Hyperbole and Hysteria: Immune System of the Body Politic?
I’ve never heard the word “fear” used so much on television. “Do you fear a government takeover of health care?” The conservative and Republican strategy has been to block this bloated reform package by frightening the citizenry with unfounded rumors about “death panels” and the like.
Maybe, in the fog of Too Much Information, scare tactics are the only way to get citizens involved.
I know that what I feel for that 1,000+-page bill I’ve read only bits of isn’t fear; it’s loathing. Prove to me if you can that big government bureaucracy isn’t the most inefficient, wasteful, and unaccountable way to do most things. (Exceptions like the CDC, which facilitate a swift, centralized, coordinated response, often turn out to be subsets of defense — and I’d hate to start reading about what’s wrong with the CDC. FEMA should have been a subset of defense, too.) Government can play an excellent role in establishing ground rules and incentives that reward economic efficiency and quality care — learning from the best private innovations and creating circumstances that make it easy to study, adapt, and reproduce those best practices (which cannot be assumed to work exactly the same way in different places).
I like this image and so will repeat it for about the third time: government is meant to fine-tune the engine, not to be the engine — as such, it’s a gas guzzler with tailfins!
But that isn’t fear. I’m very struck by the way conservatives see the federal government as sinister and inimical, as if it were some alien cancer on the body politic, while liberals tend to view it naïvely as just “us” — a basically healthy organ of the will of the people. If representative government has mutated into a cancer, it isn’t alien — it’s one that arose from within. In my view, it’s really more like a large benign tumor: more burdensome than toxic. Yet there’s always been a suspicion, which flared up in the Red Scare of the 1950s and is baa-aack in the claims that Barack is “furrin,” that alien ideas are being injected into the system and causing some citizens to mutate into aggressive enemies of freedom. On this analogy, fear is inflammation. “Inflammatory” rumors, or humors, are arousing citizens to surround and attack “un-American” ideas, as white blood cells recognize and destroy anything in the body that’s “not-me” — and sometimes, in their zeal, turn on the body itself.
You tell me whether the town hall shouting matches are a healthy immune response or a runaway autoimmune disease. Then I’ll tell you what I think.
Ambiance 
Maxwell said,
August 13, 2009 at 12:46 pm
Autoimmune disease. Which describes this as well, and not just in the most obvious way.
amba12 said,
August 13, 2009 at 1:15 pm
Yow. This brought the uninsured and underinsured out of the woodwork. You obviously can’t say people don’t want care.
Maxwell said,
August 13, 2009 at 1:41 pm
Especially if it’s free! You could not ask for clearer evidence that extending insurance to everyone without significant cost containment would further stress the healthcare system’s already strained capacity.
Meanwhile, according to the Washington Post, John Boehner is actually arguing against reforming Medicare to reduce spending thanks to all this “death panels” BS. So I guess the GOP won’t be playing the adult anytime soon.
PatHMV said,
August 13, 2009 at 1:55 pm
Is there much of a difference? I mean, Fear and Loathing in Washington, DC, may not have the same panache as the same story set in Las Vegas, but this line would seem to work in both:
Hey, we may be on to something here. One book is the story about delusional people living in a delusional world, experiencing a “fantastic universal sense that whatever [they] were doing was right, that [they] were winning.” The other is the story of a bunch of drugged up hippies in Las Vegas.
PatHMV said,
August 13, 2009 at 2:15 pm
On the substance of health care, let’s look at the breakdown of who exactly is without insurance. here is a chart [pdf] prepared by the Senate Republicans showing how the 47 million uninsured number actually breaks down. I can’t find right away the report on which the data is based, but the numbers seem realistic to me. 9 million of those 47 million make more than $75,000 each year. 5 million are illegal immigrants, another 5 million are legal immigrants. 10 million are already eligible for existing government programs.
On that last point, remember the debate a year or two ago over the SCHIP program, which provides medical care for young children and pregnant mothers? Proponents wanted to expand the program by easing the qualifications, raising the income threshold. But what came out during the debate was that there were millions of people who qualified for the program but did not take advantage of it.
According to the chart, there’s even 6 million people who qualify for employer-sponsored insurance ,but who don’t take it. Now, I’m willing to lump them in with the 12 million who don’t have affordable options, under the assumption that their share of the employer-sponsored health care may be too expensive for them to afford on the wages they are being paid… but I’m fairly certain that not all of that number qualifies.
These details are important, because different types of problems need different types of solutions. The 6 million who qualify for employer-sponsored insurance maybe need a small tax credit to help them pay for the insurance. The people eligible for existing programs either need to be better educated about their options, or we need to realize that no matter what we do, we won’t reach everybody. Some homeless people will no doubt continue to go to the ER for their basic medical care, even if you gave them insurance which would pay for doctors visits. Of the folks making more than $75,000, if they don’t have insurance, that’s their problem, for the most part. To the extent they can’t get insurance because of pre-existing conditions, that’s a different problem, and we don’t need to socialize the health care system (any more than it already is) to fix it. If the aim is to make them contribute to health care costs for others, even though they’re healthy young men at very low risk of needing health care, a mandate for all individuals to buy insurance should do the trick.
amba12 said,
August 13, 2009 at 2:25 pm
different types of problems need different types of solutions.
That seems of the essence. The “public option” seems like a very large, blunt, and inflexible instrument.
michael reynolds said,
August 13, 2009 at 3:45 pm
Amba:
You start from an unproven presupposition: that the government is necessarily inefficient.
It’s not a fact, it’s an assumption. And since everything else is flowing from that assumption, you should ask whether you can demonstrate the truth of the assumption.
I’ve challenged a couple of people to provide a factual basis for this bit of conservative theology. Haven’t seen such proof yet. “Everybody knows” applies as well to the existence of witches as to this assumption.
amba12 said,
August 13, 2009 at 3:52 pm
By the same token, show me some examples of government efficiency. As I said, I have a pretty good but fairly superficial impression of the CDC.
The overpricing of routine items by the military comes immediately to mind.
amba12 said,
August 13, 2009 at 3:58 pm
The conservative argument pro free enterprise is that if businesses provide lousy product/service and are economically inefficient, they go out of business. Government can’t go out of business. Since it can print money and underprice other entities, it can move towards monopoly (single payer), in which case it has less and less competition.
This is based on the utilitarian, self-interest, lowest-common-denominator view of human behavior: that its most reliable drivers are fear (of going out of business) and greed. The notion that people would do things well because it’s right and satisfying to do so … well, it’s nice when it happens, and it does, but you can’t count on it.
Business, on the other hand, and for the same reasons, needs government as a watchdog on it. Otherwise, we would have Love Canals from coast to coast as long as executives could live well away from them. That’s not all executives, by any means, but enough to do a lot of harm if the profit motive ruled unchecked.
michael reynolds said,
August 13, 2009 at 4:42 pm
Amba:
That’s deflection, of course. You don’t have an answer as to the presupposition. No one does. It’s faith, not fact. I find faith to be a poor basis for reasonable conclusions.
But moving on:
Some examples of relatively efficient government: the USMC, the IRS (trust me: very efficient, damn them,) the FBI (despite antiquated equipment,) the Social Security administration (hundreds of billions of dollars sent out at very low cost,) Medicare (more care for more people at lower cost.) The National Park service.
All of those are reasonably efficient. Relatively efficient. But of course that’s beside the point since there are things only government can do, and the real question is: what makes us think our current mix, which costs twice as much as the next competitor without delivering any better result is the best system?
I don’t know why it doesn’t bother people that we pay twice as much as a Frenchman and have the same life expectancy. How do you defend something like that?
As for private industry self-policing, in effect, with bankruptcies: not in the age of too-big-to-fail. We see with Lehman and AIG that screwed-up businesses have the potential to drag government down.
The separation — government over here, and private industry over there — are largely a myth. Our auto industry is dying in large part because only in the US are massive health care costs piled onto their shoulders. Boeing pays for health care, Airbus does not. Our government is in deeper debt because our health care industry successfully fights against transparency. Government and business are intertwined, inextricably. So analyses that pretend otherwise are beside the point. We are not a nation of gentlemen farmers, we are a modern industrialized nation with an 18th century government.
We have an absurd, wildly over-priced system, and all that folks on the right can do is terrorize granny and spread lies.
It’s simple: I want to pay what a Frenchman pays. Why can’t I?
Maxwell said,
August 13, 2009 at 4:46 pm
I provide all of the answers to these questions, and more, in my next post ;-).
amba12 said,
August 13, 2009 at 5:05 pm
Maxwell: do we assume all those people needed the care (mostly dental, sounds like), or did some of them just want it because it was free? If that indicates the depth of the need, the healthcare people aren’t getting because they can’t afford it (or in some cases, as Pat points out, just don’t know their existing options), then how in hell is it possible to serve the population AND contain costs??
amba12 said,
August 13, 2009 at 5:07 pm
Michael: it’s not deflection, it’s balance. If you’ll look up one, I’ll look up the other (or vice versa), and neither of us will be hurling baseless accusations at the other. It seems the question should be answerable. Can government be efficient? If it sometimes is, when/how/why?
amba12 said,
August 13, 2009 at 5:09 pm
As for private industry self-policing, in effect, with bankruptcies: not in the age of too-big-to-fail. We see with Lehman and AIG that screwed-up businesses have the potential to drag government down. Heh. This is true. And they’re still buying jets and paying seven-figure bonuses. And to those who argue they should have been allowed to fail, we answer that we all would’ve gone down with them.
amba12 said,
August 13, 2009 at 5:12 pm
Government and business are intertwined, inextricably. This is also true. The hysteria is really over a question of shifting the balance this way or that.
But aside from “Why can’t I pay half what I do, like a Frenchman?” my question is, “Why can a Frenchman pay half of what we do?”
amba12 said,
August 13, 2009 at 5:12 pm
Their life expectancy? Probably more a matter of wine, low stress . . . maybe sex . . .
Maxwell said,
August 13, 2009 at 5:18 pm
Short answer: that really depends on reforming _healthcare_ regulations in addition to health insurance regulations. Which is a whole big mess that, for all the complexity of these bills, they don’t really ever get into (& the media doesn’t either). But IMO, it’s at least as important as health insurance reform.
If they came for dental, I suspect that is because that lots of dental was offered (and advertised). Dental is cheaper than medical, and controls its costs better overall. Remember, somebody was paying.
wj said,
August 13, 2009 at 5:40 pm
Michael, one thought you might consider when comparing the cost of our “system” vs. those of various places in Europe. There is a very real free-rider problem here. Somebody has to pay for innovation, or it drops off enormously; but as long as someone is paying for it, everybody else can still get the benefits. As long as Americans pay the cost of innovation, the rest of the world can get the benefits while showing off a lower cost for health care than we have.
That is not to say that the current American approach cannot be improved. (I’ve spent too much time over the last decade without insurance, and the rest paying for my own, to think that.) But any proposed improvement/reform will need to at least address the question if it wants to be taken seriously.
karen said,
August 13, 2009 at 7:41 pm
:0)- hey, y’all:
i am still here(barely) and wanted to add there was a man interviewed on NPR this a.m. about his feelings and book: ~How America’s Healthcare System Killed my Dad~, i think the title was. Very accurate IMhumbleO. Hmmmm- i didn’t know there was spellck on computers for comments- kewl:0). ps- i have no internet connect at home, anymore.
Still not moved in, school starts on the 26th- 1/4 past 3a.m. sks and i love the red underlining of unchecked spellin’. Did i mention i was tired? And we hit a deer the other morning on the way to the barn and killed it– no damage to the gashawg GMC or selves. A waste of a future buck(as it was a small spikehorn).
Michael– your unwavering inflexibility is not a remarkable feature in you. I almost prefer your biting, acid wit to this supercilious tone of type. But, that’s just me.
michael reynolds said,
August 13, 2009 at 8:20 pm
Amba:
I don’t think I accused you of anything. I asked whether you had some basis for your core presupposition.
You avoided the question by asking me to prove the opposite proposition.
I’m still waiting for anyone who can show me some evidence that government is necessarily less efficient than government. The closest test cases I can find are schools and prisons.
There are public and private prisons, public and private schools. Private prisons have not so far demonstrated greater efficiency. Private schools outperform public although that’s not comparable because privates get to choose their own student body. Despite this, are they cheaper?
My son attends a private school in Orange County, CA. Public school costs $9,500 per student. My son’s school? $15,300. And that’s before they squeeze another 2 large from me in fundraising.
Randy said,
August 13, 2009 at 8:21 pm
Some odd thoughts:
It is my understanding that, contrary to widespread belief, much of what FEMA does is not done in-house but is outsourced. The problems associated with New Orleans had more to do with moving FEMA to the new Dept. of Homeland Security and the ensuing disruption of tried-and-true lines of communication and division of responsibilities than normal government bureaucracy.
Medicare outsources most of its claims processing. For example, until a few years ago, Blue Shield of California processed all Medicare claims in California. The current processor for California is a division of Blue Shield or Blue Cross of South Carolina. IF (a big IF) the government attempts to take all public plan medical claims processing in-house at the same time as offering a public option, one can be sure that there will be tremendous problems for a long time before things settle down.
An interesting complaint about Medicare comes from providers fearful (with good reason) of being sued for fraud for over-billing because Congress invariably dithers about setting acceptable billing rates until the last possible day (on occasion, AFTER the last day). By the time the software updates come out weeks (or months) later, bills for service in the new year have already gone out. (I’ve been told that allowable rates for mental health treatment have been cut almost every year for a decade and that they are now about the same as what Medicare was paying in 1982.)
It has been said that we already spend almost the same percentage of GDP on Medicare beneficiaries alone as Japan spends insuring every single citizen of Japan. Medicare underpays actual costs and the insureds not covered under a public plan subsidize that underpayment. It strikes me a unreasonable to expect any reform to actually reduce overall expenditures to anything approaching Japan, as so much of our built-in expenses are cultural, behavioral and geographical in nature.
In 39 or 40 states, two companies alone account for a minimum of 50% of all private insurance. There isn’t as much competition as some would have one believe.
Every insurance company makes decisions on what it will or will not pay for according to the contract in force and its definition of what is rational, so those people screaming about the dreaded “death panel” sound ignorant about the reality of their current policies. Claims involving expensive medications, operations of dubious value, and unusual conditions are routinely denied every day.
WJ’s point about other nations free-riding off the American system is well-taken. This wasn’t as big an issue a couple of decades ago when few group plans had separate co-pays for prescriptions. Drugs were just another cost, like doctor visits, lumped into the deductible and then part of 20% co-pay until the out-of-pocket limit was reached. Now, the average group-insured consumer has no clue how much the drug costs. Some plans are $5, $10, $20 no matter what. Others might pay $10 for generic, $20 for others and $40 for the really expensive without wondering just how expensive or rare a drug has to be to be considered really expensive.
Maxwell:
Dental is usually cheaper than medical for a few specific reasons:
1) There is almost always a low maximum pay-out benefit per year no matter what the charges add up to.
2) There is a definite schedule of benefit payments that takes no account of unsual circumstances. (For example, crown replacement will not be reimbursed within 5 years of the original crown even if the crown has to be replaced because the person lost a tooth and needs a bridge. They’ll pay for the bridge but not the crown.)
3) As a result, dental expenses within a large pool are actually highly predictable.
michael reynolds said,
August 13, 2009 at 8:25 pm
WJ:
I agree there is a free ridership issue. But I seriously doubt that accounts for a 100% disparity.
Rather I think we have an inefficient system, a bastardized part public, part private, mostly employer, fragmented-by-state, stock-price-oriented system that rewards doctors and hospitals for wasting money on endless tests, and has as a clientele a bunch of paranoid, ill-informed, disconnected-from-cost, spoiled, philosophically infantile people.
amba12 said,
August 13, 2009 at 11:24 pm
Michael: You accused me of avoiding the question.
There’s a wonderful typo/Freudian slip in that comment.
amba12 said,
August 13, 2009 at 11:28 pm
In 39 or 40 states, two companies alone account for a minimum of 50% of all private insurance. There isn’t as much competition as some would have one believe.
Excellent point.
amba12 said,
August 13, 2009 at 11:30 pm
those people screaming about the dreaded “death panel” sound ignorant about the reality of their current policies.
On NPR, someone at a town hall was quoted as yelling, “Get your government hands off my Medicare.”
amba12 said,
August 13, 2009 at 11:36 pm
fragmented-by-state
Big problem, fairly easily solved as I understand it. If people could shop for good insurance deals out of state, prices would go down.
rewards doctors and hospitals for wasting money on endless tests
Another big problem: perverse incentives.
and has as a clientele a bunch of … disconnected-from-cost… people.
The only way to control costs is to fix that “disconnected-from-cost.” The other problems you mention would probably lessen. Someone suggested routine health care costs should be paid for out of pocket (with help for those who can’t) and all insurance should be catastrophic. That was interesting.
Donna B. said,
August 14, 2009 at 12:42 am
Could we decide on what health care is first?
My problem with the end of life counseling thing was that it is not health care and should not be paid for as such. If the government thinks such counseling will reduce costs, let them contract with AARP or other senior-based non-profits. There’s probably already a HHS program that would fit neatly into. I think doctors and hospitals have a distinct conflict of interest in providing the counseling for pay.
A similar problem is with the proposal to provide in-home visits and parental training to new parents to prevent child abuse. Again, it’s not the service I’m griping about — it’s calling it health care that bothers me. HHS funds many child abuse prevention programs and most states add their own $$ to that. I’d have less of problem calling this health care if the training was offered to parents during the pregnancy.
OR… abolish HHS and use those funds to pay for the two new agencies and all the health care or semi-health care stuff HHS already provides.
Wasn’t funding for electronic health records included in the stimulus bill? Did that get cut out? If not, there’s no need to address it again in this bill. I thought comparative effectiveness research was funded there too… I could have imagined it.
I was also wondering if these are record-breaking bills as far as number of pages. Anybody know the longest bill ever passed by Congress?
amba12 said,
August 14, 2009 at 1:16 am
I think doctors and hospitals have a distinct conflict of interest in providing the counseling for pay.
Very interesting point!!
I was also wondering if these are record-breaking bills as far as number of pages.
The length of the bill feels like one or both of two things: 1) its length and convolution correlates directly to the size and structure of the bureaucracy that will administer it; dealing with that system will be as labyrinthine as reading the bill; 2) someone doesn’t WANT the bill read or understood before it’s passed — the length is an obfuscating & discouraging tactic — protective squid ink.
Scott said,
August 14, 2009 at 2:58 am
Micheal, Here are 2 examples about how bad the government can be running something:
United states postal service, and Amtrak
Also one of the main reason Medicare works so well, is the cost-shifting it does on billing for hostipal services, and how it pawns off Fraud prevention to Law Enforcement, whereas most, if not all private insurance has to pay the for their own Fraud Enforcement and also pay more for services at hospitals because of Medicare’s undercutting of base price of hospital services.
That is why more and more doctors are refusing to take medicare patients (Besides the extra paperwork) (http://www.aapsonline.org/medicare/medrep.htm )
Scott said,
August 14, 2009 at 3:06 am
When I mean Post Office being poorly run, they have lost money the last 11 out 12 quaters
http://www.usps.com/communications/newsroom/2009/pr09_066.htm
Scott said,
August 14, 2009 at 3:07 am
or another article on the US Postal Service
http://thehill.com/leading-the-news/gao-postal-service-in-financial-disarray-2009-08-06.html
Scott said,
August 14, 2009 at 3:23 am
Here is another Government Program that has failed and is still getting money:
the Safe and Drug Free Schools Program
Click to access performance.pdf
or
http://www.csdp.org/news/news/darerevised.htm
Scott said,
August 14, 2009 at 3:24 am
sorry for the spam, amba
amba12 said,
August 14, 2009 at 3:27 am
That’s not spam!
Scott said,
August 14, 2009 at 3:29 am
Longtime lurker, amba. Love the site
amba12 said,
August 14, 2009 at 3:54 am
Well, welcome!
Scott said,
August 14, 2009 at 3:56 am
Also if the US cannot get it right with Native health care funding, how do you expect it to work on a larger scale.
http://www.newsminer.com/news/2009/jun/16/native-health-care-funding-federal-failure/
or
http://www.ama-assn.org/amednews/2008/02/18/gvsc0218.htm
Along the same lines, do we even need to discuss how badlly we have failed the native american populations
michael reynolds said,
August 14, 2009 at 12:31 pm
Scott:
First, the Postal service is an independent agency, a bit like the Federal Reserve. It’s not run by government directly, it’s run by an independent board.
Second, it delivers a letter from Buttcrack, Vermont to Cowpatty, Montana for 44 cents. One of the great deals ever. What else can you get for 44 cents? A pack of gum costs three times as much.
Third, yes, Amtrak is a mess. It probably should be closed down.
But pretending that a government entity that uses outside contractors to provide services ceases to qualify as a government entity is silly. Of course they use private contractors. Every part of government, even the Army, uses private contractors. And private industry uses government services: police, fire, air traffic control, roads and bridges, the regulatory agencies.
It’s a symbiosis. Which again makes my point: there is no proof of the theological belief that government is necessarily less efficient than private industry.
michael reynolds said,
August 14, 2009 at 12:35 pm
Also if the US cannot get it right with Native health care funding, how do you expect it to work on a larger scale.
It does in fact deliver on a larger scale. Military hospitals. VA hospitals. Medicare. Medicaid.
When people defend the current system they are defending a system that is already about 1/3 government-funded or government-run.
The federal government also has a huge role in our vaunted system of medical research.
So, we already have a hybrid government/private health care system. It will regardless of what bill passes, remain a hybrid. So the question does not come down to either/or, it comes down to how we manage the hybrid.
amba12 said,
August 14, 2009 at 12:51 pm
So, we already have a hybrid government/private health care system. It will regardless of what bill passes, remain a hybrid. So the question does not come down to either/or, it comes down to how we manage the hybrid.
That is exactly true; and those who pretend otherwise are preying on the ignorance and credulity of their constituents.
I can’t stop thinking about the guy who said “Get your government hands off my Medicare.” Isn’t that it in a nutshell? With entitlements we’ve come to take for granted, the government becomes invisible — like the air we breathe.
Courtney Haynes said,
August 14, 2009 at 4:19 pm
Wow, I wish I had a better understanding of how all this works (or does not work). I always come back to this thought: We think of ourselves as the greatest country on earth. If other countries can handle health care effectively and equitably for their citizens, why can’t we? I believe we can, but we first have to decide we want to. The cost of letting this situation get worse and worse really is too expensive for the country. Why don’t we gather the best brains we can find together and just figure it out and make it work?
Scott said,
August 14, 2009 at 7:45 pm
Micheal
I understand that our surrent systems has gaps and other problems, and I do believe somethings need to change. But I disagree with you about how much government involment there should be. I am not one of those people with a gold plated insurance. I am included in the 47 million without insurance.
My main point about the programs and Agencies, I have mentioned is that unlike a Business, a failed or severly under performing government Entity does not go out of business, it just gets more money from the government and hear all the ways they will “contain” cost and eliminate waste, and then 3 years later the same “Entities” are back at the table asking for more money, etc., etc.
My basic Ideas for reform are these
1) The Federal government set regulations for a Basic Plan, and a Catastorphic Plan for insurance companies instead of each state. A State can set regulations for other plans put forth by Insurance companies at their own proclivities
2) Pre-Existing Conditions: Have the Federal Government set strict provisions on rescission for the two basic plans mention in point 1, also Create a program that will help cover a portion of the costs for a person with Pre-Existing Conditions for the two basic plans mention in point 1.
3) Instead of a Civil Trial with a jury, have malpratice cases heard by a special court (Similair to Tax Courts, or FISA Courts but Open and Transparent) or special arbitration board set-up with a numbers of doctors, with 1/3 picked by the insurance companies, 1/3 by Consumer Advocate groups, and 1/3 by the government. This way no one can be blamed as gaming the system.
4) Tort Reform: Have 3 tiers of caps on awards, One for Malpratice causing death with a Cap of 2 million plus Expected Life time income, One for Malpratice causing major Life altering effects with a cap of 1 million plus Expected Life time income, and a third tier for all other types of claims set at $500,000. And if found that the doctor egregiously violated ethical or professional standards, they will lose their licence throughout the United States by an amout of time set by whichever option is setup in point 3
Scott said,
August 14, 2009 at 7:53 pm
Another idea instead of Special courts, is to Request that the AMA(or similair group or agency) setup what are the expected procedures for presenting symptoms. If the doctor follows these guidelines/rules they cannot be sued. This will, I think stop alot of the defensive medicine in use today. Mind you, a doctor can go above and beyond these rules. This basically is to allow a “Safe Habor” provision for doctors against lawsuits only. Disciplinary actions taken by medical boards are not affected by these guidelines/rules.
This is different from some current plans where a board will decide/”strongly encourage” which specific treatments are good or bad.
Scott said,
August 14, 2009 at 8:00 pm
err surrent = current.
Note to self, Spell check is your friend :)
amba12 said,
August 14, 2009 at 9:06 pm
Tort reform: a must. I know doctors whose malpractice premiums are prohibitive and I am sure there are young people deciding against going into medicine, certainly into certain specialties, for just this reason.
Scott said,
August 15, 2009 at 12:39 pm
For the record, I believe the government is not evil, I just think there are certain things it cannot do well, or should not do, but there are other areas that government influnce is needed to guide or make fenceposts for acceptable behavior in business.
To follow on to my post at 7:45pm didn’t want to make a post look like an essay :)
With Point 1, these 2 plans would be available to anyone in any state, from any insurance company, also with the optional plans a state must allow it to be offered unless they can show good cause in not allowing it in that state. I believe this point could open up competition and also allow new types of plans.
With Point 2 this will help reduce the financial burden of Pre-Existing condition and also allay fears of rescission and also curb most of the criminal or illegal uses of this clause. I would say a good punishment for the abuse of rescission is fines and even upto the revoking of the Insurance company’s License to insure people
with Point 3, it will first stop the forum shopping that goes (I know not all malpratice suit do it, but a large minority try it). This also takes the emtional baggage out of the determination of the case.
The big thing with Point 4 is Stability. While the $20 million awards might not happen often, a company must take that into account when priving premiums. Afterall, for example if a Insurance company is only expecting to payout in a given 90 million in malpratice suits, but they get judgements for 60 million from 5 cases well their whole budget get blown apart. So instead I think most insurance companies plan for 3-5 big awards which drive up costs for doctor. With caps like these it gives the insurance companies the ability to at least plan ahead on expected awards for a year which should reduce premiums for doctors.
The big thing with these propsals are it allow the government set the Fenceposts of the playground but it does not have the government in the playground playing with others.
Scott said,
August 15, 2009 at 12:40 pm
err priving = pricing
Chicken pecking is an art form for typing :)
amba12 said,
August 15, 2009 at 2:45 pm
“fenceposts” — an excellent way to describe the government’s role.
I’m going to tweet your comments & try to get some people to come read ’em. Good ideas.