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Since this post was ignored, disputing the fact that tort reform wouldn't make a big difference, I'll reply to myself
These types of things make up a lot of visits to a doctor.
Back in those days, your Primary handled them...very often with no need for any tests.
Treating these things cost a pittance compared to what they would cost now because the first thing that would happen is that you'd be sent elsewhere immediately and usually a few elsewhere.
No way, no how, will a physician take a chance on relying on his own skill, knowledge and experience to treat any one of them himself in his office...all due to the possibility of getting sued.
The doctor I had since I was a child, told me as retirement loomed, that this was one of the biggest reasons he wasn't sorry to go...that he was no longer able to use all his skills as a doctor and was more and more becoming just a 'pass-through' referral service.
With the advent of so many "no referral needed" policies, even that wasn't needed.
$300 events became $3000 events.
Your post was ignored because of your general tone. You chose to dismiss the results of a comprehensive study conducted by the Congressional Budget Office in 2004. This was a time when both the U.S. House of Representatives and the U.S. Senate were both under the control of the GOP (the pro business party). One would have predicted a contrary result, due to the political nature of our system.
The survey broke increased medical costs into two possible categories: 1. the cost due to having to purchase malpractice insurance; and 2. the alleged cost of practicing defensive medicine. A thorough review of all sources established that the total cost of both problems added somewhere between an additional 1% to 2% to health care costs.
You offer nothing in your post that would refute either the methodology or the conclusions of that research. Instead, you give us YOUR opinion. Why would a rational person see your opinion as being more accurate than the results of this kind of research? The simple answer is that it isn't. You are simply choosing to mouth platitudes or "old wife's tales" that other people have repeated, ad nauseam, over a long period of time. Honestly, I've listened to people make this claim for years. I've listened to others tell me that "droves of physicians" are leaving medicine because of the malpractice system as well. BTW, that's another claim that can't be substantiated.
Nor, do you tell us what we should do about the malpractice problem if we were to reform it. If all you do is change it to some other model like a "worker's compensation system" there is still going to be cost and there is still going to be expense. Under any system that you devise, its still going to cost this country at least 1% of of total health care expenditures. So, all this hullaballoo is about reducing malpractice costs by 1/2 of 1%? People are never going to accept the notion that if they are the victim of malpractice that the system won't let them do anything about it.
You can talk all you want about when you were five years old that no one sued anyone. Big deal. The world I grew up in the 1960's wasn't really a safe world at all. I rode in cars without seat belts during my early childhood. I had a gun explode in my face because it was defectively designed. I had a friend who was about two or three years old when she accidentally poured water from a steamer in her bedroom on her torso because they built steamers with unsecured lids in those days. I know people who lost fingers and toes in lawnmowers because those mowers didn't have "dead man switches or controls".
The truth is that malpractice is a serious problem in this country and may kill more people every year than the numbers killed in car accidents. The article I quote below indicates that as many as 195,000 people a year may die in hospitals for this reason. I shudder to think how serious a problem it would be without a quality control on medicine outside of the medical community itself. The tort or liability system is this control. It is far from perfect, but it does save lives and it does make the medical community accountable for their mistakes and malfeasances.
Your post was ignored because of your general tone. You choose to dismiss the results of a comprehensive study conducted by the Congressional Budget Office in 2004. This was a time when both the U.S. House of Representatives and the U.S. Senate were both under the control of the GOP (the pro business party). One would have predicted a contrary result, due to the political nature of our system.
The survey broke increased medical costs into two possible categories: 1. the cost due to having to purchase malpractice insurance; and 2. the alleged cost of practicing defensive medicine. A thorough review of all sources established that the total cost of both problems added somewhere between an additional 1% to 2% to health care costs.
You offer nothing in your post that would refute either the methodology or the conclusions of that research.
Dismissing the report? No.
What was taken into consideration and called defensive medicine, yes.
Don't try to infer that I am endorsing ending the ability to sue, either...that calls for a remark about your tone, but I try not let possible misinterpretation of someone's tone intyped formkeep me from considering the validity of their actual remarks.
Appears that you're one that applauded all the safety warnings for stupid-beyond-belief people that they still don't read since fingers and toes still get cut off with lawnmowers ( for instance)but have also taken many good products off the market and even have run some companies out of business because they got sued anyway.
Since it would be difficult not to read arrogance in your tone in your last post, be happy...I won't bother reading or responding to your posts again. Pontificate on.
The doctor I had since I was a child, told me as retirement loomed, that this was one of the biggest reasons he wasn't sorry to go...that he was no longer able to use all his skills as a doctor and was more and more becoming just a 'pass-through' referral service.
My general physician who retired years ago told me something similar. In fact he discouraged his son from going to medical school because he believed that doctors were not free to practice medicine; they were bound by what insurance companies dictated to them.
There is no single measure that would bring down health care costs in the USA. Our system is rife with abuse and inefficiencies that add huge cost. These include:
1 Cost of insurance against litigation and the defensive medicine that fear of litigation promotes.
<snip>
Jaggy, me thinks you do not research your statements carefully before hand. I worked in the property-casualty insurance field for over 30 years doing everything from underwriting to ratemaking to compliance officer--and in the middle of all that was a sales representative for awhile. And early in my career was even involved in underwriting some individual medical malpractice insurance.
Medical malpractice insurance has been one of the most profitable lines of business over the years. The cycle of good/bad loss ratios is primarily affected by investment income returns (which have been down the last few years). People who don't research are stuck believing the lies of politicians--on both sides of the aisle.
But once again I'll provide some data from an insurance insider publication, Insurance Journal, the report is almost five years old but calculations of success or failure of large sections of insurance business is generally tracked over ten to twenty year increments to determine if profit is being impacted and whether a company should remain in or get out of a line of business:
Quote:
Medical malpractice premiums are less than one-half of one percent of the country’s overall health care costs; medical malpractice claims are a mere one-fifth of 1 percent of health care costs. In more than 30 years, premiums and claims have never been greater than 1 percent of the nation’s health care costs.
Medical malpractice insurer profits are higher than the rest of the property/casualty industry, which has been remarkably profitable in the past five years.
The periodic premium spikes that doctors experience, as they did from 2002 until 2005, are not related to claims but to the economic cycle of insurers and to drops in investment income.
Many states that have resisted enacting severe restrictions on injured patients’ legal rights experienced rate changes (i.e., premium increases or decreases for doctors) similar to those states that enacted severe restrictions on patients’ rights, i.e., there is no correlation between “tort reform” and insurance rates for doctors.”
The report was authored by Gillian Cassell-Stiga and Joanne Doroshow of the Center for Justice & Democracy, and actuary J. Robert Hunter, who is director of insurance for the Consumer Federation of America (CFA), former Commissioner of Insurance for the State of Texas, and former Federal Insurance Administrator under Presidents Carter and Ford.
In describing the study’s findings, Hunter said, “Our study shows that states that have passed severe medical malpractice tort restrictions on victims of medical error have rate changes similar to those states that haven’t adopted these harsh measures. Finally, our research makes clear that medical malpractice claims and premiums have almost no impact on the cost of health care. … If Congress completely eliminated every single medical malpractice lawsuit, including all legitimate cases, as part of health care reform, overall health care costs would hardly change, but the costs of medical error and hospital-induced injury would remain and someone else would have to pay.”
I'm sure there's some fodder for everyone's arguments there.
OTOH - it's hard to dismiss the concept of "defensive medicine" - which may overlap to a greater or larger extent with medical customers insisting that this/that/the other thing be done when x,y,z happens.
This is something that old_cold has mentioned. What's done today versus what was done in "yesteryear". Like when I was a kid - someone got the bright idea I should learn to ride horses. Although horses and I don't get along. I don't know how many times I got thrown off horses. Probably had a few concussions (I was unconscious). But never got any medical care - much less a battery of expensive tests (of course - MRIs didn't exist then). Today - if you have even the slightest hint of a concussion - from anything - well how much is that work-up going to cost? As a result of defensive medicine - the patient insisting - simply prudent medicine - or all of the above?
The last time I was on a horse was in 1981 - during a visit to Egypt - riding a horse into the sunset in the desert and all that (except I bear no resemblance to Peter O'Toole ). And that sucker almost threw me off too! Will never get on a horse again. Only way it affects me today is there's a class of antibiotics I avoid - they're on the no-no list for people who've had concussions in the past.
In retrospect - maybe when you get thrown off a horse - and pass out - you should get an expensive work up. Just because I wound up ok doesn't mean everyone without immediate obvious symptoms after being thrown off a horse will wind up ok too.
I happen to like advances in medical technology in general. If for no other reason than something like cardiac bypass surgery has extended the lives of people on my mother's side of the family (bad cardiac genes) by about 20 years give or take. Still - all of us have to recognize that TANSTAAFL. We want more and better - we have to pay for more and better - at least in some spending areas - like medical care. What we save in terms of spending in other areas - like what we pay for food (a relatively small % of average income household budgets today) - allows us to spend money elsewhere. Robyn
I'm sure there's some fodder for everyone's arguments there.
OTOH - it's hard to dismiss the concept of "defensive medicine" - which may overlap to a greater or larger extent with medical customers insisting that this/that/the other thing be done when x,y,z happens.
<snip>. Robyn
WOW!!! Your link fully supports my point about how profitable medical malpractice insurance is--
On page 4:
Quote:
When the Florida market is compared to other large states;
Florida is the fifth largest market as measured by direct premium written.
Florida ranks eighth among the ten most populous states when measured by losses incurred to earned premium ratio (25.3%).
Florida has the second highest ratio of total expenses to earned premium
------
Their (insurance companies) loss and expense ratios in Florida, while varied across companies, are often among the lower loss ratios for each of the company’s top five premium states.
The premium weighted effective average return on surplus was 12.2% in 2010, up from 6.6% in 2009, also up from 9.5% in 2008 and 11.0% in 2007.
--------
From state insurance filings:
On average, physicians and surgeons rates for companies writing in the admitted market decreased approximately 2.3%.
Florida is one of the most profitable states for medical malpractice insurance of any state out there. A loss ratio of 25.3% compares to personal auto loss ratios that run about 70%-78%. A loss ratio is how much of each dollar is paid out to claimants compared to earned premium which is the amount of money earned by the insurance company at the end of policy period.
The difficulty with assessing medical malpractice claims is they are written on what is called a "claims made basis:
Quote:
Medical malpractice insurance, for example, is typically claims-made. This is because insurers cannot accurately price premiums in an affordable way for these types of losses if they are then liable for the losses for an indefinite amount of time. The claims-made policy language limits the amount of time an insurer must pay these potentially large losses.
------
If you have a claims-made policy, your claims situation must meet two criteria for your insurance company to successfully process the claim. First, the incident that caused you to file the claim must have occurred between the inception and termination dates of the policy. Second, you must actually file the claim within those same dates. Therefore, if you have a policy with a certain insurer between April and December, but you do not file a claim until the following February, the insurer is not obligated to cover your claim.
The flip side is that an insurance company can write a policy and then receive notice of claim that OCCURRED three years previously--they are on the hook for that old claim.
So insurance companies jack their rates up to be "sure." It's quite obvious that in Florida they have been more than sure.
It's also quite obvious, as previously stated, that medical malpractice claims have just about the smallest impact on overall health insurance costs of any component out there.
Good evening all, I am from the UK, now living in the USA. I have waded through a number of healthcare reform threads and with growing frustrations, I would now just like to put in my tuppence worth
First of all, can I just say that I have never read so much rubbish about the NHS in all my life and until you have been a recipient of and/or worked in that particular system, then as far as I'm concerned, you can read as much as you like but you will never fully comprehend the peace of mind that knowing the needs of your own and loved ones healthcare needs will be met, in full, 100%, with no compromising on quality...cradle to the grave. No-one will be chasing you to sign co-payment agreements, thrusting a clipboard under your nose and asking for your credit card as you lie sick in your hospital bed. No-one will ask for your insurance card and intentions to pay as you watch a loved one being hurtled through emergency surgery doors following a horrific car accident, and you won't be watching for the mail coming through the door in the days/weeks/months after an episode of ill health, worrying about what bills are winging your way, how you are going to pay them, and in fear of losing your home. And lets not even talk about cost implications of chronic long term conditions, progressive or terminal illness.
Granted you might have had to wait 3/4 months for elective back surgery that will alleviate your pain, however that's a small price to pay for not finding yourself in financial distress and sick with worry. My father is about to undergo back surgery on Monday..yes he has had to wait 3 months for it. He also had cardiovascular surgery this year including cardiac stents and post op rehab, a hospital inpatient stay for possible meningitis a couple of months ago and goodness knows how many Doctor office visits - Cost = big fat 0. Cost here in the USA? Dread to think!
I have worked in the NHS healthcare system for over 20 years as a clinician and in the latter 10 years as a senior manager. I have also been a recipient of NHS healthcare from birth until I left the UK as has my family.
I now work in healthcare services here in the States after being offered a position and I have worked here now for 6 years, firstly as a clinician and then promoted to a management position. I still have HUGE difficulties in coming to terms with the system here and I can hand on heart say that the NHS Universal Healthcare system is superior by far. I only wish that Americans would open their minds and hearts to considering this an option and striving towards that.
Don't listen to and believe all that you are told. Until you have experienced first hand, the peace of mind that good quality universal healthcare can offer, then you are not qualified to judge and to compare in my humble opinion.
Yes, the NHS has it's weaknesses, as does most healthcare systems. As a manager, I experienced many frustrations including managing waiting lists and triaging/prioritising referrals based on medical urgency and need. However within the NHS, there is a constant drive towards continuous improvement through innovative change, improving standards of care, encouraging risk management /reflective learning for all and there is huge investment in staff training to support continuous professional development,knowledge and skills to ensure the best care is provided. (As opposed to the mindset here which tends to be that of sweeping issues under the carpet and pretending incidents don't occur for fear of litigation). National drivers and initiatives for more effective management of waiting times is underway and to my understanding has been very successful in bringing about significant positive change. This is because there is a GENUINE DESIRE from all concerned in healthcare to make things better for the people of Great Britain.
You are having the wool pulled over your eyes by greedy fat cat , FOR PROFIT insurance companies and pharmaceutical companies who you are entrusting with your hard earned dollar, month after month..handing over hundreds of thousands of dollars every year. You are placing the healthcare decisions and needs of you and your loved ones in the hands of people in suits who are in this business, NOT to genuinely ensure your health and wellbeing, but to make money and to find every which way to deny you the support when you need it most. REALLY??!!!...It's a no brainer! I'd far rather put my life in the hands of a doctor who I trust will make the best decisions for my healthcare, not based on what its worth to HIM personally, but on what my needs truelly are... and without having to jump through numerous "authorisation" processes with people who are programmed to find a way to deny my request..
I chose healthcare as my profession many years ago because I have a true and genuine compassion for people and I have a heartfelt desire to help and support people in difficult times. I am dedicated and committed to ensuring the best quality service and care for all in my care..not because of what I can get paid..but because that is what healthcare should be about. Caring for and supporting each other's wellbeing. In my role here I have implemented a number of initiatives that are designed to promote an environment for continuously improving standards of care and service delivery and I constantly come up against barriers (all financially orientated). It is very frustrating. I guess I was promoted because despite my "whacky universal healthcare system ideas and mindset", I do bring about positive change and my rationale is quite convincing once I get started!
I love my job, mainly because of the people I work with. I love being here, I have made many friends and there are so many things I love and admire about American Society. Healthcare however is America's downfall. It just breaks my heart to know that the people I have grown to care so much for are walking on eggshells for fear of becoming ill...and this is WITH good insurance packages! The people of America truely deserve so much more. You deserve honesty and truth and I fear you will never get that because there are too many people with their hands in the pie who have way too much to lose.
My partner (also from UK) also works in healthcare and has done so her whole working life. She is seeing things that literally make her toes curl. In short, you may believe that you are receiving cutting edge technology using the best of equipment...not always the case...remember cutting edge technology and the best equipment costs money..bear in mind that that is considered profit money! Some of the care provided here as standard practice would be considered poor practice and unethical at best by UK NHS standards.
I hate appearing critical, particularly when this is not my country and I often feel that I should just keep my mouth shut and keep my opinions to myself...and I do ..often! However my words, however critical, come from the heart and a genuine desire to do the best I can while I am here. For as sure as god made little apples, if I or any of my family become ill, I am on the first flight home!
Just one more point if I may..healthcare back home does not fall solely on the NHS. Local authorities(social services) and councils are also responsible for the healthcare of it's people. NHS and Local authorities have formed Community Health Partnerships in some geographical areas, where the medical health needs are catered for within the hospitals etc, then the social/support needs are provided for patients on discharge, as required and for as long as is necessary, by the local authorities, often referred to as "packages of care". Both organisations (NHS and Local Authorities) accept equal responsiblity for ensuring the health and wellbeing with a focus very much on prevention and health promotion. This partnership healthcare model is absolutely invaluable in supporting particularly the elderly population, with the focus being to support patients in their own home rather than ending up in a nursing home. There are many jointly funded initiatives (by NHS and Social Services) such as Integrated care at home schemes ( intensive daily 7/7 care at home with up to 4 visits a day) and crises/rapid response teams to support social breakdown situations which are frequently a cause of hospital admission for elderly patients. A universal healthcare system does not just focus on hospital services/doctors etc...it is a "whole person" approach optimising health and well being both in hospital settings and in the community. Guess what...its free!
Home health services are short term only and sparse to say the least and any other type of care at home needs are to be paid for by the recipient. That's a poor show America! Look after your elderly who have lived and worked for their country
Good evening all, I am from the UK, now living in the USA. I have waded through a number of healthcare reform threads and with growing frustrations, I would now just like to put in my tuppence worth
First of all, can I just say that I have never read so much rubbish about the NHS in all my life and until you have been a recipient of and/or worked in that particular system, then as far as I'm concerned, you can read as much as you like but you will never fully comprehend the peace of mind that knowing the needs of your own and loved ones healthcare needs will be met, in full, 100%, with no compromising on quality...cradle to the grave. No-one will be chasing you to sign co-payment agreements, thrusting a clipboard under your nose and asking for your credit card as you lie sick in your hospital bed. No-one will ask for your insurance card and intentions to pay as you watch a loved one being hurtled through emergency surgery doors following a horrific car accident, and you won't be watching for the mail coming through the door in the days/weeks/months after an episode of ill health, worrying about what bills are winging your way, how you are going to pay them, and in fear of losing your home. And lets not even talk about cost implications of chronic long term conditions, progressive or terminal illness.
Granted you might have had to wait 3/4 months for elective back surgery that will alleviate your pain, however that's a small price to pay for not finding yourself in financial distress and sick with worry. My father is about to undergo back surgery on Monday..yes he has had to wait 3 months for it. He also had cardiovascular surgery this year including cardiac stents and post op rehab, a hospital inpatient stay for possible meningitis a couple of months ago and goodness knows how many Doctor office visits - Cost = big fat 0. Cost here in the USA? Dread to think!
I have worked in the NHS healthcare system for over 20 years as a clinician and in the latter 10 years as a senior manager. I have also been a recipient of NHS healthcare from birth until I left the UK as has my family.
I now work in healthcare services here in the States after being offered a position and I have worked here now for 6 years, firstly as a clinician and then promoted to a management position. I still have HUGE difficulties in coming to terms with the system here and I can hand on heart say that the NHS Universal Healthcare system is superior by far. I only wish that Americans would open their minds and hearts to considering this an option and striving towards that.
Don't listen to and believe all that you are told. Until you have experienced first hand, the peace of mind that good quality universal healthcare can offer, then you are not qualified to judge and to compare in my humble opinion.
Yes, the NHS has it's weaknesses, as does most healthcare systems. As a manager, I experienced many frustrations including managing waiting lists and triaging/prioritising referrals based on medical urgency and need. However within the NHS, there is a constant drive towards continuous improvement through innovative change, improving standards of care, encouraging risk management /reflective learning for all and there is huge investment in staff training to support continuous professional development,knowledge and skills to ensure the best care is provided. (As opposed to the mindset here which tends to be that of sweeping issues under the carpet and pretending incidents don't occur for fear of litigation). National drivers and initiatives for more effective management of waiting times is underway and to my understanding has been very successful in bringing about significant positive change. This is because there is a GENUINE DESIRE from all concerned in healthcare to make things better for the people of Great Britain.
You are having the wool pulled over your eyes by greedy fat cat , FOR PROFIT insurance companies and pharmaceutical companies who you are entrusting with your hard earned dollar, month after month..handing over hundreds of thousands of dollars every year. You are placing the healthcare decisions and needs of you and your loved ones in the hands of people in suits who are in this business, NOT to genuinely ensure your health and wellbeing, but to make money and to find every which way to deny you the support when you need it most. REALLY??!!!...It's a no brainer! I'd far rather put my life in the hands of a doctor who I trust will make the best decisions for my healthcare, not based on what its worth to HIM personally, but on what my needs truelly are... and without having to jump through numerous "authorisation" processes with people who are programmed to find a way to deny my request..
I chose healthcare as my profession many years ago because I have a true and genuine compassion for people and I have a heartfelt desire to help and support people in difficult times. I am dedicated and committed to ensuring the best quality service and care for all in my care..not because of what I can get paid..but because that is what healthcare should be about. Caring for and supporting each other's wellbeing. In my role here I have implemented a number of initiatives that are designed to promote an environment for continuously improving standards of care and service delivery and I constantly come up against barriers (all financially orientated). It is very frustrating. I guess I was promoted because despite my "whacky universal healthcare system ideas and mindset", I do bring about positive change and my rationale is quite convincing once I get started!
I love my job, mainly because of the people I work with. I love being here, I have made many friends and there are so many things I love and admire about American Society. Healthcare however is America's downfall. It just breaks my heart to know that the people I have grown to care so much for are walking on eggshells for fear of becoming ill...and this is WITH good insurance packages! The people of America truely deserve so much more. You deserve honesty and truth and I fear you will never get that because there are too many people with their hands in the pie who have way too much to lose.
My partner (also from UK) also works in healthcare and has done so her whole working life. She is seeing things that literally make her toes curl. In short, you may believe that you are receiving cutting edge technology using the best of equipment...not always the case...remember cutting edge technology and the best equipment costs money..bear in mind that that is considered profit money! Some of the care provided here as standard practice would be considered poor practice and unethical at best by UK NHS standards.
I hate appearing critical, particularly when this is not my country and I often feel that I should just keep my mouth shut and keep my opinions to myself...and I do ..often! However my words, however critical, come from the heart and a genuine desire to do the best I can while I am here. For as sure as god made little apples, if I or any of my family become ill, I am on the first flight home!
Sorry mate, its just the American way. Our arrogance always assumes that we not only have the best, but that everyone else desires to be just like us. Few are able to see the progress in care and concern for their fellow citizens that our European neighbors have. For the most part Americans are more willing to believe what their politicians tell them than do their own work and research what have been the best systems in the world. I actually think Canadians receive the worst of the remarks.
Saw one of your fellow countrymen working in a sub shop about three weeks ago. Told him to be sure to tell everyone how awful he thinks the NHS is---he looked at me startled and said, "But that's not what I think!" I said, "Yeah, but we're Americans, we prefer not to hear the truth." He laughed and said, "I try to tell my co-workers here all the time how much better health care is in Kent, but they just don't seem to get it."
Thanks for having the courage to speak up to a lot of folks who are going to write you off as the exception to the rule!
Shame our country is so myopic and close-minded - especially those who know the least.
Of course, in the US, it is always - ALL..ABOUT..THE..MONEY.
I'm on a couple of international boards. People from the UK never talk about healthcare costs or issues. Never. Hope we hear from you again. Enlightening, is putting it mildly.
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Sorry mate
