National health systems: too much vs too little medical care: which is worse? (lawyer, health care system)
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For example, if there were no malpractice lawsuits, and if all medical costs were paid by the government, and all medical decisions were made by doctors following guidelines set by panels of medical experts and cost experts, then there might be too little medical care, because people might have a hard time getting the medical care they needed.
But, in our present system, people get too much medical care, because doctors worry that if they don't do every possible test and try every possible approach to every medical condition, they might get sued. A lot of people end up bankrupt trying to pay the bills for all that excessive medical care. Or they might not get the medical care they really need, because the doctors are too focused on the extra medical care, and not the common sense simple solutions people might really need.
A typical example: You have a staph infection that makes an area of your skin red. You need to start antibiotics immediately, to keep it from getting worse. So you go to a doctor. But he knows people sometimes have major problems when that kind of infection gets worse, and he's not sure the antibiotic will be enough. Maybe it will be enough 99% of the time, but that other 1% there might be major problems. So, instead of prescribing the antibiotic, he sends you to the emergency room. And you wait several hours there, while your infection gets worse. Then the ER doctor wants to admit you to the hospital, for all kinds of tests and treatment. Then you might have to pay so much in copayments that it might leave you bankrupt. At that point, a lot of hours have passed, and your chances of solving your problem with a simple prescription are running out. The simple prescription would have solved your problem 99% of the time, but too much time was wasted by doctors having a CYA philosophy. So having too much medical care can actually result in too little medical care, putting people at major risk because it takes them too long to fight the red tape to get the simple solutions they need.
But in the other system, with too little medical care, it might actually be a lot easier. In that system, you can't sue a doctor for malpractice, and all costs are paid by the government, so the doctor is more likely to use the simpler solution, even though it gives you a 1% risk of major problems. Life is a gamble, and that 1% risk would be considered part of the gamble of life. Because the person taking the risk wouldn't be the doctor. So the doctor would be motivated to take the common sense approach, in spite of the 1% risk.
The purpose of malpractice is to provide funds to those who suddenly need them due to a practioner's failure to meet minimum standards of care.
It is meanwhile fanciful to suppose that fearful doctors are somehow pulling out all the stops for a case of the sniffles. Doctors practice medicine. The simplest and most likely causes are treated -- and if the condition persists -- ruled out first. Then you move on to explore the more complex and less likely explanations. If you have a particularly rare condition, it can take quite a while to get a proper diagnosis and treatment. This is just the way medicine works, and it does so because it has been so successful.
It is meanwhile fanciful to suppose that fearful doctors are somehow pulling out all the stops for a case of the sniffles.
A case of the sniffles is a bad example. Sniffles don't have to be caused by diseases. They can be caused by a cool humid breeze when you're dressed for hot summer weather. Which has nothing to do with medicine.
My example was much better. It illustrates the point, and shows that it's a valid issue.
"Sniffles" was hyperbole. The larger point was that I found your "defensive medicine" spiel much less than either accurate or persuasive.
When a doctor sends a patient to the ER, to sit and wait for hours while an infection gets worse, that doctor is practicing defensive medicine. Not wanting to get involved with a patient whose care is a gamble, even if the odds of bad results are only 1%. Therefore, my example does show my point of view to be valid, while all you can do is keep repeating that yours is more valid, without showing it.
Another reason why malpractice lawsuits are bad is that they don't get anywhere near giving equal justice. How well your lawsuit does depends partly on who your lawyer is, and partly on luck. Some plaintiffs get huge awards, others don't. In any case, malpractice lawsuits add a lot to medical costs and make medical insurance expensive.
Malpractice awards could be granted by a panel that looks only at the medical facts of the case, and uses guidelines set by panels of experts. How eloquent a lawyer is should not have any bearing on such awards.
When a doctor sends a patient to the ER, to sit and wait for hours while an infection gets worse, that doctor is practicing defensive medicine. Not wanting to get involved with a patient whose care is a gamble, even if the odds of bad results are only 1%. Therefore, my example does show my point of view to be valid, while all you can do is keep repeating that yours is more valid, without showing it.
A GP will send a patient either to the ER or to a specialist when he or she feels that tests and evaluations not within the purview of the GP's office are called for in order to reach a proper diagnosis.
In any case, malpractice lawsuits add a lot to medical costs and make medical insurance expensive.
No, they are trivial cost factors. The principal driver of high medical insurance premiums in any specialty is a low level of competition in state insurance markets.
Quote:
Originally Posted by eok
Malpractice awards could be granted by a panel that looks only at the medical facts of the case, and uses guidelines set by panels of experts. How eloquent a lawyer is should not have any bearing on such awards.
This is sort of what happens in France where many doctors don't need to carry malpractice insurance at all. Instead, claims are heard in a special medical court system which determines what if any award should be made.
The National Health Service in the UK is often cited as a standard to emulate. But, Americans have been taking statins (anti-cholestrol) meds since the late 1980's. But it was only in the past few months that the the NHS decided it could "afford" to provide people with statins. How many people had heart attacks due to high cholesterol that could have been prevented? How much did those patients ultimately cost the NHS?
And then there are certain vaccines the NHS deems "unnecessary," among them the chickenpox vaccine that is NOT given to children under the NHS. So, it's setting up those kids who get chickenpox for a later adult case of shingles, a much more serious disease.
Too little medical care is not worth the risk.
BTW, the NHS has had 2 doctors' strikes this year,, is chronically short of nurses, is closing facilities, etc.
Last edited by nightlysparrow; 10-06-2016 at 03:18 PM..
Well, the UK had a lot more such problems once Cameron came along. Quite the across-the-board failure, he was. And of course, the actual people who so often want to bring up the UK and the NHS are in fact those who are OPPOSED to any sort of national health care system at all. The UK and Canada are of course UNCOMMON in their reliance on state-run health care systems. Most national systems rely on private-sector providers or on a public-private mix. Virtually all of them of course have provided better overall health care over the years than what the old US system did. But UK-bashers typically do not much like to talk about such things as that.
Last edited by Pub-911; 10-06-2016 at 03:55 PM..
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