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Biggs3535

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« #15 : June 02, 2013, 09:23:21 AM »

Since this is a football site, I have decided to expand my previous comments and SOLVE the HC issue.


John Galt?'s "Sudden Death" Healthcare Solution:

Step 1: Kill all the lawyers

Step 2: Kill all the lobbyists              Insurance Co.s spend Billion$ on lobbyists, Big Pharma spends Billion$ on lobbyists, the AMA spends Billion$ on lobbyists, patients spend ZERO on lobbyists. Guess who is NOT gonna benefit from any HC reform legislation or regulations??

Step 3: Kill Obamacare        it is highly flawed and primarily benefits insurers and bloated bureaucratic workers. It does nothing to address high drug costs or procedure costs.


Step 4: Kill Fraud   
       Medicaid and Medicare fraud is rampant. Root it out and make the penalties for involvement in fraud so stiff as too discourage it i.e. jail time and loss of licenses.

Step 5: Kill unilateral pricing         Prices for drugs and procedures is neither regulated nor competitive. Instead, every year have a price setting committee meet. The committee will be composed of an equal number of reps from 1) medical professionals, 2) insurers 3) pharma 4) a group of average Joe's to rep the patients-no doctors, lawyers, nurses, or insurance workers allowed. This committee will then set maximum prices for MRIs, mammograms  surgeries, and other emergency and vital procedures and for vital and necessary drugs. Prices should be based on costs and a reasonable profit margin. For instance, Drug X cost $50 million to develop and test, and you expect 5 million bottles to be prescribed per yr, and the production costs are $3/bottle, the price of Drug X is set at $16.25/bottle which includes a 25% profit margin for the developer. (as opposed to $90.00/bottle w/insurance or medicare paying $81.00 of that under our current system)

Step 6: Kill Medicare/caid        Replace these gargantuan fraud ridden programs with a Federal 2 State HC grant program. The Fed takes Medicare payroll taxes ($400 billion) and allocates that based on both how much they paid in and what their excess need may be, and grants that to the states and the states are mandated to come up with their own Universal HC system. With 50 different systems and administrations, some will work great, others not so, but the bad ones can learn from the good ones, and the better ones and see what not to do from the bad ones. 50 brains instead of just one.

If you were to simply socialize healthcare by creating a single payer system, and socialize liability insurance by creating single payer malpractice coverage for doctors, then you would have to kill a significantly lower number of people.

A single payer system makes Medicare/aid unnecessary, and also makes unilateral pricing virtually impossible. A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor. Canada does this and malpractice insurance premiums there are nearly ten times lower than they are here. Tort reform wouldn't even be necessary. No lawyers need be harmed.

That sounds awesome.  I hope there aren't any negative consequences to this utopia you speak of.


John Galt?

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« #16 : June 02, 2013, 11:27:20 AM »

Since this is a football site, I have decided to expand my previous comments and SOLVE the HC issue.


John Galt?'s "Sudden Death" Healthcare Solution:

Step 1: Kill all the lawyers

Step 2: Kill all the lobbyists              Insurance Co.s spend Billion$ on lobbyists, Big Pharma spends Billion$ on lobbyists, the AMA spends Billion$ on lobbyists, patients spend ZERO on lobbyists. Guess who is NOT gonna benefit from any HC reform legislation or regulations??

Step 3: Kill Obamacare        it is highly flawed and primarily benefits insurers and bloated bureaucratic workers. It does nothing to address high drug costs or procedure costs.


Step 4: Kill Fraud   
       Medicaid and Medicare fraud is rampant. Root it out and make the penalties for involvement in fraud so stiff as too discourage it i.e. jail time and loss of licenses.

Step 5: Kill unilateral pricing         Prices for drugs and procedures is neither regulated nor competitive. Instead, every year have a price setting committee meet. The committee will be composed of an equal number of reps from 1) medical professionals, 2) insurers 3) pharma 4) a group of average Joe's to rep the patients-no doctors, lawyers, nurses, or insurance workers allowed. This committee will then set maximum prices for MRIs, mammograms  surgeries, and other emergency and vital procedures and for vital and necessary drugs. Prices should be based on costs and a reasonable profit margin. For instance, Drug X cost $50 million to develop and test, and you expect 5 million bottles to be prescribed per yr, and the production costs are $3/bottle, the price of Drug X is set at $16.25/bottle which includes a 25% profit margin for the developer. (as opposed to $90.00/bottle w/insurance or medicare paying $81.00 of that under our current system)

Step 6: Kill Medicare/caid        Replace these gargantuan fraud ridden programs with a Federal 2 State HC grant program. The Fed takes Medicare payroll taxes ($400 billion) and allocates that based on both how much they paid in and what their excess need may be, and grants that to the states and the states are mandated to come up with their own Universal HC system. With 50 different systems and administrations, some will work great, others not so, but the bad ones can learn from the good ones, and the better ones and see what not to do from the bad ones. 50 brains instead of just one.

If you were to simply socialize healthcare by creating a single payer system, and socialize liability insurance by creating single payer malpractice coverage for doctors, then you would have to kill a significantly lower number of people.

A single payer system makes Medicare/aid unnecessary, and also makes unilateral pricing virtually impossible. A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor. Canada does this and malpractice insurance premiums there are nearly ten times lower than they are here. Tort reform wouldn't even be necessary. No lawyers need be harmed.

First off let's not compare Canada and their 34 million people to the US and its 314 million people. Heck California has a bigger population than Canada.  And SIZE does MATTER 0when talking about a single payer administrating all those claims.

Here are the problems with a single payer system:

1. if it is a bad system, you sink the whole country, not just one state.

2. Too big. Usually an organization gains efficiency as it gets larger, but only to a point. Above that maximum point it quickly becomes duplicitous, redundant, and fraught with fraud and corruption. And you are talking about a system that is Titanic. And they all said the Titanic couldn't sink, right?

3. No competition, no flexibility, no choice. With private insurers in the loop, you will get some that go the  Mercedes route, higher priced but top of the line features and great customer service. Others will go the Walmart route, lowest prices but crap customer service and no bells or whistles. And others will go some where in between. A single payer system gives EVERYONE a cookie cutter plan the same for all, regardless of age, income, preferences, wants, etc. Some people might want a lower co-pay in lieu of higher premiums, others might want dental included, others might not care about psychological services, others might want lowest monthly costs and will accept a higher co-pay. Does a gay man HAVE to have pregnancy covered??

There is a reason restaurants in this country have menus, people want choices, not just "Lunch". Some people want a red Miata, others prefer a Black Town car.

4. No chance for improvement by comparison. In a State by State plan, Kansas might come up with a system that is great, Missouri might have a problematic plan. Mo. can then look at the Kansas plan and adjust its plan to be more like that. Iowa can look at Maine and say " they have this one concept that really works well, we should adopt that"

5. No flexibility- Not all states are the same. The HC issues affecting Wisconsin are far different than Florida (with its huge elderly population). Florida doesn't need Frostbite and Hypothermia care units, but does need a lot more Dialysis, Alzheimer's care, etc. Lymes disease is rare in California, but rampant in Connecticut. etc.

6. More Federal bloating. A single payer system just adds to an already over bloated and over burdened Federal Govt. I say it is far better to put the majority of the burden on the states, and leave the Fed's responsibility to just monitoring 50 states rather than administrating 314 million people.   


VinBucFan

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« #17 : June 02, 2013, 10:05:03 PM »

A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor.

wtf?  huh?

in the US, all doctors' malpractice insurance premiums account for suits and the risk of suits against ALL doctors.

CBWx2

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« #18 : June 03, 2013, 10:21:35 AM »

First off let's not compare Canada and their 34 million people to the US and its 314 million people. Heck California has a bigger population than Canada.  And SIZE does MATTER 0when talking about a single payer administrating all those claims.

In terms of burden to the taxpayer, I don't see a great deal of difference between a federal department being paid for by public funds to oversee claims and each state having one. If anything, shrinking the payer pool for administrative costs seems less cost effective.

Here are the problems with a single payer system:

1. if it is a bad system, you sink the whole country, not just one state.

It is not as though there are no systems in which to model it after. There are plenty. We wouldn't exactly be walking blind here.

2. Too big. Usually an organization gains efficiency as it gets larger, but only to a point. Above that maximum point it quickly becomes duplicitous, redundant, and fraught with fraud and corruption. And you are talking about a system that is Titanic. And they all said the Titanic couldn't sink, right?

There is nothing in a single payer system that suggests that individual states cannot be in charge of policing the process. In fact, in Canada, quite the opposite is the case. Each province oversees implementation of the health care system. When you apply for health care coverage in Canada, you do not get a Canadian insurance card, you get a card issued by your provincial government. Ontarians get an Ontario card, Quebecans get a Quebec card, and so on. Each also has their own anti-fraud divisions.

3. No competition, no flexibility, no choice. With private insurers in the loop, you will get some that go the  Mercedes route, higher priced but top of the line features and great customer service. Others will go the Walmart route, lowest prices but crap customer service and no bells or whistles. And others will go some where in between. A single payer system gives EVERYONE a cookie cutter plan the same for all, regardless of age, income, preferences, wants, etc. Some people might want a lower co-pay in lieu of higher premiums, others might want dental included, others might not care about psychological services, others might want lowest monthly costs and will accept a higher co-pay. Does a gay man HAVE to have pregnancy covered??

There is a reason restaurants in this country have menus, people want choices, not just "Lunch". Some people want a red Miata, others prefer a Black Town car.

The choice argument is really just a mirage. For the vast majority of people, there is no real choice. You get whatever your company is willing to pay for. Typically, if your company doesn't pay for anything, then you don't get anything.

Ultimately, what people want from health care coverage is to be covered. The reason that Mercedes plans and Miata plans exist in this country is because some can afford good insurance, and some cannot. If given the choice, cost not being a factor, who in their right mind would pick a Miata plan over a Mercedes plan?

If bells and whistles are what you want, you can purchase supplemental insurance. But a single payer system gives people more healthcare choices. It gives them the choice to see any PCP, not just ones that happen to accept their insurance; to go to any hospital, not just ones that are "in network"; and most importantly, it gives them the choice to see a doctor in the first place, regardless of where they work.

4. No chance for improvement by comparison. In a State by State plan, Kansas might come up with a system that is great, Missouri might have a problematic plan. Mo. can then look at the Kansas plan and adjust its plan to be more like that. Iowa can look at Maine and say " they have this one concept that really works well, we should adopt that"

Having 50 different systems will simply assure that some receive better coverage than others, depending on your geographic location, and relative wealth or poverty of the state that you live in. It's healthcare, not rocket science. A broken leg in Kansas is treated the same as a broken leg in Missouri. Diabetes is still diabetes, whether the person that has it lives in Iowa or Wisconsin.

In a system like this, the odds favor the fact that the rich states will have those plans that everyone thinks works wonderfully, and the poorer states will have the ones that have the greatest amount of dissatisfied patients.

5. No flexibility- Not all states are the same. The HC issues affecting Wisconsin are far different than Florida (with its huge elderly population). Florida doesn't need Frostbite and Hypothermia care units, but does need a lot more Dialysis, Alzheimer's care, etc. Lymes disease is rare in California, but rampant in Connecticut. etc.

This is actually my argument FOR a single payer system. Taking Florida, for example, with it's aging population. Implementing a single-payer plan in Florida is going to put a far greater burden on Floridians than it would in a state with a large degree of young people, like say Massachusetts, which has the largest percentage of high income-earning young people in the USA.

What a single payer plan does is broadens the pool. The broader the pool is, the lower the cost is to each individual covered. This is the sole purpose of insurance; it's only reason for being necessary. What introducing competition into this equation does is shrinks the payer pool, and shifts the focus of the provider from simply paying for care to marketing itself and insuring that a profit is made. This does not lower the costs to those covered, it raises them exponentially.

6. More Federal bloating. A single payer system just adds to an already over bloated and over burdened Federal Govt. I say it is far better to put the majority of the burden on the states, and leave the Fed's responsibility to just monitoring 50 states rather than administrating 314 million people.

The states are already burdened a great deal. You can almost be assured that if all states were forced to pay for coverage out of pocket, many of them would be seeking financial assistance from the Federal government anyway. Why complicate the process? It seems to me that this is really just a symbolic measure than a truly efficient and cost effective one.


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« #19 : June 03, 2013, 10:25:36 AM »

A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor.

wtf?  huh?

in the US, all doctors' malpractice insurance premiums account for suits and the risk of suits against ALL doctors.

Malpractice premiums are not subject to the risk against ALL doctors, Vin. They are subject to the risk against only those doctors covered by the same insurance company. Having 100 different malpractice insurance providers shrinks the payer pool for each, which means that a financial hit to the provider is absorbed by fewer doctors than it would be in a single payer system.

A single payer, non-profit provider also means that the risk assessment process in terms of litigation will be streamlined and more effective at weeding out frivolous claims. As it stands now, most insurers would rather not risk taking claims to court, because the cost to litigate is more expensive in many cases than the payoff is. Removing the profit motive gives the freedom for the provider to be more aggressive at weeding out frivolous claims, which in turn lowers the incentive of those who would intend on bringing them forward.

Having one provider to sue that you know the odds favor them taking it to court is much more difficult to take advantage of than having 100 different providers to sue that you already know going in don't want to spend the money on a trial.
« : June 03, 2013, 10:34:06 AM CBWx2 »


VinBucFan

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« #20 : June 03, 2013, 10:51:05 AM »

A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor.

wtf?  huh?

in the US, all doctors' malpractice insurance premiums account for suits and the risk of suits against ALL doctors.

Malpractice premiums are not subject to the risk against ALL doctors, Vin. They are subject to the risk against only those doctors covered by the same insurance company. Having 100 different malpractice insurance providers shrinks the payer pool for each, which means that a financial hit to the provider is absorbed by fewer doctors than it would be in a single payer system.

A single payer, non-profit provider also means that the risk assessment process in terms of litigation will be streamlined and more effective at weeding out frivolous claims. As it stands now, most insurers would rather not risk taking claims to court, because the cost to litigate is more expensive in many cases than the payoff is. Removing the profit motive gives the freedom for the provider to be more aggressive at weeding out frivolous claims, which in turn lowers the incentive of those who would intend on bringing them forward.

Having one provider to sue that you know the odds favor them taking it to court is much more difficult to take advantage of than having 100 different providers to sue that you already know going in don't want to spend the money on a trial.

You're mixing two concepts

Of course malpractice insurance takes into account ALL doctors. That is classic risk analysis and part of the reason a podiatrist pays generally lower premiums than an OBGYN. The risks are generally much higher for a doctor handling birth then one handling feet (ie the doctor handling births is sued more frequently and at higher exposure. Insurer look at the individual risk of an individual doctor in underwriting BUT that is to adjust from a premium established by looking at the risk for the market as a whole.

You may just be mixing the words up, but cases do not settle solely because of the cost to litigate. In fact, that applies primarily on small disputes. The real issue is exposure AND the exposure would not change (absent tort reform) if there was a single government payer. In fact, absent tort reform that system would arguably only embolden plaintiff attys. plaintiff attys are not the ones that mind going to trial, they want to go to trial. Anyway, why would the odds favor a government single payer taking things to trial over a private insurer. Private insurers often INTENTIONALY take matters to trial because of the profit motive.  why would a government entity without a profit motive care about costs?
« : June 03, 2013, 03:48:05 PM VinBucFan »

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« #21 : June 03, 2013, 08:02:06 PM »

A single payer malpractice system would lower costs significantly for MD's, because rather than a doctor's premiums being subject to change by being sued, the premiums would only be subject to change by the total amount the payer had to pay out in all cases being brought against all doctors practicing that form of medicine. In other words, the cost of malpractice suits are absorbed by all doctors, not just a single doctor.

wtf?  huh?

in the US, all doctors' malpractice insurance premiums account for suits and the risk of suits against ALL doctors.

Malpractice premiums are not subject to the risk against ALL doctors, Vin. They are subject to the risk against only those doctors covered by the same insurance company. Having 100 different malpractice insurance providers shrinks the payer pool for each, which means that a financial hit to the provider is absorbed by fewer doctors than it would be in a single payer system.

A single payer, non-profit provider also means that the risk assessment process in terms of litigation will be streamlined and more effective at weeding out frivolous claims. As it stands now, most insurers would rather not risk taking claims to court, because the cost to litigate is more expensive in many cases than the payoff is. Removing the profit motive gives the freedom for the provider to be more aggressive at weeding out frivolous claims, which in turn lowers the incentive of those who would intend on bringing them forward.

Having one provider to sue that you know the odds favor them taking it to court is much more difficult to take advantage of than having 100 different providers to sue that you already know going in don't want to spend the money on a trial.

You're mixing two concepts

Of course malpractice insurance takes into account ALL doctors. That is classic risk analysis and part of the reason a podiatrist pays generally lower premiums than an OBGYN. The risks are generally much higher for a doctor handling birth then one handling feet (ie the doctor handling births is sued more frequently and at higher exposure. Insurer look at the individual risk of an individual doctor in underwriting BUT that is to adjust from a premium established by looking at the risk for the market as a whole.

The initial premium amount takes into account risk factors of a specific field of medicine and cost of living in a particular region, but once an MD gets hit with a claim, his individual premium is subject to increase. This does not happen in Canada. Individual premiums are not subject to increase simply because a claim was filed against you. The cost to MD's of a claim being filed against them is significantly lower, because the costs are being absorbed by a larger pool of doctors, and there is no incentive to raise premiums other than to cover costs, because there is no profit margin in need of protecting.




You may just be mixing the words up, but cases do not settle solely because of the cost to litigate. In fact, that applies primarily on small disputes. The real issue is exposure AND the exposure would not change (absent tort reform) if there was a single government payer. In fact, absent tort reform that system would arguably only embolden plaintiff attys. plaintiff attys are not the ones that mind going to trial, they want to go to trial. Anyway, why would the odds favor a government single payer taking things to trial over a private insurer. Private insurers often INTENTIONALY take matters to trial because of the profit motive.  why would a government entity without a profit motive care about costs?

Vince, you just said in the same paragraph that plaintiff atty's want cases to go to trial for a potential bigger payout AND that private insurers want to take matters to trial to save money. That seems to be a bit contradictory. Also, if they both want trials, then why doesn't every case go to trial?

« : June 03, 2013, 08:03:45 PM CBWx2 »


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« #22 : June 03, 2013, 08:35:12 PM »

I think I misunderstood your first post, so my apologies. Having read it more closely,  I now understand what you meant about the cost being absorbed by a larger pool and that makes sense in theory but the part you're leaving out is that it is the government absorbing those costs. in other words, the single payer is not a single national insurer it is the Canadian government, which means taxes.  It would still be a more efficient system to have multiple free market insurers competing for that space. You could have the same approach in this country if insurance was not State driven. With the exception of things like national defense, there is almost nothing that one could reasonably expect the government to do more efficiently than the private sector and thats without even getting to the work-turned-welfare government entities like the post office.

The profit motive is NOT the problem. The problem with health insurance is that it does not fit with the concept of insurance, except for catastrophic care. The very concept of insurance is coverage for unexpected and infrequent events, not insurance for preventative maintenance.

On the trials issue, you suggested that single payer would reduce exposure, which is not accurate.  Generally speaking, all plaintiff's attys want to push cases to trial because of the big upside.  Some insurers choose to avoid that risk and others intentionally choose to take the risk head on.  Both insurers are motivated by profits, they just take different approaches based on their own assessment. The reason not all cases go to trial is because there is always a discount that make sense based on uncertainty, the same would exist with a single payer.  That said, if you told the med mal plaintiffs bar in the US that all med mal was going to be defended by GOVERNMENT ATTYS or by government claim handlers . .  the plaintiff bar would grow three fold . . . they would be lining up . . . because those claim handlers would not be truly accountable like claims people in a private insurer.  Fraud would also go through the roof.  Doubt that?  Look right here at Citizens, how has that gone?

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« #23 : June 03, 2013, 08:56:42 PM »

By the way CBW, you dont have to look far to see the flaws in your single payer system.  In Canada I believe some of the provinces have laws against private insurance (why would that be?) and you have people queue jumping.  I dont have personal experience in Canada, so that is just what I have read. However, I recently lived in the UK and every modestly affluent person has private medical insurance that they pay for on top of outrageous taxes.  One only need open the many local tabloids to see many adds for "jumping the NHS queue"  These are ads for PRIVATE insurance. Why would there be private insurance but for the gross inefficiency that comes with government sponsored anything.

The profit motive is not evil

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« #24 : June 03, 2013, 09:49:31 PM »

I think I misunderstood your first post, so my apologies. Having read it more closely,  I now understand what you meant about the cost being absorbed by a larger pool and that makes sense in theory but the part you're leaving out is that it is the government absorbing those costs. in other words, the single payer is not a single national insurer it is the Canadian government, which means taxes.

Actually, the Canadian Medical Protective Association is not funded via taxes, it is funded via premiums, just as a private insurer would be. The difference is that it is strictly not for profit, which means that it doesn't spend money on anything other than it's primary purpose, which is to provide legal counsel and representation to physicians.

Competing, for-profit firms are not more cost efficient in terms of insurance. The statistics actually point to the contrary for the reasons stated. Multiple, competing, for-profit firms must pay their CEO's, their shareholders, and their marketing costs (the cost of competition). The actual amount of coverage offered and the costs associated with offering it must be formulated after first taking all of that into account. There is no example here or anywhere that suggests that this is a cheaper approach than a single payer system. You cannot add additional things that have to be paid for on top of the initial costs and expect it to be cheaper. It's like suggesting that buying a Big Mac, large fries, and a Coke is cheaper than buying just a Big Mac. It simply doesn't work that way.

The profit motive is NOT the problem. The problem with health insurance is that it does not fit with the concept of insurance, except for catastrophic care. The very concept of insurance is coverage for unexpected and infrequent events, not insurance for preventative maintenance.

The concept of insurance is to pool money in order to pay for whatever is agreed upon by those insured. There is nothing that suggests that insurance is only for infrequent events. Certain kinds of insurance operate that way, such as car insurance or homeowner's insurance, but that is because of the model that has been accepted, not because that is the concept of insurance.

In catastrophic cases, such as car insurance, homeowners insurance, etc., because payouts occur less frequently, the additional funds typically are just kept as profit. That does not fit the concept of insurance. In fact, very little about the capitalist model does, because insurance is an inherently socialist concept.

On the trials issue, you suggested that single payer would reduce exposure, which is not accurate.  Generally speaking, all plaintiff's attys want to push cases to trial because of the big upside.  Some insurers choose to avoid that risk and others intentionally choose to take the risk head on.  Both insurers are motivated by profits, they just take different approaches based on their own assessment. The reason not all cases go to trial is because there is always a discount that make sense based on uncertainty, the same would exist with a single payer.

You are 100% right up until that last part, where you are only partially right. The key words there is risk based on uncertainty. Because private insurers are motivated by profits, some pursue legislation more aggressively than others, with maintaining the profit being the primary cause of action. The reason that insurance costs so much less for physicians in Canada is because the Canadian Medical Protective Association does not take maintaining a profit margin into account when deciding to take matters to court, they simply look at the legitimacy of the claim. Removing the desire to maintain profitability affords a larger degree of discretion when deciding to pursue a trial.

That, coupled with the fact that they are working with a much, much larger funding pool in which to pay for cases to go to trial means that the risk is far lower for them taking a case to trial than it is for a private insurer with a much, much smaller funding pool in which to operate from. Since losing a trial causes a much smaller hit to them, the risk associated with going to trial is also significantly smaller, which means that more cases are ultimately pursued. This, in and of itself, tends to serve as a deterrent for the amount frivolous claims being brought forward.

  That said, if you told the med mal plaintiffs bar in the US that all med mal was going to be defended by GOVERNMENT ATTYS or by government claim handlers . .  the plaintiff bar would grow three fold . . . they would be lining up . . . because those claim handlers would not be truly accountable like claims people in a private insurer.  Fraud would also go through the roof.  Doubt that?  Look right here at Citizens, how has that gone?

The reality of this doesn't match the rhetoric. Insurance coverage in Canada for physicians is, on average, about 10 times lower in cost than it is in the US, and the not-for-profit provider pursues frivolous claims far more aggressively than private insurers do here. Those are the facts. I'm not sure what Citizens has to do with it. Do you mean Citizens United? If so, how is that relevant?


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« #25 : June 03, 2013, 10:30:39 PM »

This is at best overstated and at worst just flat wrong, at least your linking of the two

Insurance coverage in Canada for physicians is, on average, about 10 times lower in cost than it is in the US, and the not-for-profit provider pursues frivolous claims far more aggressively than private insurers do here. Those are the facts.

You are assigning a benefit (lower malpractice costs and premiums)  to single payer that is not related to single payer.  It is not the fact that healthcare is single payer or that there is a larger loss pool and that makes the single payer take things to trial. Med mal premiums are lower in Canada mostly because awards are lower and less frequent BUT THAT IS BECAUSE THE  ENTIRE  LEGAL SYSTEM IS DIFFERENT not because the single payer aggressive pursues frivolous claims (although I agree they do)

Among the biggest differences between Canada and the US is that the US legal system is premised on each side bearing their own costs.  Canada is a loser pays country and that is a HUGE difference. That one reform would completely change the US system.  Add to that a contingency fee system in the US and we have way more med mal lawsuits even though I imagine (I dont know) that the skill of the doctors in both countries are the same. In other words, our legal system makes med mal litigation easier because it is, in essence, financed by contingency fees and the traditional fee rule (each pays its own). Another HUGE difference is the negligence standard.

 We also have jury trials where many countries (Canada may be one, not sure) rely on panels.  Juries return big verdicts because they don't see a victim in the verdict (this is why single payer here could be a disaster).  Another very big difference is the nature of damages in the US, much bigger awards in the US over Canada because we award income and benefits (ironically including high insurance premiums).  There's more than that BUT the point is: its not a single payer system that reduces med mal premiums in Canada, its a completely different legal system.
« : June 03, 2013, 10:38:08 PM VinBucFan »

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« #26 : June 03, 2013, 10:46:11 PM »

Here's a couple links:

Medical malpractice, of course, is not just an American issue. And now that the U.S. is considering universal health-care systems similar to those found elsewhere, it's worth a quick peek at their medical malpractice systems -- which usually attract far less controversy, and are far less expensive, than our own.

Litigation in the U.S. has at least four distinctive procedural features that drive up malpractice costs. The first is jury trials, which can veer out of control and in any case introduce significant uncertainty. The second is the contingency-fee system, which allows well-heeled lawyers to self-finance litigation. The third is the rule that makes each side bear its own costs. This induces riskier lawsuits than are undertaken in most other countries, such as Canada, England and most of Europe, where the loser pays the legal costs of the winner. The fourth is extensive pretrial discovery outside the direct supervision of judges, which occurs far more readily here than elsewhere.

Even these features aren't the whole story. American judges frequently let juries decide whether honest mistakes are negligent. Judges in other nations are less likely to do so. American courts commonly think it proper for juries to infer medical negligence from the mere occurrence of a serious injury. European judges usually will not.


http://online.wsj.com/article/SB124631652544770707.html

Malpractice insurance premiums in Canada are lower than those in the United States for the following three major reasons:

The courts in Canada have set caps on medical liability awards.
Existing Canadian laws set a high hurdle for proving medical liability.
The CMPA is notorious for vigorously defending any and all medical liability suits.
Additionally, in Canada, the losing party pays approximately two-thirds of the winner’s costs. This is a significant disincentive for bringing a medical liability suit.

The Canadian Supreme Court has established guidelines for noneconomic awards at a maximum of roughly $300,000, and the types of cases in which noneconomic awards can be made is limited. Although the number of medical liability cases in Canada has risen steadily in the past decade, the bar to prove malpractice remains high. In order to sue, the plaintiff must prove that the physician not only caused injury, but also violated a duty of care. Errors in judgment are generally not causes for lawsuit.


http://www.aaos.org/news/aaosnow/sep11/managing4.asp

CBW, if you noticed your comment about fighting frivolous suits is in there BUT it is only one of FOUR things mentioned in the second article and not even mentioned in the fist article. The real difference is the EXACT type of tort reform that Democrats seem to reject -- caps, higher negligence standard, loser pays, contingency fees.  Just reform those and allow  more efficient private market insurers to provide coverage and the cost will drop
« : June 03, 2013, 10:48:33 PM VinBucFan »

CBWx2

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« #27 : June 04, 2013, 07:14:11 AM »

By the way CBW, you dont have to look far to see the flaws in your single payer system.  In Canada I believe some of the provinces have laws against private insurance (why would that be?) and you have people queue jumping.  I dont have personal experience in Canada, so that is just what I have read. However, I recently lived in the UK and every modestly affluent person has private medical insurance that they pay for on top of outrageous taxes.  One only need open the many local tabloids to see many adds for "jumping the NHS queue"  These are ads for PRIVATE insurance. Why would there be private insurance but for the gross inefficiency that comes with government sponsored anything.

The profit motive is not evil

That has nothing to do with inefficiency, Vince. That assessment is at best, a reach. The reason that affluent people have better options in the UK than poor people do is the same reason that they do here. Because they can afford to. My guess is that the reason that Canada outlaws private insurance is to prevent this very thing from happening.

As I stated, most affluent people can purchase supplemental insurance, even in a single-payer system to get the same bells and whistles that they are getting now. The difference being, that in a single payer system, everyone gets to at least see a doctor and receive care, whereas in our current system, not everyone does.

I also don't believe that the profit motive is evil, Vince. Never said it was. Now, it certainly can be in some instances, but in general, I am in favor of it, except in certain circumstances. Health insurance, and insurance in general for that matter, is one of those circumstances. For profit insurance is not cost effective and is less efficient. It is the primary reason that our medical system is in as bad a shape as it is.

Single payer care is not a perfect solution. No one has ever suggested it is. There are negatives associated with it, as I am sure you are very aware of. But if you are looking for a perfect solution, then you're going to be looking forever. What you should be looking for is better than what we have, and in the case of virtually every first world country that has some form of socialized medical care, what they have is better than what we have, both in terms of efficiency, cost effectiveness and overall satisfaction.
« : June 04, 2013, 07:21:35 AM CBWx2 »


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« #28 : June 04, 2013, 07:19:32 AM »

CBW, if you noticed your comment about fighting frivolous suits is in there BUT it is only one of FOUR things mentioned in the second article and not even mentioned in the fist article. The real difference is the EXACT type of tort reform that Democrats seem to reject -- caps, higher negligence standard, loser pays, contingency fees.  Just reform those and allow  more efficient private market insurers to provide coverage and the cost will drop

I don't know why you said that it was flat out wrong. I can cede to the overstated part, however. You make a compelling case. I am actually not opposed to the type of reforms mentioned, with the exception of caps. I can't in good conscience say that I can never see a situation where a plaintiff would be morally and justifiably entitled to more than a $300,000 award. I think such a cap protects the grossly negligent at the expense of the consumer. I am, however, all for raising the negligence standard, and pretty much all of the other aforementioned reforms.


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« #29 : June 04, 2013, 07:56:20 AM »

ObamaCare is going to be a clusterf*ck.... I'd rather have single-payer , and that's saying a lot .



...but come to think of it , I think that's exactly the opinion they are hoping to generate in the future....
« : June 04, 2013, 03:41:05 PM Fire Mark Dummynik »

What is your point? I was wrong? Ok. You win. I was wrong.

           
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