Perry: Tort reform must be part of health care reform

[DarrinS]

http://www.washingtonexaminer.com/opinion/columns/OpEd-Contributor/Tort-reform-must-be-part-of-health-care-reform-8096175.html

If already posted, my bad.





To hear federal officials tell it, they've got all the answers on health care and it's up to the rest of us to sit, wait and embrace whatever solution -- if any -- they may eventually provide.

I find this troubling, since states have shown they know a thing or two about solving problems that affect their citizens.

Texas, in fact, stands as a good example of how smart, responsible policy can help us take major steps toward fixing a damaged medical system, starting with legal reforms.

Just six years ago, Texas was mired in a health care crisis. Our doctors were leaving the state, or abandoning the profession entirely, because of frivolous lawsuits and the steadily increasing medical malpractice insurance premiums that resulted.

Two thirds of our state's counties had no practicing obstetricians, and for pregnant women that meant long trips in cramped cars and higher fuel bills. Sixty percent of our counties had no pediatricians, which often meant delayed, or denied, health care for sick children.

And 24 counties in the Rio Grande Valley had no primary care doctors at all.

Each of those factors made it more likely that patients in underserved areas would postpone seeking care, which meant minor issues became major issues, and illnesses that could have been treated simply, easily and economically in the doctor's office turned into severe health crises that had to be treated in the emergency room.

And the situation was worsening with every passing day. By 2002, 13 of the state's 17 liability insurance carriers had left Texas, leaving less competition and leaving doctors with insurance bills that were seeing double-digit increases, if they could get insurance at all. That same year, applications for medical licenses plummeted to the lowest level in a decade.

This being Texas, instead of throwing money at the problem or debating endlessly, we identified the root causes and decided to do something about it.

In 2003, I declared the medical liability crisis an emergency item, and the legislature responded, passing sweeping reforms that protected the patient, but also shielded doctors and hospitals from unscrupulous trial lawyers eager to make a quick buck at the system's expense.

We capped non-economic damages at $250,000 per defendant, or up to $750,000 per incident, while placing no cap on more easily determined economic damages, such as lost wages or cost of medical care due to injury.

We ended the practice of allowing baseless, but expensive, lawsuits to drag on indefinitely, requiring plaintiffs to provide expert witness reports to support their claims within four months of filing suit or drop the case.

These measures were supported by the people of Texas, who in September of 2003 approved a ballot measure, Proposition 12, authorizing all of these changes.

Changes were seen immediately, and continue to be felt. All major liability insurers cut their rates upon passage of our reforms, with most of those cuts ranging in the double-digits. More than 10 new insurance carriers entered the Texas market, increasing competition and further lowering costs.

As a result, Texas doctors have seen their insurance rates decline by, on average, 27 percent.

The number of doctors applying to practice medicine in Texas has skyrocketed by 57 percent. In 2008, the Texas Medical Board received 4,023 licensure applications and issued a record 3,621 new licenses.

In all, in just the first five years after reforms passed, 14,498 doctors either returned to practice in Texas or began practicing here for the first time.

And our reforms finally brought critical specialties to underserved areas. The number of obstetricians practicing in rural Texas is up by 27 percent, and 12 counties that previously had no obstetricians now have at least one. The statistics show major gains in fields like orthopedic surgery, pediatrics, neurosurgery and emergency medicine.

The Rio Grande Valley has seen an 18 percent growth in applications to practice medicine, adding about 200 doctors to this critically underserved area.

And what about the money that used to go to defending all those frivolous lawsuits? You can find it in budgets for upgraded equipment, expanded emergency rooms, patient safety programs and improved primary and charity care.

Success stories like ours need to be told, and need to be remembered as we continue this national debate.

Instead of handing down "one size fits all" mandates on how it's going to be, Washington should be enabling states to set their own agendas, and solve their own problems, when it comes to health care.

[rjv]

juxtapose this next to the stat that almost 100,000 people die from medical malpractice each year and you get some perspective on this issue.

http://www.chron.com/disp/story.mpl/deadbymistake/6555095.html

[TeyshaBlue]

I'd sure like to see the data backing Cpt. Haircut's ascertations.

I can't believe anything that slips through that syncophant's lips.

[SouthernFried]

Of course...if the govt takes it over, you wont have to worry about tort reform. Not many people have the funds it takes to sue the govt...not many lawyers have the time.

[DarrinS]

I'd sure like to see the data backing Cpt. Haircut's ascertations.

I can't believe anything that slips through that syncophant's lips.


You want to see the data (which is in the OP)? Or, do you want the source of the data?

[DarrinS]

Of course...if the govt takes it over, you wont have to worry about tort reform. Not many people have the funds it takes to sue the govt...not many lawyers have the time.


You can't sue the fed. I don't think.

[TeyshaBlue]

You want to see the data (which is in the OP)? Or, do you want the source of the data?

I'd like to see the source. I certainly don't have a good feel for his conclusions as they fly in the face of what I think is goin on.

[DarrinS]

juxtapose this next to the stat that almost 100,000 people die from medical malpractice each year and you get some perspective on this issue.

http://www.chron.com/disp/story.mpl/deadbymistake/6555095.html



So, it's twice as dangerous to go to the hospital than it is to drive a car? I find this a little hard to believe.

[rjv]

You can't sue the fed. I don't think.

that is more or less true outside the scope of sueing a person acting for the federal government.

Under the FTCA, the government can only be sued 'under circumstances where the United States, if a private person, would be liable to the claimant in accordance with the law of the place where the act or omission occurred.' 28 U.S.C. S 1346(b). Thus, the FTCA does not apply to conduct that is uniquely governmental, that is, incapable of performance by a private individual.

[rjv]

So, it's twice as dangerous to go to the hospital than it is to drive a car? I find this a little hard to believe.

i work as a medical physicist who contracts out of various hospitals and have seen some teaching hospitals that i would never allow myself to be admitted to. not hard for me to believe at all.

[DarrinS]

i work as a medical physicist who contracts out of various hospitals and have seen some teaching hospitals that i would never allow myself to be admitted to. not hard for me to believe at all.

100,000 per year doesn't seem high to you?

That's about how many American casualties we'd have in Iraq if we stayed there for 120 years.

I'd say that there's a lot of subjectivity in that 100,000 figure.

[LnGrrrR]

A question: What are the negatives of tort reform? I've only heard the side that's for it.

[FuzzyLumpkins]

You can't sue the fed. I don't think.

Yes you can. You cannot sue the military but there are cases involving government agencies all the time.

[coyotes_geek]

A question: What are the negatives of tort reform? I've only heard the side that's for it.

I've got the same question. It seems to me that the only ones against tort reform are trial lawyers and those who are going to automatically be against whatever it is that republicans are for. So long as the direct economic damages aren't capped, what's the harm in limiting non-economic damages?

[rjv]

100,000 per year doesn't seem high to you?

That's about how many American casualties we'd have in Iraq if we stayed there for 120 years.

I'd say that there's a lot of subjectivity in that 100,000 figure.

from the CDC:

HAIs account for an estimated 107 million infections and 99,000 deaths per year and affect 5-10 % patients anually. this adds up to 20,000,000,000 dollars per year to healthcare costs.

i've personally witnessed health care works hold no regard whatsoever for standard hygiene procedures when dealing with patients.

http://www.cdc.gov/ncidod/dhqp/pdf/hicpac/HHSpresentationHICPAC_11_08.pdf

[SnakeBoy]

A question: What are the negatives of tort reform? I've only heard the side that's for it.

I don't know the details of how Texas tort reform affects cases of gross negligence but the potential downside is that if it is not done correctly it will not provide enough financial incentive for hospitals to change their practices or get rid of incompetent physicians. There is quite a bit of dishonesty going on here as far as what constitutes negligence. I don't support any caps in the cases blatant negligence/incompetence. Amputating the right leg of someone who was supposed to have their left leg amputated for example.

The number being used in this thread (~100k) is referencing hospital borne infection though. It is dishonest to imply that all of those or even the majority are do to negligence. Opportunistic bacteria are called opportunistic for a reason and as we enter into the post antbiotic era you can only expect to see those numbers go up. It is also dishonest to use that as a condemnation of our healthcare system. We have a 100 thousand deaths from hospital borne infections as compared to 12-14 thousand in the Canadian healthcare system. So we are in fact doing a better job controlling these infections than they are in the Canadian system.

As far as the OP, I can tell you that my wife's malpractice insurance went from $18k/yr to 11k/yr after tort reform. So it has had a positive impact. However Texas tort reform has not done enough to end the practice of defensive medicine. I don't know and have heard any good proposals on how to better acheive that. Much of it has to with Texas physicians still being in the habit of practicing defensive medicine so any further reform would have to include guidelines and legal education for physicians on how to reduce the cost of healthcare without placing themselves at risk legally.

[DarrinS]

from the CDC:

HAIs account for an estimated 107 million infections and 99,000 deaths per year and affect 5-10 % patients anually. this adds up to 20,000,000,000 dollars per year to healthcare costs.

i've personally witnessed health care works hold no regard whatsoever for standard hygiene procedures when dealing with patients.

http://www.cdc.gov/ncidod/dhqp/pdf/hicpac/HHSpresentationHICPAC_11_08.pdf




So THIS is what you are counting as medical malpractice?

[rjv]

So THIS is what you are counting as medical malpractice?


Medical Malpractice occurs when a negligent act or omission by a doctor or other medical professional results in damage or harm to a patient.


Negligence by a medical professional can include an error in diagnosis, treatment, or illness management. If such negligence results in injury to a patient, a legal case for medical malpractice can arise against:

The doctor, if his or her actions deviated from generally accepted standards of practice; The hospital for improper care or inadequate training, such as problems with medications or sanitation;
Local, state or federal agencies that operate hospital facilities.
http://www.statelawyers.com/Practice/Practice_Detail.cfm/PracticeTypeID:63

hospitals also fall under the auspices of corporate negligence.

as a medical physicist who contracts, i myself need malpractice insurance coverage.

[FuzzyLumpkins]

Medical Malpractice occurs when a negligent act or omission by a doctor or other medical professional results in damage or harm to a patient.


Negligence by a medical professional can include an error in diagnosis, treatment, or illness management. If such negligence results in injury to a patient, a legal case for medical malpractice can arise against:

The doctor, if his or her actions deviated from generally accepted standards of practice; The hospital for improper care or inadequate training, such as problems with medications or sanitation;
Local, state or federal agencies that operate hospital facilities.
http://www.statelawyers.com/Practice/Practice_Detail.cfm/PracticeTypeID:63

hospitals also fall under the auspices of corporate negligence.

as a medical physicist who contracts, i myself need malpractice insurance coverage.

What is a medical physicist? The reason I ask is because I am highly considering going back to school for biomechanical engineering.

[SnakeBoy]

Medical Malpractice occurs when a negligent act or omission by a doctor or other medical professional results in damage or harm to a patient.


Negligence by a medical professional can include an error in diagnosis, treatment, or illness management. If such negligence results in injury to a patient, a legal case for medical malpractice can arise against:

The doctor, if his or her actions deviated from generally accepted standards of practice; The hospital for improper care or inadequate training, such as problems with medications or sanitation;
Local, state or federal agencies that operate hospital facilities.
http://www.statelawyers.com/Practice/Practice_Detail.cfm/PracticeTypeID:63

hospitals also fall under the auspices of corporate negligence.

as a medical physicist who contracts, i myself need malpractice insurance coverage.

Thanks for providing an excellent example of why tort reform is needed. Under this legal definition lawyers can sue for negligence in this case...
http://www.theatlantic.com/doc/200909/health-care

When you cut through the emotional aspect of this guys story it boils down to this. 83 year old man with multiple health issues develops pneumonia and ultimately dies from secondary infections due to his failing immune system. You may call this negligence, I call it life. We don't get to live forever.

[ChumpDumper]

Interesting. I didn't see anything about lower health costs brought about by tort reform.

Now Texas doctors are bitching about the increase in the number of complaints to the medical board. That number more than doubled the year after tort reform was enacted.

[rjv]

What is a medical physicist? The reason I ask is because I am highly considering going back to school for biomechanical engineering.

plainly put, it is physics applied to medicine, especially in the areas of medical imaging and radiotherapy. you will see mp's working is dosimetry or in programming algorithms for PET (positron emission topography) scans, MRIs and CTs. they can also train radiology techs, they monitor radiation exposure for health care providers as well as patients and may work with radiologists, oncologists and radiation therapists. i myself work with radiology picture, archiving and collection (PAC) systems. i did my graduate work at UT health science center and got certified in imaging informatics at the veterbi school of engineering at USC (it is an oline program by the way and is under the school of biomedical engineering). you probably have taken at least up to quantum physics and diff eq as well as some c++ classes so you can easily qualify for admission into a program.

[SnakeBoy]

plainly put, it is physics applied to medicine, especially in the areas of medical imaging and radiotherapy. you will see mp's working is dosimetry or in programming algorithms for PET (positron emission topography) scans, MRIs and CTs.

Maybe you can answer this question. Why is it that I can get an MRI on my dog for $400 but for a person it costs thousands? Same equipment/results or no?

[SnakeBoy]

Now Texas doctors are bitching about the increase in the number of complaints to the medical board. That number more than doubled the year after tort reform was enacted.

Always two sides to the story...


DOCTORS SUE TEXAS MEDICAL BOARD FOR MISCONDUCT – Cites institutional culture of retaliation & intimidation
December 21st, 2007 The entire Texas Medical Board (TMB) and its officials have been named in a lawsuit filed by the Association of American Physicians and Surgeons (AAPS). The complaint, filed this week in District Court in Texarkana, accuses the board of misconduct while performing its official duties, specifically:

1.Manipulation of anonymous complaints;
2.Conflicts of interest;
3.Violation of due process;
4.Breach of privacy; and
5.Retaliation against those who speak out.
“The situation has reached the crisis point for patients and doctors,” said Jane M. Orient, M.D, Executive Director of AAPS. “Our members are too afraid of retaliation to sue the Board as individuals.”

The lawsuit specifically points out misconduct by Roberta Kalafut, the Board president. The law suit claims that Kalafut “arranged for her husband to file anonymous complaints again other physicians, including her competitors in Abilene…”

She then “…worked inside the TMB, with other defendants, to discipline doctors based on anonymous complaints filed by her physician husband.”

The lawsuit also charges that Kalafut and Donald Patrick, Executive Director, knew about the conflict of interest of Keith Miller while he was Chair of the Disciplinary Process Review Committee. Miller served as plaintiffs’ witness in at least 50 cases brought before the Board without disclosing that to the disciplined doctors or the public.

During a marathon 11-and-a-half hour legislative hearing about the Texas Medical Board on October 23, 2007, Kalafut and Patrick admitted under oath that they were aware of the conflicts of interest.

“It seems clear from the sworn testimony before the legislative committee that they knew about the problems and had done what they could to hide them,” said Dr. Orient.


The lawsuit demands that the Court put an immediate stop to abuses by the Board, and that previous disciplinary actions tainted by the Board’s violations be re-opened.

“Doctors in Texas should not be forced to practice in this atmosphere of fear and intimidation,” said Dr. Orient. “Complaints from our members have identified the TMB as probably the worst in the country. It’s bad for patients when their doctors are afraid that doing the right thing could result in licensure action.”

[rjv]

Thanks for providing an excellent example of why tort reform is needed. Under this legal definition lawyers can sue for negligence in this case...
http://www.theatlantic.com/doc/200909/health-care

When you cut through the emotional aspect of this guys story it boils down to this. 83 year old man with multiple health issues develops pneumonia and ultimately dies from secondary infections due to his failing immune system. You may call this negligence, I call it life. We don't get to live forever.


As of 1999, in the United States alone, an estimated 27 million surgical procedures are performed each year. The CDC’s National Nosocomial Infections Surveillance (NNIS) system, established in 1970, monitors reported trends in nosocomial infections in U.S. acute-care hospitals.
Based on 1993 NNIS system reports, SSIs are the third most frequently reported nosocomial infection, accounting for 14% to 16% of all nosocomial infections among hospitalized patients. NIs are infections acquired in hospitals (yes, even pneumonia can be considered such an infection and that is why we distinguish between viral and bacterial forms of pneumonia). in larger hospitals the quick movement from patient to patient is an ideal way to spread pathogens. and everyone, not just the elderly, fall into the risk demographic. from the period between 1992-2002, there were 33,269 deaths in high risk nurseries, 19,059 in well baby nurseries and 417.946 deaths amongst adult and children outside of ICUs .

www.cdc.gov/ncidod/dhqp/pdf/hicpac/infections_deaths.pdf (http://www.cdc.gov/ncidod/dhqp/pdf/hicpac/infections_deaths.pdf)

as for the emotive aspect of this, hard for me to look at the picture that way. this isn't like triage and i am not machiavellan so i am not easily persuaded to be so nihilistic about medicine.

[ChumpDumper]

Always two sides to the story...So that accounts for all of the increase? These guys made 3000 complaints in one year?

I don't think so.

[rjv]

Maybe you can answer this question. Why is it that I can get an MRI on my dog for $400 but for a person it costs thousands? Same equipment/results or no?

that depends on what kind of MRI is being done. it is possible that an MRI on a dog could run as high as that for a human if a pet owner was willing to pay for the more expensive types (e.g., a brain MRI is far more expensive than one for the shoulder). also, your vet was probably the only one running the MRI, that is, he (or she) acted as a radiology tech, radiologist and medical physicist all at once.

[TeyshaBlue]

plainly put, it is physics applied to medicine, especially in the areas of medical imaging and radiotherapy. you will see mp's working is dosimetry or in programming algorithms for PET (positron emission topography) scans, MRIs and CTs. they can also train radiology techs, they monitor radiation exposure for health care providers as well as patients and may work with radiologists, oncologists and radiation therapists. i myself work with radiology picture, archiving and collection (PAC) systems. i did my graduate work at UT health science center and got certified in imaging informatics at the veterbi school of engineering at USC (it is an oline program by the way and is under the school of biomedical engineering). you probably have taken at least up to quantum physics and diff eq as well as some c++ classes so you can easily qualify for admission into a program.

Sounds like a pretty interesting gig. :king

[SnakeBoy]

So that accounts for all of the increase? These guys made 3000 complaints in one year?

I don't think so.

Increase in what?

http://www.tmb.state.tx.us/agency/statistics/enforce/inv.php

[SpurNation]

Instead of handing down "one size fits all" mandates on how it's going to be, Washington should be enabling states to set their own agendas, and solve their own problems, when it comes to health care.



I wouldn't mind if it meant regarding all matters within that state.

[ChumpDumper]

Increase in what?

http://www.tmb.state.tx.us/agency/statistics/enforce/inv.phpAfter the $250,000 cap was imposed, the number of complaints against Texas doctors to the Medical Board rose from 2,942 to 6,000 in one year. More than half those complaints were about the quality of medical care.

http://www.mysanantonio.com/health/52925462.html

[SnakeBoy]

that depends on what kind of MRI is being done. it is possible that an MRI on a dog could run as high as that for a human if a pet owner was willing to pay for the more expensive types (e.g., a brain MRI is far more expensive than one for the shoulder). also, your vet was probably the only one running the MRI, that is, he (or she) acted as a radiology tech, radiologist and medical physicist all at once.

Ok that makes sense, especially the last part. Almost all the lab work, cultures, x-rays, echo, and the MRI was done in-house by the vet. It was expensive but would have been completely unaffordable if it cost the same as human medicine.

[SnakeBoy]

After the $250,000 cap was imposed, the number of complaints against Texas doctors to the Medical Board rose from 2,942 to 6,000 in one year. More than half those complaints were about the quality of medical care.

http://www.mysanantonio.com/health/52925462.html

Oh ok, those numbers don't jive with TMB's own statistics but since lawyer gave those stats to a local reporter who then published them they must be true.

[SpurNation]

Let me get this straight. Under the current Tort Reform if a physician or hospital makes a million dollar mistake all that can be awarded in a suit is $250,000?

[SnakeBoy]

Let me get this straight. Under the current Tort Reform if a physician or hospital makes a million dollar mistake all that can be awarded in a suit is $250,000?


We capped non-economic damages at $250,000 per defendant, or up to $750,000 per incident, while placing no cap on more easily determined economic damages, such as lost wages or cost of medical care due to injury.

[ChumpDumper]

Oh ok, those numbers don't jive with TMB's own statistics but since lawyer gave those stats to a local reporter who then published them they must be true.I'm just saying what I read -- there are several sources with the same number. The article in mysa is a nice one about the near complete lack of a medical error reporting system in Texas.

And where's the savings?

[coyotes_geek]

The article Chump linked did say the number of lawsuits fell dramatically once tort reform kicked in. I'd be curious to know how many people pre-tort reform were just suing their doctors and not bothering with filing official complaints. I have a hard time believing that tort reform and the corresponding drop in malpractice insurance premiums caused some massive reduction in the quality of health care doctors started providing. It's not like if everyone's car insurance got cut in half we'd all start going out of our way to drive recklessly.

[exstatic]

Strangely enough, after "tort reform" my medical costs have skyrocketed. I thought this was going to make it cheaper to care for people!

[SnakeBoy]

I'm just saying what I read -- there are several sources with the same number. The article in mysa is a nice one about the near complete lack of a medical error reporting system in Texas.

Well that's one of the big problems with the healthcare topic. It's so easy to spin the stats depending on your position.



And where's the savings?

I think we've been through this in a past thread. Texas Tort reform was designed to keep physicians and insurers in the state. It has worked in those regards but I don't think will result in great savings. The argument is made that because we have more competition among insurers that the cost is lower than it would have been had insurers continued to flee the state. I don't know how to find meaningful stats on that. I just know I'm happy with my policy and it's not too expensive.

More needs to be done to eliminate defensive medicine as I said. I don't know exactly how they could do that, nobody on either side has made any specific proposals that make sense to me.

[exstatic]

States without "tort reform" still have doctors. There's no mass fleeing.

[ChumpDumper]

Well that's one of the big problems with the healthcare topic. It's so easy to spin the stats depending on your position.Well according to their own data, the number of litigations and disciplinary actions has increased quite a bit.



I think we've been through this in a past thread. Texas Tort reform was designed to keep physicians and insurers in the state. It has worked in those regards but I don't think will result in great savings. The argument is made that because we have more competition among insurers that the cost is lower than it would have been had insurers continued to flee the state. I don't know how to find meaningful stats on that. I just know I'm happy with my policy and it's not too expensive.

More needs to be done to eliminate defensive medicine as I said. I don't know exactly how they could do that, nobody on either side has made any specific proposals that make sense to me.It's not defensive medicine anymore with tort reform, yet it is still being done. Testing is a cash cow.

[DarrinS]

I'm just saying what I read -- there are several sources with the same number. The article in mysa is a nice one about the near complete lack of a medical error reporting system in Texas.

And where's the savings?



Greedy hospitals and doctors will just pocket the savings. Those doctors have no principles -- they'll cut off a diabetic's foot to make some cash. Obama said so:

SG56B2et4M8

[ChumpDumper]

Look, I'm posting YouTubes from work again!I'm in favor of maggot therapy to eliminate necrotic tissue in diabetic foot ulcers. Insurance should cover it.

[SpurNation]

We capped non-economic damages at $250,000 per defendant, or up to $750,000 per incident, while placing no cap on more easily determined economic damages, such as lost wages or cost of medical care due to injury.

This makes more sence and an explainable reason why malpractice insurance might rise 25% because many times it cost 4 to 5 times more to fix a mistake. It also makes sense why the insurance companies are being targeted regarding trying to pass the health bill. Using malpractice premiums as an excuse as to why it needs to pass.

Now my next question. If this bill is passed...will the government be allowed to sue a physician, hospital or pharmeceutical company for neglegence in treatment of a person being provided this insurance?

[DarrinS]

I still need several years of non-stop posting to catch up to your ridiculous post count CHump.

[ChumpDumper]

I still need several years of non-stop posting from work to catch up to your ridiculous post count CHump.

[rjv]

Well that's one of the big problems with the healthcare topic. It's so easy to spin the stats depending on your position.


very true indeed. one example is that it would be just as easy to say that there are suits against doctors for the sake of getting money (which i am sure is quite true) and then there can be some who argue that there are many patients who could have sued for malpractice but never did due to being intimidated by the process (which i am sure is true as well).

[DarrinS]

I wonder why doctors aren't coming out in droves in support of ObamaCare/KennedyCare?

[DarrinS]

Look at me! I can spoof the quote feature! WEEEEEEE! Well, time to go smoke some pole.

[ChumpDumper]

Look at me! I'm posting about gay sex from work!

Again!

I can't help myself!

[SnakeBoy]

Well according to their own data, the number of litigations and disciplinary actions has increased quite a bit.

So has their staff and so has the population. Like I said, easy to spin the numbers.



It's not defensive medicine anymore with tort reform, yet it is still being done. Testing is a cash cow.

First part doesn't even make sense in response to what I've said. Second part is not true. Most of the testing is not done in house and the docs aren't making a dime on it so there isn't any financial reason for them to do it. No physicians that I know of are doing PSA tests in house, they aren't making money on them, and it's a completely unreliable test. So why do they do them? To cover their ass.

[ChumpDumper]

So has their staff and so has the population. Like I said, easy to spin the numbers.Is it a 1:1 ratio?


First part doesn't even make sense in response to what I've said. Second part is not true. Most of the testing is not done in house and the docs aren't making a dime on it so there isn't any financial reason for them to do it. No physicians that I know of are doing PSA tests in house, they aren't making money on them, and it's a completely unreliable test. So why do they do them? To cover their ass.But there is no reason to ass cover anymore. And don't think there is absolutely no possible financial motive for doctors. That's simply naive.

[DarrinS]

But there is no reason to ass cover anymore. And don't think there is absolutely no possible financial motive for doctors. That's simply naive.


Doctors are greedy a-holes.

[ChumpDumper]

Doctors are greedy a-holes.Some most certainly are. Others are not.

[George Gervin's Afro]

Did insurance become more affordable in Texas after tort reform was passed? That's the question.

[SpurNation]

Did insurance become more affordable in Texas after tort reform was passed? That's the question.

Good question.

[ChumpDumper]

Did insurance become more affordable in Texas after tort reform was passed? That's the question.Texas families saw their health insurance premiums soar 40 percent in five years — 10 times faster than their incomes increased, according to a report being released today by a national foundation that promotes health care improvement.

Nationally, Texas ranked third — behind Oklahoma and Idaho — in premium increases from 2001 to 2005, according to the report on employer-offered insurance by the Robert Wood Johnson Foundation in Princeton, N.J.

At the same time, Texas ranked No. 1 in the percentage of residents without insurance. In 2005-06, that figure was 27 percent. The state had 5.5 million of the nation's 47 million uninsured people.

http://www.palmbeachpost.com/shared/content/shared/money/stories/2008/04/0429insurance_FN.html

I'm going to say no.

[George Gervin's Afro]

Texas families saw their health insurance premiums soar 40 percent in five years — 10 times faster than their incomes increased, according to a report being released today by a national foundation that promotes health care improvement.

Nationally, Texas ranked third — behind Oklahoma and Idaho — in premium increases from 2001 to 2005, according to the report on employer-offered insurance by the Robert Wood Johnson Foundation in Princeton, N.J.

At the same time, Texas ranked No. 1 in the percentage of residents without insurance. In 2005-06, that figure was 27 percent. The state had 5.5 million of the nation's 47 million uninsured people.

http://www.palmbeachpost.com/shared/content/shared/money/stories/2008/04/0429insurance_FN.html

I'm going to say no.


We're #1! We're #1

[George Gervin's Afro]

Didn't Wild Cobra mention he could connect the dots?

[boutons_deux]

A disadvantage is the with state court rewards capped at $250K, lawyers' slice is too low for them to risk their time.

And trying to get into federal court is even more expensive.

So many have the court room door slammed in their faces.

"Everybody gets their day in court" .... if you can afford it. Like anything else in USA, the legal system is for sale.

[SonOfAGun]

Are you saying a welfare check will not be enough for me to enjoy this country's legal system?

I guess I better find work.

[FuzzyLumpkins]

plainly put, it is physics applied to medicine, especially in the areas of medical imaging and radiotherapy. you will see mp's working is dosimetry or in programming algorithms for PET (positron emission topography) scans, MRIs and CTs. they can also train radiology techs, they monitor radiation exposure for health care providers as well as patients and may work with radiologists, oncologists and radiation therapists. i myself work with radiology picture, archiving and collection (PAC) systems. i did my graduate work at UT health science center and got certified in imaging informatics at the veterbi school of engineering at USC (it is an oline program by the way and is under the school of biomedical engineering). you probably have taken at least up to quantum physics and diff eq as well as some c++ classes so you can easily qualify for admission into a program.

sounds very cool. everything but the quantum mechanics. ive read some oppenheimer and feynman but never anything formal. QED just looks like a big pain in the ass.

regardless thanks for the response.

[Nbadan]

...big surprise Perry doing the bidding of his corporate overlords, what a joke...i'm no fan of Hutch but Perrys got to go...

[rjv]

I can likely guess which hospitals...:lol


yes sir. we will just keep mum on that one as it should be obvious to most.

[rjv]

QED is really overstated in a lot of curriculum. QED often took years if not decades to produce for a lot of Quantum physics, which course often make you replicate in a few minutes. Most people just memorize the proof algorithms, which I highly recommend. Quantum physics is statistical without certainty (even though it attempts to quantize solutions), an analogy I like to use is: quantum physics is as to precise physics as therapy is as to a cure. Essentially, what it is is just a way to get things going and make money. I wouldn't take it as point of stoppage.

not literally, of course, but i've always joked that quantum mechanics is the point at which physics becomes mystical (or at least downright philosophical). it's a lot like hollinger's NBA analysis. :lol

[TeyshaBlue]

not literally, of course, but i've always joked that quantum mechanics is the point at which physics becomes mystical (or at least downright philosophical). it's a lot like hollinger's NBA analysis. :lol

Hollinger wishes.
At least the study of quantum mechanics makes some sense.:lol

[rjv]

Hollinger wishes.
At least the study of quantum mechanics makes some sense.:lol

touche'.

[FromWayDowntown]

A disadvantage is the with state court rewards capped at $250K, lawyers' slice is too low for them to risk their time.

Someone asked a few pages ago about the disadvantages of tort reform in the medical context, and I think this is probably the biggest one. A significant majority of those who would be plaintiffs in medical malpractice claims lack the money needed to fund that litigation. So, if they're going to sue, they depend on lawyers who take those cases on a contingency fee basis and foot the bill for the expenses of litigation -- which are substantial in a med mal context, if only because med mal requires expert witnesses, who are necessarily doctors, who don't offer expert opinions on the cheap.

Economically, no sane attorney is going to take on the representation in a med mal case unless relatively likely to get back the funds put into undertaking the representation (that concern is certainly not unique to lawyers; most professionals don't just work for free). That means that people with real claims, but not real big claims, are obligated to either fund very expensive litigation or simply let even valid claims go. Certainly, the tort reform net weeds out some frivolous claims -- though I know that it doesn't completely accomplish that result -- but it absolutely weeds out the legitimate claims that have small dollar values.

[LnGrrrR]

Someone asked a few pages ago about the disadvantages of tort reform in the medical context, and I think this is probably the biggest one. A significant majority of those who would be plaintiffs in medical malpractice claims lack the money needed to fund that litigation. So, if they're going to sue, they depend on lawyers who take those cases on a contingency fee basis and foot the bill for the expenses of litigation -- which are substantial in a med mal context, if only because med mal requires expert witnesses, who are necessarily doctors, who don't offer expert opinions on the cheap.

Economically, no sane attorney is going to take on the representation in a med mal case unless relatively likely to get back the funds put into undertaking the representation (that concern is certainly not unique to lawyers; most professionals don't just work for free). That means that people with real claims, but not real big claims, are obligated to either fund very expensive litigation or simply let even valid claims go. Certainly, the tort reform net weeds out some frivolous claims -- though I know that it doesn't completely accomplish that result -- but it absolutely weeds out the legitimate claims that have small dollar values.

So, if I'm reading you right, are you positing that if claims go down, it is most liekly not due to the efficacy of the reform in eliminating, but merely that poorer people were unable to attain lawyers to sue? Do you believe that the frivolous claims eliminated aren't worth the weight of the people who can't afford to sue but have a non-frivolous claim?

[jman3000]

I think that certain limits need to be set in certain situations... perhaps an investigative unit designed to check the validity of lawsuits. Frivolous lawsuits aren't as major as people would have you believe, although they are large enough to the point that something should be done.

If some stupid bitch sues a doctor for 5 million for giving her a pill she didn't know she was allergic to and she breaks out in hives for a week... that should be thrown out or perhaps give her 500 bucks or something meager along those lines.

On the other hand, if a doctor leaves his Rolex in some dudes stomach and causes him to get an infection and nearly lose his life... that asshole should get ass raped financially.

Maybe something along the lines of misdemeanors and felonys. Depending on the amount of damage/pain caused there should be certain guidelines that limit the amount of compensation somebody gets. Since pain is such a relative term it could run into problems, but fuck it.

I don't think blanket caps on everything is smart or fair.

[FromWayDowntown]

So, if I'm reading you right, are you positing that if claims go down, it is most liekly not due to the efficacy of the reform in eliminating, but merely that poorer people were unable to attain lawyers to sue? Do you believe that the frivolous claims eliminated aren't worth the weight of the people who can't afford to sue but have a non-frivolous claim?

I'm saying that the effort to eliminate frivolous claims also has a strong tendency to insulate the medical profession from smaller suits that have been rendered economically disadvantageous for people who are actually injured.

I'm also saying that the effort to eradicate frivolous claims has succeeded, but only to an extent. There are still frivolous med mal suits being filed in Texas, even as the overall number of med mal suits in this state has fallen.