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 Post subject: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 12:05 pm 
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http://online.wsj.com/article/SB2000142 ... 51050.html

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A Doctor's Plan for Legal Industry Reform

Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.

At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)

Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.

Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.

• Legal "DRGs." Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine's Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I'm surprised lawyers don't tack shipping and handling onto their bills.

• Legal "death panels." Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you're on your own.

• Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that' s tough: What do you want for "free"?

• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.

• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many. This reform will guarantee a selection of mediocre, unmotivated attorneys but should help slow rising legal costs. Big shot under indictment? Classified National Archives documents down your pants? Sitting president defending against impeachment? Have FBI agents found $90,000 in your freezer? Too bad. Under reform you too may have to go to the government legal shop for advice.

• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily.

• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.

• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.

• Collect data about the supply of and demand for attorneys. Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.

• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.

Enthusiastically embracing the above legal changes can serve as a "teachable moment" and will go a long way toward giving the lawyers who run Congress a taste of their own medicine.

—Dr. Rafal is a radiologist in New York City.

Nobody should have to live without affordable legal care. I particularly like the part about legal DRG's and electronic legal records.

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 Post subject: Re: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 12:31 pm 
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I'm impressed with the way he managed to stay on task with the parody.

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 Post subject: Re: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 1:03 pm 
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That's relatively awesome, actually.

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 Post subject: Re: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 1:12 pm 
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All this would do is drive people to Canadia for legal services.


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 Post subject: Re: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 2:34 pm 
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I'm tired of Big Legal raking in profits while the poor are going unrepresented. We need a public representation option. Oh wait...

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 Post subject: Re: Legal Care Reform.
PostPosted: Fri Sep 04, 2009 2:47 pm 
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Screeling wrote:
I'm tired of Big Legal raking in profits while the poor are going unrepresented. We need a public representation option. Oh wait...



Co-ops. That is what is needed.

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 Post subject: Re: Legal Care Reform.
PostPosted: Sat Sep 05, 2009 1:56 pm 
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Screeling wrote:
I'm tired of Big Legal raking in profits while the poor are going unrepresented. We need a public representation option. Oh wait...


but that exists only for criminals. what we need to do is extend the fine work done by the Public Defenders Office to all people, not just the criminally accused. after all don't people have a basic right to sue their neighboor?

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 Post subject: Re: Legal Care Reform.
PostPosted: Sun Sep 06, 2009 7:49 am 
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The Honduras situation demonstrates that the Obama Administration has no real interest in the Rule of Law or Basic Human Rights.

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PostPosted: Tue Sep 08, 2009 11:33 am 
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We already have government-provided legal counsel. In fact, it's a pretty good example of how something like legal representation and health care are not, in fact, goods.

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PostPosted: Tue Sep 08, 2009 11:39 am 
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Acess to them certainly is not a good, but that doesn't mean you get the service.

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PostPosted: Tue Sep 08, 2009 11:16 pm 
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If I demand a lawyer to represent me criminally, that lawyer is appointed. I get the service.

I have to ask this - what good do health insurance companies do for the quality of our health care?

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PostPosted: Tue Sep 08, 2009 11:44 pm 
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Insurance companies aren't there to improve quality. That's the provider's job. Insurance companies are there to guard against catastrophic events.

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 Post subject: Re:
PostPosted: Wed Sep 09, 2009 12:51 am 
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Monte wrote:
If I demand a lawyer to represent me criminally, that lawyer is appointed. I get the service.


If you are charged with burglary, you must be provided an attorney, if you do not have or cannot afford one of your own. If you will note, no guarantees are made regarding their quality, beyond the bare minimum. If you are having a heart attack, emergency care must be given. Again, no guarantees are made regarding their quality beyond the bare minimum.

Examining other scenarios, however, reveal that those situations are extreme. You may demand legal counsel for a variety of reasons, but without the ability to pay, you are forced to rely on the kindness of others. In the same vein, you may demand medical treatment for a variety of reasons, but without the ability to pay, you are forced to rely on the kindness of others. For one of these two scenarios, there exist a non-trivial amount of the population convinced that the kindness of others should be involuntary.

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 Post subject: Re: Re:
PostPosted: Wed Sep 09, 2009 7:41 am 
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shuyung wrote:
If you are charged with burglary, you must be provided an attorney, if you do not have or cannot afford one of your own. If you will note, no guarantees are made regarding their quality, beyond the bare minimum.

And that bare minimum is very low. When you are appointed an attorney, with a very few exceptions*, the appointment can be any attorney, regardless of what they actually practice day to day. Just because someone has been charged with a crime doesn't mean they won't get a tax attorney, an IP attorney, or a wills and trust attorney with next to no court room experience as their legal counsel.

It would be akin to walking into the ER and through random selection getting a plastic surgeon to diagnose and remove your appendix.

* prosecutors are generally protected from being chosen for court appointed cases, and some cases or courtrooms require special certifications. You have to be certified to defend death penalty cases, or to appear in some of the upper courts.


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 Post subject: Re:
PostPosted: Wed Sep 09, 2009 9:25 am 
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Screeling wrote:
Insurance companies aren't there to improve quality. That's the provider's job. Insurance companies are there to guard against catastrophic events.


So, my next question is, why do we have them at all? It seems to me that insurance companies do two things very well - skim money from people for a service necessary for their lives, and then avoid paying those services or simply drop people from coverage.

We could simply expand Medicare to cover all Americans, have anyone pre-retirement age pay a premium in addition to their normal medicare taxes, and then let private insurance companies deal with things like cosmetic surgery and the like.

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PostPosted: Wed Sep 09, 2009 9:31 am 
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He just answered why we have them: "to guard against catastrophic events". Why do we have auto insurance or homeowner's insurance? Afterall, couldn't you argue your lienhold against your house that because you are responsible and have no history of burning things, that they are just skimming?

Medical insurance have expanded in their role beyond this scope to negotiate bulk contract services with providers because of the nature of health care.

If health care insurance carriers provide no service, then why are they offered as "benefits" by employers that employees opt in to pay for the service?

I think your issue lies with health-care providers, not insurance carriers. do you care to validate your theory that insurance companies should be involved at all with things like cosmetic surgery given the stated function of an insurance carrier?

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 Post subject: Re: Re:
PostPosted: Wed Sep 09, 2009 9:46 am 
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Monte wrote:
Screeling wrote:
Insurance companies aren't there to improve quality. That's the provider's job. Insurance companies are there to guard against catastrophic events.


So, my next question is, why do we have them at all? It seems to me that insurance companies do two things very well - skim money from people for a service necessary for their lives, and then avoid paying those services or simply drop people from coverage.

We could simply expand Medicare to cover all Americans, have anyone pre-retirement age pay a premium in addition to their normal medicare taxes, and then let private insurance companies deal with things like cosmetic surgery and the like.



Really? Are you this dumb? What about the MILLIONS of people who love their insurance and never have an issue with the service they provide? Stop drinking the kool-aid.

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 Post subject: Re:
PostPosted: Wed Sep 09, 2009 9:58 am 
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Rafael wrote:
He just answered why we have them: "to guard against catastrophic events".


That isn't what our health insurance companies do. In fact, if you have a catastrophic event, you can be dropped from your insurance, and will likely be unable to get insured by any other company due to your "pre-existing condition".


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Why do we have auto insurance or homeowner's insurance?


People are not products, no matter how much libertarians like to think that we're a commodity. People are more valuable than cars and homes. Maybe you don't think so, but if I had to chose between the life of my loved ones and my home, or my car, that would be a fairly easy, if painful choice.

Furthermore, there isn't a single bit of car insurance that can even remotely stand up to the cost of, say, cancer treatment. If you happen to live in a mansion, you might be able to have a loss as financially significant.

In addition to that, if my car is totaled, I get a single check that pays for the cost of replacement. I am not going to spend the next 10 months in a hospital bed and have one check to cover it. It's a lot more complicated than that.

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Medical insurance have expanded in their role beyond this scope to negotiate bulk contract services with providers because of the nature of health care.

If health care insurance carriers provide no service, then why are they offered as "benefits" by employers that employees opt in to pay for the service?


That's a great question. Health Insurance is not an option. If you don't have it, you are in a very precarious position. Really, you're just playing russian roulette. It's a "benefit" because our society has **** up priorities. Health care is a right, not a good.

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I think your issue lies with health-care providers, not insurance carriers. do you care to validate your theory that insurance companies should be involved at all with things like cosmetic surgery given the stated function of an insurance carrier?


I have no problem with health care providers (assuming they aren't hacks, or crooks, etc).

You have stated a function for health insurance that is simply not accurate. Most health insurance is comprehensive because of the nature of human health care. However, it also drives up the price of health care considerably, and provides no measurable benefit to the quality of health care. We basically subsidize salaries, profit margins, and huge administrative costs just to have access to a living need.

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 Post subject: Re: Legal Care Reform.
PostPosted: Wed Sep 09, 2009 10:11 am 
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The largest growth in health care costs in this country stems from same day doctor's office visits and same day hospital visits, which tracks closely with the increased use of HMO's and other managed care insurance plans where the client is almost completely divorced from the cost of the service.

Is it any mystery that when people don't have to consider costs, use increases?

And this is why I believe all the current plans being spouted by the politicians in DC will fail. Every one of those plans further removes the decision making criteria from the exchange, and will only further increase use... and not needed use, but irrelevant use, creating additional levels of demand and inefficiency in the system.


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PostPosted: Wed Sep 09, 2009 10:26 am 
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Auto insurance can be just as expensive as costly medical bills because it covers just that: costly medical bills. The bulk of the premium you pay is not for property damages, but for medical liabilities.

Health insurance is just like any other insurance and it has nothing to do with commoditizing the person (which is ironic, given your professed love for the school of economics which does exactly that). It is governed by contract. It is not magic or mystical. If people are dicked over by their insurance companies, its their fault for not understanding the limitations for the liabilities assumed by the carrier.

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 Post subject: Re: Re:
PostPosted: Wed Sep 09, 2009 12:08 pm 
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Monte wrote:
Rafael wrote:
He just answered why we have them: "to guard against catastrophic events".


That isn't what our health insurance companies do. In fact, if you have a catastrophic event, you can be dropped from your insurance, and will likely be unable to get insured by any other company due to your "pre-existing condition".


Did you know?
If your coverage is a group health plan, this is illegal under Federal law.


Monty wrote:
In addition to that, if my car is totaled, I get a single check that pays for the cost of replacement. I am not going to spend the next 10 months in a hospital bed and have one check to cover it. It's a lot more complicated than that.


Fun Fact:
Medical expenses incurred as a result of a car accident can be and often are covered under an individual's auto insurance policy, not health care insurance.

Monty wrote:
Health care is a right, not a good.


Fun Fact:
This is called the Bare Assertion Fallacy, and therefore irrelevant. So is the quote below:

Monty wrote:
You have stated a function for health insurance that is simply not accurate. Most health insurance is comprehensive because of the nature of human health care. However, it also drives up the price of health care considerably, and provides no measurable benefit to the quality of health care. We basically subsidize salaries, profit margins, and huge administrative costs just to have access to a living need.

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 Post subject: Re: Re:
PostPosted: Wed Sep 09, 2009 1:37 pm 
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DFK! wrote:
Monte wrote:
Rafael wrote:
He just answered why we have them: "to guard against catastrophic events".


That isn't what our health insurance companies do. In fact, if you have a catastrophic event, you can be dropped from your insurance, and will likely be unable to get insured by any other company due to your "pre-existing condition".


Did you know?
If your coverage is a group health plan, this is illegal under Federal law.

See, I thought this was more of a Fun Fact because it destroys Monty's argument.

Health care is not a right any more than food and housing is a right. If I want them, I have to pay for them. When a service (health insurance) provides me with certain benefits such as not having to worry about losing my house if I have a bad series of medical events, I don't expect them to do it at no cost. Even faith-based non-profits (such as the hospital I volunteer at) have to operate in the black.

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PostPosted: Wed Sep 09, 2009 10:48 pm 
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Health care is as much a right as water and air. I know you disagree with me, but that doesn't actually change my mind. Health care is not a commodity. It is not a good. It's a right.

Rafael - when have I ever professed a love for (I presume you refer to) Keynesian economics?

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PostPosted: Wed Sep 09, 2009 11:53 pm 
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Monte wrote:
Health care is as much a right as water and air. I know you disagree with me, but that doesn't actually change my mind. Health care is not a commodity. It is not a good. It's a right.



Define "right."

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PostPosted: Thu Sep 10, 2009 12:20 am 
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Monte how can anyone have a right to another's time?

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