Why not attack the $600 billion health care cost driver?

[healthmyths]

Many of you are so ignorant of the real villains in the health care costs or you are either afraid!

You naively attack the health insurance companies that are simply the payers of the health care bills presented to them!

If any of you took the time to honestly look at health insurance companies "PUBLIC" financial documents you'd see the average health insurance company pays out 80% of premiums in claims.

AND $600 billion according to the people [health care providers!!!]
that MAKE those payment claims to the insurance company is done purely out of fear of lawsuits!

Who pays that?
Insurance companies/Medicare and the general public.

All because 90% of the doctors admit they practice "defensive medicine" so they won't be sued!

Nine out of 10 physicians reported practicing defensive medicine.
Doctors Estimate Defensive Medicine Costs Americans $650-850 Billion Annually
Doctors Practice Medicine in Fear, New Study Finds

Why is is so hard to face this Number ONE cost driver..FEAR of Lawsuits create "Defensive Medical practices"!

There is a solution if any of you have any interest in learning rather then constantly blaming the wrong parties!

 

[Dragon]

AND $600 billion according to the people [health care providers!!!]
that MAKE those payment claims to the insurance company is done purely out of fear of lawsuits!

First, your figures appear to be wildly inflated:

Malpractice liability costs U.S. $55.6 billion: study | Reuters

Try $55 billion.

Total health care costs in the U.S. in 2008 was roughly $2.3 trillion, or $2,300 billion. That means the cost of malpractice liability in increased health care costs constitute no more than 2.3% of the total health care cost in this country.

Moreover, not all of that can be saved through health-care reform. A patient injured or killed by medical malpractice must have some form of redress; it is simply not acceptable to tell a patient who has been crippled or brain-damaged for life to lump it. So in terms of realistic tort reform, the savable cost is bound to be much less than 2.3%.

 

[healthmyths]

It is NOT the malpractice insurance idiot!

It is the FACT the doctors themselves SAY they order duplicate tests, MRIs, specialist opinions at the rate of $1 for every $4 spent!
Or the entire health industry is $2.5 trillion 25% of $2.5 trillion is ....
$625 BILLION a year in DEFENSIVE MEDICINE
Read closer or get your glasses FIXED!

 

[healthmyths]

How about some anecdotal illustrations to see if you understand what $600 billion IS!!

"In a recent letter to the Wall Street Journal, a Texas doctor described how, since being
unsuccessfully sued in 1995, he has "doubled and tripled the number of tests and consultations that I order."
But the orthopedic hospital would not accept month-old test results,
nor even an explicit waiver by me of any liability. The result was pure waste:
more than $1,000 spent on wholly unnecessary tests.
Philip K. Howard - Medical Tort Reform Could Save Billions



Overall, 91 percent of doctors surveyed agreed with both statements.

http://www.google.com/hostednews/ap/article/ALeqM5js4_BkHmmxcniut6D1lhI_3GzHyAD9GKG3A82

"Defensive medicine is when doctors order multiple tests, MRIs and other procedures, not because the patient needs them, but to protect against litigation based on allegations that something should have been done but wasn’t.
Experts estimate as much as $300 billion in unnecessary costs is attributable to defensive medicine.
Besides more time-consuming appointments, patients are left with fewer services and less access to quality care as doctors either narrow their practices or leave the profession entirely."
http://www.sfexaminer.com/opinion/E...take-on-trial-lawyers-in-speech-57953202.html

 

[CrusaderFrank]

We need to adopt a loser pays medmal system

 

[healthmyths]

Why is it so hard to comprehend that the $600 billion a year spent by Medicare/private insurance and out of pocket is totally unnecessary?
It's called "defensive medicine!
90% of physicians admit they order duplicate tests,etc. out of fear of lawsuits!
Do you and others understand that Obamacare NEVER addressed this big 800 lb gorilla!

Don't be confused! It's not the malpractice insurance!
It is the FEAR of lawsuits drive doctors to order duplicate tests!
$600 billion a year!

 

[edthecynic]

How about some anecdotal illustrations to see if you understand what $600 billion IS!!

"In a recent letter to the Wall Street Journal, a Texas doctor described how, since being
unsuccessfully sued in 1995, he has "doubled and tripled the number of tests and consultations that I order."
But the orthopedic hospital would not accept month-old test results,
nor even an explicit waiver by me of any liability. The result was pure waste:
more than $1,000 spent on wholly unnecessary tests.
Philip K. Howard - Medical Tort Reform Could Save Billions



Overall, 91 percent of doctors surveyed agreed with both statements.

http://www.google.com/hostednews/ap/article/ALeqM5js4_BkHmmxcniut6D1lhI_3GzHyAD9GKG3A82

"Defensive medicine is when doctors order multiple tests, MRIs and other procedures, not because the patient needs them, but to protect against litigation based on allegations that something should have been done but wasn’t.
Experts estimate as much as $300 billion in unnecessary costs is attributable to defensive medicine.
Besides more time-consuming appointments, patients are left with fewer services and less access to quality care as doctors either narrow their practices or leave the profession entirely."
http://www.sfexaminer.com/opinion/E...take-on-trial-lawyers-in-speech-57953202.html

So he was UNSUCCESSFULLY sued, which means what he was already doing was adequate to avoid a successful lawsuit, but the CON$ervative quack doctor saw an opportunity to pad his income by charging his patients for useless tests. The more tests he orders the more money HE makes. We need to get the greedy CON$ out of the medical profession to save $600 billion!

 

[Dragon]

It is NOT the malpractice insurance

The figure I presented was for the total increase to the cost of healthcare from defensive medicine, not just malpractice insurance.

I also note that you didn't answer the second part of what I said. Unless you're prepared to say that nobody can sue a health-care provider for malpractice, ever, defensive medicine WILL add to the cost of health care. Tort reform may reduce that amount somewhat but it can't eliminate it. And since the cost of defensive medicine is a trivial portion of the total cost of health care in this country, tort reform is only going to reduce those costs by a fraction of a trivial amount. As a cost-saving measure, it's really not worth doing (although it may be worth doing for other reasons).

If you really want to go after reducing the cost of health care in this country, what we need is a single-payer system -- Medicare for all -- and aggressive use of bargaining power by the government to drive down the cost of pharmaceuticals and medical procedures. At the same time, on the other end, reduction of the cost of a medical education by one means or another will result in doctors who don't emerge from medical school and residency so burdened with debt that they are desperate to make as much money as possible.

 

[healthmyths]

you wrote" The figure I presented was for the total increase to the cost of healthcare from defensive medicine, not just malpractice insurance."


Then maybe you should talk to the 1,231 physicians...(90%) Ninety percent of physicians surveyed said
"doctors overtest and overtreat to protect themselves from malpractice lawsuits.
"Defensive medicine is when doctors order multiple tests, MRIs and other procedures, not because the patient needs them, but to protect against litigation based on allegations that something should have been done but wasn’t. according to the survey published Monday in Archives of Internal Medicine.
A) $600 billion defensive medicine
Nine out of 10 physicians reported practicing defensive medicine.
Doctors Estimate Defensive Medicine Costs Americans $650-850 Billion Annually
Doctors Practice Medicine in Fear, New Study Finds
As far as your
"also note that you didn't answer the second part of what I said. Unless you're prepared to say that nobody can sue a health-care provider for malpractice, ever, defensive medicine "
=======================
Let a doctor answer for me ok???
"In a recent letter to the Wall Street Journal, a Texas doctor described how, since being
unsuccessfully sued in 1995, he has "doubled and tripled the number of tests and consultations that I order."
But the orthopedic hospital would not accept month-old test results,
nor even an explicit waiver by me of any liability. The result was pure waste:
more than $1,000 spent on wholly unnecessary tests.
Philip K. Howard - Medical Tort Reform Could Save Billions


In 2005, Illinois was so litigious that OB-GYNs could save $75,000 to $100,000 per year on liability insurance by moving to the neighboring states of Wisconsin, Indiana or Missouri. Legislators in the Land of Lincoln took note and passed the Medical Malpractice Reform Act, which placed a cap of $500,000 on noneconomic damages in medical malpractice cases while not limiting compensation for the lost value of life or other physical harm.
By the end of 2006, OB-GYN liability premiums in Illinois had fallen by 30 percent.
EDITORIAL: Health care lawsuits - Washington Times

NOTE did NOT limit compensation for lost value...!

 

[kiwiman127]

It is NOT the malpractice insurance idiot!

It is the FACT the doctors themselves SAY they order duplicate tests, MRIs, specialist opinions at the rate of $1 for every $4 spent!
Or the entire health industry is $2.5 trillion 25% of $2.5 trillion is ....
$625 BILLION a year in DEFENSIVE MEDICINE
Read closer or get your glasses FIXED!

You sure like to call people "idiots", yet you consistently use very questionable data to back up your claims.
In another thread, you mis-used Census Bureau data and I caught you red handed by using the actual Census Bureau Report which blew your misrepresentation the facts out of the water.
Below is link to a Pro and Con sheet to whether Tort Reform would in fact substantially lower the cost of health care. On the Pro side, we find partisans coming up with some pretty scary numbers. On the Con side we find the CBO, a health care insurance company who measured the usage of defensive medicine and other non-partisan experts who also use facts.
WellPoint said the following:

"Despite the common belief that costs increase due to excess insurer profits, the aging of America and the high cost of medical malpractice, these factors have little if any impact on health care premiums...

Medical malpractice is not a major driver of spending trends. Premiums for liability coverage and defensive medicine contribute to health spending at any moment in time but are not considered a recent significant factor in the overall growth of health care spending. Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase."


The CBO:

"On the basis of newly available research, CBO has updated its analysis of the effects of tort reform to include not only direct savings from lower premiums for medical liability insurance but also indirect savings from reduced utilization of health care services. Many analysts surmise that the current medical liability system encourages providers to increase the volume or intensity of the health care services they provide to protect themselves against possible lawsuits...

CBO now estimates, on the basis of an analysis incorporating the results of recent research, that [tort reform]... would reduce total national health care spending by about 0.5 percent (about $11 billion in 2009). That figure is the sum of the direct reduction in spending of 0.2 percent from lower medical liability premiums, as discussed earlier, and an additional indirect reduction of 0.3 percent from slightly less utilization of health care services."

[Editors Note: The CBO estimates total health care spending at $2.6 trillion dollars. Since the CBO finds that $11 billion in savings would result from tort reform (medical malpractice reform), this means that tort reform would reduce health care spending by about 0.5%. We have placed this entry in the "con" column because 0.5% is not "a major contributor" to total health care costs.]

Would medical malpractice reform (tort reform) significantly reduce the cost of health care? - Health Care Reform - ProCon.org

And yet you call other people "idiots"?
Your name Healthmyths says it all, you use myths to make your points.

 

[healthmyths]

Tell it to the people that CREATE the claims NOT the people that look at it from a distance!

"Ninety percent (90%) of physicians surveyed said doctors overtest and overtreat to protect themselves from malpractice lawsuits. That sentiment is more common among male doctors than female doctors, according to the survey published Monday in Archives of Internal Medicine. The findings echo a recent Associated Press story in which many emergency room doctors said lawsuit fears are the main reason for overtreating in the ER.

The Archives survey of 1,231 physicians nationwide included ER doctors and other specialists, surgeons and primary care doctors. The survey asked two questions: "Do physicians order more tests and procedures than patients need to protect themselves from malpractice suits?" And, "Are protections against unwarranted malpractice lawsuits needed to decrease the unnecessary use of diagnostic tests?"

Overall, 91 percent of doctors surveyed agreed with both statements.
According to Gallup’s study, physicians estimate that one in four dollars (26 percent) spent on health care in America pays for unnecessary tests and treatments.
“The consequences of this waste affect all of us,” said Jackson. “Costs go up and quality and access go down when our physicians are under the constant personal threat of litigation.”
“Our online survey found that they feel trapped between the Hippocratic Oath and their personal desire to stay out of court and in business.”
Doctors Practice Medicine in Fear, New Study Finds

 

[kiwiman127]

FACTORS THAT HAVE A SMALLER IMPACT ON COSTS
Intensive diagnostic testing and defensive medicine: Intensive diagnostic testing contributed only 0.2 percent to the increase in health care costs in 2007 as compared to 0.8 percent in 2005. This change is attributed to a slowdown in outpatient spending.4
Medical malpractice: Medical malpractice is not a major driver of spending trends. Premiums for liability coverage and defensive medicine contribute to health spending at any moment in time but are not considered a recent significant factor in the overall growth of health care spending.15 Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase.
http://www.wellpoint.com/prodcontri..._research/documents/wlp_assets/pw_d014959.pdf

Also read this report from Price Waterhouse:
The Factors Fueling Rising Health Care Costs
http://www.ahip.org/content/ShowFil...Factors+Fueling+Rising+Health+Care+Costs+2008

 

[healthmyths]

Thank you for the link! Very informative AND supportive of my point though in that
Page 9 of the Wellpoint study:

Medical malpractice:
Medical malpractice is not a major driver of spending trends. Premiums for liability coverage and defensive medicine contribute to health spending at any moment in time but are not considered a recent significant factor in the overall growth of health care spending.15 Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase."

THE POINT WELLPOINT was making.. "Premiums for liability coverage" which is TRUE!
But even Wellpoint CAN'T refute the professionals, the physicians that say THEY cause $600 billion in duplicate tests,referrals,etc. OUT OF FEAR of Lawsuits...not fear of liability premiums!

You conveniently though ignored the statistic that people like you ignore when blaming health insurance companies like Wellpoint for being GREEDY evil profiteers!


Page 3...
"87 cents of every premium dollar received is spent on providing medical services to members: physician services, hospital costs (inpatient and outpatient costs), drugs and other medical services."
Are you smart enough to understand the SIMPLE fact if 87% of Wellpoint premiums go to pay the $600 billion in defensive medicine claims the EXPERTS say they create the claims for... THAT would reduce premiums???

 

[kiwiman127]

Thank you for the link! Very informative AND supportive of my point though in that
Page 9 of the Wellpoint study:

Medical malpractice:
Medical malpractice is not a major driver of spending trends. Premiums for liability coverage and defensive medicine contribute to health spending at any moment in time but are not considered a recent significant factor in the overall growth of health care spending.15 Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase."

THE POINT WELLPOINT was making.. "Premiums for liability coverage" which is TRUE!
But even Wellpoint CAN'T refute the professionals, the physicians that say THEY cause $600 billion in duplicate tests,referrals,etc. OUT OF FEAR of Lawsuits...not fear of liability premiums!

You conveniently though ignored the statistic that people like you ignore when blaming health insurance companies like Wellpoint for being GREEDY evil profiteers!


Page 3...
"87 cents of every premium dollar received is spent on providing medical services to members: physician services, hospital costs (inpatient and outpatient costs), drugs and other medical services."
Are you smart enough to understand the SIMPLE fact if 87% of Wellpoint premiums go to pay the $600 billion in defensive medicine claims the EXPERTS say they create the claims for... THAT would reduce premiums???

""87 cents of every premium dollar received is spent on providing medical services to members: physician services, hospital costs (inpatient and outpatient costs), drugs and other medical services."
Are you smart enough to understand the SIMPLE fact if 87% of Wellpoint premiums go to pay the $600 billion in defensive medicine claims the EXPERTS say they create the claims for... THAT would reduce premiums???


So are you now claiming that the 87% of every premium dollar is going to defensive medicine?
.
And you using WellPoint as a point of your argument was actually ironic when WellPoint itself (in my earlier post), said that the cost of defensive medicine was not a major factor in the cost of health care.

Also, you seem to cherry pick the number $600 billion, yet other experts put it a a lower number. Here's a report claiming the number is $60 billion:
http://www.mssm.edu/about-us/news-a...e-medicine”-according-to-new-physician-survey

Better yet, here's a quote that sums about everything up:
"However, the potential of tort reform to control health care costs comes under question in a study published in the September issue of the journal Health Affairs. It puts the cost of malpractice litigation and defensive medicine combined at $55.6 billion annually in 2008 dollars, or 2.4% of total health care spending. In contrast, a 2007 study by the conservative National Center for Policy Analysis estimated that the annual cost of defensive medicine alone was between $100 billion and $178 billion in 2005, while a 2006 study by PriceWaterhouseCoopers reported that the cost of malpractice insurance and defensive medicine topped $200 billion."
http://www.medscape.com/viewarticle/728128

(Please note that I offered up a variety of opinions, just like I did on another thread regarding tort reform when I again offered up different opinions from across the board.)

The point is, again you choose a number that is the highest estimate by a long shot and you ride that train, even though many other reports by experts put the numbers much lower than your claim.

This is like when you misrepresented the Census Bureau Report on how many people are uninsured, you seem to have a creditability problem and that's what you get from cherry picking facts

 

[Listening]

So he was UNSUCCESSFULLY sued, which means what he was already doing was adequate to avoid a successful lawsuit, but the CON$ervative quack doctor saw an opportunity to pad his income by charging his patients for useless tests. The more tests he orders the more money HE makes. We need to get the greedy CON$ out of the medical profession to save $600 billion!

Why would a doctor tell on himself if this was actualy the case ?

Is that really what happened here or did was he forced to admit that he ran unnecessary tests ?

 

[healthmyths]

you wrote: "So are you now claiming that the 87% of every premium dollar is going to defensive medicine?"
---------------------
1) NO I DID NOT claim 87% I said it was 87 cents of every dollar!
2) and I didn't say going to defensive medicine!

What 90% of doctors surveyed said was $1 of every $4 spent on defensive medicine!
And they are the ones the order the tests NO ONE else does!
WellPoint itself (in my earlier post), said that the cost of defensive medicine was not a major factor in the cost of health care.

And Wellpoint STATEMENT WAS this:
Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase. "
AND IT ISN'T! It is the DEFENSIVE MEDICINE practices... NOT the premiums!

You also said I "cherry pick" NO I didn't!
Physicians claim every $1 of $4 in claims is defensive medicine!
That's 25% right? 25% of 2.5 trillion health care is $625 Billion!

Finally you evidently HAVE NO where near the experiences in health care finance I have as I STARTED a business that provides health care providers information if they will get paid by Medicare.. 10,000 times a day!

What do you do???

 

[kiwiman127]

you wrote: "So are you now claiming that the 87% of every premium dollar is going to defensive medicine?"
---------------------
1) NO I DID NOT claim 87% I said it was 87 cents of every dollar!
2) and I didn't say going to defensive medicine!

What 90% of doctors surveyed said was $1 of every $4 spent on defensive medicine!
And they are the ones the order the tests NO ONE else does!
WellPoint itself (in my earlier post), said that the cost of defensive medicine was not a major factor in the cost of health care.

And Wellpoint STATEMENT WAS this:
Put another way, tort reform would lower health insurance premiums but medical malpractice is not currently driving the rate of increase. "
AND IT ISN'T! It is the DEFENSIVE MEDICINE practices... NOT the premiums!

You also said I "cherry pick" NO I didn't!
Physicians claim every $1 of $4 in claims is defensive medicine!
That's 25% right? 25% of 2.5 trillion health care is $625 Billion!

Finally you evidently HAVE NO where near the experiences in health care finance I have as I STARTED a business that provides health care providers information if they will get paid by Medicare.. 10,000 times a day!

What do you do???

What do I do? Strategic planning for a health care organization I'm sure you have heard of.

Also, you DID cherry pick. As I noted, there are several "expert" theories to what the total cost of defensive procedures is, funny though no one went as high as the nunber you like to throw around as the gospel truth!! I hope you don't apply that tunnel vision approach to your professional practice. What we do in my department is we look at everything and consider everything!

 

[dblack]

If you really want to go after reducing the cost of health care in this country, what we need is a single-payer system -- Medicare for all -- and aggressive use of bargaining power by the government to drive down the cost of pharmaceuticals and medical procedures. At the same time, on the other end, reduction of the cost of a medical education by one means or another will result in doctors who don't emerge from medical school and residency so burdened with debt that they are desperate to make as much money as possible.

Putting the state in charge of paying for something doesn't, in general, make that something cheaper - especially if those actually providing the service are still operating for profit in the "free" market. More often, state contracted services result in overpriced, overspeced services that react slowly to the needs of consumers, if at all. The real culprit behind health care inflation, is exactly this mindset: that however things pan out, 'someone else' should pay for my health care.

The notion that we can somehow get 'something for nothing' is a fantasy that the insurance companies, and their government cronies, have been promoting for generations. Unfortunately, it's simply not viable. It never was, but a long-lasting increase in the number of new enrollees to insurance plans, creating what was essentially a pyramid scheme, masked our abuse of health insurance for a long time. But the well has dried up, and insurance companies can no longer sign on new people fast enough to pay the bloated prices of 'free' health care.

We've been over this before. The problem with rising health care prices is nothing inherent in the nature of health care. It has little to do with malpractice or inefficiencies in delivery, and it's not due to the profit motive of doctors OR insurance company greed. In fact, it's our delusional efforts to pretend that health care is, or should be, something other than a market commodity that have painted us into this corner. The more we try to relieve people of the burden of paying for their own health care, the more expensive it will become. We can hide this expense behind a deficit driving government program, but it won't actually solve the problem.

 

[Dragon]

dblack, the key factor is not putting "the state" in charge of paying for medicine, it's putting one single entity in charge of it -- whoever that might be -- with an incentive for bargaining down costs. Hell, you could put me in charge of it if you want. (If I get a salary, of course. And the money to do it with.)

What happens now is that no payer has the clout to make pharmaceuticals charge here the same prices they charge for the same drugs just about everywhere else in the world. A Canadian, a Frenchman, a Japanese, an Englishman, a German -- all these people can by American-made drugs for (I'm not exaggerating here) about ten percent of what we have to pay for them here in the U.S. Why? Because the national health coverage systems in all of those countries say to our pharma companies, "You will sell the drugs for that price or you will not sell them."

Now, the interesting thing is that they DO sell them for that price, which means they must be making a profit doing so or they wouldn't do it, which means that 90+% of what they're charging for the same stuff here is pure profit -- and that's just unconscionable. There is the main reason why our medical costs are so high: a captive market, and no effective way to bargain the price down.

We know what works. We've seen it work elsewhere. The only reason we don't have it here right now -- the only reason a single-payer system rather than the Rube Goldberg ACA wasn't passed through Congress and signed by Obama in 2009 -- is because too many Congresscritters are bought and paid for by corporate interests, including the health-insurance, pharmaceutical, and health-care fields. And no, I don't just mean the ones with an R after their names.

 

[midcan5]

Damn, a real un-alive corporate bot - corporate propaganda gets better by the day, soon reality will be so contrived we'll all have to turn to great great grandma's letters to learn what life was like in the real world. I loved this line, "Doctors Estimate Defensive Medicine Costs Americans $650-850 Billion Annually." I wonder how they do that, who measured it, and whether our healthcare bot has the actual figures? Billion with a B, sure thing bottie. Bizarre stuff, is it any wonder nothing works for the people in America today.


"Not only does there seem to be widespread social fragmentation and disillusionment with democracy in the United States, but the possibility of reversing this sense of alienation appears to many of us to be already lost. Any democratic president who wants to institute the desperately needed reforms in health, welfare and the environment faces one of two options. He can stick by his reform program and suffer a loss of public confidence through orchestrated campaigns to publicly portray him as 'too liberal' and ineffectual (the Carter image) or too indecisive or sexually indiscreet (the Clinton image). Alternatively, a reforming democratic president can move further to the Right, forget his promises and become part of the propaganda campaign. Given the history of democratic propaganda in the United States, some of us doubt that another Roosevelt or New Deal is possible. The political system is now so attuned to business interests that this kind of reformer could no longer institute the substantial health, welfare, education, environmental and employment reforms the country needs." Andrew Lohrey, Introduction, Alex Carey "Taking the Risk Out of Democracy"