***OFFICIAL*** Obama's Healthcare summit discussion thread

[theeedude]

You are under false impression.
Corporations will pass on the savings to their shareholders, not use it to hire new workers.

Some of it, maybe, but so what? Those shareholders will have more money to invest in companies that create value, and who will hire workers instead of parasites.

 

[lothar]

Some of it, maybe, but so what? Those shareholders will have more money to invest in companies that create value, and who will hire workers instead of parasites.

Do you believe in trickle down economics only when it helps augment your position?

Why not reduce the corporate tax from 35% to 12%? That would lead to corporations hiring more workers, right?

Why not reduce the top income tax rate from 35% to 30%? Some rich people will fundle some of it maybe, but so what? The other people will have more money to invest in companies that create value, and who will hire workers instead of parasites.

 

[theeedude]

Do you believe in trickle down economics only when it helps augment your position?

Why not reduce the corporate tax from 35% to 12%? That would lead to corporations hiring more workers, right?

Why not reduce the top income tax rate from 35% to 30%? Some rich people will fundle some of it maybe, but so what? The other people will have more money to invest in companies that create value, and who will hire workers instead of parasites.

Ignoring your diversion because it's completely orthogonal to discussion in hand. You can choose to reward people who create real value in economy, or you can chose to reward parasites who leech off transactions. Based on who you chose to reward is the type of economy you are going to get. If you think insurance companies are creating 20-30% of value in health care and deserve 20-30% cut of money they get from employers before paying for actual healthcare, then we simply have a difference of opinion on this.

 

[Budmantom]

I have a feeling that Barry might not be completely honest.

 

[mattpegher]

Many speak of decreasing the cost of actual health care delivery. However, I do not know of a single hospital in the NY/NJ/PA area that is even breaking even. Most live off of endowments which are quickly dwindling. Techs and nurses need to make more not less. And the machines/equipment are expensive. I would like someone to tell me where we can save money in the system besides the obvious expense of financing/insurance.


I hope that tort reform can gather some savings but the pundits keep saying that it is minimal.

I would like to see people live healther but I won't hold my breath.

I want my doctor to be the guy that beat out the rest of his class, and didn't think it more lucrative to go to law school.

I would love to have doctors not saddled with hundreds of thousands of dollars of debt.

I would hope that the average american can accept that there is a time for medicine and a time for tests, and that doing tests just because they want to be sure and do not wish to wait is dangerous and wastefull. For this I will simply dream because it is only that a dream.

I will hope that the administration realizes that patients are better cared for when primary care physicians are plentifull, well reimbursed and have time to evaluate thoroughly.

For these things are all included in my dreams.

 

[Fern]

Many speak of decreasing the cost of actual health care delivery. However, I do not know of a single hospital in the NY/NJ/PA area that is even breaking even. Most live off of endowments which are quickly dwindling. Techs and nurses need to make more not less. And the machines/equipment are expensive. I would like someone to tell me where we can save money in the system besides the obvious expense of financing/insurance.


I hope that tort reform can gather some savings but the pundits keep saying that it is minimal.
-snip-

The information is out there.

I no longer have the link, I supplied it in a previous thread, but the former Chairman of the AMA has said 1/3 to 1/2 of our annual HC costs could be reduced with decent tort reform. It's not the malpractice premiums, it's the redundant and excessive & unnecessary procedures physicians' prescribe or allowing patients to insist on because physicians fear suits. Put yourself in their shoes, why deny the (unnecessary) procedure/visit etc when it costs them nothing (actually is just more billable services) and may help ward off a lawsuit?

The below is related to the above:

I saw a Congressman last night on cable news, he is part of the Physicians' caucus (apparently we have 19 doctors serving now in Congress). His name is Murphy. Apart from his (and another doctor's complaint) that Obama will not meet with them or let them attend this HC summit, he spoke of where real savings are to be obtained.

The New england Institute has estimated approx $700 - 800 billion can be saved annually by implementing clinical standards. Their study found huge variations in patient care for chronic diseases among different regions/hospitals etc, sometimes running into the hundreds of thousands of $'s per patient. Only 4% of the variance was attributable to legit/explainable causes.

Their suggestion is the various groups such as the Academy of Surgeons etc be made to set clinical standards for the treatment of chronic diseases. Chronic diseases account for 95% of medicare and 75% of all HC expenditures.

Link: http://www.foxnews.com/story/0,2933,587208,00.html

I.e., the medical profession is freakin mess. I'm shocked that they lack national standards, everyone just doing what they want. It seems to me the place for HC reform is fixing that. Other professions (i.e., accounting/CPA's) have national standards that must be adhered to. Under CPA standards, doing excessive audit procedures will get you into as much trouble as doing too few/inadequate procedures

With standardized procedures physicians should be better able to defend themselves in worthless lawsuits (the vast majority are dismissed or the doctor wins). You properely follow the standards, you're 'safe'.

IMO, HC reform should mandate the appropriate medical academies develop standards, then some tort reform giving physicians 'safe harbor' if they follow those procedures properly

We could do this in something like a 2 page frickin bill. The heavy lifting would be at the academies, but who better than physicians to set medical care standards?

BTW: when you look at studies claiming tort reform is chump change, notice what they focus on - malpractice insurance fees, attorney court costs and damages. But the real money is obviously in 'defensive medicine'.

Fern

 

[woolfe9999]

The information is out there.

I no longer have the link, I supplied it in a previous thread, but the former Chairman of the AMA has said 1/3 to 1/2 of our annual HC costs could be reduced with decent tort reform.

Can't find the link in your prior posts after a search. That is a pretty shocking claim to say the least. Tort reform alone will give us medical costs similar to Canada, with no downsides. Amazing.

- wolf

 

[JEDIYoda]

Starting soon on C-Span. Going to be ~6 hours long(or so I heard)

*EDIT*: Thursday, not today!

Obama's plan in summary:
http://www.nytimes.com/interactive/2...222Health.html

Those of you who don't want government mandated health insurance, there's a way out.

There is nothing official about this thread....just because you say it`s official doesn`t amount to anything.....

 

[mattpegher]

The information is out there.

I no longer have the link, I supplied it in a previous thread, but the former Chairman of the AMA has said 1/3 to 1/2 of our annual HC costs could be reduced with decent tort reform. It's not the malpractice premiums, it's the redundant and excessive & unnecessary procedures physicians' prescribe or allowing patients to insist on because physicians fear suits. Put yourself in their shoes, why deny the (unnecessary) procedure/visit etc when it costs them nothing (actually is just more billable services) and may help ward off a lawsuit?

The below is related to the above:

I saw a Congressman last night on cable news, he is part of the Physicians' caucus (apparently we have 19 doctors serving now in Congress). His name is Murphy. Apart from his (and another doctor's complaint) that Obama will not meet with them or let them attend this HC summit, he spoke of where real savings are to be obtained.

The New england Institute has estimated approx $700 - 800 billion can be saved annually by implementing clinical standards. Their study found huge variations in patient care for chronic diseases among different regions/hospitals etc, sometimes running into the hundreds of thousands of $'s per patient. Only 4% of the variance was attributable to legit/explainable causes.

Their suggestion is the various groups such as the Academy of Surgeons etc be made to set clinical standards for the treatment of chronic diseases. Chronic diseases account for 95% of medicare and 75% of all HC expenditures.

Link: http://www.foxnews.com/story/0,2933,587208,00.html

I.e., the medical profession is freakin mess. I'm shocked that they lack national standards, everyone just doing what they want. It seems to me the place for HC reform is fixing that. Other professions (i.e., accounting/CPA's) have national standards that must be adhered to. Under CPA standards, doing excessive audit procedures will get you into as much trouble as doing too few/inadequate procedures

With standardized procedures physicians should be better able to defend themselves in worthless lawsuits (the vast majority are dismissed or the doctor wins). You properely follow the standards, you're 'safe'.

IMO, HC reform should mandate the appropriate medical academies develop standards, then some tort reform giving physicians 'safe harbor' if they follow those procedures properly

We could do this in something like a 2 page frickin bill. The heavy lifting would be at the academies, but who better than physicians to set medical care standards?

BTW: when you look at studies claiming tort reform is chump change, notice what they focus on - malpractice insurance fees, attorney court costs and damages. But the real money is obviously in 'defensive medicine'.

Fern

You are quite right, but Americans must understand that we have many "Guidelines" but the multifactoral nature of pathology and presentation make these guidelines very vague in many instances. Establishing standard of care is often unclear, and the focus of most malpractice cases. In addition, there are always some inscrupulous physicians who are willing for a fee, to claim that you did not meet standard of care. The problem is that in America, we are often too eager to find blame when there are negative outcomes. They fail to realize that sometimes, you just cant prevent these.
During my Advanced Trauma Life Support recert last time, I was talking to a Replant surgeon (someone who reattaches limbs) who was in a suit because a patients who's arm he reattached had lost the limb. The limb had been severed more than 6 hour before, he got to the hospital capable of the repair (you really only have about 3 hours). Surgery was imediate but there was a poor chance of saving the limb anyway. So negative outcome, dispite care that exceeded standards.
Every step towards fixing the wildly inaccurate tort system will result in an incremental savings for the system as a whole.
Guidelines are very helpfull, mostly because they synopsize the literature. But we have been developing and modifying these guidelines for the past 30 years ( I have only been in medicine for 18 years),and it has not decreased the frequency of suits, cost of care or cost of malpractice coverage.

I also agree that the most of the cost is in defensive practices.

 

[rudder]

When are the repugs post their healthcare plans?

http://www.whitehouse.gov/blog/2010/02/22/will-republicans-post-their-health-plan-and-when

oh wait.... they are linked from this page already...

http://www.whitehouse.gov/health-care-meeting/bipartisan-meeting

 

[Slew Foot]

My wife has had patients threaten to sue/complain to the state medical board if they didnt get tests/medications/procedures done that she didnt think was warranted. But she did them anyway, it doesnt cost her anything and too many complaints and you lose your license.

The information is out there.

I no longer have the link, I supplied it in a previous thread, but the former Chairman of the AMA has said 1/3 to 1/2 of our annual HC costs could be reduced with decent tort reform. It's not the malpractice premiums, it's the redundant and excessive & unnecessary procedures physicians' prescribe or allowing patients to insist on because physicians fear suits. Put yourself in their shoes, why deny the (unnecessary) procedure/visit etc when it costs them nothing (actually is just more billable services) and may help ward off a lawsuit?

The below is related to the above:

I saw a Congressman last night on cable news, he is part of the Physicians' caucus (apparently we have 19 doctors serving now in Congress). His name is Murphy. Apart from his (and another doctor's complaint) that Obama will not meet with them or let them attend this HC summit, he spoke of where real savings are to be obtained.

The New england Institute has estimated approx $700 - 800 billion can be saved annually by implementing clinical standards. Their study found huge variations in patient care for chronic diseases among different regions/hospitals etc, sometimes running into the hundreds of thousands of $'s per patient. Only 4% of the variance was attributable to legit/explainable causes.

Their suggestion is the various groups such as the Academy of Surgeons etc be made to set clinical standards for the treatment of chronic diseases. Chronic diseases account for 95% of medicare and 75% of all HC expenditures.

Link: http://www.foxnews.com/story/0,2933,587208,00.html

I.e., the medical profession is freakin mess. I'm shocked that they lack national standards, everyone just doing what they want. It seems to me the place for HC reform is fixing that. Other professions (i.e., accounting/CPA's) have national standards that must be adhered to. Under CPA standards, doing excessive audit procedures will get you into as much trouble as doing too few/inadequate procedures

With standardized procedures physicians should be better able to defend themselves in worthless lawsuits (the vast majority are dismissed or the doctor wins). You properely follow the standards, you're 'safe'.

IMO, HC reform should mandate the appropriate medical academies develop standards, then some tort reform giving physicians 'safe harbor' if they follow those procedures properly

We could do this in something like a 2 page frickin bill. The heavy lifting would be at the academies, but who better than physicians to set medical care standards?

BTW: when you look at studies claiming tort reform is chump change, notice what they focus on - malpractice insurance fees, attorney court costs and damages. But the real money is obviously in 'defensive medicine'.

Fern

 

[mattpegher]

My wife has had patients threaten to sue/complain to the state medical board if they didnt get tests/medications/procedures done that she didnt think was warranted. But she did them anyway, it doesnt cost her anything and too many complaints and you lose your license.

This is true. Not to mention malpractice suits. Also many physicians are not their own boss, so complaints to the hospital administration, employers etc are often a case of guilty until proven innocent.

 

[cubby1223]

Absolutely need tort reform.

Couple weeks ago there was a situation here in Illinois of a hospital nurse that mistakenly switched up two newborn babies, gave them to the wrong mothers for a short period of time. We're talking just hours in length, not like days, weeks, etc.

Well, one of the parents is now suing the hospital seeking $30k! On the radio program discussing this, half the callers are saying this is ridiculous, but the *other* half is saying they absolutely are entitled to that payoff!

The nurse makes one slip-up on day, and her entire year's salary is now gone? Is this reasonable or unreasonable expectations of perfection? I know the hospital on the whole will absorb the loss, but put in those terms is quite shocking...


Then we have the trial lawyers association running radio adds running all over the airwaves here crying that the only reason for tort reform is to pad greedy insurance executives' pockets...

 

[theeedude]

Why is 30K an outrageous sum, considering how much hospitals charge for births, they better get it right. Also, what if the babies breast fed of the wrong mothers, now they have to worry about what they might have picked up. That sounds like a reasonable sum within the context of how much the hospital bills them for their services.

 

[piasabird]

Still waiting for some stimulus money.

Where are all the jobs?

Health care is not important if you dont have a job.

 

[woolfe9999]

Absolutely need tort reform.

Couple weeks ago there was a situation here in Illinois of a hospital nurse that mistakenly switched up two newborn babies, gave them to the wrong mothers for a short period of time. We're talking just hours in length, not like days, weeks, etc.

Well, one of the parents is now suing the hospital seeking $30k! On the radio program discussing this, half the callers are saying this is ridiculous, but the *other* half is saying they absolutely are entitled to that payoff!

The nurse makes one slip-up on day, and her entire year's salary is now gone? Is this reasonable or unreasonable expectations of perfection? I know the hospital on the whole will absorb the loss, but put in those terms is quite shocking...


Then we have the trial lawyers association running radio adds running all over the airwaves here crying that the only reason for tort reform is to pad greedy insurance executives' pockets...

Sure, and where I live, a nurse gave a cancer patient a 10x dose of chemo, which killed the patient in 24 hours. Let's play tit-for-tat with anecdotes. It's so much fun.

- wolf

 

[cubby1223]

Why is 30K an outrageous sum, considering how much hospitals charge for births, they better get it right.

No physical harm came to any of the people involved.

Because health care costs need to be reduced.

Isn't that the whole damn point of all this reform?

 

[cubby1223]

Sure, and where I live, a nurse gave a cancer patient a 10x dose of chemo, which killed the patient in 24 hours. Let's play tit-for-tat with anecdotes. It's so much fun.

- wolf

So I present a situation where no harm was done to any of the people involved, and you counter with a situation where someone died?

Hell, maybe if there were tort reform, the hospitals could use the savings to better train, and better staff their hospitals.

 

[mattpegher]

I often wonder if we allowed the defendant to countersue for expenses should a case be lost, what affect that would have on the number of suits. And what would constitute a frivolous law suit.

 

[Fern]

I often wonder if we allowed the defendant to countersue for expenses should a case be lost, what affect that would have on the number of suits. And what would constitute a frivolous law suit.

They do that in other countries (IIRC, the UK).

IMO, a lot of tort lawyers would be looking for other jobs. I think if we removed that 'free swing at the pinata' people would think long and hard before starting a lawsuit.

Fern

 

[JSt0rm]

So I present a situation where no harm was done to any of the people involved, and you counter with a situation where someone died?

Hell, maybe if there were tort reform, the hospitals could use the savings to better train, and better staff their hospitals.

hasn't it been proven that tort reform wont save enough money to dent the problem? Sounds like your trying to get a oil change after the cars been totaled out.

 

[Fern]

hasn't it been proven that tort reform wont save enough money to dent the problem? Sounds like your trying to get a oil change after the cars been totaled out.

No, and you're doing a fine job of demonstrating that you haven't read the thread.

Your 'free hint' for today is "defensive medicine".

Fern

 

[soundforbjt]

No. 1 Force the AMA to lift the restrictions on doctor graduation. More doctors= more competition= lower costs.

No. 2 Stop the drug companies monoploy.

No. 3 Stop frivilous law suits...not the ones that should be tried.
Tort reform is ok to a degree, but isn't the end-all cost saver.

These imo, would be a good start.

 

[Slew Foot]

No. 1 Force the AMA to lift the restrictions on doctor graduation. More doctors= more competition= lower costs.

No. 2 Stop the drug companies monoploy.

No. 3 Stop frivilous law suits...not the ones that should be tried.
Tort reform is ok to a degree, but isn't the end-all cost saver.

These imo, would be a good start.

1. Physician salary are about 5% of your total heathcare cost, you wouldnt save much money, and a whole lot of idiots would now be doctors.

2. Drugs and equiptment are way overpriced, allow more competition to decrease these costs.

3. eliminating stupid lawsuits and defensive medicine would save a huge chunk of change

 

[werepossum]

Sure, and where I live, a nurse gave a cancer patient a 10x dose of chemo, which killed the patient in 24 hours. Let's play tit-for-tat with anecdotes. It's so much fun.

- wolf

Under our current system the hospital and its insurance company are going to settle. Two of the conditions of the settlement are probably going to be no legal complaints filed and a gag order. The patient's family gets a butt load of money, but a dangerous nurse (assuming she is, anyone can screw up once) is not removed from the system. Our present system encourages the protection of dangerous health care providers, they just pay higher malpractice premiums.

IMO the absolute most disastrous thing we could do is institute government control of health care without eliminating the ability of patients to sue and get jury trials. First we control costs by cutting pay to doctors. Right now doctors make up a good portion of our brightest, most driven young people because it is both an honorable profession and a quite lucrative one. So where do the best and brightest in university go? Not into medicine, with very high educational costs, diminishing returns and increasing workload. Probably into law instead, where they too can sue the system and quite possibly make even more money than they would have as doctors. We would then be as the UK, where medicine is largely a field for immigrants willing to be less ambitious.