Political opinion - medical malpractice

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Gene DeMambro
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Post by Gene DeMambro »

There is no right to medical care in The United States - even for its legal citizens.
Yes and no. While there is no fundamental right to medical care, certain federal (and probably state) laws have mandates for physicians and hospitals who accept Medicaid and Medicare and the standard of care they must meet. This also includes a mandate to accept for treatment certain classes of people (pregnant women in active labor, emergency room patients and elderly, for example).

Even though there is no right to medical care, once a physician voluntarily invites you into the exam room, the pharmacist voluntarily seeks to fill the prescription, the visiting nurse voluntarily looks in on and takes the BP of a shut-in, they must provide medical care that meets a certain standard. That is their duty that they voluntrily undertake. And just because they do it voluntarily does not mean they get a pass when they breech.

I am not going to get on the case of insurance companies, physicians (or pharmacists or nurses or whomever...) for seeking to make money. That's America, and if they can do it legally, more power to 'em. I hope that's straight.
And I challenge you to come up with any credible economic analysis that suggests otherwise.
I'm not going to dispute you, Bill, 'cause I'm on the side of the ethical trial lawyers. Good for them if they can go about their business, and do well. Good for them if they are going to make their money at the end of the day-just like the insurance industry and doctors.

I did read the DHHS paper, especially:
In theory, the tort system is designed to compensate those who have been injured, and prevent further injury to others. However, whether the tort system does either is arguable. In reality, medical malpractice claims are expensive to pursue, can take years to resolve, and can result in the injured party receiving little of the settlement.
If you're trying to get me to hit lawyers, I'm not biting. But the answer to
so where did all that money go?
is found in
medical malpractice claims are expensive to pursue
.

Regarding the proposed bill:
  • Does the now defeated legislation include a requirement to address the Collateral Source Rule?
  • Does the now defeated legislation include high standards for Expert Witnesses?
  • Does the now defeated legislation address the Joint and Several Liability rule (a particularly loathsome doctrine in my view)?
  • Does the now defeated legislation require Periodic Payment of Awards, in order to lessen the immediate financial impact of a large jury award (assuming such award is held up on appeal)?
  • Does the now defeated legislation require or encourage Pre-Trial Screening Panels (used in Massachusetts since 1986 and they work very well to separate the wheat from the chaff)?
  • Does the now defeated legislation require or encourage Aternative Dispute Resolution or Arbitration?
  • Does the now defeated legislation address the supposed fear-based quality control system?
  • Does the now defeated legislation require or encourage the use of Medical Guidelines (like Ian has proposed and I very much favor)?
The HHS report references these concepts, as well as capping jury awards, and a few others.

Remember my initial response to this thread, to wit
The solution to obscenely high malpractice insurance premiums does not lie solely within the realm of capped damages
?

By focusing solely on capping jury awards, the insurance industry and physicians make it appear that making patients who are harmed by malpractice whole again isn't even on the radar screen. And remember, that's what we are talking about. Winning plaintiffs aren't hitting the "malpractice lottery" (and if anyone thinks otherwise I want to see data). They simply win awards that make them whole again, as judges and Courts of Appeal will reduce high jury verdicts.

By focusing on their own interests, to the exclusion of fixing a possibly broken system and making the situation fair for all, they risk making it
appear
that they want to protect themselves vs. big awards, without changing the way health care is practiced, or making sure that people are fairly compensated.

A fair piece of legislation will maintain the ability to collect damages (and only those who are harmed can collect-like now), while still maintaining the professional integrity of health care practitioners, as well as the long-term fiduciary interests of the insurance industry. The now defeated legislation, it appears, only sought to help the insurance industry in limiting payouts. Yes?

What about the other side of the equation? We're spending all kinds of time and hyperbole on limiting payouts, what about increasing what we pay for health care? Private insurance companies, Medicare and Medicaid have for years chiselled down how much they pay for medical services (and goods) rendered. Many practitioners have cancelled or not renewed contracts due to pitifully low payments. In many cases, payments do not even meet cost. And I'm willing to bet they don't look at how that effects quality. We don't have a health care crisis in the US. We have a health care reimbursement crisis.

The situation's gotten so bad in some areas that hospitals have closed and physicians and pharmacies have shut down or turned patients with these low-paying plans away. So how is the consumer supposed to get care when there is no such care available in the immediate area, because no one takes Medicaid patients (a solely voluntary undertaking) or a particular private insurance (a solely voluntary undertaking) ?

As I intimated, and Dana explored more, the solution is more complex than just capping jury awards.

Gene
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TSDguy
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Post by TSDguy »

Obviously I meant frivolous in a common sense defintion and not a legal defintion. As it's already been observed, people expect perfect results and throw temper tantrums when they don't get them.
Gene DeMambro
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Post by Gene DeMambro »

Le'

Bill is absolutely correct when he said that there is no right to medical care in the United States. Some might call it a moral right, and it may very well be an ethical right, and it certainly is a Utopian ideal to aspire to but there is no legal right to medical care in the United States.

Certain state and federal laws may grant this right to patients under certain circumstances, and I'd imagine most doctor's offices, hospitals, pharmacies and like places are considered places of public accomodation for purposes of anti-discrimination legislation. But as a general rule, hospitals, physicians, pharmacies, etc can turn away patients. When they do accept patients for treatment, it's completely voluntary.

Again, morality and ethics aside, but that's the long and short of it on the jurispridential side.

Gene
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TSDguy
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Post by TSDguy »

Adding on to my last post:

Bill said:

"When a patient sues, the health care practitioner (physician, hospital, nurse practitioner, acupuncturist, chiropractor, etc., etc.) loses - regardless of the merit of the case. That's the way our legal system works. The accused and/or his insurer must foot the bill to defend him/herself. The accused must take time away from patient care to prepare the case and to testify. A legal victory may be a moral one, but it is a financial and psychological disaster."

A physician I knew, who was very well respected, a leader at many medical facilities and a university 'learning' hospital, chair of the ethics commity etc. had someone file a "frivolous" law suit after a surgery went badly (i.e. the patients was healed?). The patient lost overwhelmingly in court of course, but the cost and strain of the trial, and more importantly the threat of being sued for hundreds of thousands of dollars and being bankrupt with 4 kids to raise caused the physician to retire at a ridiculously early age. That is anti-social and a frivilous law suit. That can't happen. I'd quit too if someone sued me; then we have no doc's left.
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Le Haggard
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Post by Le Haggard »

Gene DeMambro wrote: Bill is absolutely correct when he said that there is no right to medical care in the United States. Some might call it a moral right, and it may very well be an ethical right, and it certainly is a Utopian ideal to aspire to but there is no legal right to medical care in the United States.
Gene,

I didn't mean to imply that the current interpretation of the Constitution provides the right to medical care in the US. I was more specifically refering to the reference to rights as being "negative" rights instead of "positive" rights, the so called "entitlements" that people gripe about granting. That is an ongoing philosophical debate between classical liberalism (libertarianism) and welfare liberalism positions. There is an interpretation of the constitution and the entire concept of what rights are that addresses the obligation of society to provide it's citizens the basics of survival, which includes medical care. Currently, that interpretation is not the one in vogue by the government. That doesn't mean it's invalid.

That is a long and heated debate and the one I was refering to in my previous post. I disagreed with the interpretation of rights as negative rights, where people are not "entitled" to the means necessary to survive. In short, I'm on the side of the debate that interprets what "rights" means to be both "postiive" and "negative" rights. I won't get into it more here because it would be pointless and simply infuriating for everyone.

I still think the actions of the government that I mentioned before prove them to be a bunch of hypocrits. That is a different discussion ....

Le'
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Dana Sheets
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Another dime in the bucket...

Post by Dana Sheets »

http://story.news.yahoo.com/news?tmpl=s ... _lawsuit_5
Bechler's Widow Sues Makers of Ephedra

Thu Jul 17, 5:35 PM ET

BALTIMORE - The widow of Baltimore Orioles (news) pitcher Steve Bechler has sued the manufacturer and the distributor of a dietary supplement containing ephedra for $600 million.

The 23-year-old Bechler was taking the supplement to lose weight at the start of spring training when he collapsed Feb. 16 in Fort Lauderdale, Fla. His body temperature rose to more than 108 degrees and he died the next day. A bottle of Xenadrine RFA-1 was found in Bechler's locker.

Toxicology tests confirmed "significant amounts" of an over-the-counter supplement containing ephedra led to Bechler's heatstroke, along with other factors, the medical examiner said.

The lawsuit, filed Wednesday by Kiley Bechler in U.S. District Court in Fort Lauderdale, also seeks a ban on the sale of ephedra-based products.

"It's a simple case of corporate and personal greed being placed ahead of consumer safety and the public welfare," said her attorney, David Meiselman.

The lawsuit names Manasquan, N.J.-based Cytodyne Technologies and its president, Robert Chinery, and Hicksville, N.Y.-based manufacturer Phoenix Laboratories. Receptionists who answered phones Thursday at both businesses said no one was immediately available to comment.

A receptionist who answered the phone Thursday at Cytodyne said no one was immediately available to comment.

In the past, Cytodyne has criticized Meiselman for blaming the company, saying Bechler had a history of heat-related illnesses.

Ephedra products are marketed in drug stores, convenience stores and gyms as a weight-loss and energy miracle pill made from natural herbs, but the Food and Drug Administration (news - web sites) has said the drug is blamed for nearly 120 deaths nationwide.
While not true in this case, most Pharma Companies make prescription AND over-the-counter meds. So this kind of suit contributes to driving up the cost of all medicines because their force companies to anticipate that they too might be open to this level of liability for their products.
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Bill Glasheen
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Post by Bill Glasheen »

Le

Part of me understands your frustration.

If Iraq had never invaded a country with a lot of petroleum reserves, and if Iraq didn't possess the second largest petroleum reserves in the world, we'd have let Saddaam gas all the citizens he wanted to, and kill a SECOND million Iranians. But since the U.S. is addicted to oil and oil money buys lots of terrorists (Sadaam openly paid the families of Palestinian suicide bombers), well...the writing was on the wall. It is what it is. Considering we financed the butcher in the Iran/Iraq war and sold him much of his WMD technology, we (and the Brits) have a lot of blood on our hands. But then the French and the Russians financed the food and medicine (a.k.a. pesidential megapalaces) for oil campaign. The whole bloody thing disgusts me.

Sigh...

Stay angry, Le. Continue to care. Continue to fight for justice. Continue to fight for free and civil speech. But...we should probably stay on topic.

I realize you have "issues" with a health care system that has been marginal at best in dealing with you and your boys. But keep looking. There are many wonderful, caring health care practitioners (of many persuasions) out there. A few visit these pages all the time.

Gene

OK, at least now we are constructively dealing with issues. Thanks.
If you're trying to get me to hit lawyers, I'm not biting. But the answer to
--------------------------------------------------------------------------------

quote:
--------------------------------------------------------------------------------
so where did all that money go?
--------------------------------------------------------------------------------

is found in
--------------------------------------------------------------------------------

quote:
--------------------------------------------------------------------------------
medical malpractice claims are expensive to pursue
That's a euphemism for "the trial lawyer industry is profiting."
A fair piece of legislation will maintain the ability to collect damages (and only those who are harmed can collect-like now), while still maintaining the professional integrity of health care practitioners, as well as the long-term fiduciary interests of the insurance industry. The now defeated legislation, it appears, only sought to help the insurance industry in limiting payouts. Yes?
No.
The measure, similar to a bill that cleared the House earlier this year, would have limited noneconomic damages, commonly known as pain and suffering, to $250,000. Punitive damages would be capped at the greater of $250,000 or twice the amount of economic damages, which cover medical expenses, loss of wages, funeral expenses and similar costs. States would be permitted to enact higher limits.
Note that there would be NO LIMIT on economic damages. Now, how is that not fair?

If I were a trial lawyer, I would see why. What's causing the 40 to 50 percent increases in awards a year is the incentives in the legal system. The party that stands to gain the most is not the plaintiff - it's the legal system. The primary motivation for the astronomical amounts asked for in these suits is greed. The law firm gets a cut. It's a bigger cut if the noneconomic damages are as high as they possibly can get. The simple motivation here is greed. Greed is not necessarily a bad thing in a free market economy. But greed at the expense of the number of people who are uninsured in this country because of the high cost of care (partly due to the portion associated with inappropriate liability expenses) is unconscionable.

The malpractice insurance industry (note, this is not the health insurance industry) doesn't give a rip at the end of the day. They will pass the costs on to the healthcare providers. Then the government assesses a higher cost per relative value unit of work done (the 3-part RBRVS-based payment system used by Medicare/Medicaid, and shadowed by most in the health insurance industry). That causes an increase in payments to providers by health insurance companies (private insurance) and by the federal government (Medicare and Medicaid). These costs are then passed on to the consumer in the form of higher insurance premiums (for individuals with private insurance) and higher taxes (to compensate for the higher costs of Medicare and Medicaid).

So at the end of the day, its a redistribution of wealth. It's taxation. The biggest winners are the trial lawyers. We all pay one way or another, unless we are unemployed and totally dependent on the government.

The "crisis" happens when you have states and/or local regions where jury awards are increasing so rapidly that the system can't keep pace, or where the average standard of living can't bear the expenses. That's what's happening in certain states (like WV and PA), in some regions (like medically underserved areas), and in certain specialties (like obstetrics, emergency medicine, and neurosurgery).

Clearly there is a problem. And if you want to minimize (NOT eliminate) risk and mistakes, all the quality experts tell you that a punitive tort system isn't the answer. You need six sigma. But that's another thread...
Does the now defeated legislation include a requirement to address the Collateral Source Rule?

Does the now defeated legislation include high standards for Expert Witnesses?

Does the now defeated legislation address the Joint and Several Liability rule (a particularly loathsome doctrine in my view)?

Does the now defeated legislation require Periodic Payment of Awards, in order to lessen the immediate financial impact of a large jury award (assuming such award is held up on appeal)?

Does the now defeated legislation require or encourage Pre-Trial Screening Panels (used in Massachusetts since 1986 and they work very well to separate the wheat from the chaff)?
I don't know. But to a certain extent, this is a red herring. Complex problems are best fixed one piece at a time. Make a bill too complex and it will never pass (which is one tactic used by opponents of a piece of legislation). If it's a solution the opponents want, then the opponents should get off their a*sses and start doing something about it. But my contention is they don't want a solution because too many in the legislative branch of government are either themselves lawyers or receive donations from the trial lawyer lobby. Those last two points are facts.

If it were a piece of legislation dealing with (and benefitting) the oil industry and someone in the legislative branch worked for such, don't you think there would be a conflict-of-interest furror? Why do we not demand all lawyers recuse themselves when this type of legislation is considered and voted on? It's a double standard. It's an industry protecting itself with an unethical advantage.
Does the now defeated legislation require or encourage Aternative Dispute Resolution or Arbitration?
Are you kidding??? It would never pass because it makes too much sense (i.e. it takes the greed out of the process). The trial lawyers have too much at stake. But I like the idea anyhow, and am sorry I didn't mention it first (it's a favorite of mine).
Does the now defeated legislation address the supposed fear-based quality control system?
Most people in this country haven't the foggiest notion of what it takes to produce a quality product. Do you know what six sigma is? Have you heard of Deming? Wennberg?

If they did, then we'd have more GEs in our economy, and fewer GMs.

You can't legislate this, Gene. Au contraire, you need to get legislation and litigation out of the way of a proper free-market economy where decisions and choices are made in a system where information about risk and quality is plentiful.

Am I doing something about that in my business? You betcha. Another thread....
Does the now defeated legislation require or encourage the use of Medical Guidelines (like Ian has proposed and I very much favor)?
This is a double-edged sword, Gene. A lawyer never met a quality guideline they didn't like. The more that are out there, the more fodder lawyers have to sue. It's a well known problem.

There's an experiment going on in Maine right now where legislation was passed that essentially said a provider was protected from a lawsuit if (s)he provided guideline-based care. AND...deciding not to follow a guideline (because every patient is unique and problems often present themselves as multiple comorbidities) was not in itself grounds for a lawsuit. It's an experiment - on the state level.

In any case, these points are no reason not to pass the defeated legislation.

- Bill
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RACastanet
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Post by RACastanet »

The ears of the GE alumni were burning. Also, I am currently wading through a nightmare of expensive medical tests, some quite unpleasant, in search of the cause of my mystery malady so am sensitive to this issue. Medicine is unfortunately full of uncertainty. No warranty either.

First, in addition to being a Uechi black belt and a Marine Corps green belt, I am a Six Sigma green belt. When Bill refers to Six Sigma, he is referring to approximately 1 defect per 3.4 million operations (such as tightening a screw, soldering a wire...). I expect our medical system is a 1 Sigma system, more the 1 failure per 10 definable operations or something like that (do not have my bell curve book handy).

In the GE aircraft engine business, 6 sigma is unnacceptable quality. They are closer to 8 or 9 sigma, or roughly one failure per 34 million or thereabouts (again, working on memory here). Airlines measure reliability in hours of flight time so GE designs engines to run 10s of millions of hours without experiencing unplanned downtime (regular maintenance is planned downtime). One obvious result is that 2002 was the safest year ever for commercial airlines with ZERO fatalities from any cause. That is a damn good record.

Can the medical system achieve 6 Sigma? I do not think so, but they need to try. But costs willl go up. The goal at GE with 6 Sigma was improvement. Aircraft engine is the best example because people will pay for safety. A set of 4 engines costs as much as the plane. People will not pay for a 6 sigma washing machine though, and we are around 3 to 4 sigma in that business.

The telecom industry and data handling industry use the concept of 'Five Nines' reliability. That refers to 99.999% uptime, almost 6 sigma. That is about 5 minutes of unplanned downtime a year. Also pretty good unless your system crashes and loses all of its data. That 5 minutes annually costs the telecom and datacom industry $Billions annually, so they want to be even better.

That is your 6 sigma lesson for today.

Rich
Last edited by RACastanet on Mon Jul 21, 2003 12:32 am, edited 1 time in total.
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Gene DeMambro
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Post by Gene DeMambro »

That's a euphemism for "the trial lawyer industry is profiting
So?
But greed at the expense of the number of people who are uninsured in this country because of the high cost of care (partly due to the portion associated with inappropriate liability expenses) is unconscionable
Remember, only those people or entities that harm their patients pay out. Other than supposedly inappropriately high non-economic damages, are there other examples of inappropraite liability expenses?

[quotes]That causes an increase in payments to providers by health insurance companies (private insurance) and by the federal government (Medicare and Medicaid).[/quotes]

I'd like to see the data, where Medicare/Medicaid and private insurance companies are increasing their reimbursement rates. Here in Massachusetts, there has been a drastic reduction in reimbursement. That point is fact.
I don't know. But to a certain extent, this is a red herring. Complex problems are best fixed one piece at a time.
Why put limiting non-economic payouts first, and will once the insurance insurance industry continue to push for tort reform once this passes? By leading with such an an obviously polarizing issue, they may have made a tactical error. If they approached it with determining what's fair all around (for both them and for the injured parties), then they may have received more support.

And all these "red herrings" are mentioned on equal footing with capping jury awards. And many of these are less controversial. So whay start with hard caps first?
It's a double standard. It's an industry protecting itself with an unethical advantage.
So vote for the non-lawyer next time at the ballot box. Query the candidates at the next open forum, or when they knock on your door, looking for you and your vote. Call your congressman and voice your opinion (like you advocated in the first post). Participate in the electoral process. This might be a bit PollyAnnish, but the other recourse is...?
If they did, then we'd have more GEs in our economy, and fewer GMs.

You can't legislate this, Gene. Au contraire, you need to get legislation and litigation out of the way of a proper free-market economy where decisions and choices are made in a system where information about risk and quality is plentiful.
The same free-market that made GE is the same free-market that made GM. The rules are the same for both companies. Why, then, such a stark difference between the two? Maybe another thread, but if GE can kick @ss, then why not GM?
This is a double-edged sword, Gene. A lawyer never met a quality guideline they didn't like. The more that are out there, the more fodder lawyers have to sue. It's a well known problem.
It's also a clearly defined and enumerated standard that health care professionals must meet. If a physician wants to deviate, no problem, but they better make sure they also clearly delineate their reasons why, so as to ensure they maintain the standard level of care.

And remember, a layer can only sue if there is a violation of the standard of care.
The patient lost overwhelmingly in court of course,
What state did your friend practice in? Did it have a Pre-Trial Screening Program, like we have here in Massachusetts? What were the merits of the case? If there was a Pre-Trail Screening Program, and the case indeed had no merit, then it would have got tossed. If the case did indeed have merit, then the plaintiff deserved to have his case heard at trial. That is a fundamental right. Are you saying that people shouldn't have the right to bring cases to trial?

Just becasue a defendant's legal victory might be a financial and psychological disaster doesn't mean we should take away the right of people to bring merited cases to trail.
In any case, these points are no reason not to pass the defeated legislation.
There are other avenues we can pursue that can reduce the problem, without removing the ability of harmed parties to fairly collect on their injuries.

Gene
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Le Haggard
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Post by Le Haggard »

Bill Glasheen wrote:
Stay angry, Le. Continue to care. Continue to fight for justice. Continue to fight for free and civil speech. But...we should probably stay on topic.

I realize you have "issues" with a health care system that has been marginal at best in dealing with you and your boys. But keep looking. There are many wonderful, caring health care practitioners (of many persuasions) out there. A few visit these pages all the time.
Bill,

Yes we should stay on topic and I didn't mean to disparage any of the doctors here. It is, however, my view on the original problem and political issue that the malpractice and cost issues could be solved with Socialized Medicine. The arguements against socialized medicine don't wash with me. My response is "find a way to make it work." I believe if the high profits were taken out of the medical industry and more uniform quality standards established, there wouldn't be a "cash cow" to milk with unwarranted lawsuits. I can't see the argument that socialized medicine "would cost too much" holding water with the current expenditures on these other things.

Le'
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TSDguy
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Post by TSDguy »

Gene,

Unfortunetly I don't have the details on the case and wouldn't know where to find them. But... if the patient had sued for Bill's suggestion of no "pain and suffering" costs, perhaps we'd still have that good doc out there teaching more good docs of all ages. (I doubt it in this case actually, since the insurance and hostile environment eventually took their toll as well).

With her unsually pricey claim she went and found herself a good lawyer and then she literally threatened to ruin the doc's, and 5 other people's lives because of her (proven illegitimate) "pain and suffering." The risks are simply too high, considering that people without legitmate cases can make it to court and even win with (c'mon, you have to admit lawyers are good at getting people to say things on record they didn't mean, whether for good or evil). It's pretty scary several lives could be ended in court because someone found a lawyer willing to take a chance at a multimillion dollar reward ("NO cost to you, unless WE get money for YOU!").
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Bill Glasheen
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Post by Bill Glasheen »

Le

First: Socialized medicine won't work in The United States because citizens in the U.S. value choice. Countless surveys, and countless examples of products with choice prove this. It's as simple as that. Socialize the medicine, and you have a one-size-fits-all solution that is antithetical to the American way. It'll work in a Scandinavian country, but it wouldn't be tolerated here.

Second: If you DID socialize medicine, then you might actually have to make choices of what to cover and what not to cover for the citizens. We have a fixed GNP and more medical care than a body can afford, so this would be a requirement. Oh...my...god... Just you try it. And imagine what happens when a Christian rightwing supporter makes it into the Whitehouse. Let's see now... No birth control... No abortions...

Third: The United States government already has problems with Medicare. It's a disaster, and many physicians won't participate anymore because reimbursements are too low. And it doesn't even have a drug benefit!!!! You want to add more to that?

Fourth: Socialized medicine will not change the legal system's assault on medical providers and the medical device industry. Even in countries like Estonia that have a socialized medicine system, the government often pays a greater percentage of the GNP on medical care (17%) than we see here (around 14%). The money is still there. The trial lawyers still have free reign. Sutton's law... You will still need tort reform, one way or another.

Gene
Remember, only those people or entities that harm their patients pay out.
Wrong. Even innocent providers found not guilty pay out - BIG time. And the greater the economic incentive for a "win," the greater the number of lawsuits. The greater the number of lawsuits, the greater the chance that innocent parties suffer financial and psychological damages. And in our legal system, these innocent parties damaged by an out-of-control tort system effectively have no recourse.

We've seen it in the health insurance industry too, Gene. When the Supreme Court allowed for "racketeering" charges against insurance companies (read TRIPLE THE DAMAGES), then class action lawsuits started coming out of the woodwork. They have by-and-large been found to be without merit - at great cost to us all.
I'd like to see the data, where Medicare/Medicaid and private insurance companies are increasing their reimbursement rates. Here in Massachusetts, there has been a drastic reduction in reimbursement. That point is fact.
The Resource-Based Relative Value Scale is the system used by the government to reimburse medical professionals for services rendered. Each CPT code, for an example, has a number of RV units associated with it. The RVUs for a procedure are determined by three separate components. One is associated with liability risk.

You can lower fees by lowering the conversion factor (dollars paid per RVU or Relative Value Unit). The government can vary the conversion factor. Insurers like our plan vary the conversion factor by product. But the RVUs for a procedure still go up when liability costs increase. OK?

- Bill
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Bill Glasheen
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Post by Bill Glasheen »

Rich

By six sigma, I was referring not only to the statistical error measure, but also to the trademarked company that teaches the process designed to lower error rate.

No, you cannot make all of medicine six sigma. But you can make pieces and parts of it that way. And you can use the process to quantify error and work at the barriers to quality.

Speaking of which, what's the product error associated with a GE CAT scan machine? Betcha it's darned near six sigma.

My GE range/oven may not be six sigma, but it's on the top of the heap in Consumer Reports. GE knows quality. Having employees trained as six sigma green and black belts changes a company's mindset. Got a few here as a matter of fact...

- Bill
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Post by Gene DeMambro »

With her unsually pricey claim she went and found herself a good lawyer
Good for her. Everyone deserves a good, ethical lawyer.
and then she literally threatened to ruin the doc's, and 5 other people's lives because of her (proven illegitimate) "pain and suffering."
A good, reliable Pre-Trial Screening Program would have fleshed this case out, if it did indeed have illegitimate claims. And how could the case have made through the preliminary stage, and the Summary Judgement phase, without having at least some merit to the claims? What state was it in?
The risks are simply too high, considering that people without legitmate cases can make it to court and even win
Where? When? If the case has no legitimacy, then it can't win. Period
c'mon, you have to admit lawyers are good at getting people to say things on record they didn't mean, whether for good or evil
A whole other issue altogether. And if this indeed does exist, I'm not convinced it's limited to the plaintiffs bar...
It's pretty scary several lives could be ended in court because someone found a lawyer willing to take a chance at a multimillion dollar reward ("NO cost to you, unless WE get money for YOU!").
Are you saying only the rich should have access to the civil court system?

Gene
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RACastanet
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Post by RACastanet »

Bill: Glad to hear you are impressed by the 6 Sigma process. There are a lot of ex-patriot GE employees who went on to other companies to ply their trade for more $$. GE purchased the rights to modify 6 sigma to its needs and all of its processes, and to train both employees and customer employees in the methods.

The culture change took about 5 years and many did not buy into it. Those that did not were put into the square peg box. I embraced it early on and started the training process in the summer of 1997. My GE Six Sigma certification was one of the few things I brought home with me.

What GE did to make it unique was to apply it to all of the processes in the company, not just manufacturing. Regarding Medical Systems CAT Scanners and MRI machines etc., they were designed for Six Sigma. Also, the new product marketing was based on the Six Sigma process. So, from day one as a dream on the design board to maintenance and upgrades in the hospital, Six Sigma was there.

More than a few martial artists have taken offense at the belt structure, myself included early on. But, after seeing the training and commitment required to get a Six Sigma black belt in GE, the martial artists should be proud of the use of the belt system. All future managers at GE will be at least a green belt, and likely a black belt.


By the way, one of my two mandatory projects to get certified was so successful that it made it as a finalist in the $6 Billion division I worked in. I actually ended up #3 in the division in 2000 based on my success in implementing Six Sigma in industrial projects.

Rich
Member of the world's premier gun club, the USMC!
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