National Review: Welcome to the Vast Right-Wing Conspiracy

[spursncowboys]

Welcome to the Vast Right-Wing Conspiracy
A team of NPR reporters unearths the truth about health care.

By Stephen Spruiell

In May 2008, Chicago Public Radio teamed up with National Public Radio (NPR) to produce an episode of the show This American Life called “The Giant Pool of Money.” The episode garnered widespread praise and won several awards for explaining the subprime-mortgage crisis with clarity and concision. It was such a success that NPR created a podcast, Planet Money, featuring the same team of reporters and producers. Planet Money covered the financial collapse last fall and continues to file jargon-free reports on the economy three times a week.

A few weeks ago, that crew put together another big project, this time a two-parter of This American Life and several subsequent podcasts devoted to the subject of health care. As in “The Giant Pool of Money,” the reporting was clear and even-handed. The team’s correspondents sought out industry professionals, economists, and patients. (They ignored politicians, by and large.) They surveyed the history of the American health-care system and drew some conclusions about why it has so many problems. And, if you’re someone who expects a certain amount of leftishness from NPR, those conclusions might surprise you.

1. Medical-malpractice lawsuits drive up the cost of health care. The first episode began by defining the problem: The average cost of a health-insurance policy for a family of four doubled between 2000 and 2007, host Ira Glass said, and it is projected to double again in the next seven years. Health-care costs are spiraling out of control, eating into the wages of those who have insurance and making it harder for the uninsured to buy it. Why? The answer is complex, but one of the problems the NPR team identified is that doctors practice what’s known as defensive medicine. That is to say, they order tests and perform procedures that their patients might not need, out of fear that otherwise they might get sued.

The NPR team produced several stories on how defensive medicine drives up costs, including one about a doctor named Dan Merenstein. As a third-year resident, Merenstein counseled a 53-year-old man on the benefits and risks of getting a PSA screening (a common test for prostate cancer). Merenstein told his patient that he thought the risks outweighed the benefits: False positives are common, follow-ups invasive and potentially harmful. The man declined the test.

The man was later diagnosed with a fatal prostate cancer, a kind that early detection probably would not have helped. He nevertheless sued Merenstein and his residency program. The plaintiff’s lawyers argued that Merenstein shouldn’t have given the man a choice on whether to have the test. “The jury . . . rejected the idea of following the guidelines based on evidence,” Merenstein said. “They took this approach that this thing called evidence-based medicine is just a way to save money, just a way to ration care.”

The verdict left Merenstein alone, but found his residency program liable for $1 million. He told NPR that it’s hard not to see patients as potential plaintiffs. He says he still counsels patients on the potential drawbacks of the expensive, not-always-necessary screening, but he admits that he gives patients a little push by telling them that most people do get the test.

2. Insurance companies are not evil. This summer, amid all the town-hall pushbacks against Obamacare, Nancy Pelosi lashed out at private insurance companies: “They are the villains in this,” she said. “They’ve been immoral all along in how they have treated the people. . . . You know, the litany of it all.”

Many mainstream reporters know the litany of it all, or at least they think they do. But NPR actually probed this received wisdom, and found a lot of holes. For instance, a former insurance executive named Wendell Potter had a conversion experience and now goes around the country talking about all the bad things insurance companies do to save money. Potter is fond of telling one story about how Aetna purged 8 million people from its insurance rolls and subsequently saw its stock price go up. Taking away people’s coverage for profit: proof positive of insurance-company greed.

“The truth of the story,” producer Sarah Koenig explained, “is a little more complicated, a little less Machiavellian.” In 2001, Aetna was losing $1 million a day. Aetna did two things to turn the company around: It raised premiums, and it pulled out of markets where it did not have a large presence. It turns out, the less competition an insurance company faces in a particular market, the cheaper it can price its products, and the lower premiums are for the insured. Why? Because insurance companies have to wield a lot of clout in order to bargain effectively with the large health-care provider groups in a given area.

Obama says, “One of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest.” But if the public option would actually weaken dominant players in the insurance market and concentrate more pricing power in the hands of provider groups, it would drive health-care costs up.

3. Our reliance on third-party payers is at the heart of the problem. So if insurance-company greed isn’t to blame, what does ail our health-care system? NPR’s reporting points to what economists call the “third-party-payer problem.” As David Goldhill pointed out in a must-read article for The Atlantic earlier this year, you don’t get the bill for your medical care. Someone else gets the bill, and that distorts incentives for payers, providers, and consumers of health care.

The NPR team put together a couple of stories that illustrated this problem, but the most succinct explanation came from Adam Davidson and Alex Blumberg in a segment on the history of American health care. “We the consumers are totally separated from the cost of what we’re consuming,” Davidson said. “We get tests and procedures we don’t need because, well, why not? We’re not paying for it a la carte. Our employers are paying for part of it, our government is paying for part of it through . . . tax incentives.”

How did we end up with such an inefficient system? Prior to World War II, health insurance existed, but most people paid for medical care out of their own pockets. The government instituted price and wage controls during the war, but placed no controls on benefits, so companies turned to benefit packages as a means of competing for workers.

Wage and price controls made the third-party-payer system possible, but a different policy set it in stone: a change in the tax law allowing employers to deduct the cost of health benefits from their taxes. After the IRS ruled that employers did not have to pay taxes on health benefits for their workers, the proportion of the population getting health insurance through their employers went from 9 percent in 1940 to 63 percent of the population in 1953.

4. Obamacare won’t fix it. The NPR team did not come right out and say it, but its reporting points to this conclusion. Alex Blumberg put it this way:

Markets are usually really good at controlling costs. When they work best, products come into existence like cell phones or stockings, they start expensive and then they get cheaper and better. But markets don’t guarantee that everyone can afford the things they need. Government can be good at that, ensuring universal access. But when you’re paying for everybody, it’s hard to control costs.

For [economic historian] Melissa Thomasson, she says that either extreme — a competitive market system where consumers know what price they’re paying and what they’re getting, which would drive the cost of health care down, or a government-run system which would cover everyone — would be better than the accidental mixture that we have today: a really expensive system that doesn’t cover us all.

Obamacare would pour even more cement over this broken system. It’s not a single-payer system that would cover everyone and control costs through price controls and rationing. Nor is it a market-oriented reform that would empower consumers by equalizing the tax treatment of health insurance and reducing the role of government in the market. Instead, it makes health insurance mandatory for everyone. It bends the cost curve up by subsidizing insurance without putting any real cost-control measures in place. And it creates a public option that would weaken the power of insurance companies to bargain with hospitals for better rates.

Democrats have accused conservatives of spreading fear and misinformation about their health-care legislation. They might want to look into this new and most insidious propaganda arm of the conservative movement: NPR.

[ChumpDumper]

So how much did tort reform lower health care costs in Texas?

[symple19]

So how much did tort reform lower health care costs in Texas?

I don't know

How much did it lower them in Mississippi?

[ChumpDumper]

Good question.

[CosmicCowboy]

So how much did tort reform lower health care costs in Texas?

It's like trying to define how many jobs have been "created or saved".

I know that the average for a family in Massachusetts is $14,000 a year and I pay closer to $10,000 in Texas.

[George Gervin's Afro]

Welcome to the Vast Right-Wing Conspiracy
A team of NPR reporters unearths the truth about health care.

By Stephen Spruiell

In May 2008, Chicago Public Radio teamed up with National Public Radio (NPR) to produce an episode of the show This American Life called “The Giant Pool of Money.” The episode garnered widespread praise and won several awards for explaining the subprime-mortgage crisis with clarity and concision. It was such a success that NPR created a podcast, Planet Money, featuring the same team of reporters and producers. Planet Money covered the financial collapse last fall and continues to file jargon-free reports on the economy three times a week.

A few weeks ago, that crew put together another big project, this time a two-parter of This American Life and several subsequent podcasts devoted to the subject of health care. As in “The Giant Pool of Money,” the reporting was clear and even-handed. The team’s correspondents sought out industry professionals, economists, and patients. (They ignored politicians, by and large.) They surveyed the history of the American health-care system and drew some conclusions about why it has so many problems. And, if you’re someone who expects a certain amount of leftishness from NPR, those conclusions might surprise you.

1. Medical-malpractice lawsuits drive up the cost of health care. The first episode began by defining the problem: The average cost of a health-insurance policy for a family of four doubled between 2000 and 2007, host Ira Glass said, and it is projected to double again in the next seven years. Health-care costs are spiraling out of control, eating into the wages of those who have insurance and making it harder for the uninsured to buy it. Why? The answer is complex, but one of the problems the NPR team identified is that doctors practice what’s known as defensive medicine. That is to say, they order tests and perform procedures that their patients might not need, out of fear that otherwise they might get sued.

The NPR team produced several stories on how defensive medicine drives up costs, including one about a doctor named Dan Merenstein. As a third-year resident, Merenstein counseled a 53-year-old man on the benefits and risks of getting a PSA screening (a common test for prostate cancer). Merenstein told his patient that he thought the risks outweighed the benefits: False positives are common, follow-ups invasive and potentially harmful. The man declined the test.

The man was later diagnosed with a fatal prostate cancer, a kind that early detection probably would not have helped. He nevertheless sued Merenstein and his residency program. The plaintiff’s lawyers argued that Merenstein shouldn’t have given the man a choice on whether to have the test. “The jury . . . rejected the idea of following the guidelines based on evidence,” Merenstein said. “They took this approach that this thing called evidence-based medicine is just a way to save money, just a way to ration care.”

The verdict left Merenstein alone, but found his residency program liable for $1 million. He told NPR that it’s hard not to see patients as potential plaintiffs. He says he still counsels patients on the potential drawbacks of the expensive, not-always-necessary screening, but he admits that he gives patients a little push by telling them that most people do get the test.

2. Insurance companies are not evil. This summer, amid all the town-hall pushbacks against Obamacare, Nancy Pelosi lashed out at private insurance companies: “They are the villains in this,” she said. “They’ve been immoral all along in how they have treated the people. . . . You know, the litany of it all.”

Many mainstream reporters know the litany of it all, or at least they think they do. But NPR actually probed this received wisdom, and found a lot of holes. For instance, a former insurance executive named Wendell Potter had a conversion experience and now goes around the country talking about all the bad things insurance companies do to save money. Potter is fond of telling one story about how Aetna purged 8 million people from its insurance rolls and subsequently saw its stock price go up. Taking away people’s coverage for profit: proof positive of insurance-company greed.

“The truth of the story,” producer Sarah Koenig explained, “is a little more complicated, a little less Machiavellian.” In 2001, Aetna was losing $1 million a day. Aetna did two things to turn the company around: It raised premiums, and it pulled out of markets where it did not have a large presence. It turns out, the less competition an insurance company faces in a particular market, the cheaper it can price its products, and the lower premiums are for the insured. Why? Because insurance companies have to wield a lot of clout in order to bargain effectively with the large health-care provider groups in a given area.

Obama says, “One of the best ways to bring down costs, provide more choices, and assure quality is a public option that will force the insurance companies to compete and keep them honest.” But if the public option would actually weaken dominant players in the insurance market and concentrate more pricing power in the hands of provider groups, it would drive health-care costs up.

3. Our reliance on third-party payers is at the heart of the problem. So if insurance-company greed isn’t to blame, what does ail our health-care system? NPR’s reporting points to what economists call the “third-party-payer problem.” As David Goldhill pointed out in a must-read article for The Atlantic earlier this year, you don’t get the bill for your medical care. Someone else gets the bill, and that distorts incentives for payers, providers, and consumers of health care.

The NPR team put together a couple of stories that illustrated this problem, but the most succinct explanation came from Adam Davidson and Alex Blumberg in a segment on the history of American health care. “We the consumers are totally separated from the cost of what we’re consuming,” Davidson said. “We get tests and procedures we don’t need because, well, why not? We’re not paying for it a la carte. Our employers are paying for part of it, our government is paying for part of it through . . . tax incentives.”

How did we end up with such an inefficient system? Prior to World War II, health insurance existed, but most people paid for medical care out of their own pockets. The government instituted price and wage controls during the war, but placed no controls on benefits, so companies turned to benefit packages as a means of competing for workers.

Wage and price controls made the third-party-payer system possible, but a different policy set it in stone: a change in the tax law allowing employers to deduct the cost of health benefits from their taxes. After the IRS ruled that employers did not have to pay taxes on health benefits for their workers, the proportion of the population getting health insurance through their employers went from 9 percent in 1940 to 63 percent of the population in 1953.

4. Obamacare won’t fix it. The NPR team did not come right out and say it, but its reporting points to this conclusion. Alex Blumberg put it this way:

Markets are usually really good at controlling costs. When they work best, products come into existence like cell phones or stockings, they start expensive and then they get cheaper and better. But markets don’t guarantee that everyone can afford the things they need. Government can be good at that, ensuring universal access. But when you’re paying for everybody, it’s hard to control costs.

For [economic historian] Melissa Thomasson, she says that either extreme — a competitive market system where consumers know what price they’re paying and what they’re getting, which would drive the cost of health care down, or a government-run system which would cover everyone — would be better than the accidental mixture that we have today: a really expensive system that doesn’t cover us all.

Obamacare would pour even more cement over this broken system. It’s not a single-payer system that would cover everyone and control costs through price controls and rationing. Nor is it a market-oriented reform that would empower consumers by equalizing the tax treatment of health insurance and reducing the role of government in the market. Instead, it makes health insurance mandatory for everyone. It bends the cost curve up by subsidizing insurance without putting any real cost-control measures in place. And it creates a public option that would weaken the power of insurance companies to bargain with hospitals for better rates.

Democrats have accused conservatives of spreading fear and misinformation about their health-care legislation. They might want to look into this new and most insidious propaganda arm of the conservative movement: NPR.

Can you find a right wing blog or website to prove tort reform reduces healthcare costs? If you can't then you need to stop posting anything related to tort reform and healthcare...

[exstatic]

So how much did tort reform lower health care costs in Texas?

It didn't, because HC companies never lower premiums, and they never stop raising them. They simply pocketed the lower costs as profit, and we never saw any difference.

[EVAY]

I think it's pretty hard to deny that tort reform is needed, and that it COULD lower health care costs. If, as has been pointed out, Insurance companies pocket the savings, it wouldn't help, but there is no doubt that it COULD.

Besides the three areas defined in this article that need reform, another is the 'fee-for-service' aspect of medical payments to physicians, which is universally accepted as a large part of the high rate of increase in the costs of medical care.


SnC, this is a good contribution to the debate, I think.

I really wish that the republican party would have come up with something, in the 6 years in which they had complete control over the WH and Congress, that would address these issues, and simultaneously address the need for coverage for so many uninsured Americans.

Or they could have done it in the months during which the Democrats came up with their plans.

Instead, they did nothing. Actually, worse than nothing. During the time they were in control, they increased medicare costs without paying for it.

Democrats are doing what they always do...they are spending money on social issues that need to be addressed. They don't often do it particularly well, they don't often exhibit fiscal restraint when they do it, but you always know when they get elected that they will do [I][B]something [B][I] about the issue...that is their platform.

Republicans have forfeited their rights to complain with any credibility by doing NOTHING FOR SO DAMN LONG!!!! With health care costs having doubled between 2000 and 2007 for average Americans, and being scheduled to double again in the next 7 years unless something is done, how can Republicans look at voters with a staight face and claim that we should continue to do nothing?!!

[mogrovejo]

Why is doing something always better than doing nothing?

[EVAY]

Why is doing something always better than doing nothing?

It is not necessarily ALWAYS the case...but in THIS case, doing nothing leaves almost 40 million Americans with no medical insurance and the rest of us with premiums doubling every 7 years. THAT is not acceptable to me. Infact, MY premiums have MORE than doubled in the past 7 years.

If you cannot understand why the status quo is unacceptable you leave yourself open to the very things that got the democrats elected this time.

[clambake]

Why is doing something always better than doing nothing?

because they did nothing and still managed to blow the future out of the water.

don't get me wrong, it would be disingenuous if they pretended to care.

[Wild Cobra]

Can you find a right wing blog or website to prove tort reform reduces healthcare costs? If you can't then you need to stop posting anything related to tort reform and healthcare...
It was spelled out good in the article.

I suppose you want proof that 2+2=4 also.

[boutons_deux]

Blaming the costs of defensive medicine on frivolous lawsuits is, as usual for right-wingers, a total lie.

1. frivolous lawsuits that actually get into court, and won, are a tiny percentages of total medical malpractive lawsuits.

2. doctors MAKE MONEY from every test they order, whether the test is "needed" or "defensive". The most lucrative scam is when the doctors also own the medical labs.

3. capping liability payments at $250K in, eg TX, has shut the court house door for many medical malpractice victims because lawyers on contingency won't invest their time on the chance of winning their 30% of only $250K. This was probably one of the main hidden objectives of TX tort reform.

Context: 90K deaths/year in USA from avoidable medical errors. That ANNUAL kill rate of Americans would make Al Qaiada salivate.

The prostate cancer guy was responsible for his own decisions about tests and treatment, (just like taxpayers are responsible for their declarations, not the tax preparation service). If he didn't like his urologist's recommendation, he could have changed, cherry picked until he got one he liked.

Perhaps this guy was a VN vet polluted with Agent Orange, which has been shown to cause prostate cancer earlier and more aggressively than the general population. Then he would be another victim of the US boondoogle in VN.

"you don’t get the bill for your medical care"

Well, no, of course not. That's the whole point of paying your (health) insurance bills so your insurance company pays the medical bills out of the pool of premiums.

dubya's Medicare reform act, the one that created the horrible donut hole, also subsidized the for-profit insurance companies with $50B so they could compete with Medicare (aka "business friendly"), and simultaneously made illegal any attempt by the US govt to use its bulk purchasing power to get lower prices from BigPharma, which is the standard practice in all other countries with national health systems (aka "business friendly").

Do we ever hear from the Repugs about their own "health care reform" that has cost the US taxpayer 100s of $Bs?

The Repugs never met a citizen's tax dollar they wouldn't hesitate to give to their corporate financiers/enablers.

[clambake]

damn boutons, that was excellent.

good post.

[boutons_deux]

btw, the Repug plan to $50B-bribe private insurers into Medicare prescription drug system actually costs the govt 12-13% (ie, many $Bs/year) more than the public prescription plans.

Sorta like the Repugs paying mercernaries $100K+/year rather than paying US soldiers $30K/year for the same job. Of course, there weren't enough super patriots to man the Repugs bogus wars, so the liability-free mercenaries were needed, until the Banksters' Depression "liberated" jobless youngsters into the clutches of the military.

[spursncowboys]

btw, the Repug plan to $50B-bribe private insurers into Medicare prescription drug system actually costs the govt 12-13% (ie, many $Bs/year) more than the public prescription plans.

Sorta like the Repugs paying mercernaries $100K+/year rather than paying US soldiers $30K/year for the same job. Of course, there weren't enough super patriots to man the Repugs bogus wars, so the liability-free mercenaries were needed, until the Banksters' Depression "liberated" jobless youngsters into the clutches of the military.
You have so much trust that we don't need a link.

[boutons_deux]

http://todaysseniorsnetwork.com/part_d_failure.htm

http://www.emaxhealth.com/1275/72/34473/medicare-drug-plan-costs-rise-11-percent-more-surprises.html

The corps pocketed the tax-free $50B Repug subsidy from taxpayers and citizens got fuck all for it.

[Supergirl]

also, people who think NPRs coverage come out looking GOOD for people who oppose health care reform might want to check out PART TWO of the same coverage.

There are two episodes, one of which tries to understand why costs have gotten so high, the other of which critiques the entire health insurance system, esp employer-based health insurance, and provides a good history lesson on how we wound up with the current system we have.

They are both very good episodes:
#392: Someone Else's Money
#391: More is Less

both are available on NPR's website and iTunes, I'd highly recommend people check them out.

Also, if people haven't already checked out Atul Gawande's article in the New Yorker from about 6 months ago, check it out too: http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

[George Gervin's Afro]

It was spelled out good in the article.

I suppose you want proof that 2+2=4 also.

Defensive medicine is a part of the problem but tort reform hasn't had a great track record with success.. can you give us an example of how it succeeds?Texas passed tort reform legislation.....did that lower costs or make insurance more affordable?

[ChumpDumper]

It's like trying to define how many jobs have been "created or saved".So you were against the stimulus package because the results are not tangible to you.

Why are you for tort reform?


I know that the average for a family in Massachusetts is $14,000 a year and I pay closer to $10,000 in Texas.That pretty much is in line with the overall cost of living difference between the two states.

That can't be tied to tort reform either, so you guys really have no argument that tort reform lowers health care costs.

[Ignignokt]

http://www.atra.org/wrap/files.cgi/7964_howworks.html

chump got his wish.

[Ignignokt]

How Tort Reform Works

TEXAS: Tort Reform Spurs Economic Growth; Aids Access to Healthcare

In 2003, the Texas state Legislature passed H.B. 4 to further reform the state's civil justice system. The bill addressed issues such as: limits on noneconomic damages; product liability reform; punitive damages; medical liability reform joint and several liability; and class action reform. Voters also approved a constitutional amendment, Proposition 12, in 2003, which eliminates potential court challenges to the law that limited noneconomic damages to $750,000. Since the enactment of H.B. 4 and the subsequent passage of Proposition 12, Texas has made great strides in growing its economy and providing jobs and accessible healthcare to its citizens.

Success in the business community:

* Texas was awarded the 2004 Governor's Cup award for the largest number of job creation announcements (Site Selection Magazine, 3/05).
* Texas also was selected as the state with the best business climate in the nation by Site Selection Magazine (Site Selection Magazine, 3/05).

Successes in the medical community:

* The American Medical Association dropped Texas from its list of states in medical liability crisis (Houston Chronicle, 5/17/05).
* Malpractice claims are down and physician recruitment and retention are up, particularly in high risk specialties (Houston Chronicle, 5/17/05).
* The five largest Texas insurers cut rates, which will save doctors about $50 million, according to the AMA (Houston Chronicle, 5/17/05).
* Malpractice lawsuits in Harris County have dropped to about half of what they were in 2001 and 2002. There were 204 cases filed in 2004, compared with 441 in 2001 and 550 in 2002. There were 1,154 lawsuits filed in 2003, attributed to attorneys trying to file before the new law took effect (Houston Chronicle, 5/17/05).
* Harris County has seen a net gain of 689 physicians, an 8.4 percent increase, according to the Texas State Board of Medical Examiners (Houston Chronicle, 5/17/05).
* Texas Medical Liability Trust, the state's largest liability carrier, reduced its premiums by 17 percent (Houston Chronicle, 5/17/05).
* Fifteen new insurance companies have entered the Texas market (Associated Press, 2/16/05).
* Health Care Indemnity, the state's largest carrier for hospitals, cut rates by 15 percent in 2004 (Associated Press, 2/16/05).
* American Physicians Insurance Exchange and The Doctor's Company also reduced premiums (Associated Press, 2/16/05).
* The American Physicians Insurance Exchange saw a $3.5 million reduction in premiums for Texas physicians in 2005. In addition, beginning May 1, 2005, 2,2000 of the 3,500 physicians insured by the company would see an average drop of 5 percent in their premiums (The Heartland Institute, 5/1/05).

Texas: Tort Reform Spurs Economic Growth

In 1995 the Texas Legislature passed a series of bills to reform the state's civil justice system. These bills addressed: limits on punitive damages, joint and several liability, sanctions for filing frivolous suits, limits on venue shopping and out-of-state filings, modifications to deceptive trade practices and medical malpractice reform.

According to the study, The Impact of Judicial Reforms on Economic Activity in Texas, the total cost of the Texas tort system in 2000 was $15.482 billion. Without reforms, it is estimated that the total cost would have been $25.889 billion. Of the $10.407 billion in total direct savings, approximately $2.777 billion may be attributed to improvements at the national level while $7.630 billion in savings were from reforms in Texas. Of the total savings, $2.542 billion went directly to benefit consumers.

The Perryman Group. The Impact of Judicial Reforms on Economic Activity in Texas Overall Economic Impact on State's Economy. (August 2000)

Facts to Consider: Benefits to Consumers

It is estimated that reforms enacted in 1995 resulted in savings of $2.542 billion that directly benefits consumers.

$1.796 billion in annual cost savings from reduced inflation ($216 per household)

$7.056 billion in annual total personal growth income ($862 per household)

The net result was a savings of $1,078 per year to the typical Texas household.

The Perryman Group. The Impact of Judicial Reforms on Economic Activity in Texas Overall Economic Impact on State's Economy. (August 2000)

MISSISSIPPI: Tort Reform Already Achieving Desired Results

In a 2004 legislative special session called by Governor Haley Barbour, the Mississippi Legislature passed H.B. 13, which included reforms relating to: product liability; joint and several liability; jury service; medical liability; and noneconomic damages. Improvements in the state's economy and healthcare system already are being demonstrated since the law took effect on Sept. 1, 2004.

Successes in the business community:

Businesses have made new investments in the state starting in 2004. These include:

* $35 million investment by Textron
* $3.5 million payroll by Winchester Ammunition
* $1.8 billion expansion by Fed Ex Ground
* $20 million investment by Kingsford Charcoal (The Clarion-Ledger, 2/27/05).

Successes in the medical community:

* The Medical Assurance Company of Mississippi (MACM), which provides medical malpractice insurance to about 70 percent of doctors in the state, announced a 5-percent decrease in premiums for 2006 (The Natchez Democrat, 10/19/05). MACM did not raise base premiums in 2004 or 2005, and previously had been raising rates annually up to 20 percent (Associated Press, 9/24/04).
* Mass Mutual Insurance Group, St. Paul Travelers, World Insurance Company, and Equitable Life Insurance Company are returning to Mississippi (The Clarion-Ledger, 2/27/05).

TORT REFORM AT A GLANCE: Other States Begin to Make Strides

Missouri

Expansion Management, a monthly business magazine, ranked Missouri as one of the leading states in the nation for having a business friendly climate that attracts industry and new jobs. Missouri, along with Ohio and Virginia, each had five metro areas earning top honors (Jefferson City News Tribune, 6/23/05).

New Jersey

In 1995, the state legislature passed the Affidavit of Merit Statute. The law provides that in any suit alleging professional malpractice or negligence, 'the plaintiff shall, within 60 days following the date of the filing of the answer to the complaint by the defendant, provide each defendant with an affidavit of an appropriate licensed person that there exists a reasonable probability that the care, skill or knowledge exercised or exhibited in the treatment, practice or work that is the subject of the complaint fell outside acceptable professional or occupational standards or treatment practicerthes.'

Enactment of the law coincides with a measured drop in the number of medical malpractice suits filed. In 2004, 1,493 medical malpractice suits were filed, a 24 percent decrease from 1997 when 1,971 suits were filed. 1997 is the earliest year for which data is available from the state Administrative Office of the Court (New Jersey Law Journal, 6/13/05).

West Virginia

After passing tort reform measures in 2003 that included a $250,000 cap on noneconomic damages, West Virginia has seen an increase in the number of new physicians in the state. According to the West Virginia Board of Medicine, 377 new physicians were licensed to the state in 2004, the most since 391 were licensed in 1999. The state previously had hit a low point with 305 new licenses in 2000 (The Heartland Institute, 5/1/05).

West Virginia Physician's Mutual, the states largest medical malpractice insurer has added 100 new doctors who had previously left West Virginia to its membership rolls. In addition, the company has applied in 2005 for a 5 percent reduction in premiums physicians pay for malpractice coverage. The president credits the reduced premiums and the addition of doctors to medical malpractice reforms that have been passed since 2001 (Charleston Gazette, 8/20/05).

Woodbrook Casualty Insurance, the state's largest private malpractice coverage provider serving about 250 doctors, sought a 3.9 percent rate decrease in 2005. The request must go to the state Insurance Commission for approval (Charleston Gazette, 8/20/05).

STUDIES: Noneconomic Damages Caps Led to Greater Percentage of Physicians

According to a study conducted by senior economists from the Center for Delivery, Organization, and Markets Agency for Healthcare Research and Quality, states where noneconomic damages are limited in medical malpractice cases have more physicians per capita than states without limits. The study found that:

* Counties in states with limits had 2.2 percent more physicians per capita
* Rural counties in states with limits had 3.2 percent more physicians per capita
* Rural counties in states with a $250,000 cap had 5.4 percent more OB-GYNs and 5.5 percent more surgical specialists per capita than rural counties in states with a cap above $250,000 (Health Tracking, 5/31/05).

According to a study in the Journal of the American Medical Association (JAMA), the adoption of direct medical malpractice reforms that limit the size of awards led to a greater growth in the overall supply of physicians. Three years after adoption of reforms, the study found that the physician supply increased by 3.3 percent. The direct reforms had a larger effect on:

* The supply of nongroup vs. group physicians
* The supply of most specialties with high malpractice insurance premiums
* States with high levels of managed care
* The supply through retirements and entries rather than through the propensity of physicians to move between states (Medical Society News, 5/25/05).

[Ignignokt]

In essence, Tort reform in states which passed it had an increase in doctors which allowed for more competition, which staved off price hikes or saved people money.

[Ignignokt]

We're a larger state than Massachussets, have a larger pool of poor masses, and have more illegals who don't foot medical bills, and yet we have a lower avg of healthcare cost, and that's with Mass, having a single payor system.

[spursncowboys]

In essence, Tort reform in states which passed it had an increase in doctors which allowed for more competition, which staved off price hikes or saved people money.
Not to mention all the money being spent inside the community, buying cars and houses- which all create and save jobs.

[ChumpDumper]

The net result was a savings of $1,078 per year to the typical Texas household.So what was the increase in medical premiums in Texas for the same time?

[ChumpDumper]

His studies have played a role in the creation and retention of hundreds of thousands of jobs.:lmao

He's a walking, talking stimulus package!

Of course you'll believe him.

[Ignignokt]

So what was the increase in medical premiums in Texas for the same time?

are you saying medical savings don't affect premiums?

[spursncowboys]

So what was the increase in medical premiums in Texas for the same time?
Premiums go up because costs go up. Tort reform has far more tangible benefits than not. Why is the liberal lerdership against tort reform? The tort reform that they were trying to pass in the Senate would have been the tort reform levels in California. It seems that alot of Libs are against tort reform because the conservatives thought of it. There are no core principle beliefs as to why all the libs are against it.

[ChumpDumper]

Premiums go up because costs go up. Tort reform has far more tangible benefits than not.I don't believe that the expansion of businesses that were already in Texas was a direct result of tort reform.

If you want to dodge the question, fine.

[ChumpDumper]

are you saying medical savings don't affect premiums?Well, that was indeed my question -- how much did it affect premiums?

Tell us all.

[spursncowboys]

I don't believe that the expansion of businesses that were already in Texas was a direct result of tort reform.

If you want to dodge the question, fine.
Premiums go up because cost goes up. There are many reasons for rising costs. People not paying their bills. Increasing prices to offset the expected lawsuits. etc.

[boutons_deux]

"increase in doctors which allowed for more competition"

do you really think sick people shop around for cheaper doctors?

the health care system is so fucking complicated, doctors and their staff have no idea of what what is going to cost, so searching for the lowest cost doctors is fool's errand.

price competition among doctors? GMAFB

[ChumpDumper]

Premiums go up because cost goes up. There are many reasons for rising costs. People not paying their bills. Increasing prices to offset the expected lawsuits. etc.So was Texas' rate of increase in premiums lower or higher than the average state since tort reform?

[Ignignokt]

So was Texas' rate of increase in premiums lower or higher than the average state since tort reform?

Such a liar, you just asked how it affects cost.


So you were against the stimulus package because the results are not tangible to you.

Why are you for tort reform?

That pretty much is in line with the overall cost of living difference between the two states.

That can't be tied to tort reform either, so you guys really have no argument that tort reform lowers health care costs.

[ChumpDumper]

The only argument I saw came from Perryman, a man who claims to have created or retained hundreds of thousands of jobs -- and his study had nothing at all to do with the tort reforms of 2003.

Maybe something a little more recent could be found, eh?

[spursncowboys]

So was Texas' rate of increase in premiums lower or higher than the average state since tort reform?
idk. However has tort reform hurt texas in anyway?

[ChumpDumper]

idk. However has tort reform hurt texas in anyway?I believe it has probably hurt more than a few people with legitimate medical torts that can't sue anymore.

Tort reform is sold as a panacea that will lower health care costs for consumers. For most of the consumers, that would mean a reduction in premiums, or at least the rate of increase in premiums. Has either of those things happened in Texas since 2003?

[George Gervin's Afro]

Not to mention all the money being spent inside the community, buying cars and houses- which all create and save jobs.

imaginary money? Did you notice anything curious about the article?

[George Gervin's Afro]

Premiums go up because costs go up. Tort reform has far more tangible benefits than not. Why is the liberal lerdership against tort reform? The tort reform that they were trying to pass in the Senate would have been the tort reform levels in California. It seems that alot of Libs are against tort reform because the conservatives thought of it. There are no core principle beliefs as to why all the libs are against it.

So according to you einstein the reason you are for tort reform is because you have core principals? You still haven't shown us anything to prove tort reform lowered the cots health care.

Your answer to premiums not going down is that it is because costs go up. If tort reform lowers costs then shouldn't premiums be lowered also? If tort reform does lower costs and the premiums keep rising, who did tort reform help? The same companies who are raising prices....

[mogrovejo]

It is not necessarily ALWAYS the case...but in THIS case, doing nothing leaves almost 40 million Americans with no medical insurance and the rest of us with premiums doubling every 7 years. THAT is not acceptable to me. Infact, MY premiums have MORE than doubled in the past 7 years.

If you cannot understand why the status quo is unacceptable you leave yourself open to the very things that got the democrats elected this time.

[The idea that republicans did nothing is hilarious. Republicans and Dems have been throwing money to the health-care system like crazy in the last sky-rocketing the funding of the National Institutes of Health, etc. The problem was that none of those measures did any good. But that just reinforces my point]

How do you know that the new situation is going to be an improvement over the status quo?

[George Gervin's Afro]

How do you know that the new situation is going to be an improvement over the status quo?

I guess the question to you is, how do you know it won't be an improvement?

[EVAY]

[The idea that republicans did nothing is hilarious. Republicans and Dems have been throwing money to the health-care system like crazy in the last sky-rocketing the funding of the National Institutes of Health, etc. The problem was that none of those measures did any good. But that just reinforces my point]

How do you know that the new situation is going to be an improvement over the status quo?

The new situation HAS to be better than the status quo because more people will be paying in to the system, thereby decreasing the risk for all (and theoretically, if the insurers pass the savings along, decreasing the premiums for everyone), and will ABSOLUTELY cover MILLIONS more Americans than are currently covered.

Come on, man, isn't there a shred of compassion anywhere for people who work hard but don't make enough money to get health insurance now?

How is it possible that you don't see that helping people like that (and there are millions of our fellow citizens in that predicament...you may even know a few, most people do) is an improvemnt? PLEASE, have you NO sense of compassion?

[boutons_deux]

"compassion"

... a four-letter word in the conservative vocabulary. Their hearts bleed, but it's black and toxic.

aka, "If you're poor, eat shit because you are shit." aka social Darwinism.

[mogrovejo]

The new situation HAS to be better than the status quo because more people will be paying in to the system, thereby decreasing the risk for all (and theoretically, if the insurers pass the savings along, decreasing the premiums for everyone), and will ABSOLUTELY cover MILLIONS more Americans than are currently covered.

Come on, man, isn't there a shred of compassion anywhere for people who work hard but don't make enough money to get health insurance now?

How is it possible that you don't see that helping people like that (and there are millions of our fellow citizens in that predicament...you may even know a few, most people do) is an improvemnt? PLEASE, have you NO sense of compassion?

This is a political discussion, no need to be reactionary or over-emotional.

I'm not sure what this has to do with compassion. Are you saying that communism was (and is), in fact, just compassion? There's no such thing as forced compassion or forced charity.

I still don't understand how do you know that doing something has to be better. More people paying into the system will decrease the risk for all why? It depends on the risk assessment of those entering the pool. What savings will insurers have? And why would they pass those savings? Prices depend on demand and offer, not on the savings.

Do you only apply this logic to health-care? Why not to housing or food? A government program to make sure that everybody has a decent house to live in would improve the status quo, right?

Have you ever read about the concept of "unintended consequences"?

[EVAY]

This is a political discussion, no need to be reactionary or over-emotional.

I'm not sure what this has to do with compassion. Are you saying that communism was (and is), in fact, just compassion? There's no such thing as forced compassion or forced charity.

I still don't understand how do you know that doing something has to be better. More people paying into the system will decrease the risk for all why? It depends on the risk assessment of those entering the pool. What savings will insurers have? And why would they pass those savings? Prices depend on demand and offer, not on the savings.

Do you only apply this logic to health-care? Why not to housing or food? A government program to make sure that everybody has a decent house to live in would improve the status quo, right?

Have you ever read about the concept of "unintended consequences"?

This is pathetic.

I'm going to ignore the comments about communism because they are so irrelevant to this discussion.

Your obtuseness regarding my prior answer as to the savings from a larger risk pool is, presumably, intentional (though I may be giving you credit for more critical reasoning than you possess). By forcing everyone, including the young and relatively healthy, to obtain medical insurance if they are financially able to do so, spreads the risk over a larger number of people , hence, theoretically at least, lowering the premium costs per individual.
Do you understand that.

What part of 'doing nothing means insurance premiums will double again over the next 7 years as they have doubled over the last seven' meaning that they are increasing at an unsustainable rate for us ALL, do you not get?

Speaking of logic, does it not ocur to you that the very profit motive that you reference in your observation that savings could be pocketed by insurers rather than reducing costs in a classic supply and demand model is the very REASON that lots of folks are recommending a 'public option' for insurance so that private insurers will be motivated to match the premium levels of a public option in orer to stay in business, thus perhaps being forced to pass along the savings from a reduced risk pool?

Regarding your questions about housing and food...do you live in this country? Are you unaware that government programs DO exist for public housing and food stamps ( thus addressing the housing and food questions you raise?)

I do apologize for getting emotional. It is not my normal reaction, but when you said that you thought my prior comments were hysterical I got angry.

Don't dish out what you are unwilling to tolerate.

[TeyshaBlue]

lol @ latching on to tort reform.


That's a tiny, tiny piece of the problem. But that's the one we're gonna get hung up on?

I think it was Winehole that first posted that link to The Atlantic article that the NPR report was refering to. That's one of the best reads I've had concerning this whole fiasco and certainly worth a read if you didn't get a chance the first time around.
http://www.theatlantic.com/doc/200909/health-care

[spursncowboys]

The new situation HAS to be better than the status quo because more people will be paying in to the system, thereby decreasing the risk for all (and theoretically, if the insurers pass the savings along, decreasing the premiums for everyone), and will ABSOLUTELY cover MILLIONS more Americans than are currently covered.

Come on, man, isn't there a shred of compassion anywhere for people who work hard but don't make enough money to get health insurance now?

How is it possible that you don't see that helping people like that (and there are millions of our fellow citizens in that predicament...you may even know a few, most people do) is an improvemnt? PLEASE, have you NO sense of compassion?
Why are you so compassionate with other people's money? Why is what you are doing, do you consider it compassion. To me being compassionate is letting someone decide his own life. He knows what is best for his family, not a government employee working with a rule book. If you have ever been in a welfare line, you would know there is nothing compassionate about the entire institution. Making it a crime to not have health insurance doesn't help anyone. Giving someone who is unemployed more entitlement to something they did not earn helps no one and hurts everyone involved. From the person who takes the money and gets used to "free" money to the politicians who see this as away to get reelected.

[boutons_deux]

"compassionate with other people's money"

US and state taxpayers ALREADY pay $Bs every year supporting free public services, ERs, public hospitals. The "compassion" has been in law for decades.