President Obama’s health care “reform” plan has met with significant criticism across the country. Many Americans want change and reform in our current health care system. We recognize that while we have the greatest medical care in the world, there are major problems that we must face, especially in terms of reining in costs and allowing care to be affordable for all. However, as we have seen, current plans being pushed by the Democratic leadership represent change that may not be what we had in mind — change which poses serious ethical concerns over the government having control over our families’ health care decisions. In addition, the current plans greatly increase costs of health care, while doing lip service toward controlling costs.
We need to address a REAL bipartisan reform proposition that will have REAL impacts on costs and quality of patient care.
As Governor of Alaska, I learned a little bit about being a target for frivolous suits and complaints (Please, do I really need to footnote that?). I went my whole life without needing a lawyer on speed-dial, but all that changes when you become a target for opportunists and people with no scruples. Our nation’s health care providers have been the targets of similar opportunists for years, and they too have found themselves subjected to false, frivolous, and baseless claims. To quote a former president, “I feel your pain.”
So what can we do? First, we cannot have health care reform without tort reform. The two are intertwined. For example, one supposed justification for socialized medicine is the high cost of health care. As Dr. Scott Gottlieb recently noted, “If Mr. Obama is serious about lowering costs, he’ll need to reform the economic structures in medicine—especially programs like Medicare.” [1] Two examples of these “economic structures” are high malpractice insurance premiums foisted on physicians (and ultimately passed on to consumers as “high health care costs”) and the billions wasted on defensive medicine.
Dr. Stuart Weinstein, with the American Academy of Orthopaedic Surgeons, recently explained the problem:
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Notes:
Sarah put this entry up on her facebook page about 5 hours ago and I just caught it. Once again she bats one out of the park as she goes after greedy lawyers and I agree with her 100%. Canada has had the idea of ”loser pays” (they pay ALL costs) as part of our lawsuit picture since forever and that, in my pointy headed view, is the essence of what she is saying.
Fire.The.Lawyers!
Did I mention I think she is right (again)?
More Notes:
I just added a new book to my sidebar. Double Deal is a true story about the Chicago mob and it’s alarming if you consider the current political situation in the US because it has long been said that one day the mob would gain entrance to the Whitehouse. Actually, I feel that may have happened in 1960 when it is alledged Joe Kennedy bought a US President and the book mentions it. I’ve had it for awhile but I’m re-reading it now considering what I know to be going on today and mindful that some of the players are still around. People can make of it what they will. It’s a great read.
I’ve also added Bill O’Reilly’s talking points in the sidebar. It’s video and it’s good. People can hook up when they have time.
Will Obamacare bankrupt America?
Updates:
7:30 pm EDT, August 21st, 2009 — Sorry folks, Sarah Palin is (partly) right
3:11 pm EDT, August 22nd, 2009 — Sarah Palin way out front in the “Facebook primary”
This may not be news today but it will be tomorrow as every tort lawyer in the US feels their head explode.
“Incoming!!”
OK — here they come.
By tomorrow if you live in the states that “pop, pop, pop” you hear closeby won’t be gunfire. It will be local lawyer heads exploding all around you.
Not to worry.
Heh…
The Obama administration probably doesn’t want to deal with tort reform because:
Total number of Lawyers in the US Congress: 162 out of 441 or 36%.
Total number of Lawyers in the US Senate: 54 out of 100 or 54%.
Thomas Jefferson said, “If the present Congress errs in too much talking, how can it be otherwise in a body to which the people send one hundred and fifty lawyers, whose trade it is to question everything, yield nothing, and talk by the hour? “
I’m laughing. Obama and his backers are in deep trouble.
2010 and a warlock hunt begins.
Sarah Palin – plain speaking the truth. She dares to call the lack of torte reform what it its – a sop to trial lawyers. Oh dear, the left is foaming and hperventilating again. The establishment doesn’t need immunization against H1N1 - they need rabies shots as they go out of their minds. Cheers.
The downside of Tort reform is that now there’d be nothing keeping penny-pinching HMO doctors honest. Why not take a short cut on that surgery to save a bit of money on supplies if there is no serious consequences? Medicine in the USA is a business now, not a profession, and doctors sustain just as much on Am-Way style herb sales and off-label prescriptions for drugs (including the kickbacks) as they do on reputably treating patients.
Of course doctors will flood Alaska if the consequences for their missteps are severely limited. It’s basically a free pass.
Who’s writing all this stuff for Sarah, anyway?
“there’d be nothing keeping penny-pinching HMO doctors honest”
Other than their humanity, their professionalism and the Hippocratic oath!
However, people need to realize it is their body and they had better learn how to look after it and not leave it to politicians to set up a “system” to look after them and their loved ones.
We need competition, we need choice and second opinions that aren’t based on a rationing play book set up by Queens Park apparatchiks like Smitherman who cancelled OHIP coverage for eye check ups but OK’d coverage for sex change operations. When are we going to wake up and see the lunacy of letting the government literally look after our lives?
Other than their humanity, their professionalism and the Hippocratic oath!
Hehe, yeah… that. Methinks money comes first in our dog-eat-dog environment. With the debt load of the average doctor more than doubling over the last couple decades though their salaries haven’t moved up at the same rate, cheating will come rather easily. Competition doesn’t compensate losers, nom. Buyer beware, as with any commercial product.
Now I injured myself earlier this year and had to get some physio. The experience was nomdeblog’s dream scenario – lots of choice, fast service, high quality service, no government involvement. Of course I had 80% coverage from the corporate plan which is the only way paying for the necessary treatment was possible. What if I didn’t work at a corporation, nom? What if the treatment was life-saving?
“Methinks money comes first in our dog-eat-dog environment”
Well if you believe that , how are Barney Frank and Pelosi and Reid going to save you from that? “Profit” comes in many forms, politicians “profit” in many ways.
Again the best solution is to take care of ourselves and the last person I would trust to look after me is a politician.
As to your last question .. I’m retired, I just had a similar physio scenario as you .. I paid for it, I saved for my baby boomer body which is falling apart ( not everyone has saved for Health Cynapse and your generation is going to get fed up with paying for too many irresponsible boomers). Also , I do have insurance, maybe it’s covered ? I need to submit it.. we’ll see.
“the treatment life saving?” A US hospital has to treat you.
But you’ve nailed one of the big issues and it is a tax problem of Corporations paying for the benefits and getting to expense it , individuals can’t do that. That needs to be fixed, making coverage more portable.
“the treatment life saving?” A US hospital has to treat you.
Often stated, but what is the qualification, again?
It isn’t doctors who pay for the USA’s jackpot justice system, it is healthcare consumers who pay through higher insurance premiums, and the vast majority of doctors here in Canada also work in private practices and not for the state. Are we to believe that no Canadian doctor would ever over-bill OHIP because of the superiority of our socialist moralities? I guess that line of thinking would account for all the tax cheats in the Obama administration.
The doctors do pay for their own lawsuits.
Brian, we know there are abuses in OHIP. Are you looking for a “utopia”? (great to use that line on someone else for a change). The bottom line is whether you think health care should be available to all the public to enhance the quality of life in our society, or bought and sold like Mercedes cars? If you choose the latter then you’ve got to accept that, like a Mercedes, no one will be entitled to it and as costs go up due to demand > supply, health care will progressively become “winner take all”. Sure, you can get any operation done quickly with the best of care – the line is so short that no one’s around to get in your way.
If you’re an adherent to social darwinism as much of the right is, there is no moral issue for you. But for many others …
A total of 14% of Canadians, or 3.6 million people, are without a General Practitioner, and unlike in the US where most people can actually choose their specialists, here in Canada without a referral from a GP, they have no more access to healthcare than the uninsured do in the US. Since our governments are in no hurry whatsoever to correct the situation, what exactly does it amount to other than health care rationing? Don’t get me started on all the emergency room waiting I have had to do. What exactly does that amount to other than health care rationing?
The r word – rationing. Nobody likes the thought of a government deciding who lives and who dies. But what is the free market? It’s rationing based on supply, demand and prices. So what really is the difference between these two scenarios -
A) Government panel, using their internal “logic” to determine which life-threatening cases should be treated and which people should be left to die.
B) A market using “pay to play” to determine which life-threatening cases should be treated and which people should be left to die.
A strong majority of Americans are gambling on B with the expectation that they will be among the elite who will be able to afford the operations (possibly due to the Lake Wobegon effect, or plain ignorance). It’s a gamble. One can’t tell adherents that they are morally wrong, but it’s perfectly fair play to correct them about the rationing argument – as long as there are finite resources there is rationing.
It’s a lot worse than “rationing”. It cuts against my liberty and my rights. Here’s an example.
A few years ago during an annual checkup that happily went well, my Dr mused during our usual banter about our socialist Health Care:
“ nomdenet here’s some advice, try to avoid getting by-pass surgery in the Spring. That’s when Queen’s Park budgets are at their tail end and there is a little $50 gizmo that helps regulate the heart after surgery and they tend to run out of a budget for them in the Spring. That $50 gizmo can make a big difference in your life”
I said: “that would be no problem Doc, I’d gladly pay the $50 for it”
He said “you can’t pay for it, that wouldn’t be ‘equal’ and some people don’t have the $50”.
Health is about morality. We elect legislators to represent us who are unprepared to discuss the morality of these issues which will grow with new technology available to an aging population that we must “ration” to death if all are to be “equal” and we aren’t allowed to look after ourselves.
Nom:
Granted, your story is disturbing. To go to the extreme opposite end of pay-to-play may have prevented this situation … but then again would you have been able to afford all the doctor consultations up to that point?
How about the people who can’t afford the nic nacks and procedures? Is it moral to let them die? Should your liberties (or more accurately, lack of restrictions) come at the expense of condemning millions to death? Those are the moral questions surrounding health care and it’s probably not worth making the debate front and center because it will tear this country (and the USA) apart. The “win at all costs” mentality of many North Americans has already caused much social division and it’s only going to be muddy what should be primarily a money and public welfare issue.
The more I look at health care issues on both sides of the border, the more i think there could be a better way somewhere between the two systems.
Strangely, we dont hear about tort reform in Canada, yet the information i have been able to find shows that Canada has almost exactly the same issue with malpractice suits.
For example:(2007 numbers)
Cases in Canada – 1,400. Cases in U.S. – 14,000
Average settlement in Canada – $300,ooo. In U.S. $298,000.
I found these numbers at Myth Busters.
The big difference seems to be the cost to doctors for insurance. It is part of the negotiated settlements in some Provinces, but not in others. And of course in the States, there is no Government involvement for malpractice insurance.
There are horror stories on both sides of the border. Conversely, there are good news stories as well.
I have read everything i can find and have arrived at some conclusions.
1. The U.S. has the best health care in the world.
2. The U.S. spends the most money on health care. (per capita)
3. There are a number of uninsured in the U.S. (somewhere between 8 and 50 million)
4. There are no uninsured in Canada. (except for residency requirements.)
5. Health care is rationed in Canada.
The Canadian system could be improved easily starting with a change in attitude, a lessening of hyperbole, and examination of facts and data.
And oh, did i mention we need some politicians with guts?
Cynapse you are jumping to a lot of conclusions about what I think or about what conservatives generally think.
My choice for President would have been Mitt Romney who introduced Health Care into Mass. and everybody is now covered .. .with a Honda level not a Lexus level.
My issues involve more choice because Health could consume 100% of government expenditures and 100% of my wallet as well.. but the latter should be my choice.
In my example , I should be allowed to pay the $50. Lexus option. To restrict me from doing that is immoral… it is a slippery slope to a death panel
Furthermore maybe I should always have to pay the $50 and never get it free and thus free up funds for those that can’t pay for it … I don’t know ?
But if I get out of line , the line gets shorter.. that is “win win”, why wouldn’t that be morally acceptable? The new CMA President says our Health Care is imploding, wouldn’t this approach help prevent the implosion?
But if I get out of line , the line gets shorter.. that is “win win”, why wouldn’t that be morally acceptable? The new CMA President says our Health Care is imploding, wouldn’t this approach help prevent the implosion?
The concern is that all the resources of value will follow you right into profit market, as the market system is designed to work. The remaining public resources will probably get worse, not better. The privileged make sure the system works when they actually have to use it. If they’re allowed to bolt, the remaining system could ghettoize rather quickly.
“follow you right into profit market”
Why is profit a sin? As it is , the resources are CUPE paid kitchen help in the Hospital, how does that improve your health?
Also anyone could take their OHIP card to the profit market and get treated or they could stay with the CUPE hospital, I’m not suggesting we close them, only that we get more Shouldice type solutions.
Finally what would also flow to the “profit market” would be the optimum human resources ( more Doctors, fewer Investment Bankers) and optimum MRIs and PET scans etc …McGuinty bought back the private MRIs thus creating longer lines .. .other than “profit” his CUPE base, how did this help patients?
We need to step back and discuss tort in the context of “profit” in Health.
Who is “profiting” and how do they “profit”?
We have probably reached the stage in our trillion dollar economies where we have politicians “profiting” in much the same way as Putin profits in his thugocracy.
Someone is inevitably going to “profit” when in the USA you have a 15 trillion dollar economy heading toward a 20% expenditure of it on Health. But I think the best way profit works is when it is not considered a sin but is disclosed and is subject to a lot of competition and then it is taxed.
Tort is just another word for thugocracy profit. I’ll leave it at that for today and let Palin articulate it.
It was a hospital administrator charged with the important task of freeing up beds, and not a government panel using internal “logic”, who had me doped up and kicked out of an emergency room three days in a row, despite my massive chest pains, before finally on the fourth day, arranging the CT scan required to diagnose my very serious ailment, and soon after admitting me to an intensive care unit in a different hospital in another city. Canada has 20% fewer doctors than the US, 400% fewer MRI machines, 200% fewer CT scanners, fewer hospitals, fewer beds… Emergency room waits in Toronto can last up to 30 hours, outside of Toronto they have to transport patients with emergency heart problems hundreds of miles to one of the few central hospitals set up with the ability to treat them. Our system is often so stressed whether we live or die depends more on which day of the week we get sick, and how long a shift it has been for whoever might be treating us, than it does on whatever ails us. The new CMA President is right, our healthcare system is imploding, and only more services provided by private industry will alleviate the problems.
To characterize the American system as entirely “pay to play” is bullshit. American governments are currently spending 23% more for public healthcare access than our Canadian governments spend, even though the government run portion of their system currently provides coverage to less than one third as many people as a percentage. If the incredibly wasteful government run labyrinth of bureaucracy that passes for a public system in the US could get those costs down to just 300% more than the OECD country average per client, still more than double what our Canadian governments are currently paying, then every American citizen in need could be covered without additional spending. So why attack the private aspect of the US system alone? Rhetorical question, the Obama administration isn’t ideologically inclined to go after the government employees most responsible for the current problems with public access to their healthcare system.
Profit is fine in any situation where you are willing to allow significant portions of the population to go without the good/service in question. Should we care that not everyone can afford a rolex? No, there are many other brands of watches that people can afford as well as clocks everywhere for people that don’t have a watch. Citizens without watches are unlikely to turn to crime since not owning a watch is almost never a life and death situation.
The same evaluation could be made for boats, laptop computers and manicures. But healthcare and education are a bit different. Citizens simply cannot survive without enough of either of these services, or at least not in the Beaver Cleaver fashion that Cons expect of the citizenry regardless of personal situation. EVERY person needs access to these basic services if they are expected to be functioning members of society. Being a decedent of Latin America, I can tell you that bad things happen when poorer people don’t get the basics. Once you realize your country has left you for dead, no crime is too great since you’re literally trying to survive.
That is why a somewhat slow and non-functioning OHIP is preferable to a winner-take-all US system. There is profit in both but OHIP is not profit driven (meaning, the bottom line is more important than any other consideration)
To characterize the American system as entirely “pay to play” is bullshit. American governments are currently spending 23% more for public healthcare access than our Canadian governments spend, even though the government run portion of their system currently provides coverage to less than one third as many people as a percentage.
Missing from this rosy assessment is the fact that doctors have leeway in deciding whether to accept medicaid patients, and the number of doctors willing to do that is steadily increasing. The reason? Low payment rates and high administration costs. In other words, they’re not profitable enough compared to the rich private planners.
To your other point, ambulances are regularly turned away from urban areas of the U.S. due to under staffing and a surge of patients. How is this possible when the U.S. has so many high quality facilities? Of course, those facilities are in posh suburban areas – closer to the people with the money to pay for them.
It boggles the mind how some people think health care can be set up like a market system and still expect it to function like a public good program. The market is about profit first and foremost. All of the behaviour just outlined is rational for a market system – but is that what we need in this instance.
Missing from this rosy assessment is the fact that doctors have leeway in deciding whether to accept medicaid patients, and the number of doctors willing to do that is steadily increasing.
So what? Even if some doctors choose not to treat them, that still leaves those American citizens on medicaid with more doctors available to treat them per capita than we have available to us here in Canada, because limiting the income of doctors results in fewer of them, not more. Further, those posh suburban private hospitals, and their rich clientele, do after all end up paying everyone’s way, and not just their own, through high taxes.
To your other point, ambulances are regularly turned away from urban areas of the U.S. due to under staffing and a surge of patients. How is this possible when the U.S. has so many high quality facilities?
Illegal immigrants.
It boggles the mind how some people think health care can be set up like a market system and still expect it to function like a public good program. The market is about profit first and foremost. All of the behaviour just outlined is rational for a market system – but is that what we need in this instance.
Despite the fact that your personal preference would seem to be for us all to stand in Soviet era bread lines waiting for our caloric intake quotas to be met by big nanny government so everything could be made exactly equal, private enterprise supermarkets perform a public good, as do private enterprise pharmacies…
An obvious mistake – I meant to say decreasing. The corollary was that if you’re poor, you’re no better off in the US system than the Canadian one.
Despite the fact that your personal preference would seem to be for us all to stand in a Soviet era bread line waiting for our caloric intake quotas to be met by big government so everything could be made exactly equal, private enterprise supermarkets perform a public good, as do private enterprise pharmacies…
That is the common accusation against those who don’t think not being upper middle class is a sin punishable by death. All I can see in your advocacy is promoting a system that leads to massive hidden deaths via fear mongering about opponents advocating a system that leads to massive obvious deaths.
In the long run, does it really matter whether HMO/Insurance/Doctor greed or bad government is killing people? I humbly suggest it doesn’t. Thus you advocating the knife over the gun does little to alleviate my aversion to murder.
Regardless, your side will win because of low standards, ironically. It seems that as long as SOMEONE is getting a good deal, hardcore profiteers declare the system a success. Creating a small privileged class is much easier to achieve than looking after everyone’s needs with limited resources and little incentive for human resources to work hard.
You have lost me completely. I am not advocating any violence at all, I just believe that the US would be much better off fixing the flaws in the healthcare system it has rather than go through an incredibly expensive, not to mention wealth destroying, tear down and rebuild of their current healthcare system based on the false assumption that a system modeled after ours would be without flaws, or any more sustainable in the long run than the one they already have. Since, Obamacare does little or nothing to fix the many glaring flaws in their system, it just seems an expensive waste of time.
“In the long run, does it really matter whether HMO/Insurance/Doctor greed or bad government is killing people? I humbly suggest it doesn’t. Thus you advocating the knife over the gun does little to alleviate my aversion to murder.”
There is one difference Cynapse.
Theoretically at least, In one instance the patient has a say and some choice in the matter.
In the Government run system, there is no choice.
Nit-picky i know, but but it is in the minds of many Americans.
Whether it is the health issue or any other “social” issue, the failing is that it is simply not possible to legislate “fairness”. There will always be some who will gain more benefit than others – and you can be darn sure that those who do will be the ones who have made the rules and their best freinds – and yes the evil Rich as well, because money buys anything, and socialists love money and comfort just as much as the evil capitalists.
Brian: This is not about violence, it’s about the moral merits of a health system where large swaths of people are basically relegated to death pending a lottery victory vs a system where large swaths of people are relegated to death for not knowing a government bureaucrat personally. I suggest neither is such a great idea. With the technology we have on this earth, we can do better.
Cynapse wrote “The r word – rationing. Nobody likes the thought of a government deciding who lives and who dies. But what is the free market? It’s rationing based on supply, demand and prices. So what really is the difference between these two scenarios -”
The difference Cynapse is the fact that in the private system there is a greater degree of individual control. If I work hard, save my money and buy the best coverage available then when my turn comes for a medical emergency I have coverage.
Under the public system I have no control. No matter how hard I worked or saved or how much I invested I’m at the back of the line with the guy who never worked a day in his life! Is it right that after working long and hard I can’t get heart surgery because some over protective mother just took all the funds available by getting her snuffly child checked out for the third time today. Is it right that after working long and hard I can’t have chemo therapy because some hypochondriac soaked up the funding after he discovered a new freckle and had to have it checked out, six different times!
That dear Cynapse is the difference between private and public health care.
Don’t get me wrong the overprotective mother and the hypochondriac both deserve to be looked after, but there is no way that they should be able to drain the system to the extent that people with real health issues are denied timely services.
With the technology we have on this earth, we can do better.
As far as medical advances go, most of that technology was developed in the USA precisely because it has a more entrepreneurial private enterprise system. The, infrastructure, procedures, working contacts and interrelationships between government organizations and industry that allows the US system to bring forth to market the majority of the medical miracles that we in Canada and the rest of the world have come to depend heavily enough on to take for granted, did develop in a vacuum. An absence of government. Of course, those expensive to develop medical miracles do tend to make the USA’s more private system more expensive, but people in need from around the world, including those sent for treatment by our overwhelmed healthcare systems, spend hard currency in the USA for the advanced healthcare procedures available there. Further, the wealth that is created when private companies in the USA ship locally developed and manufactured pharmaceuticals, ventilators, MRI machines, CT scanners, surgical stents, pacemakers and thousands of other such high tech medical products to Canada and abroad, employs many thousands of blue and white collar workers, mostly in Blue Dog Democrat states, and therefore helps to raise the overall standard of living in the USA while supplying enough tax revenues to pay for all kinds of government largess, perhaps even enough to pay for public access to their system if not wasted. Why put any or all of that at risk just to trade one flawed system for another?
The sad truth is money is spent on advertising and not on treating sick folks. Same with all the high priced ads for drugs. If all the waste and excesses in health care were used to treat folks the cost could go down and maybe every one could have some kind of insurance coverage. The power companies do not advertise yet I have electricity. Doctors prescribe medications so why is all the ads necessary. Educate the Doctors and put the rest back into new drug development or send dividends to their stock holders.