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TWP
Trad climber
Mancos, CO
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Dec 14, 2011 - 11:21am PT
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My apologies Fat Trad. Up thread you showed good sense and some counterpoise to your usual party line tripe when you wrote:
"Fear of litigation is just spew from the insurance industry who are opposed to actually having to pay claims when MDs screw up which, yes folks, does happen. As has been well established, caps of damages would only reduce costs by c. 1 percent. The Harvard School of Public Health performed a study several years ago that concluded that only one out of every nine patients with legitimate malpractice claims ever file suit. If doctors want to get sued less, they shouldn't screw up in the first place."
The "malpractice problem" is created by doctors NOT lawyers.
The reason? This is subtle so hang on.
The law of negligence requires only that a doctor follow the "standard of care" as mandated by the medical establishment itself.
Hence, an expert witness in a med mal case can testify that the defendant doctor's was negligence only if a DEVIATION from the standard of care was the direct cause of the patient's injury. Without this type of evidence from a qualified expert, the patient can't even get the case to the jury.
So who decides whether that extra diagnostic procedure (like an expensive MRI) is required? The doctors and the hospitals themselves establish protocols that define when a doctor should take this extra step. Likewise, the standards of care can be redefined to address the opposite issue: when it is permissible (i.e. consistent with the standard of care) to NOT order that extra procedure.
In a nutshell, all attention within the medical establishment focuses on "proactive and aggressive use of all the nice and expensive toys and procedures (IF you have the atom bomb, you'll want to use it.) Instead, the medical standards and protocols need to build in standards of care that preserve the doctor's discretion to NOT order the extra test. The system is biased against restraint. The doctors and hospitals have only themselves to blame and they have done so out of financial interests to maximize their incomes.
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mike m
Trad climber
black hills
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Dec 14, 2011 - 11:53am PT
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Hospitals, doctors, pharm. companies also benifit financially when they don't use restraint.
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TWP
Trad climber
Mancos, CO
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Dec 14, 2011 - 12:46pm PT
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Hey Fattrad.
Thanks for providing the link in support of your assertion that:
"Of course workers in other industries in Thailand average a salary of $140 a month (poverty). Sure, you got cheap care and the people of the country starve. Oh, you don't mind exporting the jobs though????
All Sectors average income PPP $ 470 $ 140"
I checked out your source and dig a little deeper.
1. Income figures seem to be based on Thailand's economy as of 2001, not one decade later.
2. The income disparity in Thailand between the professions and trades appears far LESS than the United States. In Thailand, physicians don't make the multiples against the average that appear the case in the U.S.
3. The statistics show that as a percentage of gross income, Thais health care expenses are a fraction of those in the U.S.
How sure are you about the "poverty" of the Thai given their costs of living structure is so far different than our own? Look at your own source and the costs of housing, health care, food.
I've lived in Thailand and think the Thai have a good country and standard of living. They don't think they are poor. Why should we?
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philo
Trad climber
Somewhere halfway over the rainbow
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Dec 14, 2011 - 01:14pm PT
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He can count to three? Who knew?
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TWP
Trad climber
Mancos, CO
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Dec 14, 2011 - 01:26pm PT
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Nice try Fattrad.
I suggest you look again at your source.
The footnote doesn't support what you say at all. Its meaning is slippery. I think it means their 2001 data has been converted to 2005 dollars. Look at the whole source and it only references 2001 data as a baseline and goes on to make clear its conversion to 2005 dollars. This was probably done so data from around the world, collected at widely different dates, can be rationalized to a common denominator.
Please don't insinuate that I am stupid and have no education (J.D. from ASU, 1976) so that you might enjoy in return a continuing presumption of intelligence and good faith.
PS. Continue to call other Supertaco posters "dumb and stupid" and you shall deserve a similar dismissal out-of-hand too.
PPS. Fatty. Rumors has it you are a nice guy. I beat I'd like you in person too.
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ydpl8s
Trad climber
Santa Monica, California
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Dec 14, 2011 - 01:26pm PT
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Lawsuits wouldn't cost both the patient and the doctors so friggin much if the lawyers didn't take such a big cut. (yeah, I'm hatin on lawyers). My wife had a malpractice lawsuit for a botched surgery on her thumb tendon. She received about 20 to 25 percent of the settlement and the rest went to the lawyers! Wish I could get $250 for a 3 min. phone call where I say, "no, we can't do that".
It's the trifecta, we're paying ridiculous costs to fund doctors, lawyers and insurance companies (and probably the odd Mercedes dealership).
Sorry, I'm in my Scrooge/Grinch mode this time of year.
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mission
Social climber
boulder,co
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Dec 14, 2011 - 11:34pm PT
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Another big problem with our system is that there is a huge infrastructure dedicated to health insurance sales and administration and another one dedicated to medical billing. When you see a doctor for ten minutes, hours are spent writing invoices and haggling over deductibles, copays, maximums allowed for particular procedures, etc..
I grew up in a socialist society: my dad was an officer in the United States Air Force. When we needed medical care, we went to a hospital where the doctor was a government employee and the US taxpayer footed the bill. Kind of un-American, I know.
We also had gasoline rationing, but I hate to stray from the topic.
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