I hope the President slices and dices the Gordian Knot of health care reform Wednesday night by laying out his plan in simple terms. I don't think it will happen, but I hope it does. As I see it (and I admit health care reform is a fog for me), the Four Horsemen of the problem that must be understandably addressed -- Medicare, Medicaid, Private Insurance and Tort Reform. Medicare is a plan for citizens 65 or older that is underfunded. I hope Obama announces that cuts in Medicare will not be allowed and that FICA/Medicare taxes are uncapped on earned income. I also would like to see Social Security taxes stripped from the general fund and returned to being a fund of its own. Medicaid is a plan for the poor. However, if it is to be expanded, legislators must remove some of the more onerous rules like seizing the home and personal property of elderly persons who, after using up all of their Medicare benefits, must turn to Medicaid. Private Insurance must accept new regulations that equalize insurance costs regardless of age, eliminate restrictions or cost increases for pre-existing conditions and allow interstate health insurance coverage (may the best company earn the policy). Tort Reform must be implemented across the country. At least 90 percent of the money won in class action suits should be awarded to the claimants, with the trial lawyers dividing a pool of 10 percent. The courts should limit -- and equalize -- the "legal research" funds each side can spend. The same should be true for a solitary litigant -- a 90 / 10 split rather than the traditional 70 / 30 split after the "legal research" expenditures. At the same time regarding tort reform, doctor premiums should be equalized (similar to coverage of regular people). However, if a doctor is shown to be unqualified or non-professional, he or she should be relegated to non-surgical, non-diagnostic medicine. Doctors and nurses should be treated even more carefully than airline pilots in regard to consecutive hours worked, drinking or taking certain prescribed drugs before surgery or seeing patients, etc. If Obama lays out a health care reform with clear language (I know, the aforementioned points are too simple) and clear mandates, then we will get health care reform. If not, we won't. Personally, although I am hoping he can and will, I don't think he has the political "smarts" to keep it simple.
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Tort reform as it relates to health care is the biggest red herring since the estate tax/family farm argument that Republicans trotted out under Bush.
Explain how the tort reforms I laid out are red herrings. When people get their fair share of the court awards and medical personnel are freed from onerous medical premiums which drive up medical costs, will the system not be more fair for regular citizens? I don't want aggrieved persons to be shorted in the court system nor do I want sub-standard doctors practicing.
What percentage of health care costs are driven by lawsuits? I recall the figure being something like 1%. It's a total red herring. Conservatives constantly focus on the exceptions that strike a nerve instead of focusing on the real issues that drive health care costs like the prescription drug giveaway to big pharma. Only corruption and/or incompetence can account for not using the pool patients to get better prescription drug prices. It's an outrage. The next goof Congressman that talks about tort reform in health care without addressing big pharma's raping of the American people should be investigated for fraud. Also, restricting the percentage of lawsuit awards to lawyers doesn't decrease the cost of health care. If we're going to do that, why not curb the fees that doctors can charge for all procedures. A scale of wages for the doctor's experience and patient satisfaction scores. That'll do more for health care costs than tort reform.
Thumbs, The biggest problem with sub-standard doctors is that most of them settle their malpractice claims via confidential settlements. As a result, there are no public details of their screw-ups and thus people have no way of knowing their history. Furthermore, malpractice records are only kept on a state level - if the doctor screws up 20 people in Florida, he/she can move to Colorado and have a clean slate. I've read discussions about outlawing confidential settlements, but that means victims who have already suffered enough must now suffer through a trial, during which the doctor's insurance company will do everything in their power to discredit them. Similarly, attorneys will have to spend even more money handling the case and will thus require higher fees. Litigation is expensive, especially when there is the potential for a ruling worth tens (or hundreds) of millions of dollars. To get an idea of the costs of litigation, I strongly suggest you read A Civil Action. That book makes it clear that if you limit attorney fees, many PI cases (medical or otherwise) will not be taken as the attorney won't be able to afford to provide the advocacy necessary. And if that's the case, many injured people will have no way of getting justice. Is that really what you want? As I said in another thread, I think the AMA has to take a stronger stance against doctors with a history of malpractice suits. They should be actively involved in reviewing any mistakes made by a doctor, and if there's a history of screw-ups, the doctor should lose his right to practice medicine in this country.
I'm not aware of Obama considering any cuts in Medicare and doubt he would push such a plan given the strength of the AARP in the Democractic base. As for returning Social Security taxes to its own fund (That was Al Gore's Lockbox) that's a great idea but one that will not happen under the current budget situation. Also in regard to not cutting Medicare would you support raising taxes to keep Medicare fully funded? I have never heard of people having their property siezed when they use up their Medicare benefits. Who is doing the siezing and where in the Medicaid rules does it say they must have their property siezed? He has already stated he wants to see those in a health care reform plan. As others have noted tort reform doesn't lower medical costs. For example Texas' costs have still gone up even with tort reform. That said I still find it very interesting that many of the same people demanding tort reform (not necessarily you) are the same ones up in arms about how health care reform might limit doctors salaries or that Obama's policies regarding corporate governance would limit executives salaries. Personally I'm not going to defend lawyers making a lot of money but if you believe that freedom is about allowing people to earn as much money as they can without government interference why so eager to limit lawyers salaries? Shouldn't lawyers be free to earn massive salaries as doctors or CEO's? Regulated by who though? Civil suits are primary way for individuals to check professionals but if you limit torts you are limiting that power and instead looking to professional associations to handle that. Regarding the issues you raise some of these are going to require more government involvement and spending. Dare I say more socialism.This is why I've said to you previously that if you are serious about these you are allying yourself with the wrong groups. The Tea Parties and others are the ones drawing attention to themselves with the cries of "Socialism!" and "Nazicare!" when what you are looking for is probably very different than those yelling. As I stated before if what you list is what you want you should either distance yourself from those who are spreading a message that really isn't in line with what you want or else seek to educate them on what you think the message should be because at the moment as much as the noise is drowning out Obama its drowning your message even more.
Hasn't happened in Texas In fact the Aggrieved get less and the Insurance companies have not lowered Jack ***** and the Medical cost have risen So . . . The consumer has less protect The consumer is still paying more than ever The Profits from what I understand are not going to the Doctor so Who exactly benefitted from Tort Reform in Texas Not the People. . . Not the doctors Only in the insurance companies Rocket River and if they do it on the Fed level . . it will be the same thing
I will say again in this thread. Nowhere that tort reform has been acted has seen their medical costs go down. It has been shown to not work.
Unless all Four Horsemen are resolved, the nation will continue to limp along without any real relief. I give up on trying to reason with you. I hope the Democrats use the nuclear option just to see the fallout in 2010 and the ensuing nuclear winter's chilling effect on the Democratic Party in 2012.
^^^Interesting. Like Space Ghost, thumbs seems happy to complain about various aspects (or misconstruals) of health care reform options. But, when confronted, his resolve vanishes as quickly as basso's integrity.
hilarious, you trot out your must haves and because people have actually responded reasonably to you, you say you give up trying to reason?
No, I just don't have time to explain the horrors of medical bankruptcy and the unfairness to people who worked and saved all their lives, got sick and ran out of Medicare benefits, and lost their homes and property to Medicaid. I don't have time to fully address how some the medical industry and many in the legal industries taking advantage of normal citizens. Also, if insurance companies can no longer charge doctors $100,000 to $500,000 annually for malpractice insurance, then it's only logical that medical costs will come down. Texas tort reform didn't do that. I don't have the time or the inclination to rebut everybody's minutia of disagreements. As I stated in the op, I was trying to keep simple something terribly complex. For example, I started to post this: http://themoderatevoice.com/43992/the-real-republican-health-care-proposal/ but I would be quibbling about this ad nauseum (read my sig) when I just don't have the enthusiasm for it. Mc mark, the nuclear option is the nickname of "reconciliation."
False The crazies would like folks to believe reconciliation is a form of the nuclear option. This is nothing more than scare tactics for the uninformed. The nuclear option is completely changing established rules to favor the majority in passage of legislation Reconciliation is a perfectly established legislative process to pass contentious legislation. Reconciliation was used several times by the republican majority during the bush administration (see 2001 & 2003 tax cuts)
Then use it. My most natural tendency is observation despite attempting activism at times. The results will be interesting to watch.
With all due respect, because I do think you are interested in actual debate and raise thoughtful points, this sounds somewhat petty of you. It seems like you are saying that since people aren't agreeing with you don't think they are trying to reason. I noted in another thread that it seems like the collective maturity level of the D & D has taken a plunge recently with people seeming more interested in arguing about who has insulted who rather than issues. To your credit you've raised substantitive issues and I for the most part other posters are expressing intellectual disagreement. I hope you don't take this as the feeling that you are now going to take your marbles and go home. I personally would like to hear more about your arguments particularly how people are losing their homes to Medicaid. As for whether the Democrats use reconciliation that certainly is on the table and I agree that at this point they will probably have to do that to get something passed. I also agree that it will be up to the voters to decide then whether to punish them or not. I stated in another thread that Obama and the Democrats have to decide whether they want to pass legislation or not and if the voters punish them then so be it but if they continue vacilitating they will likely get punished anyway.
