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+--- Thread: Hospital Crisis and Obamacare (/showthread.php?tid=138918)
Re: Hospital Crisis and Obamacare - $tevie - 07-17-2012
Lemon Drop wrote:
This thread needs davester or Ted king. I think it was one or maybe both of those guys who provided research in a much earlier thread showing that the claims that malpractice claims are a major cause of problems and expense in the health care system are bunk. It's a partisan talking point that caught fire and continues to be exploited by groups who want to limit physician and hospital accountability and liability for mistakes.
Malpractice lawsuits take money from the rich and give to the poor: they are a concealed form of WEALTH DISTRIBUTION! OMG OMG
Re: Hospital Crisis and Obamacare - Carnos Jax - 07-17-2012
wowzer wrote:
[quote=Pam]
Hate to tell you, but it's already happened. Tossing Obamacare won't change the path we're already on.
True, but at least it wont bring down the rest of America. The only places where this was happening was the heavily democratic states (NY, MA, RI, CT, etc). That's because the democrats love trial lawyers and frivolous lawsuits. By creating an extension of medicaid, it will expand the trial lawyers' influence on the rest of America. This is going to get very, very ugly. I'm glad that I'm in mid-career...and wont have to feel the repercussions too much. I'm really concerned about our kids and the next generation.
You might've had a good start to your argument, until you said this.
Most of my friends and relatives are doctors (one of the side effects of being of Indian ethnicity) and most of the rest are in the medical field. Most of them are in favor of or at least giving the whole Obamacare thing the benefit of the doubt in terms of what it will do to the future of the industry. The only doctors I know of that are against it are happen to also earn a million plus a year (strange). One thing for sure, I've observed first hand a perceived (and most likely accurate) decline in the state of medical service provided in this country....Obamacare isn't even in effect.
Re: Hospital Crisis and Obamacare - Carnos Jax - 07-17-2012
swampy wrote:
When 83% of current doctors say they have considered getting out of medicine due to Obama care, there won't be enough doctors to staff hospitals since there are not enouh doctors in the pipeline to make up the loss.
I see only those able to pay cash getting medical care in 20-30 years. Look at Canada. The shortage of doctors has lead to long wait times to get seen. The rich come to the USA pay cash and get care.
Swampy, I had the impression that medical schools in this country were at capacity, and that those who want to become a doctor had to go to overseas schools with cross accreditation.
Re: Hospital Crisis and Obamacare - Carnos Jax - 07-17-2012
swampy wrote:
Pam, Politifact it all you want, but I think the number does reflect a majority of doctor's feelings about Obamatax.
I have seen a great many doctors and medical practicioners over the past three years and have discussed current trends in health care. _None_ that I talked with liked the future they saw coming. Not a one! Most agreed that costs would rise, care would be rationed in some degree and overall patient care will decline due to lack of doctors. Tort reform was a major concern for them financially.
Their other big concern was the USPSTF. It was my oncologist who pointed out that the the U.S. Preventive Services Task Force, that recommended mammograms for women under 50 were not beneficial, did not have a single clinical oncologist or breast surgeon on the panel. Her fear is that this panel will be the determiner of patient care and health decisions will be bast on cost effectiveness.
Look at my post. Perhaps it's just as anecdotal as yours, but by far different in it's conclusions.
Re: Hospital Crisis and Obamacare - Avenger - 07-17-2012
Pam wrote:
Anyone who thinks 90% is acceptable, that time, money, and stress for 1.4 million American women each year is acceptable really doesn't give a flip about women.
So you would refuse the procedure for yourself based on statistics?
Re: Hospital Crisis and Obamacare - Avenger - 07-17-2012
Lemon Drop wrote:
So yeah, something more objective would be appreciated.
Well, you are not going to get it from someone who dreams free national healthcare back in the UK but has for unknown reasons chosen his permanent domicile in the US.
Re: Hospital Crisis and Obamacare - Carnos Jax - 07-17-2012
The irony is that you look to political bodies for your opinion on climate change, thereby throwing out the expert opinions of scientists who studied the issue. Yet when a doctor reflects your political position on healthcare, all of a sudden you have no problem with an 'expert' opinion. LOL, you're such a tool of the system.
Re: Hospital Crisis and Obamacare - wowzer - 07-17-2012
Lemon Drop wrote:
This thread needs davester or Ted king. I think it was one or maybe both of those guys who provided research in a much earlier thread showing that the claims that malpractice claims are a major cause of problems and expense in the health care system are bunk. It's a partisan talking point that caught fire and continues to be exploited by groups who want to limit physician and hospital accountability and liability for mistakes.
I can tell you as a physician, CYA (defined below) is being done routinely. The trouble is that when you do not order the test, the trial attorneys point to your lack of testing as a source of malpractice. Even when there's no clear evidence that the test would do anything, that is a point which comes up. No jury in a low income county would find such a physician action as acceptable. As was stated recently, standards of medical practice is now defined by the juries and not by doctors. The intricacies of clinical decision making are fraught with uncertainty. It astounds me that we have a legal system which expects a jury of 'peers' to decide upon medical wrongdoing when groups of highly educated physicians cannot reach consensus in many such cases. No wonder why Harvard Law school found what they did--the tort system for healthcare does not make sense.
CYA Defined:
I will turn the question around, if you were a physician, and you had a patient who you were 95% sure of not having a devastating disease. Would you order a test to determine if the patient has the disease? Would you order the test if you were 10% certain that the patient has the disease? What about 15%? A lot of these pre-diagnostic decision making is not based in science, as History and Physicals are not sensitive or specific enough to make a clear judgment. In fact, as we have more electronic medical records, physician researchers are delving into the science of H&P's and realizing that our classical descriptions of many diseases are quite inaccurate.
To continue the question, what if the test costs $10,000? What if that test only has an 80% chance of detecting the disease? I hope everyone here realizes that very few tests in our medical arsenal is 100% sensitive (i.e. is always able to detect disease when disease is present) and none are 100% specific (is always able to say that a person has a disease when disease is present). Most tests fall into the 70-80% sensitivity and 70-80% specificity ranges. Good tests are in the 90% for both...but they are relatively rare.
Of course, each test carries a risk. CAT Scans with intravenous contrast, for instance, carries an approximate risk of 2% for developing renal failure. However, if you have diabetes, or are older in age, have anemia, and a lot of other medical issues, your risks could be as high as 30%. If your doctor orders this test for you and you are of high risk, and you develop contrast induced nephropathy and go on to developing complete renal failure (which means you are permanently a renal dialysis patient), do you sue your doctor for malpractice? Do you sue your doctor because he didn't weigh the risks of CIN versus the risks of not doing the test for that catastrophic illness?
Or, if your doctor did not order the test, then you die or are permanently injured as a result of that catastrophic illness, do you (or your survivors) sue the doctor for malpractice? How do you weigh the risks?
In the end, many, many physicians choose to order the test because at least in the eyes of the jury, it appears that the doctor was 'competent' and caring enough to order the test. Each test we order when we are fairly certain that the patient doesn't have an illness is an example of CYA.
To be fair, even when we know that a person has an illness (i.e. pneumonia), we order tests because if we didn't, the patients would likely call that physician a 'quack' and never return. It's a strange, strange business...
Re: Hospital Crisis and Obamacare - Dennis S - 07-17-2012
"Obamatax" - swampy
Good one, swampy. Did you get that from Rush or Hannity?
Re: Hospital Crisis and Obamacare - Acer - 07-17-2012
I don't disagree that unreasonable malpractice actions exist, nor that defensive medicine is practiced, and I do agree that these areas can stand reform. But the numbers just don't add up to the level of crisis claimed.
"The cost of medical malpractice in the United States is $55.6 billion a year, which is 2.4 percent of annual health-care spending, a new study shows.
The researchers said their estimate includes $45.6 billion in what's known as defensive medicine costs -- when doctors prescribe unnecessary tests or treatments to avoid lawsuits."
http://health.usnews.com/health-news/managing-your-healthcare/healthcare/articles/2010/09/07/cost-of-medical-malpractice-tops-55-billion-a-year-in-us
Older article, feel free to find a better one.
Eliminating that 2.5% expense outright is just not going to make much difference. And relative to the income of the health care industry, this expense is not that big. Even doubling it by doubling Medicaid patients is not going affect the bottom line more than a relative blip.