Wednesday, July 12, 2006

Good Medicine

vs. Myths Propogated by the System

I just go all giddy when I see Democrats talking coherently about important issues and using intelligent and thoughtful arguments to back up what they are saying. It is undeniably refreshing, especially when those intelligent and thoughtful arguments fly in the face of one of the best selling right wing myths of our time: bad medicine.

From Slate:
The Republican answer to runaway health-care spending is to cap jury awards in medical malpractice suits. For the fifth time in four years, Senate Majority Leader Bill Frist tried and failed to cap awards at $250,000 during his self-proclaimed "Health Care Week" in May. But this time, the Democrats put a better idea on the table.

Sens. Hillary Clinton and Barack Obama also want to save on health care. But rather than capping jury awards, they hope to cut the number of medical malpractice cases by reducing medical errors, as they explain in an article in the New England Journal of Medicine. In other words, to the Republicans, suits and payouts are the ill. To the Democrats, the problem is a slew of medical injuries of which the suits are a symptom. The latest evidence shows the Democrats' diagnosis to be right.

emphasis gleefully added by the Management - HR
Oh my gosh, finally some coherency. This is common sense selling against fantasy, and I am so glad to see it on the national stage, I could do a victory lap around my office.

Democrats: Making Patient Safety the Centerpiece.

Republicans: more worried about the Doctor's paycheck than the patient's safety.

What makes this really work? The bold, fat, provable reality on the ground:
including legal fees, insurance costs, and payouts, the cost of the suits comes to less than one-half of 1 percent of health-care spending. If anything, there are fewer lawsuits than would be expected, and far more injuries than we usually imagine.
When's the last time you saw a doctor driving anything less than a Mercedes? There ain't no shortage of medical school students taking out hundreds of thousands of dollars in loans. Why would anyone do that if the only result is increased liability and personal risk? The answer is quite simple: doctors make serious cash.

With great reward comes great responsibility. The biggest? Do your job correctly! Read further:
Anesthesiologists used to get hit with the most malpractice lawsuits and some of the highest insurance premiums. Then in the late 1980s, the American Society of Anesthesiologists launched a project to analyze every claim ever brought against its members and develop new ways to reduce medical error. By 2002, the specialty had one of the highest safety ratings in the profession, and its average insurance premium plummeted to its 1985 level, bucking nationwide trends.
So, there's a link to better service, safer medical practices and lower costs across the board? Sweet. I love it when good policy and good politics go hand in hand.

And I am overjoyed that it is the Democrats on the right side of this one.


Dante said...

I fail to see how these two issues are mutually exclusive. I also fail to see how "We'll stop the injuries from happening!" is a real solution unless Obama and Clinton have a modified Delorean, Phone Booth, or Police Box that I'm not aware of.

"They found that more than 90 percent of the claims showed evidence of medical injury, which means they weren't frivolous."

I don't think anyone is arguing that the suit itself is frivilous. The argument is that the payout is frivilous. Sure there's medical injury present but the payout for some of those injuries is absurd. That's the argument as I am aware of it. This study completely ignores that aspect from what I've read so far of it.

"Democrats: Making Patient Safety the Centerpiece."

Republicans: Wondering why the medical profession isn't already doing what's proposed by Obama and Clinton. Oh wait, they already are. Changing procedures to decrease risk of injury and/or death is a constant feature of the medical field, which typically goes out of its way to be extraordinarily precautious.

I'm not particualrly opposed to the grants, but I fail to see how a national database will be any more effective than well-respected medical journals. I also still fail to see what this has to do with tort reform other than them both involving the medical field.

Patrick Armstrong said...

For me, those issues were covered in the article from the New England Journal of medicine.

And I have never heard a complaint about frivilous payouts. I have only heard what the Slate article describes as the meidcal lawsuit "urban legend mixed with the occasional true story, supported by selective references to academic studies." And I have heard that an awful lot, from Sen. Frist and President Bush, from Ann Coulter and Rush Limbaugh, Bill O'Reilly and Sean Hannity.

Why have we not heard about frivilous payouts? Because it would be political suicide for any Republican to put a price tag on life ending injury at the hands of the US Health Care system.

Instead, the right spins this issue in order to relate outrageous health care costs to frivilous lawsuits, which is hogwash.

dadvocate said...

This is an issue, where for the most part, I side with the Democrats. As Slate essentially says, if doctors don't want huge payouts in lawsuits, make fewer mistakes. I'm absolutely against caps.

Health care has partly become so expensive due to regulations, etc. related to Medicaid and Medicare. But insane markups on products and services add to the problem. Example: I worked in a nursing home 15 years ago. We charge $8 to but a foam eggcrate pad on a patients bed. The hospital a mile away charged $100 for the same pad.

When my oldest daughter was born in 1971, my out of pocket cost was $18.61 and I had only had my state employee health insurance policy for 6 weeks. Total doctor's bill including pre-natal and delivery: $270. You'll pay that or more for a sonogram now.

Bottom line, health care is way too expensive.

Dante said...

The proof is in the pudding, Pat. Looks at the suits they're referring to. I'll do some research when I get the chance but the specific suits I've heard mention of aren't suits in which real injury didn't occur due to malpractice. They're situations where outright silly amounts of money were showered on people relative to the situation. They may be spun as "frivilous lawsuits" but only for the reasons you've already mentioned. The anecdotal cases themselves are legitimate lawsuits with frivilous payouts.

"Bottom line, health care is way too expensive."

"my out of pocket cost was $18.61"

I think you've explained your own statement, dadocate. As long you're not paying for it out of your own pocket, health care cost will go nowhere but up.

dadvocate said...

Trouble is I am paying for it out of my own pocket and the cost continues to go up. Despite the fact that I have health group insurance through my work, which I part part of, I have two prescriptions that I fill monthly, $30 for one $60 for the other. That's over 4 times what I paid to have a kid 34 years ago.

$25 for each doctor visit. When you have 3 minor children that adds up fast. The out of pocket for my last child, now 10, was several thousand despite having insurance.

I pay out the wazoo and costs continue to rise.

Dante said...

"Trouble is I am paying for it out of my own pocket and the cost continues to go up. Despite the fact that I have health group insurance..."

Sorry for not being clearer. As long you're not paying for the entire bill out of your own pocket, health care cost will go nowhere but up.

Copayments and deductibles can add up fast but they're still a pittance compared to the overall price. As an example, my last child was born a month early with premature lungs. He's doing fine now but he spent two weeks in the NICU. Under the HMO plan I had at the time, the cost was somewhere in the neighborhood of $250. Under the PPO plan I have now, the cost would've been in the neighborhood of $3,200. That's a lot of money but if I had no insurance at all, the cost would've been about $120,000 not counting the costs of delivery and recovery for my wife. I don't even owe that on my house! I'll take $3,000 and my monthly insurance payments any day. Then again, if I had no insurance, I would've gladly paid the $120,000. I might've tried to haggle though :)

Patrick Armstrong said...


And how many Americans are uninsured? That's a huge problem, especially for our most at-risk families in the lower income brackets.

This could be especially prescient now, with doctors reporting that 1 out of every 8 babies is born premature.

Dante said...

He didn't have an issue that would affect all premature babies. He had underdeveloped lungs. It's a condition that affects white males more than any other newborns and is still pretty uncommon given my son's birth weight (6lbs 2oz). I forget the name of the chemical they have to pump into the lungs to help develop them but they typically do 1 to 3 treatments. They had to do 4 on him. From what I've read, if he were born about 20 years ago, his chances of survival would've been about 50/50 but hey his medical bill would've been a whole lot smaller! I'll take the $120k and the medical advancements that go along with it.

My daughter straddled the line of prematurity but just barely wasn't. She weighed the exact same as my son, was only born a week later, and had no issues whatsoever. I make the joke that my wife's body is like those parents who kick their kids out at 18. When a baby hits 6lbs 2oz, they had better find a new place to live because they're sure not staying inside her.

Dante said...

Oh and after reading the 1 in 8 premature link, 3 weeks early is NOT premature. 1 in 8 are born early. Premature is 4 weeks or more. Also, one thing the artcile doesn't mention is that doctors are not nearly as concerned about delivering a baby premature as they used to be. With our current state of medicine, it's safer to deliver early now than trying to stall the labor in most cases. That didn't used to be true and I imagine that has a huge impact on early delivery.