Yes, "loser pays" will work. There is another strategy that I foresee coming in the medical malpractice lawsuit theater: doctors will start fighting back. Heretofore, many, if not most lawsuits were settled out of court, regardless of their merit. The result: more lawsuits. What gets encouraged, gets repeated. I think this will change.

From now on, we physicians will fight every one to the bitter end. We will win the vast majority and then counter-sue the losing attorney for LEGAL malpractice. We may not win, but we WILL begin to bankrupt these unscrupulous bozos who live to make our lives difficult. We will see how they like having a sword hanging over them all the time. We will fight fire with fire. Since the government won't end this nonsense, we will take matters into our own hands!

Once Mr. Sowell put in articulate and concise words the folly of government interference into the private sector. No free lunch is something that the democrat party doesn't seem to understand. In fact the lunches they serve could cost an arm and a leg....[cooperscopy.blogspot.com]

Thomas, once again, a well thought-out article. Stating what should be obvious. It is hard not to come to the conclusion that the Dems are more interested in power than reason.

TM

The recipe for reducing medical costs is competition. Lasik eye surgery has demonstrated that.
I also take doctors to task for restricting competition in their field.

Yes, well said! Except this...Tort Reform will not "save" money, we will just be refusing to pay tort lawyers outlandish fees. By not paying them, fewer bright, ambitious young people will take on the costs of Law School... which is EXACTLY what we need!

Dr. Sowell always makes sense, which is why the Lefties can do nothing but call him names.

Tort reform - and especially Loser Pays - will never get through a congress filled with 90% attorneys (in both parties). Too bad.

Yes, via the gifts of the left we all pretend that everything is free, and instead end up getting less of it, and lower quality of what we do get. It is government enforced self-delusion. A free market forces us to face reality, and optimizes the production of services and goods through competition. The Democrats don't seem to understand the meaning of the word competition - they use it to mean the opposite, as in "a public option would provide some competition for private insurance." The only way to stop this abomination is to make it absolutely clear to our representatives that THEY WILL BE VOTED OUT OF OFFICE IF THEY SUPPORT IT. There is a website where you can pledge to vote against politicians supporting the bill. Representatives will then be informed of how many votes they are losing. It is called www.PledgeOfLiberty.com

Sowell displays amusing ignorance about costs. There's a fundamental difference between price and cost.

If price and cost meant the same thing, then identical medical treatment for which price differs by more than tenfold across different hospitals and other providers, would mean that cost differs by the same degree, which is ridiculous.

Sowell would have his readers believe, for example, that an aspirin priced at $15 actually "costs" $15 dollars, or one gall bladder removal for $20,000, actually "costs" $20,000, when the identical treatment is available from other providers at far lower prices, which translates into lower costs for insurers or patients.

Sowell ignores the one element of reform which could reduce prices set way above "costs", competition through a strong public option, then proceeds to claim that costs can only be shifted around with reform, because cost itself cannot be reduced, amazingly claiming that the only way to reduce cost is to refuse to consume the service.

But that solution works only when competition works, and competition doesn't work in health care, having failed miserably across the board. Refusing to consume a $15 aspirin in a hospital doesn't result in another provider offering aspirin to the patient at lower prices.

Until Sowell addresses the essential reason for outrageous increases in health care costs, the absence of competition in the private sectors of insurance and providers, and reform which addresses that failure, his entire framing of the issue is critically flawed.

Provider costs are not a given to be shifted around. Insurance costs are not a given to be shifted around. Both are hugely excessive, way above what would occur in a competitive market.

The cost of medical education, like the cost of all education, has been wildly inflated in the past generation. Can it be brought down? Could more medical schools be opened? Could we make it easier for foreign trained physicians to come to the United States and practice? These questions aren't even part of the debate.

Even if you believe that doctors have to be paid so much in order to pay down their debts (which should have very low interest rates these days), this doesn't explain why dental hygienists make $50,000 right out of school and $80,000 with experience; why physical therapy assistants with two years of higher ed make in the 40s; and generally why there are so many Mercedes in the staff parking lot.

We're spending way to much, and certain people are profiting from the spending.

Tiger 1985 Wrote:
-------------------------------------------------------
> In all seriousness, if Tort Reform in not part of
> a final bill, then anyone voting for that bill is
> not serious about Americans number 1 concern - the
> run away costs of health care. I cannot wait to
> see the details of the GOP Bill. It seems
> focussed on free market reforms to reign those
> costs in. This IS exactly what we need

Probably, but with the Dems in control, they'll never let any of the GOP ideas get included in the final bill. The Dems don't want to negotiate or compromise, they want total and complete power over healthcare. Lowering costs and improving care is not what this whole debate is about. What we are going to get, though, is another entitlement program that will end up disappointing all of us and bankrupting our country. Some day folks, we have to accept our own personal responsibility and pay our own way for what we need and want. Spending our childrens futures now to make our lives more cushy today will only end up lowering their standard of living. Shamefull it is, shamefull! Do we really deserve to live that far outside of our ability to pay for our own lives?

Steve Hansmann/East Central Minnesota Wrote:
-------------------------------------------------------
> Sowell touches on the problem, but then avoids the
> obvious solution. Public financing and at least
> malpractice insurance support from the government
> in exchange for substantive public service in
> underserved areas, like most of the rural areas
> of the country, would do much to alleviate both
> localized shortages and inequalities, reduce the
> financial obligations on physicians, provide more
> comprehensive health care, including preventative
> health care, and ultimately reduce costs. The
> other elephant in the room is, indeed, physician
> salaries. Do cops or firefighters become cops or
> firefighters to get rich? How about nurses? Dr.
> Jonas Salk gave away the polio vaccine to the
> public and literally made no money from it. Can
> you imagine any physician or researcher doing that
> today? Altruism and compassion has been largely
> hammered out of most health industry workers, (I
> know, I'm a psychiatric RN working in the VA
> system). The free market and self-interest is not
> the model for caring for the most ill and
> vulnerable among us. Our slavery to
> ever-increasing profits and insisting that
> everything make a profit is not even rational, and
> health care, especially among the elderly and most
> vulnerable among us has suffered.

You should seek counseling. Lawyers create a problem and your solution is let the government pay the insurance to pay the lawyers.........and then have the doctors work for the government. Brilliant.

It reminds of the government taking over the car companies so they could keep the unions well paid. Is GM better off now?

Government is NOT a solution. Government is usually the problem....even in healthcare.

A modest proposal: shut the law schools for ten years; fund a spot in medical, dental, and nursing school (scholarships) for each displaced law student.

valuemonitor Wrote:
-------------------------------------------------------
> The cost of medical education, like the cost of
> all education, has been wildly inflated in the
> past generation. Can it be brought down? Could
> more medical schools be opened? Could we make it
> easier for foreign trained physicians to come to
> the United States and practice? These questions
> aren't even part of the debate.
>
> Even if you believe that doctors have to be paid
> so much in order to pay down their debts (which
> should have very low interest rates these days),
> this doesn't explain why dental hygienists make
> $50,000 right out of school and $80,000 with
> experience; why physical therapy assistants with
> two years of higher ed make in the 40s; and
> generally why there are so many Mercedes in the
> staff parking lot.
>
> We're spending way to much, and certain people are
> profiting from the spending.


Have you ever heard of Capitalism? In that system, we are free to pay or recieve what the market will bear. Do you want the government to tell you how much you can make after you put yourself thru college and have loans to pay off?

I don't really want any foreign-trained doctors here.

Has your Congressman ever complained that cost of college is so high because of liberal tenured professors that work one day a week? NO. Your congressman/Obama has now taken over the student loan process totally so that can keep loaning money forever and who knows if it will ever be paid back. But at least the tuition got paid didn't it.

"Britain has had a government-run medical system for more than half a century and it has to import doctors, including some from Third World countries where the medical training may not be the best. In short, reducing doctors' income is not reducing the cost of medical care, it is refusing to pay those costs. Like other ways of refusing to pay costs, it has consequences."
*****************************************************


Mr Sowell, oh my gosh.

If one does not understand something, "big" and this is big, the best thing to do is write about it, as if one has knowledge, and pretense of research, that at one time was the hallmark of people who called themselves journalist. I hear about it all the time that journalist don't research things anymore, they go on line and read what someone else, has decided, is journalistic research.

Well journalism is nothing like Hollywood pretends it is, and Sowell's glaring lack of "Investigation efforts" sheds little light on the problems of Medicine American style. Sowell, seems content to run with high circular moments, chase his tail, to push over used buttons, all the while "trying" to be little Toto, pulling the curtain on the big bad Oz of the Government.

I learned nothing here, in his discussion, in fact it is so shallow, it leads one to suspect Sowell will soon be running for Congress himself, as his "Fix It" brand, fits in very well with the rest of the tail chasers, in Government who can't solve problems, because they have been bought and paid for so many times, as "Bill Clinton" once famously said, "I don't even recognize my own self," as the left demanded legislation.

What is scary or comforting, depending upon how one looks at it, is the overwhelming lack of knowledge, journalist, and TV "buzz people," have, about how medicine operates American style.

Scary: Because the lack of knowledge and understanding.

Comforting: Because it really does show, beyond any shadow of doubt, "they" are nothing special, journalists, pundits, they grab and hold onto the same old tired ideas, concepts, and blame, and try to twist and turn them as if it will give them new meaning.... It don't work.

The "Big Take" on Medicine in America, is (exactly) the same as Politics in America, it's a seething cesspool of corruption. Just like from the ground up, as politics is corrupt in this country, medicine is the exact same way.

The quote* above from Sowell, about England, having to import "Third world" trained doctors, America is the exact same way, except, America imports more third world foreign trained doctors than (any) other country in the world.

These journalist and pundits are a joke they know nothing about the real problems, and try to fix things (exactly) like Sowell says the government is doing. He ought to know, people like him are leading the charge. Smoke, mirrors, and inverted sentences... when it comes to medicine and politics it's the American way.

Reformer Wrote:
-------------------------------------------------------
> Sowell displays amusing ignorance about costs.
> There's a fundamental difference between price and
> cost.
>
> If price and cost meant the same thing, then
> identical medical treatment for which price
> differs by more than tenfold across different
> hospitals and other providers, would mean that
> cost differs by the same degree, which is
> ridiculous.
>
> Sowell would have his readers believe, for
> example, that an aspirin priced at $15 actually
> "costs" $15 dollars, or one gall bladder removal
> for $20,000, actually "costs" $20,000, when the
> identical treatment is available from other
> providers at far lower prices, which translates
> into lower costs for insurers or patients.
>
> Sowell ignores the one element of reform which
> could reduce prices set way above "costs",
> competition through a strong public option, then
> proceeds to claim that costs can only be shifted
> around with reform, because cost itself cannot be
> reduced, amazingly claiming that the only way to
> reduce cost is to refuse to consume the service.
>
> But that solution works only when competition
> works, and competition doesn't work in health
> care, having failed miserably across the board.
> Refusing to consume a $15 aspirin in a hospital
> doesn't result in another provider offering
> aspirin to the patient at lower prices.
>
> Until Sowell addresses the essential reason for
> outrageous increases in health care costs, the
> absence of competition in the private sectors of
> insurance and providers, and reform which
> addresses that failure, his entire framing of the
> issue is critically flawed.
>
> Provider costs are not a given to be shifted
> around. Insurance costs are not a given to be
> shifted around. Both are hugely excessive, way
> above what would occur in a competitive market.


Firstly, let's determine if the current system is true competition and the answer would be, eh, kind of sort of, not really. So why are Massachussets premiums higher than the national average? Is it because the system there that is eerily similar to Obamacare is not strong enough? Or could it be that mandates, subsidies, taxing and spending don't create competition but rather destroy it? I don't know how you come to this conclusion that a strong public option creates competition. Simply using common sense that notion can be debunked.

The pencil you use daily is actually quite costly to produce, including cutting trees, mining graphite, producing rubber, to name some things involved. But why do you pay only a few dollars for a pack of pencils? Well it's competition and innovation. Something that a public option does not do and cannot do. We have limited resources on this planet and there is not a single person on earth that is able to dictate what to make, how, why, and for whom, that is the beauty of the free market.

[fee.org]

I am not a racist, crazy right winger or anything of the sort. Of course, I am in favor of insuring everyone everywhere as much as I'd be in favor of everyone recieving a house and a car and a business to run, but that is just not the world we live in, nor is it feasible by the proposed bill. If you want to donate your time and/or money to charities or volunteer work then I admire that and do so myself. Unfortunately from Henry Ford (pick your entrepreneur) on up, all the things we enjoy and take for granted today were not products of charity. Healthcare is a service, the same as any other, and innovation, lifesaving techniques or new equipment don't just show up out of nowhere and doctors aren't born to serve, that is their profession. Your plumber doesn't fix your toilet for free, and he will charge above what it actually costs in order to take some money home for himself to live on. Costs and prices are market driven and not dictated by a supreme being in the government.

Sowell forgot to mention, that 40% of American Doctors, are imported foreign 3rd world trained, that the US, imports more than any country in the world...

You're being generous with "half facts" Sowell, he doesn't have a blooming clue...


trafamadore Wrote:
-------------------------------------------------------
> Sowell forgot to mention that the imported doctors
> in England only made up for the doctors who came
> to the US so they could make more money. Typical
> Half the Facts Sowell.

marjon Wrote:
-------------------------------------------------------
> The recipe for reducing medical costs is
> competition. Lasik eye surgery has demonstrated
> that.
> I also take doctors to task for restricting
> competition in their field.

Not ALL Docs....can you say 'AMA'?

texas jack wrote:

"I don't really want any foreign-trained doctors here."

Sorry Jack, there are already thousands here and there will be more. We just don't train enough physicians in this country to fill the need. And it will be worse if Obamacare passes, and it will be the case almost immediately (or at least in 4 years when 30m plus are added to the insured roles). Too much demand and not enough supply equals increased cost. Simple economics. Affordable health care is an oxymoron. It's not "affordable" anywhere in the modern world. Believe me, someone pays...alot.

Reformer Wrote:
-------------------------------------------------------
> Sowell displays amusing ignorance about costs.
> There's a fundamental difference between price and
> cost.
>
> If price and cost meant the same thing, then
> identical medical treatment for which price
> differs by more than tenfold across different
> hospitals and other providers, would mean that
> cost differs by the same degree, which is
> ridiculous.
>
> Sowell would have his readers believe, for
> example, that an aspirin priced at $15 actually
> "costs" $15 dollars, or one gall bladder removal
> for $20,000, actually "costs" $20,000, when the
> identical treatment is available from other
> providers at far lower prices, which translates
> into lower costs for insurers or patients.
>
> Sowell ignores the one element of reform which
> could reduce prices set way above "costs",
> competition through a strong public option, then
> proceeds to claim that costs can only be shifted
> around with reform, because cost itself cannot be
> reduced, amazingly claiming that the only way to
> reduce cost is to refuse to consume the service.
>
> But that solution works only when competition
> works, and competition doesn't work in health
> care, having failed miserably across the board.
> Refusing to consume a $15 aspirin in a hospital
> doesn't result in another provider offering
> aspirin to the patient at lower prices.
>
> Until Sowell addresses the essential reason for
> outrageous increases in health care costs, the
> absence of competition in the private sectors of
> insurance and providers, and reform which
> addresses that failure, his entire framing of the
> issue is critically flawed.
>
> Provider costs are not a given to be shifted
> around. Insurance costs are not a given to be
> shifted around. Both are hugely excessive, way
> above what would occur in a competitive market.


Have you read much of Dr. Sowell's writing? If you have you should know that he has a firm grasp of the difference between price and cost. He has written extensively about competition in the "private sectors of insurance and providers." His point in this essay is that government has virtually no concept of the difference between cost and price, but they are experts at diverting our attention from that fact.

What Mr. Sowell forgets in his usual conservative diatribe is that we have a perfectly good government-run health care model in the U.S. now--it's called the Veteran's Administration and it covers millions of people.

The V.A. has had its problems in the past, but it has worked to solve them. The doctors, nurses, and staff are employed by the government, but I never hear any conservative point to their dificiencies, like they do Britain's and Canada's systems. You can always find negative examples in any system, but I'd guess that most Americans are satisfied with their care through the V.A.

If he, and other conservatives, had a little more compassion for their fellow Americans without health insurance, and their consequent limitations on health care--instead of discounting its benefits--we'd be able to solve this thing in an economical fashion. But then, he's be out of a job.

MRahen Wrote:
-------------------------------------------------------
> TexasJack Wrote:
>
>
> " Have you ever heard of Capitalism? In that
> system, we are free to pay or recieve what the
> market will bear. "
>
>
> The same question could be posed to you Texas
> Jack. The supply of doctors has been artificially
> kept lower than need. Specialties have a limited
> number of slots. As a result, limiting the supply
> of physicians increases the costs of those
> services. There are numerous medical school
> applicants that are well qualified who are turned
> down.


So if you can recognize that the AMA's efforts at holding down the numbers of doctors is bad do you recognize that granting unions a monopoly on labor in states with no right to work laws is also bad? Both are bad for the same reason really.

As I returned to RCPLAND after my accident last year , I found the warm welcome I received to be one of those treasure's to stash away to help me in those times that I need fond memories to lean on .

This is one of those times as I prepare to return to the hospital for what I hope is my last surgery towards my recovery . Tommorow I will be having my right shoulder replaced and expect to be out of commission again for a couple of weeks .

I would like to take this opportunity to let you all know how much I appreciate your concerns . It is friends like you that make it easy to overcome such odds .

A special note to my Indian Relative "Tell Like It Is" . While the Yankees have a 3-2 lead , remember the wise words of an old yankee himself .

It Ain't Over Till The Fat Lady Sings .

Dandy Wrote:
-------------------------------------------------------
> As I returned to RCPLAND after my accident last
> year , I found the warm welcome I received to be
> one of those treasure's to stash away to help me
> in those times that I need fond memories to lean
> on .
>
> This is one of those times as I prepare to return
> to the hospital for what I hope is my last surgery
> towards my recovery . Tommorow I will be having my
> right shoulder replaced and expect to be out of
> commission again for a couple of weeks .
>
> I would like to take this opportunity to let you
> all know how much I appreciate your concerns . It
> is friends like you that make it easy to overcome
> such odds .
>
> A special note to my Indian Relative "Tell Like It
> Is" . While the Yankees have a 3-2 lead , remember
> the wise words of an old yankee himself .
>
> It Ain't Over Till The Fat Lady Sings .

Best wishes for a speedy recovery.....BUT....Yanks in 6.

Best wishes for a speedy recovery.....BUT....Yanks in 6.

------------------------------------------------------------------------------

Yea I know , even I had them picked in 6 but I couldn't let tell it off the hook that easy .

Author wrote "There is a fundamental difference between reducing costs and simply shifting costs around, like a pea in a shell game at a carnival. Costs are not reduced simply because you pay less at a doctor's office and more in taxes-- or more in insurance premiums, or more in higher prices for other goods and services that you buy, because the government has put the costs on businesses that pass those costs on to you.

Costs are not reduced simply because you don't pay them."


Perfect, perfect. And it fits so nicely with everything else this administration does (as Mr. Sowell
has pointed out in other articles). Just because you say something is so, does not make it so. This is what this administration does - makes up things - presents them as facts - and thinks we will not catch on.

Speaking truth to power or some other stupid thing I guess

This is the stuff that groups like ACORN and SEIU thrive on – that people are not smart enough to understand what they are doing or saying – just because they say it – it must be right

Fire Chuck "I love groups like ACORN" Schumer! and the rest

Yes, I agree completly shifting costs around should not be the goal here, actually reducing the cost of the health care should be the focus. While many in this camp focus specifically on medical malpractice I would rather focus on non value added steps. When your doctor has to go to a medical biller who then goes to the insurance company, back to the biller, and back to the doctor and sends you an incorrect statement which you then have to fight with all these people about the waste is tremendous. This happens every day. Medical insurance should simply work out a rate with the doctors for all standard visists, lab tests, ect and allow you to pay the doctor directly. That way you pay for your age, your lifestyle, your pre conditions yourself. Medical insurance simply offers you a wholesale rate instead of retail and pays large claims. It's so easy, you pay less upfront for the insurance and more when you go to the doctor. Medical insurance should however cover routine visits that keep you healthy. So if you want to smoke and woof down big macs go ahead and you can pay for it yourself. Also, allow health savings accounts to roll over and be portable and now people have the choice of saving for health costs long term or scrambling later. Personal responsibility is always better than government "care". It's okay, no one will listen to reason we'll just sit back and laugh at how screwed up the government makes things.

TadCF Wrote:
-------------------------------------------------------
> What Mr. Sowell forgets in his usual conservative
> diatribe is that we have a perfectly good
> government-run health care model in the U.S.
> now--it's called the Veteran's Administration and
> it covers millions of people.
>
> The V.A. has had its problems in the past, but it
> has worked to solve them. The doctors, nurses,
> and staff are employed by the government, but I
> never hear any conservative point to their
> dificiencies, like they do Britain's and Canada's
> systems. You can always find negative examples
> in any system, but I'd guess that most Americans
> are satisfied with their care through the V.A.
>
> If he, and other conservatives, had a little more
> compassion for their fellow Americans without
> health insurance, and their consequent limitations
> on health care--instead of discounting its
> benefits--we'd be able to solve this thing in an
> economical fashion. But then, he's be out of a
> job.

You need to do a little more research on the VA hospitals. It's not necessarily true that they provide great care. Like everything else you have to did a little to find out the truth. The VA hospitals have many continuing problems and most are much less than state of the art to put it kindly.

TadCF Wrote:
-------------------------------------------------------
> What Mr. Sowell forgets in his usual conservative
> diatribe is that we have a perfectly good
> government-run health care model in the U.S.
> now--it's called the Veteran's Administration and
> it covers millions of people.
>
> The V.A. has had its problems in the past, but it
> has worked to solve them. The doctors, nurses,
> and staff are employed by the government, but I
> never hear any conservative point to their
> dificiencies, like they do Britain's and Canada's
> systems. You can always find negative examples
> in any system, but I'd guess that most Americans
> are satisfied with their care through the V.A.
>
> If he, and other conservatives, had a little more
> compassion for their fellow Americans without
> health insurance, and their consequent limitations
> on health care--instead of discounting its
> benefits--we'd be able to solve this thing in an
> economical fashion. But then, he's be out of a
> job.


As a former military physician, I can tell you flat out the VA system relies heavily on the private system of medical care in order to "satisfy" its recipients of care. Using the VA system as an example of perfectly run gov't health care is equivalent to saying the post office is a great example of a gov't run system. Without the Fed-Ex's and UPS's out there, the mail system would be crushed. Without the private practice physicians out there, the VA system and the military medical system would be crushed.

What happens when the private sector goes away?

David Doney Wrote:
-------------------------------------------------------
> I mostly agree with Sowell for once, which is
> rare. We need to tackle cost. Here are the
> main strategies for that:
>
> 1) Comparative effectiveness research (CER) - what
> works the most cost effectively?
> 2) Independent review panels - somebody to take
> the CER and communicate it widely
> 3) Tort reform, to stop defensive medicine
> 4) Tackle obesity with exercise programs, taxes on
> non-nutritious foods like soft drinks
> 5) More doctors and nurses - we have critical
> shortages of both.
> 6) Doctor incentives - salary and bonuses based on
> providing cost effective treatment, as opposed to
> "fee for service"
> 7) End of life care- 25% to 33% of care is for
> those in last year of life. We have to say no to
> heroics and keep folks comfortable when their
> condition cannot be improved (e.g., Alzheimers,
> terminal cancer)
>
> This is a great article on this below from
> Surgeon/Author Atul Gawande:
>
> [www.newyorker.com]
> 01fa_fact_gawande
>
> All that said, we could cover our folks for about
> $100 billion per year. Since we spend $750
> billion per year on defense, lets shift the cost
> over to cover the 30 million of us without
> insurance until we figure out how to cut costs
> overall.


Just a few comments fomr one in the field:
1. CER- as a doctor this means someone telling me the only way to treat someone is X,Y, Z....humans are all different and while a good idea different people respond to treatments differently. How would you feel if your treatment wasn't the most cost effective thus not allowed under your insurance?
2. Review panels- just what I need, soneone telling me what I can read in a magazine/journal about what may or may not work...wonderful for colds and primary care concerns, but not so lovely for specialists who already know quite a bit about what they are doing.
3. Absolutely!
4. People need to take responsibility for their actions. You can't charge your renovations due to your wild parties on your home-owners insurance can you?
5. Nurses are a fluid system, being mostly women they will always be in and out of the work-place (child-birth) plus nursing can be incredibly taxing on people...doctors are always in demand, but flooding the system with bad ones will only add costs not lower them. Not sure there is an easy solution here.
6. In private practice, salaries are tied to incentives, mainly how hard you work and how many patient syou feel comfortable seeing. Are you telling me you want another sector of the private enterprise regulated by salary caps? A few places, namely institutions have physicians on staff on salary only (Mayo, Cleveland Clinic to name a few) and these are well paid positions. However, to regulate a complete profession, I say we incentivize (spelling?) lawyers first, make it so they can't get large money "bonuses" from their clients and instead give them bonuses for not taking up so much court time....we'll never see that happen.
7. As the money pot gets smaller and smaller, where do you draw the line? Anyone over 90, over 80, over 65? Maybe under 24 weeks of life as the brits do. Very slippery slope you are crossing there and gets right to the point of death panels and eventually to active euthanasia. Not ready to go there yet (never will be as a physician and human-being), given there are so many other options to try first.

Doggone... there goes Sowell again...

He is applying Common Sense to a problem that is mostly Ideological-Political in nature.

Steve Hansmann/East Central Minnesota Wrote:
-------------------------------------------------------
> Sowell touches on the problem, but then avoids the
> obvious solution. Public financing and at least
> malpractice insurance support from the government
> in exchange for substantive public service in
> underserved areas, like most of the rural areas
> of the country, would do much to alleviate both
> localized shortages and inequalities, reduce the
> financial obligations on physicians, provide more
> comprehensive health care, including preventative
> health care, and ultimately reduce costs. The
> other elephant in the room is, indeed, physician
> salaries. Do cops or firefighters become cops or
> firefighters to get rich? How about nurses? Dr.
> Jonas Salk gave away the polio vaccine to the
> public and literally made no money from it. Can
> you imagine any physician or researcher doing that
> today? Altruism and compassion has been largely
> hammered out of most health industry workers, (I
> know, I'm a psychiatric RN working in the VA
> system). The free market and self-interest is not
> the model for caring for the most ill and
> vulnerable among us. Our slavery to
> ever-increasing profits and insisting that
> everything make a profit is not even rational, and
> health care, especially among the elderly and most
> vulnerable among us has suffered.


I always find it interesting how those opposed to the free market system are also those least likely to be involved in charitable care (not referring to you personally, but the overwhelming trend in the US). Captalists give more. A lot more. And I don't know about the psychiatrists that you work with in the government-run VA system, but Doctors give away a lot of care and a lot of years at no pay getting to where they are.

Take for example two female students starting a 15-year cycle of education-to-income at the same university: one to be an RN and one a primary care MD. If both pay $50K per year in undergrad (2 years for the RN and 4 for the MD) and the RN earns $75K in fixed income her entire 13 years of earnings, she is still way ahead of the MD earning $180K for the mere 3 years that remain in the 15-year cycle after residency. This is due to the fact that Med School costs at least $100k per year (not even couting interest) and four years of residency pays only $45K per year (more or less). Net-net, the RN makes $975K by the end of the cycle and the MD makes $720K (also not counting the hugh savings advantage for the RN over the same timeframe and the fact that primary care doctors make less than $180K/year on average).

At no time during the RN's work week is she expected to give away, donate care, or simply not bill for services too hard or too expensive to collect from government agencies. The RN gets paid or she doesn't go to work. The MD is asked to give away care every week from one source or another.

Oh and by the way, both of these young women in my scenario are now pushing 35 years old and will in all likelyhood be looking to work part-time to raise their families.

But "redistributors" look simplistically to the $180K or $250K that the doctor makes and call them greedy. Oh and another by-the-way, the firefighter and cop comparison is even more starkly unequal when you consider the education investment required, compressed work-week arrangements and 90-100% pensions. Bottom line is that young people that go into medical school are smart and know how to do math. They are increasingly learning that becomming a doctor is an enourmous lifetime donation to society and not a viable investment of treasure and one of the most painful educational processes known to modern civilization. (result: fewer doctors to "enslave" to phantom profits = reduced survivability of Americans with deadly diseases).

Please visit a London hospital at your earliest convenience for a view of what is to come with government-enforced altruism.

voyager5k, you fail to understand the economics of law.

Fighting the suits is a wash for plaintiff's lawyers. This will lead to fewer, but larger, verdicts. However, fighting the suits is great for defendant's lawyers, who get paid by the hour. Bringing a legal malpractice suit only makes more work for the lawyers.

Your plan will only make the lawyers richer.

voyager5k Wrote:
-------------------------------------------------------
> Yes, "loser pays" will work. There is another
> strategy that I foresee coming in the medical
> malpractice lawsuit theater: doctors will start
> fighting back. Heretofore, many, if not most
> lawsuits were settled out of court, regardless of
> their merit. The result: more lawsuits. What gets
> encouraged, gets repeated. I think this will
> change.
>
> From now on, we physicians will fight every one to
> the bitter end. We will win the vast majority and
> then counter-sue the losing attorney for LEGAL
> malpractice. We may not win, but we WILL begin to
> bankrupt these unscrupulous bozos who live to make
> our lives difficult. We will see how they like
> having a sword hanging over them all the time. We
> will fight fire with fire. Since the government
> won't end this nonsense, we will take matters into
> our own hands!

Tim in UK Wrote:
-------------------------------------------------------
> Sowells arguments would be stronger if he didn't
> keep falling back on the old "Britain has
> socialised medicine", "Britain has problems"
> therefore problems are caused by socialised
> medicine line.
>
> Britain's problems have been exacerbated by higher
> pay - not lower. The planned number of doctors (as
> the government bankrolls the med schools) was
> under requirements because of the switch to a more
> equal balance of the sexes. Higher pay has
> increased the trend for those doctors to go part
> time when they have children (as they don't have
> huge loans to payoff). Add that to increased
> number of positions because the Conservative cut
> backs had reduced the service to an unacceptable
> level and you end up with a shortage. Very few
> doctors leave for financial reasons.
>

There were a few things that struck me here. Why is is necessary for the government to bankroll the schools? The only reason is that the doctors wouldn't be making enough money to pay off whatever loans they could get to pay for school. You actually say that there aren't enough doctors because they are paid too much. That is an unbelievable claim. Especially when you combine the fact that you seem offended that doctors work part time. If you had a truly free market that paid doctors appropriately then that pay would drive more to become doctors and for more medical schools to be opened from the increased demand for medical schools. Having the ability to work part time is a good thing. It is something that would attract more people to the profession. If you think otherwise then why stop at making them work full time. Pay them so low that they have to work 80 hours a week to make a living. Do you think that would be a way to get more doctors?

The average person today works much less than they did 30 years ago. Many people have realized that if you have a certain amount of money then why work more if more money makes you less happy than more time to spend with friends and family. Can doctor's not do the same thing? They have friends and family as well. Often times their jobs are more stressful than the average persons. I have friends that are doctors and one is an ER doctor. If I have a bad day nothing of much consequence happens. If my friend has a bad day then people die. I have seen him take things hard when literally there was nothing he could do to save the person. He trained for years to be able to do what he does everyday. The fact that you think that it is a problem because people like him are paid too much in the UK is a joke.

David Doney Wrote:
-------------------------------------------------------
> I mostly agree with Sowell for once, which is
> rare. We need to tackle cost. Here are the
> main strategies for that:
>
> 1) Comparative effectiveness research (CER) - what
> works the most cost effectively?
> 2) Independent review panels - somebody to take
> the CER and communicate it widely
> 3) Tort reform, to stop defensive medicine
> 4) Tackle obesity with exercise programs, taxes on
> non-nutritious foods like soft drinks
> 5) More doctors and nurses - we have critical
> shortages of both.
> 6) Doctor incentives - salary and bonuses based on
> providing cost effective treatment, as opposed to
> "fee for service"
> 7) End of life care- 25% to 33% of care is for
> those in last year of life. We have to say no to
> heroics and keep folks comfortable when their
> condition cannot be improved (e.g., Alzheimers,
> terminal cancer)
>
> This is a great article on this below from
> Surgeon/Author Atul Gawande:
>
> [www.newyorker.com]
> 01fa_fact_gawande
>
> All that said, we could cover our folks for about
> $100 billion per year. Since we spend $750
> billion per year on defense, lets shift the cost
> over to cover the 30 million of us without
> insurance until we figure out how to cut costs
> overall.


The CER stuff is unnecessary if you make cost a factor for people when they are looking for healthcare solutions. The CER stuff won't tell you the best solution if cost isn't a factor though, it will just say what is better of the available known options. With many problems there could be solutions that aren't even being examined because our system is so distorted in regards to cost. Most doctors are incredibly familiar with the latest research data on different treatments. So when they know that something is more effective are you going to be pushing CER so hard that you punish them for recommending the more effective treatment that happens to cost more? If the doctor looks for cost effective approaches first then are they really helping the patient or helping the bottom line of the program. I think if the doctor did that type of thing as an employee of an insurance company you wouldn't be so positive about it. Why does it change when if the doctor did it at the behest of government? Again the only "right" way to do it is to have the consumer face that cost themselves. The doctors can then lay out the options that are available and make recommendations.

Tort reform needs to take place without eliminating the ability of patients who have experienced gross negligence from having an outlet for possible recovery. Some sort of arbitration supervised by medical industry personel that know the difference between negligence and a bad outcome.

Taxes on food that you or others consider bad? Seems unnecessary. Why not just make people responsible for their increased risks through higher insurance premiums or having to face a greater percentage of their own health costs. Why tax those "sin" foods? Any food if eaten in abundance will make you fat. I am considered to be a healthy weight for my height and yet I eat those types of foods here and there. In moderation it isn't harmful. Again like the CER thing if people faced their own costs then this wouldn't be an issue in anyway. The exercise program thing is a joke. Do you think that people don't know what exercise is? They don't exercise because THEY DON'T WANT TO or they have other things that make exercise less of a priority. I haven't really worked out in years. I ran enough as a college athlete and before to last a lifetime. Really what people need is activity. My definition of exercise from my days as an athlete isn't necessary for adults. Moderate activity is sufficient. You know, take the stairs, walk down to get the mail instead of driving, etc... it all adds up.

In regards to end of life care what was a terminal disease 50 years ago isn't now. Why do you think that is? It isn't because for the last 50 years we let them all die without a fight and suddenly happened upon a cure. There is a benefit to fighting battles that you may lose. Without fighting them you aren't going to win the war.

Who exactly can we cover for $100 billion per year and why can't they pay for their own healthcare? Certainly we can't cover everyone because that would be $333 for every man, woman, and child. Are you claiming that we could cover the uninsured for that? I have no problem helping people out who are in need, but when you make it a national policy to do that you do something else. You take away incentive for people to fix their own problems. When people get knocked down sometimes it is hard to get up. When people are taking care of their needs while they are down it doesn't make them get up any faster. It is a line that is walked that is better to be done on more of a local level where you can deal with people face to face. National defense is a shared responsibility while ones health is a personal one. Because it is a personal one people have the right to be fat, to drink, smoke, do dangerous things, etc... if it became a national one than those rights would slowly disappear. Responsibility and freedom go hand and hand. You can never have one without the other.

Steve Hansmann/East Central Minnesota Wrote:
-------------------------------------------------------
> Sowell touches on the problem, but then avoids the
> obvious solution. Public financing and at least
> malpractice insurance support from the government
> in exchange for substantive public service in
> underserved areas, like most of the rural areas
> of the country, would do much to alleviate both
> localized shortages and inequalities, reduce the
> financial obligations on physicians, provide more
> comprehensive health care, including preventative
> health care, and ultimately reduce costs. The
> other elephant in the room is, indeed, physician
> salaries. Do cops or firefighters become cops or
> firefighters to get rich? How about nurses? Dr.
> Jonas Salk gave away the polio vaccine to the
> public and literally made no money from it. Can
> you imagine any physician or researcher doing that
> today? Altruism and compassion has been largely
> hammered out of most health industry workers, (I
> know, I'm a psychiatric RN working in the VA
> system). The free market and self-interest is not
> the model for caring for the most ill and
> vulnerable among us. Our slavery to
> ever-increasing profits and insisting that
> everything make a profit is not even rational, and
> health care, especially among the elderly and most
> vulnerable among us has suffered.


I couldn't disagree more with your statements. Your solution of having the federal government (taxpayers) pick up malpractice insurance in exchange for public service highlights Sowell's premise. What you propose does nothing to lower the costs of malpractice insurance, it just shifts the costs from doctors to taxpayers. How does shifting the costs reduce the costs? Hint: it doesnt. There is absolutely no incentive to reduce lawsuits, perform expensive defensive medicine or change any of the reasons for the high costs of malpractice insurance.

Also, you assume you have the right to tell others how much they may make from their efforts, education and experience. What gives you the right? People can seek out whichever doctor and healthcare provider they choose to in our current system. The more illustrious or experienced the physician, the more that professional will charge. Are you asserting that all physicians should be compensated at the same rate without regard to skill, speciality, experience and success rates?

I happen to believe that RNs are the overpaid bunch, why don't you take a 50% pay cut in the name of "altruism"? You misstate the facts: we do not nor have we had a free market system in healthcare for about 40+ years. The reality is we have a 50/50 healthcare system and the question is whether or not we want to go for broke (literally) by having the feds take over the entire industry. From what I've seen and heard of VA system, it stinks and I'd rather not go gently into that good night, thanks!

DWHarper Wrote:
-------------------------------------------------------
> Once again the old doddering fool gives the reader
> NO FACTS to support his opinion. And Sowell
> whips that tired horse of "frivolous lawsuits" as
> the reason for our high medical costs. If he did
> look up the facts, he would see that medical
> malpractice makes up less than 1 percent of our
> medical costs and the real reason for these
> lawsuits is bad doctors as 90 percent of the
> lawsuits are against 10 percent of the doctors.
> Sowell just plays on the prejudices of his loyal
> readers and tells them what they want to hear,
> regardless of the facts.


Those statistics, even if they are true, don't reflect the very real cost that is added because of defensive medicine. That tests are run just to prevent a lawsuit even when doctor's know that there is really no medical justification for it. The cost of malpractice insurance has driven many OB/GYN's out of my state for instance. It isn't just the bad doctors that pay for the insurance. When lawsuit settlements are awarded because it isn't worth fighting against the lawsuit more litigation is encouraged. You can't act like it isn't an issue when every single person that works in the industry that I talk to says that it is.

If you have any solid information that contradicts any of that feel free to source it.

I am so fed up with the mentality that medical care is a burden of the "people". It is a burden that shoudl rest solely on the person who wants medical care.

Since when has anyone ever said this: "We are endowed by our creator with certain unalienable rights such as life liberty, liberty, the pursuit of hapiness, and free medical care...."

Health care as a 'right' is a man-made myth.

This entitlement mentality has to end, once you take everyone's money, where do you go from there?

Here is what I don't understand. Maybe someone smarter than me can explain it. Every election cycle every politician sings the praises of Social Security, Medicare and promises to take care of our injured vets with good VA care. All three are pure socialism. After the GOP/conservative politicians get elected they set about bashing socialism on things like health care reform, but never want to get rid of Social Security or VA benefits as socialism. This is a huge logical disconnect. Either socialism is bad and we must get rid of it or it is not bad and we can keep it. Which is it? Ir is it just that the GOP/conservative politicians know their constituents love those three forms of socialism and they wouldn't get elected if they bashed them when campaigning. Either way, it is prue hypocrisy. Which is it?

Socialism Good?

Or

Socialism Bad?

About one year ago, my insurance premium rose 30% and the deductible went from two hundred to two thousand dollars per year. At the same time, my employers's contribution went from 60% to 50%.Just last week, we were told that our rate was going up another thirty percent and our deductible would be rising to 5 thousand dollars per annum. My employer also stated that in the very near future it woud be likely that he would not be able to contribute anything to our health insurance and we should start to shop for our own individual plan. As a cancer survivor,I am not eligible to purchase a plan that woud include any coverage for future cancer episodes,what with a big "C" stamped on my forehead. I work two jobs now and have never taken asssistance of any kind but quitting my jobs so that I may be eligible for Medicaid is looking like the only feasible option at this point. Notice that nowhere in my current situation does the phrase "government plan" show up . I'm supposed to think that the gov't would make my situation worse but I ask "how"?

The list of private sector criminals in banking,wall street etc in the last few years is quite impressive and yet there are those who will posit that they should also be trusted with my health care over the gov't. In the last five years, my employer and I have sent over $20,000 to our insurance man and I haven't even received a band aid for that.

I don't understand what tort reform is supposed to achieve. Some states have passed tort reform. TX is one of them. It was promised that if tort reform was passed health insurance premiums would go down. But they didn't. They didn't in TX or any of the other states that passed tort reform. So what is tort reform supposed to accomplish?

BobinTx Wrote:
-------------------------------------------------------
> AustinG Wrote:
> --------------------------------------------------
> -----
> > DWHarper Wrote:
> >
> --------------------------------------------------
>
> > -----
> > > Once again the old doddering fool gives the
> > reader
> > > NO FACTS to support his opinion. And Sowell
> > > whips that tired horse of "frivolous
> lawsuits"
> > as
> > > the reason for our high medical costs. If he
> > did
> > > look up the facts, he would see that medical
> > > malpractice makes up less than 1 percent of
> our
> > > medical costs and the real reason for these
> > > lawsuits is bad doctors as 90 percent of the
> > > lawsuits are against 10 percent of the
> doctors.
> >
> > > Sowell just plays on the prejudices of his
> > loyal
> > > readers and tells them what they want to
> hear,
> > > regardless of the facts.
> >
> >
> > Those statistics, even if they are true, don't
> > reflect the very real cost that is added
> because
> > of defensive medicine. That tests are run just
> to
> > prevent a lawsuit even when doctor's know that
> > there is really no medical justification for it.
>
> > The cost of malpractice insurance has driven
> many
> > OB/GYN's out of my state for instance. It
> isn't
> > just the bad doctors that pay for the insurance.
>
> > When lawsuit settlements are awarded because it
> > isn't worth fighting against the lawsuit more
> > litigation is encouraged. You can't act like
> it
> > isn't an issue when every single person that
> works
> > in the industry that I talk to says that it is.
>
> >
> > If you have any solid information that
> contradicts
> > any of that feel free to source it.
>
> It is like listening to a doctor tell you why a
> lawyer charges so much for their services. Why do
> people believe what lawyers tell us about medical
> malpractice costs and practice behaviors of
> doctors becasue of medical liability?
>
> I can tell you first hand there is much more to
> tort reform than simply saying it will lower the
> cost of malpractice insurance. The practice of
> defensive medicine is a lot more than anyone could
> predict.
>
> Case in point...you have a lung mass, you lived in
> the Ohio river valley so it is more than likely a
> histoplasmosis spot on your lung, but the x-ray is
> read out as suspcious lesion in lung recommend CT
> scan to correlate, because the radiologist can't
> say based on the clinical history that it is in
> fact most likely histo in this otherwise healthy
> person with no history consistent with cancer. So
> the PCM goes ahead and orders the CT scan which
> was recommended by the radiologist, and the CT
> shows no inflammation aorund the lesion, but
> possible lymph node involvement, so they recommend
> a consult to pulmonologist who will not be able to
> clinically say it is histo without doing a
> bronchoscopy and biopsy if possible, so a
> bronchoscopy is done and a biopsy is sent to
> pathology which is read out as not definitive for
> histoplasmosis due to inadequate sample, but can
> not rule out neoplasm due to some reactive
> epithelial tissue seen on one of the slides they
> prepared, so the pulmonologist does another
> bronchoscopy to get more tissue. This time they
> get it and it is positive for histo, which was the
> clinically indicated disease in the first place,
> for which there is no real treatment, and will not
> cause any harm to the patient. All of that simply
> to CYA in the event that this lung lesion was a
> small cancer and the failure to diagnose cancer is
> a costly mistake no doctor is willing to make in
> this lawsuit happy society we live in....in the
> end, decreased malpractice insurance won't reduce
> the cost of this!!!
>
> We have to change the thought process of the
> society to change these practice patterns, and
> until tort reform is well ingrained in our
> society, these patterns will not change.

BobinTx,

I think your response was really to the original poster that I replied to because I don't disagree with you at all. What you didn't even mention was the fact that these trials are usually decided by people with no knowledge about medicine. That lawsuits are sometimes settled to avoid the cost of a trial. I have been told that to avoid lawsuits that doctors are told to load patients up on painkillers. That along with the situation described clearly shows that medical decisions are being made in an effort to avoid litigation. That isn't healthy or cost effective in anyway.

FPC Wrote:
-------------------------------------------------------
> The list of private sector criminals
> in banking,wall street etc in the last few years
> is quite impressive and yet there are those who
> will posit that they should also be trusted with
> my health care over the gov't. In the last five
> years, my employer and I have sent over $20,000
> to our insurance man and I haven't even received a
> band aid for that.


Yes you have, you have had the peace of mind knowing that if your cancer caused a hospitalization, you would be covered.

I pay thousands upon thousands of dollars for home, car, disability insurance, yet don't cash in on them at all. I don't complain my money is going to waste. Peace of mind knowing there is a security blanket at the end of the line is a good thing.

marjon wants to kill my aged mother by denying her Medicare. She would die without it. But marjon doesn't care. He is a death panelist who wants to take away Medicare.

marjon Wrote:
-------------------------------------------------------
> barrli Wrote:
> --------------------------------------------------
> -----
> > It doesn't cost firemen, policemen or nurses
> > nearly as much to get the education they need
> to
> > pursue their chosen professions. Doctors go to
> > school for a long time, at great expense to
> become
> > doctors (as you should know if you are a nurse).
>
> > There is nothing wrong with them wanting
> adequate
> > compensation to pay back student loans and to
> pay
> > themselves back for all the time and energy
> they
> > put into becoming a doctor. If they stop
> getting
> > paid what they are worth, then the smart kids
> > won't go to medical school anymore and then
> where
> > will we be?
> >
>
> Why does it cost so much? From what I have
> observed, medical school training is very
> inefficient and necessarily harsh because that is
> the way it always is.
> How much research has been done for effective
> training? (36 hour shifts seem very stupid,
> inviting mistakes.)
>
> >
> >
> > Steve Hansmann/East Central Minnesota Wrote:
> >
> --------------------------------------------------
>
> > -----
> > > Sowell touches on the problem, but then
> avoids
> > the
> > > obvious solution. Public financing and at
> > least
> > > malpractice insurance support from the
> > government
> > > in exchange for substantive public service
> in
> > > underserved areas, like most of the rural
> > areas
> > > of the country, would do much to alleviate
> both
> > > localized shortages and inequalities, reduce
> > the
> > > financial obligations on physicians, provide
> > more
> > > comprehensive health care, including
> > preventative
> > > health care, and ultimately reduce costs.
> The
> > > other elephant in the room is, indeed,
> > physician
> > > salaries. Do cops or firefighters become
> cops
> > or
> > > firefighters to get rich? How about nurses?
> > Dr.
> > > Jonas Salk gave away the polio vaccine to the
> > > public and literally made no money from it.
> > Can
> > > you imagine any physician or researcher doing
> > that
> > > today? Altruism and compassion has been
> > largely
> > > hammered out of most health industry workers,
> > (I
> > > know, I'm a psychiatric RN working in the VA
> > > system). The free market and self-interest
> is
> > not
> > > the model for caring for the most ill and
> > > vulnerable among us. Our slavery to
> > > ever-increasing profits and insisting that
> > > everything make a profit is not even
> rational,
> > and
> > > health care, especially among the elderly and
> > most
> > > vulnerable among us has suffered.

AGV Wrote:
-------------------------------------------------------
> I don't understand what tort reform is supposed to
> achieve. Some states have passed tort reform. TX
> is one of them. It was promised that if tort
> reform was passed health insurance premiums would
> go down. But they didn't. They didn't in TX or
> any of the other states that passed tort reform.
> So what is tort reform supposed to accomplish?
>

The question is what is that reform and what else was going on in the insurance market. States tend to add mandates onto coverages which drive up prices over time. To me the need for tort reform is a serious problem, but it isn't the primary driver of increased health insurance costs. The primary driver of that is the fact that health insurance policies on average cover too much. Price is the best way to determine need and in some cases the only way. If I am getting treatment for my back how do I determine when I no longer need treatment. If insurance covers it and the treatment is "free" to me then I am likely to keep going even if I get little noticable benefit. If the cost of providing the service is paid for by me then I can make the correct choice of whether or not I need the treatment. Much of what is covered in healthcare is subjective in that way. Much of the growth in cost is providers finding new "needs" in an effort to attract consumers that aren't spending their own money. I mean you see ads on TV for treatment for things that our grandparents wouldn't have even bothered complaining about. From Restless Leg Syndrome, to going to the bathroom too much, to older men not being 18 anymore in the bedroom they find new ways to create new needs for consumers who are buying things with other people's money. The main problem again being people making decisions with the money of others. People are mighty generous with themself in that situation and in the end we all pay more.

AGV Wrote:
-------------------------------------------------------
> Here is something I don't understand. Back in
> 1964, when Congress was thinking of passing
> Medicare, the health insurance industry had a B
> grade actor named Ronald Reagan make a vinyl
> record (all they had back then) that was then
> mailed out. On that record the actor Reagan said
> if Medicare passed Americans would lose their
> freedom. But when Reagan became president, which
> was 16 years after Medicare passed, Reagan kept
> bragging about what a wonderfully "free" country
> America was. Was Reagan lying in 1964 on the
> record, or was he lying when president? He had to
> be lying one of the two times.


The country did give up some of its freedom in passing Medicare. You pay 3% of every paycheck you ever receive to get Medicare. The country as a whole was and is still free though. For now anyway. What happens when people enact 33 programs like Medicare or programs that are in total agregate 33 times its size. You have 1% of your money left to get things that you want. Medicare takes away freedom it doesn't take away all of your freedom. How is that tough to understand?

If Americans saved their own money they could likely get better healthcare at a better price than Medicare, but that isn't an option for them. You have to pay the tax. I mean I suppose that you could turn down the benefits, but why would you when you have paid into the system for so long. If it was honestly run then people would be able to opt out. It isn't though because the system operates like a Ponzi scheme, similar to SS. Current beneficiaries didn't pay for their care all this time, they paid for other peoples. Current workers pay for current beneficiaries. So lets say we that we decided that the whole thing was a disaster and wanted to end it. How can you do that to those that have "paid into" the system all this time and are now dependant upon it? Certainly freedom has been lost in that regard as well.

Accepting all you say as true, 97% of Americans on Medicare love the program and would go after any politician with pitch forks and daggers who dared to suggest doing away with Medicare. How can something that is loved that much by the end users be bad?

AustinG Wrote:
-------------------------------------------------------
> AGV Wrote:
> --------------------------------------------------
> -----
> > Here is something I don't understand. Back in
> > 1964, when Congress was thinking of passing
> > Medicare, the health insurance industry had a B
> > grade actor named Ronald Reagan make a vinyl
> > record (all they had back then) that was then
> > mailed out. On that record the actor Reagan
> said
> > if Medicare passed Americans would lose their
> > freedom. But when Reagan became president,
> which
> > was 16 years after Medicare passed, Reagan kept
> > bragging about what a wonderfully "free"
> country
> > America was. Was Reagan lying in 1964 on the
> > record, or was he lying when president? He had
> to
> > be lying one of the two times.
>
>
> The country did give up some of its freedom in
> passing Medicare. You pay 3% of every paycheck
> you ever receive to get Medicare. The country as
> a whole was and is still free though. For now
> anyway. What happens when people enact 33
> programs like Medicare or programs that are in
> total agregate 33 times its size. You have 1% of
> your money left to get things that you want.
> Medicare takes away freedom it doesn't take away
> all of your freedom. How is that tough to
> understand?
>
> If Americans saved their own money they could
> likely get better healthcare at a better price
> than Medicare, but that isn't an option for them.
> You have to pay the tax. I mean I suppose that
> you could turn down the benefits, but why would
> you when you have paid into the system for so
> long. If it was honestly run then people would be
> able to opt out. It isn't though because the
> system operates like a Ponzi scheme, similar to
> SS. Current beneficiaries didn't pay for their
> care all this time, they paid for other peoples.
> Current workers pay for current beneficiaries. So
> lets say we that we decided that the whole thing
> was a disaster and wanted to end it. How can you
> do that to those that have "paid into" the system
> all this time and are now dependant upon it?
> Certainly freedom has been lost in that regard as
> well.

Curt - I too hate the government getting its hands on my money. But I also hate health insurance company monopolies doing the same thing - getting their hands on my money.

I'm a capitalist. I want competition in the health insurance market. It doesn't exist. 95% of markets in the US have just one or two providers. All providers in the US fix prices. Wait a minute! How can they do that? Isn't that illegal to fix prices? Oh ..... gee ..... I forgot ....... the insurance companies got themselves exempted from the federal anti-trust laws that prevent price fixing. That is like Charles Manson getting himself exempted from laws that prevent murder.

We need to focus on the real issues. The real issue is competition in the health insurance market. The rest is all fluff and feathers.

CurtF Wrote:
-------------------------------------------------------
> marjon Wrote:
> --------------------------------------------------
> -----
> > The recipe for reducing medical costs is
> > competition. Lasik eye surgery has demonstrated
> > that.
> > I also take doctors to task for restricting
> > competition in their field.
>
>
> But not competition from the Government. Let me
> shop for the best deal for me and my family. As
> others have said, if all you pay is $25 per visit,
> you don't have a clue how expensive your medical
> care is. Why won't politicians give me the right
> to control how I spend my money? Because they
> don't get to touch it! That is all this is about,
> contol of the checkbook. If you have not
> determined that our politicians could completely
> care less about spending our money uncontrollably,
> you must be in fantasyland. Wise up!

AustinG Wrote:
-------------------------------------------------------
> BobinTx,
>
> I think your response was really to the original
> poster that I replied to because I don't disagree
> with you at all. What you didn't even mention was
> the fact that these trials are usually decided by
> people with no knowledge about medicine. That
> lawsuits are sometimes settled to avoid the cost
> of a trial. I have been told that to avoid
> lawsuits that doctors are told to load patients up
> on painkillers. That along with the situation
> described clearly shows that medical decisions are
> being made in an effort to avoid litigation. That
> isn't healthy or cost effective in anyway.


I agree, not meant to offend or anything, just getting my replies mixed up. Sorry

I have seen it with both my parents. Neither ever went to the doctors when they were young. Both practically live in one doctors office or another now that they are old. They are being kept alive by the miracles off modern medicine. I'm glad for that and to have them with me several more years than would have been the case even 50 years ago. Their medical bills would have bankrupted them if they had to pay on their own. Insurance premiums would be astronomical if they had to pay for them on their own. So, it all depends on your perspective. Medicare has made it possible for them to live longer and keep their assets. Call me selfish, but I like that.

AustinG Wrote:
-------------------------------------------------------
> AGV Wrote:
> --------------------------------------------------
> -----
> > marjon wants to kill my aged mother by denying
> her
> > Medicare. She would die without it. But
> marjon
> > doesn't care. He is a death panelist who wants
> to
> > take away Medicare.
> >
>
> If your mother wasn't forced to pay into Medicare
> to begin with she could have saved the money that
> was paid into it. This savings could allow her to
> spend money on her own care or not depending on
> her wants and desires. The left is seeking to cut
> costs in Medicare how do you think they will
> achieve that. When they talk about using
> healthcare more efficiently who do you think will
> get less? In countries with socialized medicine
> the average amount spent on a person's healthcare
> remains relatively constant for their lifetime.
> In our country more is spent on the elderly than
> on the young. Why do you think that is? The
> elderly obviously have greater healthcare needs so
> why do they get the same amount of care in
> countries with socialized medicine.
>
> Beyond that you, me, your mother, and everyone
> reading this is going to die at some point
> regardless of whether or not we have Medicare or
> health insurance. The next person who has no
> Medicare or health insurance on their death
> certificate as the cause of death will be the
> first.

What the health care reform debate has laid on the table to examine is the central issue in all organized societies: what should we contribute into the kitty for the good of the whole - each of us being part of the whole - and what should we do on our own. Most modern societies believe the following are matters with sufficient common good that it is worthwhile for each individual to pay money into the system to obtain:

1. A governmental structure
2. A system of common defense
3. Safe water treatment/distribution
4. Waste elimination
5. A system of roads and bridges
6. An educational system
7. A system of laws/regulations
8. A system to enforce laws regulation
9. A health care system

If one wanted to be a true "rugged individualist" and live as a mountain man in the remote recesses of the Rocky Mountains, it would be possible to live without any of the foregoing. Or one could possibly survive in the swamps of Florida by killing wild animals and finding shelter in caves. But, to live in an integrated society, there must be agreement among all members of that integrated society as to what services will be provided by some formal system that is worthwhile for each to pay into.

We hear a lot of talk about "liberty" and "freedom" from those opposing health care reform. It is essentially empty rhetoric. While liberty and freedom are heroic sounding words, no one in a modern society is at liberty to do whatever they want when they want and no one is free in the sense of being able to do what they want when they want. We all live within the confines of a set of rules society has imposed on each of us to protect each and all of us.

The question for all Americans at this point in time is whether health care is something each of us can provide for ourselves or whether we should include it as a service provided for the greater good of the whole that we are all willing to chip in to pay for. I'm OK with either having a government run health care system like they have in all the other modern countries, or I'm OK with having each individual fend for themselves as people do in third world countries. What I'm not OK with is having a bunch of blood sucking vultures in the form of insurance companies standing between me and my health care. That is neither rugged individualism, or freedom or liberty. It is merely trading one form of tyranny (governmental) for another form of tyranny (monopolistic oppression).

AustinG Wrote:
-------------------------------------------------------
> AGV Wrote:
> --------------------------------------------------
> -----
> >
> > Thanks for the explanation, but it didn't make
> any
> > sense to me. I understand the connection
> between
> > tort reform and medical malpractice insurance.
> If
> > tort damages are limited, then the amount of
> > insurance coverage a doctor has to buy is also
> > limited, which should drive down the doctor's
> > malpractice insurance policy. That's easy to
> > understand.
> >
> > But capping tort damages doesn't do anything to
> > address the real problem regarding malpractice
> > lawsuits and that is the "defensive medicine"
> > practiced by doctors to avoid being sued. That
> > includes doing lots of unnecessary tests just
> so
> > the doctors can cover their butts and protect
> > against being sued. Tort reform doesn't do
> > anything to address that issue.
> >
> > I'm in favor of tort reform to keep doctors
> > malpractice insurance premiums low. But tort
> > reform doesn't do anything to keep my insurance
> > premiums low. Tort reform isn't the
> > be-all-end-all some folks want it to be. It is
> a
> > false issue. Makes you wonder why so many
> > Republican politicians are so eager to run it
> out
> > as the BIG SOLUTION.
>
>
> I thought you meant health insurance costs.
> Malpractice costs don't change much because it is
> the frequency of the litigation and not the fact
> that there are a great deal of high cost cases.
> Most "reform" simply puts a cap on awards. A cap
> would seem to be arbitrary and does nothing to
> prevent frivalent cases that seek to get a payout
> to avoid a trial. It might avoid the lawyer
> seeking the giant payday, but it does little else.
>
>
> Real reform would give individuals better access
> to a place to petition their grievance. Some sort
> of arbitration would make sense for that. It
> would avoid the John Edward's of the world making
> millions talking as the voice of the unborn child
> that he says would have survived if a C-section is
> performed when the hard data says that C-section
> births are more risky. It is true that more high
> risk births are C-section so that could lead to
> that, but the point is that Edwards in those
> situations would play on the emotions of the jury
> in what should not be an emotional issue. Either
> the doctor did what was reasonable or he/she
> didn't.

I just figured out how we can make Mr. Sowell support any kind of healthcare reform.
Put him to sleep for about three months, and, upon waking him, inform him the latest proposed changes to healthcare are Republican ideas.

JimBeam Wrote:
-------------------------------------------------------
> voyager5k, you fail to understand the economics of
> law.
>
> Fighting the suits is a wash for plaintiff's
> lawyers. This will lead to fewer, but larger,
> verdicts. However, fighting the suits is great
> for defendant's lawyers, who get paid by the hour.
> Bringing a legal malpractice suit only makes more
> work for the lawyers.
>
> Your plan will only make the lawyers richer.
>
> voyager5k Wrote:
> --------------------------------------------------
> -----
> > Yes, "loser pays" will work. There is another
> > strategy that I foresee coming in the medical
> > malpractice lawsuit theater: doctors will start
> > fighting back. Heretofore, many, if not most
> > lawsuits were settled out of court, regardless
> of
> > their merit. The result: more lawsuits. What
> gets
> > encouraged, gets repeated. I think this will
> > change.
> >
> > From now on, we physicians will fight every one
> to
> > the bitter end. We will win the vast majority
> and
> > then counter-sue the losing attorney for LEGAL
> > malpractice. We may not win, but we WILL begin
> to
> > bankrupt these unscrupulous bozos who live to
> make
> > our lives difficult. We will see how they like
> > having a sword hanging over them all the time.
> We
> > will fight fire with fire. Since the government
> > won't end this nonsense, we will take matters
> into
> > our own hands!

Jim, I disagree. Doctors would win most lawsuits if they truly fought them, even more now, as the country is beginning to realize that there is no free lunch. Judgments against a physician ultimately come out of the pockets of the jurors! They are beginning to figure this out. Plaintiff's attorneys will receive squat if they lose, and they are out all the expenses of filing a complaint, investigating, obtaining depositions and documents, and court time. Once they lose, doctors will then sue them for the doctors' legal expenses. This will become a double whammy.

And, this is what it will apparently take, to make frivolous lawsuits go away.....permanently. The plaintiff's attorney has to look at an aggrieved pseudovictim right in the eye and say, "You will have to pay me by the hour and in advance, because I can no longer do cases on contingency."

And this will stop it. Many people seem to feel that they or their family members have been victims of medical malpractice for many reasons. It just flat isn't so. People do not even know what medical malpractice is. It IS a very rare event in this country by physicians who have been American, Canadian, or British-trained.

AGV Wrote:
-------------------------------------------------------
> Here is what I don't understand. Maybe someone
> smarter than me can explain it. Every election
> cycle every politician sings the praises of Social
> Security, Medicare and promises to take care of
> our injured vets with good VA care. All three are
> pure socialism. After the GOP/conservative
> politicians get elected they set about bashing
> socialism on things like health care reform, but
> never want to get rid of Social Security or VA
> benefits as socialism. This is a huge logical
> disconnect. Either socialism is bad and we must
> get rid of it or it is not bad and we can keep it.
> Which is it? Ir is it just that the
> GOP/conservative politicians know their
> constituents love those three forms of socialism
> and they wouldn't get elected if they bashed them
> when campaigning. Either way, it is prue
> hypocrisy. Which is it?
>
> Socialism Good?
>
> Or
>
> Socialism Bad?


AGV, What village are you from? Conservatives have been openly promoting privatization of Social Security for over 20 years. All but a handful of GOP congressman recently voted for a measure to phase out Medicare with vouchers for anyone currently under 55. VA benefits are provided, despite the cost, to those that we collectively owe a debt for their service.

Socialism benefits only the noncompetitive. Where is the compassion in stealing the self-determination of the masses to secure the economic equality of the unproductive? Libs argue for collective responsibility, because they are so inferior when it comes to individual responsibility.

Ron Smith Wrote:
-------------------------------------------------------
> I just figured out how we can make Mr. Sowell
> support any kind of healthcare reform.
> Put him to sleep for about three months, and, upon
> waking him, inform him the latest proposed changes
> to healthcare are Republican ideas.


I think Sowell would support more competition across state lines for insurance companies and more competition across the board.

Is that anywhere in the 2000 page bill?

AGV Wrote:
-------------------------------------------------------
> marjon Wrote:
> --------------------------------------------------
> -----
> > AGV Wrote:
> >
> --------------------------------------------------
>
> > -----
> > > Here is what I don't understand. Maybe
> someone
> > > smarter than me can explain it. Every
> election
> > > cycle every politician sings the praises of
> > Social
> > > Security, Medicare and promises to take care
> of
> > > our injured vets with good VA care. All
> three
> > are
> > > pure socialism. After the GOP/conservative
> > > politicians get elected they set about
> bashing
> > > socialism on things like health care reform,
> > but
> > > never want to get rid of Social Security or
> VA
> > > benefits as socialism. This is a huge
> logical
> > > disconnect. Either socialism is bad and we
> > must
> > > get rid of it or it is not bad and we can
> keep
> > it.
> > > Which is it? Ir is it just that the
> > > GOP/conservative politicians know their
> > > constituents love those three forms of
> > socialism
> > > and they wouldn't get elected if they bashed
> > them
> > > when campaigning. Either way, it is prue
> > > hypocrisy. Which is it?
> > >
> > > Socialism Good?
> > >
> > > Or
> > >
> > > Socialism Bad?
> >
> >
> > Socialism bad, unless you can't stand not
> having
> > control over other people.
>
> Okay. To be logically consistent, then, you are
> in favor of completely doing away with Social
> Security, Medicare and the VA system. Right?
> Because those programs are pure socialism.


Not on paper. SS and Medicare were supposed to be insurance. VA is for those who served in the military and was considered part of the cost of defending the country.

I would be all for taking SS and Medicare out of government control, though and I think the vets could get a better deal in the private sector.

Are you nuts? Even with all it's problems America is the greatest country in the world. Ronald Reagan recognized and celebrated that. The fact that some sectors of the society are socialized is a problem, but the country and it's citizens remain a "light on a hill" because our constitution and laws have delayed the slow progress if socialism to the point that we are facing this problem 50 years later than other nations, and can use the lessons of history to prevent our country from going down such a dangerous road.

AGV Wrote:
-------------------------------------------------------
> Here is something I don't understand. Back in
> 1964, when Congress was thinking of passing
> Medicare, the health insurance industry had a B
> grade actor named Ronald Reagan make a vinyl
> record (all they had back then) that was then
> mailed out. On that record the actor Reagan said
> if Medicare passed Americans would lose their
> freedom. But when Reagan became president, which
> was 16 years after Medicare passed, Reagan kept
> bragging about what a wonderfully "free" country
> America was. Was Reagan lying in 1964 on the
> record, or was he lying when president? He had to
> be lying one of the two times.

JimBeam said,

"Not every medical error leads to a medical malpractice suit, but every medical malpractice suit begins with a medical error."

Sorry, not true. From personal experience I can tell you that some malpractice suits occur despite the fact that the physician made NO errors. Some suits actually result because the PATIENT screwed up. This happens much more often than you might think.

To show how ridiculous the current system is: the patient can deliberately NOT follow the physician's advice and/or instructions and still SUCCESSFULLY sue for malpractice! How stupid is that? Juries have ruled against doctors for not FORCING patients to do what should have been done. I kid you not. That does not mean that the physician committed malpractice, it only means that the "victim" won a lawsuit.

And the reasons for this: stupid jurors and BAD lawyers! (as you mentioned)

Well it is possible to reduce costs, but not the way Obama has proposed. In particular, right now the number of medical schools is so small that extremely random BS is used to unnecessarilly eliminate qualified applicants. If the federal government wanted a relatively inexpensive way to lower treatment that would pay for itself, how about more medical schools, with the students footing the tuition. Knowing how desperate some are to get in, we might even be able to tax them for it.

hailingfromgeorgia.blogspot.com

It is a well documented fact that most "medical misadventures" do not result in lawsuits.

See: [content.nejm.org] and

[lsr.nellco.org]

So despite all the reports in the media, most potential medical malpractice claims do not materialize as lawsuits.


voyager5k Wrote:
-------------------------------------------------------
> JimBeam said,
>
> "Not every medical error leads to a medical
> malpractice suit, but every medical malpractice
> suit begins with a medical error."
>
> Sorry, not true. From personal experience I can
> tell you that some malpractice suits occur despite
> the fact that the physician made NO errors. Some
> suits actually result because the PATIENT screwed
> up. This happens much more often than you might
> think.
>
> To show how ridiculous the current system is: the
> patient can deliberately NOT follow the
> physician's advice and/or instructions and still
> SUCCESSFULLY sue for malpractice! How stupid is
> that? Juries have ruled against doctors for not
> FORCING patients to do what should have been done.
> I kid you not. That does not mean that the
> physician committed malpractice, it only means
> that the "victim" won a lawsuit.
>
> And the reasons for this: stupid jurors and BAD
> lawyers! (as you mentioned)