feels the insurance policy should belong to the patient, not an employer. So if your job is lost, you move or quit, your insurance policy is still in effect. The rub is that while medical practitioners can reform health care delivery, reforming health care insurance is a problem for congress. Which explains the current political pissing contest going on in the US right now.

trysail, using large font and puke-green as your favorite color shows questionable taste but it doesn't turn fiction into truth.
Oh...I turned down the size of your font. I hope you don't mind.

 

[Katyusha]

sorry, I am overstating....my main point is that we are moving to bigger governments and our tax rates will be jumping up to match others. and why do we need to do that? we need to fix the machine, and not dump more money in...I believe what we are doing is using a lighter to light a one hundred dollar bill, then using that lit bill to light up or cigar...why not skip the process of burning the one hundred dollar bill and use the lighter?

Or am I the only person on earth that believe government is wasteful (employee production, and cash to operate)?

I haven't read the whole thread so I don't know if anybody else addressed it this way: but I always put it in numbers. **Please do not misconstrue these numbers and statements as accurate; they are just an example and not necessarily the way things are or the way I think they should be done or the way I think they would work.**

Say the average family of four spends $12,000 a year on health insurance, or $1,000 per month. If their combined gross income is $60,000 a year ($5,000) per month, then their income is automatically taken down to $48,000 per year ($4,000) per month just by their premiums. They still have to pay their bills, their rent/mortgage, AND deal with their income and payroll tax deductions too.

So assume we go to a Canada-type system for healthcare, and the tax for that will be 10% on everybody's monthly income no matter what tax bracket they're in. It's taken out before all other deductions. The need to pay premiums goes away. Now, that family of four is paying $6000 per year for healthcare instead of $12,000 ($500 per month instead of $1,000). They now have an additional $6000 per year ($500 per month) in their pocket. They're coming out ahead, rather than behind.

I realize that for a lot of people the numbers aren't what matters and it's the principle of the thing. But for many, and yes, this is strongly influenced by one's economic position, they'd rather pay that extra $6000 a year in taxes if it means there are 6000 more dollars in their pockets at the end of the year.

 

[Huckleman2000]

Have you ever been in a lawsuit? Having to defend yourself in court (business or personal)?

One thing about reform that never is discussed is that for a doctor once he or she is taken to court that doctor will never practice medicine the same way. In the back of his or her mind, the thought of CYA will run ramped.

Also, for a smaller enterprise a lawsuit is very stressful and takes one’s focus away from business and focus onto defending oneself.

This topic has been brought up before and in a lot of cases most of the frivolous lawsuits do get dropped, but the doctor (enterprise) being sewed is out of luck for legal fees and the stress of being taken to court.

So the cost the actual cost is very much understated [...]

If that were true, one would expect that tort reform in Texas would have reduced what you call "CYA" medical procedures, commonly including "unnecessary" or redundant tests. In reality, the opposite has happened. From the same article I referred to above:

The marked increase in diagnostic testing has occurred as medical malpractice payments in Texas have fallen 67 percent. “The combination of soaring testing costs and dwindling liability expenditures is devastating to the defensive medicine theory,” Arkush said. That theory claims that the fear of lawsuits has driven the increase in expenditures on tests.

 

[jeninflorida]

How about the top 1% instead? Save more money.

Sure, I have no problem terminating the top 1% of government workers as you are correct these would be the highest paid employees. At this point of the game a lot of these types of people are just waiting to punch out and enjoy retirement.

 

[jeninflorida]

If that were true, one would expect that tort reform in Texas would have reduced what you call "CYA" medical procedures, commonly including "unnecessary" or redundant tests. In reality, the opposite has happened. From the same article I referred to above:

I will have to read up on that. how long was the tort reform in place when they did this study?

 

[jeninflorida]

Here is my issue; the government did nothing to address the cost only to shift payment for insurance. Yes 36 million or what ever the number is will now be eligible for healthcare but that someone else will be taxed for. When has the government operated any successful program that was at or below costs?

In the next couple of years a insurance exchange will come on line: Great! Why didn’t they create an exchange years ago? Why does blue cross need to have 50 entities and not one? Why add many layers of wasteful spending?

I just don’t understand the notion of pouring more money into a failing system. Why not start over and recreate a less costly health care system?

This is how I view this healthcare bill…How would you feel if 30 million Americans were given free cars and that everyone who has a car will be hit with a 10% value added tax and the price of your car insurance will be jumping up by a minimum of 30% to help cover the cost of adding 30 million American’s?

I do agree with the argument that a family shouldn’t have to make the decision on whether to pay rent or a health insurance premium.

Disclaimer I do state that we have great benefits and when the cost of those benefits started to skyrocket our company did something different by in most cases tripling the deductible. To offset that cost for employees the company set up an HSA program and each year transfers a payment to cover that deductible. Company saved a ton of money and employees are covered.

So for us we will not receive any benefit (unless this new exchange actually works), but our taxes will be going up.

my biggest fear is that in time the health care will shift from private enterprise to a government run enterprise. And there is no accountability to government (just look at our educational system) and government never worries about costs, the government will tax us more.

I haven't read the whole thread so I don't know if anybody else addressed it this way: but I always put it in numbers. **Please do not misconstrue these numbers and statements as accurate; they are just an example and not necessarily the way things are or the way I think they should be done or the way I think they would work.**

Say the average family of four spends $12,000 a year on health insurance, or $1,000 per month. If their combined gross income is $60,000 a year ($5,000) per month, then their income is automatically taken down to $48,000 per year ($4,000) per month just by their premiums. They still have to pay their bills, their rent/mortgage, AND deal with their income and payroll tax deductions too.

So assume we go to a Canada-type system for healthcare, and the tax for that will be 10% on everybody's monthly income no matter what tax bracket they're in. It's taken out before all other deductions. The need to pay premiums goes away. Now, that family of four is paying $6000 per year for healthcare instead of $12,000 ($500 per month instead of $1,000). They now have an additional $6000 per year ($500 per month) in their pocket. They're coming out ahead, rather than behind.

I realize that for a lot of people the numbers aren't what matters and it's the principle of the thing. But for many, and yes, this is strongly influenced by one's economic position, they'd rather pay that extra $6000 a year in taxes if it means there are 6000 more dollars in their pockets at the end of the year.

 

[cloudy]

When has the government operated any successful program that was at or below costs?

How could anything be considered "successful" if it was running below costs?

That's the definition of "unsuccessful."

If you expect anything to run below costs, then your expectations don't even approach reality.

 

[bronzeage]

How could anything be considered "successful" if it was running below costs?

That's the definition of "unsuccessful."

If you expect anything to run below costs, then your expectations don't even approach reality.

If a program were running above costs, it would be making a profit.

 

[cloudy]

If a program were running above costs, it would be making a profit.

Yes, or funding other projects that aren't.

 

[JAMESBJOHNSON]

Debating CLOUDY is about the same as giving a child a loaded gun to play with. She'll either shoot her foot, shoot you in the ass, or shoot holes in her argument.

I cant name any government program that operates within its budget or operates efficiently. Every one of them is a rat hole for Friends & Family and Special Interests. Even the 2010 Census is now a cluster-fuck of failed goals and extra costs....its $450 MILLION computer system doesnt work.

In 1955 stamps cost 3 cents; mail delivery was twice a day, 6 days per week. Stamps now cost 45 cents, delivery is once a day, and they wanna stop Saturday service.

TSA is a joke.

And the IRS is gonna manage ObamaCare. I cant wait for that!

 

[trysail]

These are just off the top of my head in fifteen seconds ( I'm not even trying hard )


Government mandated Methyl Tertiary Butyl Ether ( MTBE ) oxygenates, 1993.


Government subsidized and mandated corn-based ( i.e., maize ) ethanol ( as opposed to sugar-based [ which is prohibited ] ) as a gasoline additive, 2006.


Government mandated award of wireless spectrum to minority operator ( c. 1993 ) [ the minority owner did not have the capital necessary to build the wireless infrastructure and ultimately declared bankruptcy; by filing for bankruptcy, the owners were enabled to auction the spectrum to the highest bidder { thereby reaping a windfall profit simply because of the original award } ].


Department of Energy Coal Loan guarantee program ( 1979-1986 )
( gurarantees provided- zero, nil, none, nada )


Federal National Mortgage Association ( a/k/a "Fannie Mae" ) 1938
( bankrupt, 2008- cost to taxpayers, $100 billion-?????)
http://en.wikipedia.org/wiki/Fannie_Mae


Federal Home Loan Mortgage Association ( a/k/a "Freddie Mac" ) 1970
( bankrupt, 2008- cost to taxpayers, $100 billion ?????)
http://en.wikipedia.org/wiki/Freddie_Mac


The Savings & Loan Industry
( bankrupt, 1990- cost to taxpayers, $125 billion-?????? )
http://en.wikipedia.org/wiki/Savings_and_loan_crisis

 

[bronzeage]

Yes, or funding other projects that aren't.

The purpose of any government program is to spend money, not make it. If a government service could be provided at a profit, a private business would be doing it.

A government estimates its tax revenues and creates a budget based on that expectation. If things go well, revenues may exceed the estimate, which is called a surplus. If revenues are lower, it is a deficit.

A government program works the same way. A budget is made and money is allocated for it. It is difficult to estimate the actual costs of some programs.

For example, if a program guarantees that geriatric porn writers will have their diaper changed every day, the cost will depend on how many times the diaper fills up. If it turns out that the geriatric porn writer can produce twice as much shit as expected, program costs will be higher. By law, he gets a clean diaper every time he cries and the program exceeds its budget.

 

[jeninflorida]

How could anything be considered "successful" if it was running below costs?

That's the definition of "unsuccessful."

If you expect anything to run below costs, then your expectations don't even approach reality.

simple math, what if obama said that it will cost the American tax payer $10 a government run health system and the government started on Jan 1, 2011...after one year the actual cost of that program was $8.00 is that a failure? Why so? …or simply because the government didn't suck up more tax payer money?

 

[jeninflorida]

Well I did, and now I’m sure someone will call me an alt of yours…

Debating CLOUDY is about the same as giving a child a loaded gun to play with. She'll either shoot her foot, shoot you in the ass, or shoot holes in her argument.

I cant name any government program that operates within its budget or operates efficiently. Every one of them is a rat hole for Friends & Family and Special Interests. Even the 2010 Census is now a cluster-fuck of failed goals and extra costs....its $450 MILLION computer system doesnt work.

In 1955 stamps cost 3 cents; mail delivery was twice a day, 6 days per week. Stamps now cost 45 cents, delivery is once a day, and they wanna stop Saturday service.

TSA is a joke.

And the IRS is gonna manage ObamaCare. I cant wait for that!

 

[jeninflorida]

And to expand that, what if we assume the average number of diapers a person can change is 10 per day, and the government goes out and hires someone that can change 12 diapers a day.

Well, simple math… has nothing to do with making a profit, because we all know that if the government does earn a profit (i.e. road tolls, the sale of electricity from a government power company) that extra money will be moved to a different department and spent on some other program.

The purpose of any government program is to spend money, not make it. If a government service could be provided at a profit, a private business would be doing it.

A government estimates its tax revenues and creates a budget based on that expectation. If things go well, revenues may exceed the estimate, which is called a surplus. If revenues are lower, it is a deficit.

A government program works the same way. A budget is made and money is allocated for it. It is difficult to estimate the actual costs of some programs.

For example, if a program guarantees that geriatric porn writers will have their diaper changed every day, the cost will depend on how many times the diaper fills up. If it turns out that the geriatric porn writer can produce twice as much shit as expected, program costs will be higher. By law, he gets a clean diaper every time he cries and the program exceeds its budget.

 

[bronzeage]

And to expand that, what if we assume the average number of diapers a person can change is 10 per day, and the government goes out and hires someone that can change 12 diapers a day.

Well, simple math… has nothing to do with making a profit, because we all know that if the government does earn a profit (i.e. road tolls, the sale of electricity from a government power company) that extra money will be moved to a different department and spent on some other program.

It helps if one understands the economics. Governments do not have profits or losses. A government has surpluses and deficits. It is not the same thing.

If an enterprise is profitable, (i.e. road tolls, etc), a private business will provide it.

Governments provide services which can't be efficiently provided by private enterprise. Everyday a few thousand cars cross the Mississippi River bridge on Interstate 10. It's a convenient way to get over the river, but the economic benefit of the bridge extends from Los Angeles to Jacksonville. If we depended on private enterprise to provide these kinds of needs, we would have very few bridges and a very small army.