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Medical insurance dance https://gladerebooted.net/viewtopic.php?f=8&t=1012 |
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Author: | Squirrel Girl [ Wed Dec 02, 2009 10:54 am ] |
Post subject: | Medical insurance dance |
This link is a decent explanation of medical insurance payments from a docs point of view. http://www.associatedcontent.com/article/2422852/10_things_your_insurance_company_wont.html?cat=3 |
Author: | Dash [ Wed Dec 02, 2009 12:00 pm ] |
Post subject: | Re: Medical insurance dance |
I can imagine how frustrating it is for doctors. Socialized will be even worse I'd imagine if you go by the Medicare model. I'm going to piggyback this video on here too since it talks about a good model for medical procedures not covered by insurance: Lasik surgery [youtube]3E29LD98ruo[/youtube] |
Author: | Squirrel Girl [ Wed Dec 02, 2009 2:17 pm ] |
Post subject: | Re: Medical insurance dance |
Dash, That is a great link you have. |
Author: | Xequecal [ Wed Dec 02, 2009 2:56 pm ] |
Post subject: | Re: Medical insurance dance |
In the US you can't "shop for price" when it comes to medical care even if we manage to remove the moral hazard involved with it. Why? Malpractice cases. If there's even the slightest risk of a serious problem the doctor MUST order a legion of super-expensive tests to cover his own ***. If he doesn't, and you are the <1% that has the serious illness, you can sue him for millions. You are not allowed to make an agreement with the doctor that you'll accept treatment for the "most likely" diagnosis and accept the risk. If you refuse to pay for (or have insurance pay for) the $5000 MRI, he's not going to diagnose you, and he's not going to prescribe anything for you. |
Author: | DFK! [ Wed Dec 02, 2009 3:09 pm ] |
Post subject: | |
You can't price-shop because you aren't the customer. You're just the consumer. That's why. Malpractice is an issue, but not the primary. |
Author: | Dash [ Wed Dec 02, 2009 3:11 pm ] |
Post subject: | |
What your talking about there is torte reform to reduce some of the pressure currently on doctors, which is certainly something I'd like to see done too. That said, however you look at it prices would be driven down when people have more choices and need to consider the costs involved personally rather than have a 3rd party pay. |
Author: | Squirrel Girl [ Wed Dec 02, 2009 3:25 pm ] |
Post subject: | Re: Medical insurance dance |
Tort reform in Texas significantly helped. The cost of malpractice insurance dropped to 1/3 of what it had been before. The cost before was so high that it was more than a doctor in some specialties could make in a year. There were large areas of the state which had no neurosurgeons, for instance. |
Author: | Kaffis Mark V [ Wed Dec 02, 2009 3:25 pm ] |
Post subject: | |
Especially when one considers that it's a 3rd party that they rarely even choose. When your employer subsidizes your insurance vendor, competitors can't even, well, compete. |
Author: | Midgen [ Wed Dec 02, 2009 7:56 pm ] |
Post subject: | Re: Medical insurance dance |
Xequecal wrote: In the US you can't "shop for price" when it comes to medical care even if we manage to remove the moral hazard involved with it. Why? Malpractice cases. If there's even the slightest risk of a serious problem the doctor MUST order a legion of super-expensive tests to cover his own ***. If he doesn't, and you are the <1% that has the serious illness, you can sue him for millions. You are not allowed to make an agreement with the doctor that you'll accept treatment for the "most likely" diagnosis and accept the risk. If you refuse to pay for (or have insurance pay for) the $5000 MRI, he's not going to diagnose you, and he's not going to prescribe anything for you. Doesn't the Lasik example discussed in Dash' video prove that it would work? Why is malpractice not an issue there? |
Author: | Kaffis Mark V [ Wed Dec 02, 2009 8:55 pm ] |
Post subject: | Re: Medical insurance dance |
Midgen wrote: Xequecal wrote: In the US you can't "shop for price" when it comes to medical care even if we manage to remove the moral hazard involved with it. Why? Malpractice cases. If there's even the slightest risk of a serious problem the doctor MUST order a legion of super-expensive tests to cover his own ***. If he doesn't, and you are the <1% that has the serious illness, you can sue him for millions. You are not allowed to make an agreement with the doctor that you'll accept treatment for the "most likely" diagnosis and accept the risk. If you refuse to pay for (or have insurance pay for) the $5000 MRI, he's not going to diagnose you, and he's not going to prescribe anything for you. Doesn't the Lasik example discussed in Dash' video prove that it would work? Why is malpractice not an issue there? Lack of regulation. It's preposterously hard to prove fault, as I understand it, and there aren't special rules that basically presume guilt and make the doctor prove he *didn't* commit malpractice. |
Author: | Xequecal [ Thu Dec 03, 2009 10:07 am ] |
Post subject: | Re: Medical insurance dance |
First off, civil malpractice cases don't have a high burden of proof like criminal cases. Also you've got the problem that a jury of "common men" is always going to be heavily biased towards the suffering plaintiff (who is probably dealing with a lot of pain from a medical problem, even if it's not the doctor's fault) and against the super-rich doctor who we all "know" can easily spare the money. Second, LASIK isn't a "required" treatment for anyone to preserve their life or health. That means it's up to you who you do the surgery on, and you can pre-screen patients. If you get a bad feeling, you don't have to risk it. For "typical" medical care, you can't do that. You have to treat them when they walk in, you have no choice. There's a reason the most popular/lucrative medical field is dermatology and the least popular is obstetrics. Nobody wants to **** deliver babies anymore, if there's a birth defect or complications they're all coming after your money, and there's a good chance they'll get it even if you didn't do anything wrong. |
Author: | DFK! [ Thu Dec 03, 2009 11:38 am ] |
Post subject: | Re: Medical insurance dance |
Xequecal wrote: There's a reason the most popular/lucrative medical field is dermatology ... Yes, because dermatology as a field keeps the number of residencies prohibitively small to protect their income. |
Author: | Monte [ Fri Dec 04, 2009 11:08 am ] |
Post subject: | |
Civil Malpractice suits are barely a drop in the bucket of our overall medical cost issues. Tort reform is largely a means of turning consequences for horrible crap into just another cost of doing business. Yes, doctors pay huge insurance premiums for malpractice insurance companies. But that doesn't mean tort reform would do anything to really help the overall medical cost issue we have in this country. |
Author: | shuyung [ Fri Dec 04, 2009 11:52 am ] |
Post subject: | |
Monte, I notice you are missing some links to back up your assertions. |
Author: | Arathain Kelvar [ Fri Dec 04, 2009 12:25 pm ] |
Post subject: | Re: |
Monte wrote: Civil Malpractice suits are barely a drop in the bucket of our overall medical cost issues. Tort reform is largely a means of turning consequences for horrible crap into just another cost of doing business. Yes, doctors pay huge insurance premiums for malpractice insurance companies. But that doesn't mean tort reform would do anything to really help the overall medical cost issue we have in this country. Back this up, please. You make some pretty solid statements here. My understanding is different, so if I'm wrong I'd like to know. |
Author: | Xequecal [ Fri Dec 04, 2009 2:55 pm ] |
Post subject: | Re: Medical insurance dance |
"Cost of doing business" is exactly what malpractice is now. What do you think a doctor does after he loses a malpractice suit? His insurance pays for it, and he goes right back to practicing. The problem is doctors don't lose their licenses unless they did something truly horrible. A doctor that hurts someone should lose their license or go to prison, the suing for millions is ridiculous and just **** up everyone elses medical care. |
Author: | Elmarnieh [ Fri Dec 04, 2009 3:04 pm ] |
Post subject: | |
Maybe if civil trials for malpractice carried the same demand that criminal trials do. Way too often a jury sides with the "hurt" person against the "rich" doctor. |
Author: | DFK! [ Fri Dec 04, 2009 3:25 pm ] |
Post subject: | Re: |
Monte wrote: Civil Malpractice suits are barely a drop in the bucket of our overall medical cost issues. Tort reform is largely a means of turning consequences for horrible crap into just another cost of doing business. Yes, doctors pay huge insurance premiums for malpractice insurance companies. But that doesn't mean tort reform would do anything to really help the overall medical cost issue we have in this country. This is actually mostly correct, directly. Where the cost comes from is defensive medicine. The lawsuits themselves aren't a huge proportion of healthcare spending. Insurance is, but still nothing compared to some of the wasteful spending on, say, a X-ray prior to a CT for some particular diagnosis. Just jump to the CT. |
Author: | shuyung [ Fri Dec 04, 2009 3:35 pm ] |
Post subject: | |
DFK!, I notice you are missing some links to back up your assertions. |
Author: | DFK! [ Fri Dec 04, 2009 3:45 pm ] |
Post subject: | Re: |
shuyung wrote: DFK!, I notice you are missing some links to back up your assertions. Nothing I can access is likely to be accessible by you without personal expenditure. What would you have me do? I'd be happy to cite sources beyond my own knowledge and experience. I just don't think you'll be able to access them unless you have access to some sort of journal database as I do. I'll be happy to help meet your sourcing needs, with feedback on how to best do it. Also, much as the huge malpractice costs are in large part a myth of the right, uncompensated care is a myth of the left. Uncompensated care, IIRC, is about 2-2.4% of overall health services expenditures in the US. That's less than retail chains lose to theft. |
Author: | DFK! [ Fri Dec 04, 2009 4:11 pm ] |
Post subject: | |
Here are some publicly viewable sources, but not researched and peer-reviewed, which is what I would get for you otherwise: http://www.aarpmagazine.org/health/health_care_costs.html wrote: • Malpractice is the culprit Doctors say their worries about lawsuits drive them to order costly tests and procedures that their patients do not actually need. Malpractice reform will help save money, but not as much as some people believe. The Congressional Budget Office estimates that while tort reforms could lower malpractice-insurance premiums for physicians by as much as 25 to 30 percent, the overall savings to our health care system would be a minuscule one-half percent. http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf wrote: Evidence from the states indicates that premiums for malpractice insurance are lower when tort liability is restricted than they would be otherwise. But even large savings in premiums can have only a small direct impact on health care spending—private or governmental—because malpractice costs account for less than 2 percent of that spending.3 http://online.wsj.com/article/SB125193312967181349.html wrote: Even so, health-care experts say the direct costs of medical malpractice -- the insurance premiums, claims paid and legal fees -- amount to a very small portion of overall health-care spending. Total spending on medical malpractice, including legal-defense costs and claims payments, was $30.41 billion in 2007, according to an estimate from consulting firm Towers Perrin. That is a significant figure, but it still amounts to a little more than 1% of total U.S. health-care spending, which the federal government estimates at $2.241 trillion for 2007. I have other state-specific sources if you'd like. |
Author: | shuyung [ Fri Dec 04, 2009 4:44 pm ] |
Post subject: | |
Thank you. I find this to be sufficient corroboration to your claim for my purposes. I appreciate the effort you have undergone to assist in establishing the veracity of your position. |
Author: | DFK! [ Fri Dec 04, 2009 4:55 pm ] |
Post subject: | Re: |
shuyung wrote: Thank you. I find this to be sufficient corroboration to your claim for my purposes. I appreciate the effort you have undergone to assist in establishing the veracity of your position. No problem. Always happy to source when requested, and possible. Really, the biggest cause for healthcare inflation, IMO, is technology. Increasing technology equals increasing costs, unlike in many other fields. |
Author: | Elmarnieh [ Fri Dec 04, 2009 5:07 pm ] |
Post subject: | Re: |
shuyung wrote: Thank you. I find this to be sufficient corroboration to your claim for my purposes. I appreciate the effort you have undergone to assist in establishing the veracity of your position. I feel like I am in Zork. Verbose off. |
Author: | Diamondeye [ Sun Dec 06, 2009 2:16 pm ] |
Post subject: | Re: Medical insurance dance |
Xequecal wrote: "Cost of doing business" is exactly what malpractice is now. What do you think a doctor does after he loses a malpractice suit? His insurance pays for it, and he goes right back to practicing. The problem is doctors don't lose their licenses unless they did something truly horrible. A doctor that hurts someone should lose their license or go to prison, the suing for millions is ridiculous and just **** up everyone elses medical care. Define "hurts someone". People are people and make mistakes. Not only that, but learning from mistakes is one of the main things that makes people better at what they do. No one is going to want to go into medicine if perfection is the standard and a mistake lands you in prison or jobless with huge student loans to repay. |
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