06/16/2009 (9:54 am)
ABC Becomes White House “Love Slave”
Drudge’s 36-point font headline announces that beginning June 24, ABC News will begin full-throttle propaganda advocating national health care, including broadcasts from inside the White House and addresses by the President. They are not even going to attempt objectivity; requests for air time from the Republicans have been turned down.
The RNC letter to the chief of ABC News includes this nugget:
In the absence of opposition, I am concerned this event will become a glorified infomercial to promote the Democrat agenda. If that is the case, this primetime infomercial should be paid for out of the DNC coffers.
Indeed. In a way, I’m relieved. Mainstream press news has been flacking for the DNC for my entire adult life. It’s an improvement if they admit it. More people will know not to believe them.
More, but not enough. There’s still an uninformed middle that accepts these bozos’ infomercials as objective news reporting. It’s shrinking, but it exists. It’ll take another decade for the rotting corpses of the Big Three network news outfits to decay, maybe more.
Meanwhile, ObamaCare promises to cost in the trillions and not solve the “problem” of uninsured citizens. I’ve still not seen a single instance of a government-financed health care system that produces acceptable results, anywhere in the world, any time in history. If Obama’s sycophants could produce just one example…
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16 Comments »
Comment by suek
Riiight. And these are the same people who claim that we need the “Fairness Doctrine” for the radio.
They are _such_ hypocrites.
Comment by suek
Have you seen anyone anywhere ask the question “Why are health care costs rising?”
Obama has stated that the one thing he _won’t_ cap are medical malpractice suit awards.
Ya think _maybe_ lawsuits just _might_ have something to do with rising costs? If health care is nationalized, will people still be able to sue? Who will they sue? Will the taxpayer be on the hook not only for the health care costs, but also for malpractice suit awards???
Comment by darkhorse
Suek / Phil -
I really think the health care system we have, which encourages people to be insured and then encourages them not to ask questions about how much procedures cost, is the obvious cause of the quick rise in health care costs.
I am not really educated in this area, but I don’t think the rise in Malpractice Insurance costs, as a percentage of total health care costs, come close to telling the story.
I wonder if there are any trusted sources in places like England where we could get an honest assessment of how health care runs there. Though he is a hopeless exaggerator (and many consider exaggeration to that extent plain lying), maybe Michael Moore was not completely off base in his review of some other health care systems around the world.
I’d be interested in reading commentary that didn’t originate in the US on how it really works in other countries. Perhaps it’s hopeless…but my friends in England don’t seem to think so. That is far from scientific…but worth looking into.
Comment by darkhorse
BTW, Phil, your teaming up with Drudge to expose this horrid move by ABC is much appreciated.
Comment by Phil
darkhorse,
I’ve personally known two physicians who made major changes in their practices due entirely to malpractice insurance costs. One of them actually quit medical practice in favor of teaching when his practice lost money due to insurance costs, while the other joined a group, more than doubling his prices. I don’t think you can discount malpractice insurance as a primary cause.
I do think over-regulation and over-insuring have had an enormous impact as well, as has the AMA’s monopoly on doctor training.
Comment by Phil
Suek wrote:
Ya think _maybe_ lawsuits just _might_ have something to do with rising costs? If health care is nationalized, will people still be able to sue?
I suspect that once the government is on the hook for most medical practitioners, you’re going to see pretty severe restrictions on malpractice suits. That’s down the road, though. For the moment, Obama is busy trying to pretend that he’s really in favor of mostly free-choice medicine — while he’s jamming socialized medicine down our throats.
Comment by darkhorse
http://www.insurance-reform.org/pr/AIRhealthcosts.pdf
Again, I’m not hyper-educated here, but I suspect there is some truth in these charts…
Jim
Comment by Phil
Jim,
The charts you posted are aggregates for the entire US for all medical specialties. Apparently, the rise in malpractice insurance costs varies by region and by specialty, sometimes dramatically. On a quick search, I found this study by the US GAO, explaining some of the regional differences. They studied 14 states, and discovered localized access problems (people can’t find doctors) due to malpractice issues in 5 of them.
Consider these details:
Premium rates also vary across and within states. Across states, for example, a large insurer in Minnesota charged base premium rates of $3,803 for the specialty of internal medicine, $10,142 for general surgery, and $17,431 for OB/GYN in 2002 across the entire state. 12
In contrast, a large insurer in Florida charged base premium rates in Dade County of $56,153 for internal medicine, $174,268 for general surgery, and $201,376 for OB/GYN, and $34,556, $107,242, and $123,924, respectively, for these same specialties in Palm Beach County. In addition to the wide range in premium rates charged, the extent to which premiums increase over time also varies by specialty and geographic area. Beginning in the late 1990s, malpractice premiums began to increase at a rapid rate for most, but not all, physicians in some states. For example, between 1999 and 2002, the Minnesota insurer increased its base premium rates by about 2 percent for each of the three specialties, in contrast to the Florida insurer that increased its base premium rates by about 98, 75, and 43 percent, respectively, for the three specialties in Dade County.
As you can see, malpractice lawsuits have indeed produced problems in some locations, but not in others. The doctors I knew who had to bail were an OB/Gyn in Mobile, AL and an Internal Medicine specialist in Philadelphia. Apparently their insurance rates were among those that rose dramatically.
This is a good illustration of why you haven’t really understood a problem just because you’ve found an aggregate statistic. It pays to examine the details a bit further.
Comment by darkhorse
Just as I claimed, I am not fully educated here and was looking for some help.
As Pres. W. said, “OB/Gyns are not able to practice…” okay, no need to pick on a guy for his weakness.
I knew this particular field was having it rough…also have friends who have steered away from it.
But in general, it can be said from the charts that overall medical costs are not impacted MAINLY or PRIMARILY by malpractice suits and insurance, no?
Comment by Phil
It is correct to say there exist primary causes for high medical prices other than malpractice suits, yes. But it’s not correct to say that malpractice suits are not a major factor.
Comment by darkhorse
Phil -
I have a hard time translating the charts into “major factor”. I am sorry, and not trying to be cantankerous. It just doesn’t look to be there.
Comment by darkhorse
On the lighter side, I can’t believe how damn funny the “Day by Day” cartoon is today – “Get a Room”, indeed.
Comment by suek
Thank you for that link…I stripped it back a bit and found the main site, which looks like it has some good info.
http://www.insurance-reform.org/
One problem it doesn’t address is the tendency of doctors to require more tests in order to reduce the possibility of getting sued. That certainly adds to medical costs, although I don’t know how you’d quantify it.
My FIL was a doctor. He moved to a retirement community, and although he no longer actually practiced medicine, he kept his medical license current for about 10-15 years while he lived in the community. He also saw patients (fellow retirees), although he referred them to the appropriate physician if the problem was more than could be handled by very basic medical equipment (stethoscope, blood pressure monitor etc.). He didn’t charge for his services. At some point, he had to quit – it just didn’t make sense to do anything in the way of medical practice due to the fact that he was unwilling to risk his retirement savings by offering _any_ medical advice without having insurance, and the insurance was unreasonable for him to pay, considering he derived no income from it. The loss was to the community.
I don’t know exactly what actually is the reason for the increase in the cost of health care, but the fact is I haven’t seen the question asked, nor any answer offered.
Comment by darkhorse
Suek -
Too bad about your FIL…there should be some room made for those who are volunteering their services.
I think simple economic laws govern the rise in health care costs. The majority are insured and have no incentive to ask how much a procedure costs or whether it is necessary…so what would hold the prices down?
This is just the idea of a land surveyor, of course…but I think this is the simplest explanation…added to the cost of places that are required by law to treat those who cannot afford it.
Some kind of health insurance for these seems like the best way to head off emergency room costs at the pass…but if there is a better idea, outside of letting them die, I’m listening!
Comment by Phil
Jim –
The chart also only assesses the direct cost of malpractice awards — malpractice payouts. That’s only a minuscule part of the problem. The real price of the rising litigiousness of American patients is defensive medicine on the part of doctors and, more importantly, insurers: the insurance company requires certain tests that are truly not necessary, unless one needs them as a defense against a malpractice suit.
On a very quick review of the subject (which is therefore prone to error), the landmark research on this seems to have been a study produced by Price Waterhouse Coopers in 2008, entitled The Price of Excess: Identifying Waste in Healthcare Spending. They claim that more than half the cost of health care in the US is the result of wasteful spending, and that the largest factor in this was defensive medicine.
Short version, they said the three largest contributors to the waste in health care spending, which they say accounts for 54% of our health care costs, are defensive medicine, wasteful administrative practices, and the cost of care associated with entirely preventable conditions, in that order. The last category supposedly includes patients ignoring doctors’ instructions, smoking, obesity, and alcohol abuse.
Solving the malpractice issue thus becomes the most critical need in health care, if this is to be believed.
By the way, the answer to your question, “What is there to hold the prices down,” is “the insurers.” Insurance companies will only pay so much for a given procedure; the doctors charge precisely what the insurer will cover. The only way your theory accounts for any of the high cost of health care is the extent to which the heavily regulated insurance system divorces the doctors from the realities of the market. I do believe this contributes — when the doctor actually has to charge a patient directly, his behavior is different.
Comment by suek
>>wasteful administrative practices>>
No doubt there’s truth to this, but how much of insurance paperwork is the minimum to avoid (or enable) fraud, and how are those expenses covered? Think of the doctor’s office 50 years ago…doctor, probably one nurse and a receptionist/bookkeeper. Now the doctor has to have an additional staffer who handles the insurance claims – at least one, maybe two. That person has to be paid, and must cost $50k or so a year – maybe more with all the additional tag-ons. It’s only a bit here and a bit there, but if you figure an additional $250-300K per year of expense, and if you figure the laughable 40 hour work week, you’re adding $60-80 per hour to the doctor’s expenses. If a lawyer gets paid $175 per hour, should a doctor expect less? Let’s be generous – make it $200 per hour – he has to establish his own retirement account if he want’s more than SS in his old age – so now we’re up to $275 per hour (or so). If he can see 6 patients per hour (a whopping 10 minutes each), that’s about $45 per patient, and no medication or tests included. That doesn’t include the nurse or receptionist, and we haven’t even started on rent for the office and equipment.
So how unreasonable are the doctor’s fees? I could see us getting up to $100 per patient for a 10 minute visit, no problem.
Now…how can you reduce that? Where’s the waste?
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