Universal Healthcare in Injury Lawsuits?

[ElFenix]

That's because Americans are, on a whole, ignorant morons who hilariously think that the US is a nice place to live. Meanwhile, others of us live in genuinely enviable nations with an amazing lifestyle. And we get to spend some of our leisure time laughing at the republican primaries, reminding ourselves that about half of Americans actually believe the shit that they say.

given the voting rates it's more like less than a quarter

 

[Imp]

It can, and does happen that people in Canada sue for injury related to accidents caused by others.

They don't sue for health care costs as the basic costs are covered by government health insurance, but if there are any extended benefits from a private health care plan (private room, extended rehab services, short term disability coverage), the private health insurance plan will act to recover these costs from the liable party.

The injured individual will only sue for pain and suffering and any direct costs such as ambulance, lost wages, costs of at home care if required, etc.

I heard pain and suffering is a hard sell in Canada, since it's difficult to monetize. Lost wage or wage potential is more straight forward.

Also, I've heard the arguement that Canada isn't really completely public in health care. it's a private/public hybrid model. Forget why, or the arguements.

 

[ichy]

Kind of. Healthcare is a human right, not a privilage afforded to only the rich.

Nothing that is provided by others is a "human right."

 

[ichy]

EVERY SINGLE RICH DEMOCRACY OTHER THAN THE USA HAS A NATIONAL HEALTH PLAN AND EVERY SINGLE ONE OF THEM SPENDS LESS ON HEALTH CARE FOR HEALTH OUTCOMES.

Wrong. In Switzerland most healthcare coverage is provided by insurance companies, not the government. They do have near-universal coverage but it is not "a national health plan."

 

[D1gger]

I heard pain and suffering is a hard sell in Canada, since it's difficult to monetize. Lost wage or wage potential is more straight forward.

Also, I've heard the arguement that Canada isn't really completely public in health care. it's a private/public hybrid model. Forget why, or the arguements.

You're right on both counts. The pain and suffering is a hard sell, so most focus on the lost direct costs and try to inflate the lost past and future wages. My company has been named in suites where the lawyers have made claims for pain and suffering (slip and fall accident after we had cleared snow in a parking lot), but the two insurance companies settled the entire claim with a lump sum that was far less than the lawsuit amount.

It is a hybrid system because in most provinces you can elect to go to a private clinic for emergency treatment, MRI's, and some types of surgery.

http://www.victoriasurgery.com

Some think it is wrong that those that can afford it can get their arthroscopic knee surgery done immediately, while those who can't end up on a waiting list, but the way I look at it, if someone can afford it and pays the costs, it helps shorten the waiting list for all others.

 

[Patranus]

Nothing that is provided by others is a "human right."

You mean we cannot enslave doctors to provide for others?

 

[Train]

You mean we cannot enslave doctors to provide for others?

Well, we COULD, just gotta get rid of the "not being a slave being a human right" thing to make it work.

 

[zinfamous]

You mean we cannot enslave doctors to provide for others?

who said anything about enslave?

what about doctors being enslaved by insurance companies to do only the work that insurance companies want them to do?

are our soldiers enslaved by the government, or do they volunteer?

would doctors be allowed to make that choice to practice how they want, or would you prefer them to live and practice in your utopian fascist fantasy world.

 

[mattpegher]

who said anything about enslave?

what about doctors being enslaved by insurance companies to do only the work that insurance companies want them to do?

are our soldiers enslaved by the government, or do they volunteer?

would doctors be allowed to make that choice to practice how they want, or would you prefer them to live and practice in your utopian fascist fantasy world.

First lets start off by saying that physician compensation accounts for 8% of the national health care spending according the congressional budget office.

So lets say for instance that you dropped the salary of every physician to 1/4 of current levels. This would make the average physician salary about 35K/year. This would save about 6% of the healthcare spending.
Consequences:
1: Would now be more lucretive to be any other professional. No one smart enough to be a doctor would be dumb enough to want to. You could be a lawyer, a businessman, banker etc.
2: The ranks of those who do chose to be doctors will be so inadequately equiped to do so that not a single one of us would want to have to rely on them
3: Currently we import thousands of physicians to the US from other countries, it could be said that we recruit the brightest minds from other countries. This would stop and likely reverse.
4. The incentive to provide good care would be gone.

Altuism will not prevail given lack of reimbursement, nor should it. Like any other service, you get what you pay for. There are ways that the system could be made more efficent but physician salaries are not it.

That said I think we need a change in the system that currently rewards proceedures over face to face time, and dramatically over pays speciallist and underpays primary care. This is within the realm of Medicare to control, as they set the prices and payments, and other insurances base their rates on Medicare rates.

 

[Patranus]

EVERY SINGLE RICH DEMOCRACY OTHER THAN THE USA HAS A NATIONAL HEALTH PLAN AND EVERY SINGLE ONE OF THEM SPENDS LESS ON HEALTH CARE FOR HEALTH OUTCOMES.

How is that working out for the Eurozone?

 

[actuarial]

I heard pain and suffering is a hard sell in Canada, since it's difficult to monetize. Lost wage or wage potential is more straight forward.

Also, I've heard the arguement that Canada isn't really completely public in health care. it's a private/public hybrid model. Forget why, or the arguements.

It's not 100% public. For example after my wife delivered our child, we paid for a private room over a regular room.

It's also a hybrid because (as I understand it) most of those who provide services are private entities. They then bill the government for services performed based on a set schedule, and for almost all services it is illegal to bill additional money for something that is covered.

To the customer though, they actual experience itself is no different than if the government owned 100% of the hospitals, but it does allow for some free market forces to work.

But I don't work in the medical field so a lot of the billing operation is foreign to me.

 

[zinfamous]

First lets start off by saying that physician compensation accounts for 8% of the national health care spending according the congressional budget office.

So lets say for instance that you dropped the salary of every physician to 1/4 of current levels. This would make the average physician salary about 35K/year. This would save about 6% of the healthcare spending.
Consequences:
1: Would now be more lucretive to be any other professional. No one smart enough to be a doctor would be dumb enough to want to. You could be a lawyer, a businessman, banker etc.
2: The ranks of those who do chose to be doctors will be so inadequately equiped to do so that not a single one of us would want to have to rely on them
3: Currently we import thousands of physicians to the US from other countries, it could be said that we recruit the brightest minds from other countries. This would stop and likely reverse.
4. The incentive to provide good care would be gone.

Altuism will not prevail given lack of reimbursement, nor should it. Like any other service, you get what you pay for. There are ways that the system could be made more efficent but physician salaries are not it.

That said I think we need a change in the system that currently rewards proceedures over face to face time, and dramatically over pays speciallist and underpays primary care. This is within the realm of Medicare to control, as they set the prices and payments, and other insurances base their rates on Medicare rates.

I don't think compensation needs to fall so drastically and yea, it is somewhat irrelevant to actual costs.

I think a system like Mayo clinic, with salaried tiers that are, on average, lower than general physician compensation, but yet well above the non-physician average (say, upwards of 150k-300k) is a damn fine living.

 

[CanOWorms]

Right. But our left wingers are to the right of your right wingers. And our right wingers are the ones you guys kicked out four hundred years ago for being annoying a-holes.

Not really. It depends on the issues. For example, in much of Europe, the far-left would be the equivalent of the KKK on race/minority issues. Much of the support for healthcare is also tinged with racial overtones. That's why when minorities take advantage of the social system, everyone goes berserk.

The last French Socialist candidate wanted to send minorities to army boot camps. That should tell you something!

 

[actuarial]

First lets start off by saying that physician compensation accounts for 8% of the national health care spending according the congressional budget office.

So lets say for instance that you dropped the salary of every physician to 1/4 of current levels. This would make the average physician salary about 35K/year. This would save about 6% of the healthcare spending.

This is a complete straw man. In Canada doctors are paid based on the number of services rendered, so some make more and some less. But let's look at your ridiculous scenario:

Consequences:
1: Would now be more lucretive to be any other professional. No one smart enough to be a doctor would be dumb enough to want to. You could be a lawyer, a businessman, banker etc.

2: The ranks of those who do chose to be doctors will be so inadequately equiped to do so that not a single one of us would want to have to rely on them

3: Currently we import thousands of physicians to the US from other countries, it could be said that we recruit the brightest minds from other countries. This would stop and likely reverse.

So don't set the salary so low. Why is it that doctors have to make so much less under the premise that health care is a human right?

4. The incentive to provide good care would be gone.

No it won't. People aren't forced to see specific doctors. As long as there is an adequate supply of doctors, people will gravitate towards the best ones. As long as you are being paid by usage (as opposed to a flat salary), people will stop going to bad doctors and they won't make enough money to survive. Are you saying there is no incentive to provide good care in Canada?

Altuism will not prevail given lack of reimbursement, nor should it. Like any other service, you get what you pay for. There are ways that the system could be made more efficent but physician salaries are not it.

That said I think we need a change in the system that currently rewards proceedures over face to face time, and dramatically over pays speciallist and underpays primary care. This is within the realm of Medicare to control, as they set the prices and payments, and other insurances base their rates on Medicare rates.

Making health care a human right can have absolutely zero to do with physician salaries. You can have single payer health care and pay doctors more than you do now, it would just be hella expensive, though depending on how much more you give doctors it would probably still be cheaper overall than what you spend now.

 

[Zenmervolt]

You sue on behalf of the insurance company.

We don't get the money from the lawsuit, the insurance company does.

Bullshit.

Have to admit though that I'm rather impressed that you managed to fit so much wrong into so little space.

(1) In subrogation situations, the insurance company sues on your behalf, not the other way around.

(2) Even in subrogation situations the insurance company only recovers what it has already paid out to the injured person, so, in effect, you do "get the money from the lawsuit," you simply get it up front, from the insurance company, instead of having to wait months (or years) to recover from the negligent party.

(3) You still retain the right to sue the negligent party for things the insurance company hasn't paid for (e.g. loss of consortium, loss of enjoyment, emotional damages, etc.) so you're still free to include those claims in the insurance company's suit.

(4) Any damages awarded in excess of what the insurance company has paid out go directly to you. The insurance company can only keep an amount equal to what they have already paid you.

Basically, you get the massive benefit of having the experienced (and expensive) insurance company lawyers litigate the case for you. You get paid up front by the insurance company instead of having to wait for the trial to finish and for the court to set up a collections scheme against a person who will often simply not have the money to pay immediately. And, on top of all that, any money awarded that goes beyond what the insurance company paid out goes directly to you and not to the insurance company.

ZV

 

[mattpegher]

This is a complete straw man. In Canada doctors are paid based on the number of services rendered, so some make more and some less. But let's look at your ridiculous scenario:

So don't set the salary so low. Why is it that doctors have to make so much less under the premise that health care is a human right?

No it won't. People aren't forced to see specific doctors. As long as there is an adequate supply of doctors, people will gravitate towards the best ones. As long as you are being paid by usage (as opposed to a flat salary), people will stop going to bad doctors and they won't make enough money to survive. Are you saying there is no incentive to provide good care in Canada?

Making health care a human right can have absolutely zero to do with physician salaries. You can have single payer health care and pay doctors more than you do now, it would just be hella expensive, though depending on how much more you give doctors it would probably still be cheaper overall than what you spend now.

My point is that physician salaries are one of the smallest portions of US healthcare expenditures. Unfortunately in the current financial system it is also the easiest to cut. There are serious consequence of cutting this part of the budget.
My point also was that you have to consider the competition for intellect. Currently the top students at any university have a choice to enter many fields. And most choose based on lifestyle, interest and income. Your average A student will be looking at business, finance, law and medicine. If you cut the salaries of physicians significantly they will be looking at business, finance and law.
(I wish that we paid scientist better in this country)

As many of you know, I already provide universal health care. As an emergency physician, I provide care to anyone that enters my door. Unfortunately, the financing of that care varies depending on patients, the insured cover the uninsured, and the worst off are the working poor and middleclass that do not have coverage. I agree that a universal health care plan can be implimented that maintains a high standard of care. I just dont think it can be done by only controlling finance.


I was thinking that maybe we should open up the federal medicaid program to all americans. This would establish a minimum care that most would chose not to use. The next thing would be to begin to employ physicians to render care in Medicaid clinics. This could be gradually scaled up with increases in taxes until the Medicaid clinics were just as good and just as available as any other doctor, making private physicians unnecessary. Now this plan would cost much more than the current attempt to magically cover the uninsured without expenses. It would for a time result in a two teired system that would disolve as the "free plan" approached the quality of the premium plan.
It would also allow for a adjustable growth of the system that could be modulated depending on needs.

 

[mattpegher]

Just doing some research, The average number of physician/1000 people in UK is 2.2, and 2.3 in US.
http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people

And the average salary is about 150K/year in the UK and about 190k/year in the US

http://www.nhscareers.nhs.uk/details/Default.aspx?Id=553

http://www.guardian.co.uk/society/2005/oct/06/health.uknews

In NZ it is also 2.2/1000

http://www.imsanz.org.au/resources/documents/NZ_genmed_workforce.pdf

 

[actuarial]

My point is that physician salaries are one of the smallest portions of US healthcare expenditures. Unfortunately in the current financial system it is also the easiest to cut. There are serious consequence of cutting this part of the budget.
My point also was that you have to consider the competition for intellect. Currently the top students at any university have a choice to enter many fields. And most choose based on lifestyle, interest and income. Your average A student will be looking at business, finance, law and medicine. If you cut the salaries of physicians significantly they will be looking at business, finance and law.
(I wish that we paid scientist better in this country)

I know what your point was, obviously you completely missed mine. The poster you quoted, and the string of quotes, was talking about health care as a human right. I didn't see any of those quotes mention the salaries of physicians.

Having universal health care does not disqualify you from paying top salaries for physicians, and you can still reduce health care costs without changing what physicians make.

 

[lord_emperor]

I'm Canadian.

When I injured my leg and had a hospital stay I recieved a statement saying "your stay cost $xx,xxx.xx if you are seeking compensation because another party is responsible we want some $$$ too".

So yes the government does try to recoup costs for injuries for which someone else is at fault.

 

[mattpegher]

I know what your point was, obviously you completely missed mine. The poster you quoted, and the string of quotes, was talking about health care as a human right. I didn't see any of those quotes mention the salaries of physicians.

Having universal health care does not disqualify you from paying top salaries for physicians, and you can still reduce health care costs without changing what physicians make.

So we agree. I think many in these government health care systems just dont see the costs, I know Hal just cant seem to realize that his health care cost some amount of money that someone pays.
Its just like police, there is a budget; certain amount of staff, equipment, etc.
Of course in healthcare there is also, R&D, manufacturing costs, financing/admin costs, legal costs. I know the budget that they show us at staff meetings is mindboggling.

 

[mattpegher]

I don't think compensation needs to fall so drastically and yea, it is somewhat irrelevant to actual costs.

I think a system like Mayo clinic, with salaried tiers that are, on average, lower than general physician compensation, but yet well above the non-physician average (say, upwards of 150k-300k) is a damn fine living.

I agree, what mayo does is hold down the salaries of the high end specialist to more reasonable levels.

 

[mattpegher]

I can also tell you that I think that 2.2 physicians/1000 patients is not enough especially with the shift toward specialists. I think that there are many very smart people that either do not make it into medical school or do not consider it due to tuition costs.

One idea may be to create more funding for med students. I think the national board exams should still keep out those that arent qualified to continue. Of course that will mean more failed med students who dont get to be doctors which would be a waste of money. There is obviously a fine balance there, but I think we could tolerate at least a slight shift toward more graduates.

 

[Imp]

It's not 100% public. For example after my wife delivered our child, we paid for a private room over a regular room.

It's also a hybrid because (as I understand it) most of those who provide services are private entities. They then bill the government for services performed based on a set schedule, and for almost all services it is illegal to bill additional money for something that is covered.

To the customer though, they actual experience itself is no different than if the government owned 100% of the hospitals, but it does allow for some free market forces to work.

But I don't work in the medical field so a lot of the billing operation is foreign to me.

Bingo. I think that's it. Practices are private businesses, but they get reimbursed through the guberment if you have health insurance and the item is covered.

 

[DCal430]

Bullshit.

Have to admit though that I'm rather impressed that you managed to fit so much wrong into so little space.

(1) In subrogation situations, the insurance company sues on your behalf, not the other way around.

(2) Even in subrogation situations the insurance company only recovers what it has already paid out to the injured person, so, in effect, you do "get the money from the lawsuit," you simply get it up front, from the insurance company, instead of having to wait months (or years) to recover from the negligent party.

(3) You still retain the right to sue the negligent party for things the insurance company hasn't paid for (e.g. loss of consortium, loss of enjoyment, emotional damages, etc.) so you're still free to include those claims in the insurance company's suit.

(4) Any damages awarded in excess of what the insurance company has paid out go directly to you. The insurance company can only keep an amount equal to what they have already paid you.

Basically, you get the massive benefit of having the experienced (and expensive) insurance company lawyers litigate the case for you. You get paid up front by the insurance company instead of having to wait for the trial to finish and for the court to set up a collections scheme against a person who will often simply not have the money to pay immediately. And, on top of all that, any money awarded that goes beyond what the insurance company paid out goes directly to you and not to the insurance company.

ZV

All I know is when my brother was involved in an auto accident with an unisured driver who was at fault, he was the named plaintiff in the case, with his auto and medical insurance each contributing lawyers. In the end the Auto got around 7K the Medical around 5K and him nothing. Though obviously the auto ins paid him for his car and his medical insurance is the one who paid for the medical bill.

 

[zinfamous]

I can also tell you that I think that 2.2 physicians/1000 patients is not enough especially with the shift toward specialists. I think that there are many very smart people that either do not make it into medical school or do not consider it due to tuition costs.

One idea may be to create more funding for med students. I think the national board exams should still keep out those that arent qualified to continue. Of course that will mean more failed med students who dont get to be doctors which would be a waste of money. There is obviously a fine balance there, but I think we could tolerate at least a slight shift toward more graduates.

Primary care seems to be on the wane, and the loss of the most important aspect of individual medical care is going to cause serious problems in this country within the next 10 or more years. I agree that the biggest non-financial problem is far too few doctors--but again, I think the reason for that is tied to finances--preposterous debt out of education, far too long to pay it back and make a living, malpractice insurance, etc.