Comments on: Speaking Truth to Evasion http://healthcarecostmonitor.thehastingscenter.org/daniel-callahan/speaking-truth-to-evasion/ Commentary and opinion on cost control as part of health care reform from The Hastings Center Fri, 23 Apr 2010 16:12:37 +0000 hourly 1 By: George Soria http://healthcarecostmonitor.thehastingscenter.org/daniel-callahan/speaking-truth-to-evasion/comment-page-1/#comment-50 George Soria Sun, 24 May 2009 13:41:57 +0000 http://Iun5ouFM3BGv7mqM8ivLAg_7398e366510c1ffb515be8fb0ca34290#comment-50 I applause the organization for addressing the facts clearly concerning the healthcare issue we are facing. It is no doubt we all have to take a serious look at what we are willing and not willing to give up. The consumer, the insurance industry, and the health industry, in order to make healthcare affordable we all must return to the basic fundamental thinking and ask ourselves, What was Major Medical suppose to cover? If we look back enough we would realize healthcare was to protect for major illnesses. The reason for insurance was to protect the risk associated with those major illnesses. Today the philosophy has changed. The consumers want and expect coverage for everything. The insurance industries have realized there is more profit in the administration of the claims then in covering and insuring the risk. The healthcare industry fines it more profitable in practicing protocol and playing safe then in properly treating the patients, with double standard in billing and bombarded administration, liability concerns and expensive malpractice insurance. So it no wonder we have a broken healthcare system. The 47 million model addresses these issue and offers a viable solution to return to the basics. The consumer share in liability, the insurance returns to covering major risk, and the health industry returns to basic community quality care without being burden with administration, and can practice without worry. And perhaps the most important aspect of all is all 47 million uninsured have access to care. Why must we in order to offer a solution go from one extreme to the other? Why can we have both? I applause the organization for addressing the facts clearly concerning the healthcare issue we are facing. It is no doubt we all have to take a serious look at what we are willing and not willing to give up. The consumer, the insurance industry, and the health industry, in order to make healthcare affordable we all must return to the basic fundamental thinking and ask ourselves,

What was Major Medical suppose to cover? If we look back enough we would realize healthcare was to protect for major illnesses. The reason for insurance was to protect the risk associated with those major illnesses. Today the philosophy has changed. The consumers want and expect coverage for everything. The insurance industries have realized there is more profit in the administration of the claims then in covering and insuring the risk. The healthcare industry fines it more profitable in practicing protocol and playing safe then in properly treating the patients, with double standard in billing and bombarded administration, liability concerns and expensive malpractice insurance.
So it no wonder we have a broken healthcare system. The 47 million model addresses these issue and offers a viable solution to return to the basics. The consumer share in liability, the insurance returns to covering major risk, and the health industry returns to basic community quality care without being burden with administration, and can practice without worry.

And perhaps the most important aspect of all is all 47 million uninsured have access to care.

Why must we in order to offer a solution go from one extreme to the other? Why can we have both?

]]> By: Bettina B. Kilburn http://healthcarecostmonitor.thehastingscenter.org/daniel-callahan/speaking-truth-to-evasion/comment-page-1/#comment-20 Bettina B. Kilburn Wed, 20 May 2009 19:56:36 +0000 http://Iun5ouFM3BGv7mqM8ivLAg_7398e366510c1ffb515be8fb0ca34290#comment-20 I also think it will be important to consider tort reform in the context of monitoring costs. I am not necessarily talking about some varyingly popular ideas like capping award damages. While caps may discourage some non meritorious suits they may also decrease a sense of justice that is already diminished by reducing justice to a monetary award. Rather, I am concerned that we have no idea how much the medical malpractice system truly costs all of us in terms of the court fees, legal fees, settlement awards of all sizes, including "nuisance value settlements" (moneys paid when it is clear there is no merit and neither side wishes to continue to litigate) physician time spent in depositions, court, etc.--let alone malpractice premiums and the ordering of "defensive" tests". While statements from some trial bar representatives, like "we spend more on dog food than on malpractice awards in this country" may be accurate comparisons, they use a meaningless number for comparison. Our tort system costs us far more in real $$ than the awards given. If we think a single payer system is a way to control costs, as many do, it is worth noting that countries that provide a single payer system are considerably less tort friendly than the US and that one country (New Zealand) rid itself of the tort system. If we truly put real tort costs on the health care cost table then we can put real reforms on there as well; some states (states regulate the practice of medicine) are doing this in small steps, such as requiring a health panel review or certification before a case moves forward, staying discovery while a motion to dismiss is pending, etc. I agree that the politics of this immense subject will ultimately control, and hope it will be informed politics. There are many areas of health care in which its "consumers" have no idea of the real costs of the current fragmentation. I also think it will be important to consider tort reform in the context of monitoring costs. I am not necessarily talking about some varyingly popular ideas like capping award damages. While caps may discourage some non meritorious suits they may also decrease a sense of justice that is already diminished by reducing justice to a monetary award. Rather, I am concerned that we have no idea how much the medical malpractice system truly costs all of us in terms of the court fees, legal fees, settlement awards of all sizes, including “nuisance value settlements” (moneys paid when it is clear there is no merit and neither side wishes to continue to litigate) physician time spent in depositions, court, etc.–let alone malpractice premiums and the ordering of “defensive” tests”. While statements from some trial bar representatives, like “we spend more on dog food than on malpractice awards in this country” may be accurate comparisons, they use a meaningless number for comparison. Our tort system costs us far more in real $$ than the awards given. If we think a single payer system is a way to control costs, as many do, it is worth noting that countries that provide a single payer system are considerably less tort friendly than the US and that one country (New Zealand) rid itself of the tort system. If we truly put real tort costs on the health care cost table then we can put real reforms on there as well; some states (states regulate the practice of medicine) are doing this in small steps, such as requiring a health panel review or certification before a case moves forward, staying discovery while a motion to dismiss is pending, etc. I agree that the politics of this immense subject will ultimately control, and hope it will be informed politics. There are many areas of health care in which its “consumers” have no idea of the real costs of the current fragmentation.

]]> By: Philip W. Brickner http://healthcarecostmonitor.thehastingscenter.org/daniel-callahan/speaking-truth-to-evasion/comment-page-1/#comment-19 Philip W. Brickner Tue, 19 May 2009 15:53:36 +0000 http://Iun5ouFM3BGv7mqM8ivLAg_7398e366510c1ffb515be8fb0ca34290#comment-19 An excellent beginning to the blog, and written with expected candor and courage. It will be important to ask federal legislators to comment on this blog and its reasoning, because the politics of this immense subject ultimately will control. An excellent beginning to the blog, and written with expected candor and courage. It will be important to ask federal legislators to comment on this blog and its reasoning, because the politics of this immense subject ultimately will control.

]]>