Can medical malpractice reform really hold down health care spending?

Mar 18, 2011

Maxwell Mehlman, professor of law and medicine, says there's no evidence that reducing a victim's compensation will save money.

In light of a bill in Congress that would limit malpractice awards to $250,000 for pain and suffering, Mehlman is speaking out against the argument that medical malpractice reform keeps spending costs down. He points out that, although studies show that caps on malpractice payments do reduce premiums for doctors and hospitals, and several studies show that they reduce overall in the short term, one of those studies found that this reduction in spending was associated with a decline in the overall health of the population, and estimated that in the long run, the additional spending on health care necessary to treat these sicker people would eat up any savings from the caps.

Mehlman also points out that the malpractice system is not the main reason have risen. “It turns out that the direct costs of the malpractice system appear to account for only a tiny percentage of the total costs of health care, less than one percent,” says Mehlman, adding that “those who favor caps on damages and other changes in malpractice laws point to indirect costs, in particular, defensive medicine, as the main way that the malpractice system is driving up health care costs, but these indirect costs have proven much harder to calculate.” In fact, researchers at the Harvard School of Public Health published a study last fall in which they estimated that the money spent on defensive medicine added only about another two percent to health care spending. Moreover, the researchers pointed out, this figure doesn’t take into account any improvement in patient outcomes attributable to defensive medicine. In other words, doctors may order extra tests in order to reduce the chances that they will be successfully sued for malpractice, but some of these tests may actually help patients and lower their health care costs in the long run.

Mehlman notes that limiting malpractice compensation “rests on the assumption that the current system overcompensates malpractice victims, when in fact it undercompensates them, since most of them are not aware that they have suffered a malpractice injury and never assert a claim, those that do receive payment don’t receive enough to cover their actual losses, and the more severely a person is injured, the less adequate the compensation that they receive.”

“From time to time,” Mehlman observes, “malpractice premiums for doctors shoot up dramatically, most recently in the early part of the past decade, and as a result, some doctors are reported to stop practicing or to stop practicing certain higher-risk specialties such as obstetrics. But it is now generally agreed that these premium spikes are caused by the marketing and investment practices of malpractice insurers rather than by any sudden uptick in malpractice claims or payments.” He says, “It is true that the number of claims and the size of payouts have been increasing over time, but they have done so at a fairly steady pace. Malpractice payments have increased by only about enough to allow people to pay the increased costs of the medical care they need to treat the malpractice injuries they have suffered.”

“There is no question that would be happier if the malpractice system was less of a burden, and there may be better ways of compensating the victims of medical errors that should not have occurred. But what we know about the malpractice system does not tell us that reducing victims’ compensation will save money,” Mehlman concludes.

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richgibula
4.4 / 5 (7) Mar 18, 2011
As a doctor, I can tell that there is no "maybe" about savings with reduced malprac. losses. First, is there a reason to sustain the greed associated to gigantic settlements for non-quanitifiable losses. It is a strange concept that getting hurt at your own house is just a tragedy, but getting hurt in the same way at someone else's is worth millions. Second, there are numerous studies on the costs of litigation. They range from doctors leaving practice due to prem. costs (even without getting sued) to about 60% increases in the cost of medical care due to defensive medicine (NEJM 1985). Its absurd to think that we need the threat of litigation to run tests for diseases or health maintenance. It is usually the lack of insurance coverage that prevents good preventative care since there are good guidelines in place.
Maybe, if the temptation to sue was not so great and prem. were lower, there would be more primary care doctors. Also, maybe there would be fewer TV lawyer ads.
ryggesogn2
2.5 / 5 (8) Mar 18, 2011
There is certainly evidence that malpractice insurance costs have forced many OBGYNs out of the field.
Skeptic_Heretic
4 / 5 (4) Mar 18, 2011
Malpractice isn't really a cost of healthcare. The practices of billing and reimbursement take a far larger toll as is evidenced by the very low operating costs of cash only practitioners.

Insurance companies don't pay doctors to talk to patients, they pay to treat patients. A doctor's job isn't only to treat people as a mechanic treats a car. Consultation has a cost in time, but no payout. In order to make consultation pay one has to run tests, most of which are inconclusive, unnecessary, expensive, or all three. Then there's the matter of the administrative overhead to ensure the insurance companies and government entites pay.

Malpractice insurance and other associated costs are miniscule in comparison to these shortcommings of the healthcare system in the US. Our healthcare isn't necessarily better, we jsut have a ton more of it due to the profit incentive. Malpractice insurance is a problem, but not for the industry on the whole.
ryggesogn2
1.7 / 5 (6) Mar 18, 2011
Malpractice isn't really a cost of healthcare.

Who pays for it?
Skeptic_Heretic
4 / 5 (4) Mar 18, 2011
Malpractice isn't really a cost of healthcare.

Who pays for it?
Financially, the practitioner's insurance policy. Just in case you're a little slow on the uptake, that'd be the bank.
Lorax_2nd
3.7 / 5 (3) Mar 18, 2011
Malpractice isn't really a cost of healthcare.

Who pays for it?
Financially, the practitioner's insurance policy. Just in case you're a little slow on the uptake, that'd be the bank.

Skeptic Heretic, I'm guessing you are carrying over some bad blood from another conversation-- I can think of no other explanation for that embarrassing level of sarcasm.
Don't do that anymore-- it makes you look bad, regardless of the merit of your position.
Now, on to your statement. I'm one of those that's slow on the uptake: are you asserting that the bank pays the costs of malpractice, without those costs coming back to the average consumer of healthcare (becoming a cost of healthcare)?
Skeptic_Heretic
4 / 5 (4) Mar 18, 2011
My sarcasm is utilized proactively on Mr. Swenson here simply so he doesn't start with his inane "define the word 'is'" line of questioning he tyupically engages in. Conversations are seldom polite, and very rarely aestetically pleasing. Passing judgement accomplishes the same action that you accuse me of.
I'm one of those that's slow on the uptake: are you asserting that the bank pays the costs of malpractice, without those costs coming back to the average consumer of healthcare (becoming a cost of healthcare)?
THe interplay is more complex than that. To state the above would be overly simplistic.

Malpractice settlements immediately impact the bank who wrote the insurance policy and the practitioner who may or may not have committed the malpractice. THe former in the form of the payout, the latter by way of paying any settlement uncovered by insurance. In the long term this increases the cost of malpractice insurance by a comparitively miniscule *(TBC)
Skeptic_Heretic
4 / 5 (3) Mar 18, 2011
(cont) comparitively miniscule amount, divided amongst all practitioners in the relevant insurance pool, which includes all practitioners of a similar risk nationwide (in the US). Does that feedback into the cost of healthcare, certainly. Is it sufficient to create a massive surge in the cost of care, certainly not.

Now let's say you go to the doctor and he gives you an x-ray for a sprained wrist. Not too big a deal from your point of view, but now you're utilizing time on a dedicated piece of equipment, which means your GP, and some X-ray techs are involved, and the imaging records deartment is involved because they have to jsutify it to your insurance company, then there's the mountain of regulatory paperwork that must be submitted, requiring personel with highly specified legal and operational experience, and they don't come cheap. Multiply that by 60,000 sprained wrists. Requiring more of all of the above. Do you think a single malpractice lawsuit affects the cost of care more?
ryggesogn2
1 / 5 (5) Mar 18, 2011
Malpractice isn't really a cost of healthcare.

Who pays for it?
Financially, the practitioner's insurance policy. Just in case you're a little slow on the uptake, that'd be the bank.

Who pays the insurance policies? Insurance companies spread the financial risk to ALL doctors and the patients who pay them.
Ultimately, like all taxes, the customer must pay all costs.
"OB/GYN salaries reflect the high malpractice insurance premiums they must pay, due to the riskiness of the job and the need to regularly perform surgery. "
http://money.cnn....g/2.html
"Skyrocketing insurance premiums are forcing thousands of ob-gyns out of the baby business. And your doctor could be the next to go."
http://www.parent...hortage/
Jonseer
3.9 / 5 (7) Mar 18, 2011
Malpractice is NOT responsible in any way for the high cost of healthcare.

Just ask the state of Texas.

Under the halcyon days of Governor Bush in the 90s malpractice laws were tightened up.

The laws were re-written so that only someone with a lot of upfront cash could successfully pursue a malpractice lawsuit.

If you weren't rich, you weren't going to sue, because lawyers no longer take suits on contingency.

The result was malpractice suits plummeted to an insignificant #.

What were the results?

Prior to the elimination of malpractice lawsuits in Texas, the state had some of the highest healthcare costs in the nation.

Now over 10yrs. later nothing has changed.

The cost of healthcare in Texas has risen right along and sometimes ahead of the rise nationally.

One unintended and very harmful effect is slowly coming to light.

Incompetent, careless Drs. are headed to Texas in droves, and it shows in the medical statistics.
ryggesogn2
1 / 5 (6) Mar 18, 2011
Where is the the serious research to show how to reduce the cost of health care?
"The major culprit in the seemingly endless rise in health care costs is found to be the removal of the patient as a major participant in the financial and medical choices that are currently being made by others in the name of the patient. "
"The cure for the present problems is straightforward: the patient must once again be made the central actor in the medical marketplace. Patients need to be given the same motivations to economize on medical care that they have to economize in other markets. Tax laws need to be rewritten. The use of medical savings accounts needs to be promoted. High-deductible health insurance should be encouraged. "
http://www.cato.o...1es.html
This was written in 1994. Nothing has changed except costs keep rising and the govt has taken more control.
Skeptic_Heretic
5 / 5 (3) Mar 19, 2011
Who pays the insurance policies? Insurance companies spread the financial risk to ALL doctors and the patients who pay them.
Patients don't pay malpractice insurance. I already addressed this point above, thanks for agreeing with me.
This was written in 1994. Nothing has changed except costs keep rising and the govt has taken more control.
The government does not have more control over medical practice. Keep repeating the lie Mr. Swenson.

Healthcare costs have risen because reimbursements have declined, cost of operation has increased, and expense of sophisticated diagnostics, which are commonly misused for profit, have increased.
ryggesogn2
1 / 5 (7) Mar 19, 2011
The patient ultimately pays one way or another. If they pay for their care with cash, they pay directly. If a third party pays, the patient has premiums, co-pays and deferred cash compensation if the employer pays premiums. If the patient has no money and no insurance, he still pays, as we all do, with the quality of the physicians and timely treatments. And all other patients who pay have to pick up the tab for those who don't pay directly.

Healthcare costs have risen because reimbursements have declined,

That makes no economic sense.

Incompetent, careless Drs. are headed to Texas in droves, and it shows in the medical statistics.


Who controls certification and discipline of physicians? Other physicians.

Two guilds control this issue, the ABA and the AMA. The trial lawyers donate heavily to 'liberal' politicians.
Skeptic_Heretic
5 / 5 (3) Mar 19, 2011
Healthcare costs have risen because reimbursements have declined,
That makes no economic sense.
I pay you less for each xray you perform, so you perform more xrays to compensate, this increases the use of your xray facilities, requiring expansion more personnel, more expensive equipment, increasing hospital costs per xray. Makes perfect sense if you actually are interested in studying the economics of the situation.

ryggesogn2
1 / 5 (7) Mar 19, 2011
Healthcare costs have risen because reimbursements have declined,
That makes no economic sense.
I pay you less for each xray you perform, so you perform more xrays to compensate, this increases the use of your xray facilities, requiring expansion more personnel, more expensive equipment, increasing hospital costs per xray. Makes perfect sense if you actually are interested in studying the economics of the situation.


If costs rise and revenue falls below costs, businesses fail.
Skeptic_Heretic
5 / 5 (4) Mar 20, 2011
If costs rise and revenue falls below costs, businesses fail.
So either you're agreeing with me, or you're simply repeating memes that you think are supporting your stance.

If it's the latter, perhaps you should consider making healthcare a not for profit service.
ryggesogn2
1 / 5 (6) Mar 20, 2011
"Many of these hospitals are already struggling to make ends meet because Medicare only reimburses them for 90 percent of what it costs them to take care of Medicare patients."
{They are already not for profit. But if they make no profit, how can hospitals invest in new processes, procedures and technology to be more efficient?}
"In a misguided effort to pressure them to become more efficient, it arbitrarily assumes that they can achieve the same productivity savings as the economy at large and decrees that these hypothetical cost savings must be deducted from any Medicare reimbursements they receive after September.

The trouble with this is that it lumps hospitals in with manufacturers like IBM and General Electric and takes it for granted that they can ultimately save almost $30 billion per year by replacing their workers with equipment or by squeezing their operations into tighter quarters. Nothing could be further from the truth."
http://www.baltim...ped/bs-e
Calenur
5 / 5 (4) Mar 20, 2011
...perhaps you should consider making healthcare a not for profit service.


Completely agreed. The idea that the well-being of a human being is a commodity is a little disgusting to me.
ryggesogn2
1 / 5 (6) Mar 20, 2011
Of course the ultimate goal of the govt is to take over the hospitals and the entire system.
Forcing the medical industry out of business with below cost reimbursements will give the socialists the excuse to completely nationalize the system.
ryggesogn2
1 / 5 (6) Mar 20, 2011
...perhaps you should consider making healthcare a not for profit service.


Completely agreed. The idea that the well-being of a human being is a commodity is a little disgusting to me.

Where will a hospital get the money to invest in new technology to improve quality and save lives if they don't make a profit? Print it like the govt?
Laser eye surgery is a good example of how profit improves quality and reduces costs. It started with RK, actual cuts in the eyeball and has not developed into a sophisticated laser ablation process that is safer, cheaper and more effective.
Calenur
4.2 / 5 (5) Mar 20, 2011
ryggesogn2, I'm starting to think you and I are going to disagree on nearly everything.

I don't buy into the infallibility of 'the market', and simply because we don't live in a society where an alternative is possible, doesn't mean I wouldn't prefer it. Personally, I would love to live in a system where people worked for the good of humanity, rather than profit. Idealistic? Sure. Would there be problems with such a system? Sure. It doesn't mean this is the best we can do.
ryggesogn2
1 / 5 (6) Mar 20, 2011
Personally, I would love to live in a system where people worked for the good of humanity, rather than profit.

What are YOU willing to do and what are you willing to accept to accomplish your vision?
How do you plan to motivate people to work for the 'good of humanity' without the use of coercive force? Are you willing to sacrifice the good of individual, as defined by the individual, for the 'good of humanity'?
Free markets with the individual's liberty to pursue their self interest under a rule of law that protects every individual's right to life, liberty and property has been demonstrated to be the best method to achieve YOUR vision.
Socialists use 'the good of humanity', I just read that phrase in Hayek's The Road to Serfdom, to justify the coercive sacrifice of the individual for the 'good of humanity'.
Skeptic_Heretic
5 / 5 (3) Mar 20, 2011
Free markets with the individual's liberty to pursue their self interest under a rule of law that protects every individual's right to life, liberty and property has been demonstrated to be the best method to achieve YOUR vision.
Socialists use 'the good of humanity', I just read that phrase in Hayek's The Road to Serfdom, to justify the coercive sacrifice of the individual for the 'good of humanity'.
You can't be selfish without self interest. There is such a thing as moderation of self interest for public benefit. Those among us who are selfish harp on the individual, while most prefer a balance between the one and the many. The intellectual would recognize that self interest doesn't guarantee self benefit.
ryggesogn2
1 / 5 (6) Mar 20, 2011
"Naturally, the moral case for the profit motive in health care is not always the easiest case to make but it is important to see that critics of that case often misunderstand the nature of profit in a free economy."
"The potential for profits motivates insurers to seek greater efficiency in the way they pay for health care. And if more individuals bought their own insurance rather than having their employers do it for them the prospect of profit would motivate more insurers, doctors, and hospitals to offer what consumers want: more options and lower prices."
"we might just find that the profit motive is not the enemy of high-quality, universally accessible health care but rather its most effective servant."
http://www.nation...t-motive
ryggesogn2
1 / 5 (6) Mar 20, 2011
The intellectual would recognize that self interest doesn't guarantee self benefit.

There are no guarantees in life.
To whom are you willing to subjugate your self interest for your self benefit?
What self interest are you willing to subjugate?
Don't you or other self proclaimed intellectuals have the discipline to control yourself?
Byagam_Gokulden
5 / 5 (3) Mar 20, 2011
The intellectual would recognize that self interest doesn't guarantee self benefit.

There are no guarantees in life.
To whom are you willing to subjugate your self interest for your self benefit?
What self interest are you willing to subjugate?
Don't you or other self proclaimed intellectuals have the discipline to control yourself?


The primary objective goal of physicians is to cure and care for the social animals called human beings.
Their subjective goals of money and status are mostly just bonusses of the job.

Don't pretend like you can be fully emotionless, since it is only possible if you have the right neuro-/psychopathology which requires treatment if you want to live inside of society.

If you insist on doing it, my off-hours free medical advice would be that you stop using healthcare altogether, leave society and go back to the cave you crawled out of before the people in blue and/or white come to get you.
ryggesogn2
1 / 5 (7) Mar 20, 2011
The primary objective goal of physicians is to cure and care for the social animals called human beings.
Their subjective goals of money and status are mostly just bonusses of the job.

Are physicians human beings? Why should they devote 10+ hard years of work in school and residency, borrow a lot of money and sacrifice income opportunities for themselves and their families for small 'bonuses'?
Unless you are willing to make physicians slaves to the state, you will need to consider how to motivate individuals to devote their lives to hard work for small 'bonuses'.
Byagam_Gokulden
5 / 5 (4) Mar 20, 2011
^I edited

Are you a physician?

and yeah, I am willing to do that which is why I and most my colleagues became/are becoming physicians. Over here, where the insurance system is almost completely government regulated, doctors get paid far less outrageous salaries and far more appropriate salaries for the work that they do.
And everyone over here is legally covered for almost all medical procedures for just the small cost of approx $800/year, which can become much lower if you take a cheaper own-risk plan.

I learned at a very young age that money certainly isn't everything in life. Giving, helping and loving your fellow human beings who are in need is far more satisfying than having a short high of [insert obsession/addiction here] which can be purchased with cash.
ryggesogn2
1 / 5 (6) Mar 20, 2011
Where is 'over here'?
How much did you pay to become a licensed physician?
ShotmanMaslo
2.3 / 5 (3) Mar 20, 2011
Interesting graph of public and private healthcare spending as a % of GDP:

http://www.stateo...CD_4.png
Byagam_Gokulden
5 / 5 (3) Mar 20, 2011
Where is 'over here'?
How much did you pay to become a licensed physician?


The Netherlands, Europe.

Total cost of the degree to licensed physician is approximately EU 12.000 to 15.000. Additional costs include books, coat, standard doctor equipment, etc which can make the total come up to around EU 20.000.

Starting year salary for physicians is EU 36.000 and can go up to about EU 70.000, with enough years of work.

Specialization is practically done by all licensed physicians. No additional cost awaits you, only eventual salary increase even if you don't get your degree. Specialized physician salaries on average are EU 80.000 to EU 130.000 for those in public practice and EU 150.000 to EU 250.000 for those in private practice.

That's more than enough money to 'live a nice life'.
Skeptic_Heretic
5 / 5 (2) Mar 20, 2011
The intellectual would recognize that self interest doesn't guarantee self benefit.

There are no guarantees in life.
To whom are you willing to subjugate your self interest for your self benefit?
You're employer for one. You sacrifice your freedom of action to gain personal benefit.
What self interest are you willing to subjugate?
Depends on the benefit. Some would sacrifice their lives to save a busload of children. I'm guiessing you would not.
Don't you or other self proclaimed intellectuals have the discipline to control yourself?
Not sure where this is comming from but yes, indeed me do. It does appear that rather often you do not.

Hope you read shotman's graph. Shows rather clearly that private healthcare costs a greater percentage of GDP.
ryggesogn2
1 / 5 (7) Mar 20, 2011
That's more than enough money to 'live a nice life'.

That's your opinion.

"But new figures show she's in a minority, because in the past few years almost no foreign-qualified refugee doctors have been licensed to practise as physicians here in the Netherlands - despite the soaring need for doctors."
"Meanwhile, the number of vacancies in the sector is rising quickly. In the last three months of 2009 there were 853 vacancies for general practitioners and 761 vacancies for specialists. And there also happens to be a particularly urgent demand for geriatric specialists."
http://www.rnw.nl...shortage
Maybe the Netherlands should pay more or change the rules.
martalli
4.3 / 5 (3) Mar 21, 2011
As a doctor, I can directly relate some of my costs to malpractice. Most of this so-called defensive medicine is so ingrained that most people don't even realize it. How many people with chronic headaches get MRIs? Somewhere over 100% of them, because many of them get more than one. How often do brain tumors cause headaches? Rarely, and usually only after they have already caused some neurologic deficit. Therefore, if a patient has had an exhaustive neurologic exam and its negative, an MRI is unnecessary. Yet, people expect it, and doctors know that refusing something like an MRI would cause the sort of anger that would lead to a lawsuit if a problem would arise. As a primary care doc, I see about 6000 people a year. Chances are that some of them will develop cancer or some other terrible disease, and if I refused the MRI they asked for, I will get sued and I may very well lose, since the jury is laypeople, not doctors. Even if I win, my insurance will go up.
Calenur
5 / 5 (2) Mar 21, 2011
How do you plan to motivate people to work for the 'good of humanity' without the use of coercive force?


Fortunately for me, not everyone needs to be motivated by force. A cut-throat system engineered to favor the profit minded is not a system to achieve my goal. My happiness at the expense of others is not my goal. I have plenty of experience "subjugating my self-interests"; not everyone believes this is as good as it gets, and some of us do work to change it, even in a small way.
Calenur
5 / 5 (2) Mar 21, 2011
The primary objective goal of physicians is to cure and care for the social animals called human beings.
Their subjective goals of money and status are mostly just bonusses of the job.


Agreed. One would hope a physician joins the field because he/she wants to help others, not because it's a way to become wealthy.
ryggesogn2
1 / 5 (6) Mar 21, 2011
The primary objective goal of physicians is to cure and care for the social animals called human beings.
Their subjective goals of money and status are mostly just bonusses of the job.


Agreed. One would hope a physician joins the field because he/she wants to help others, not because it's a way to become wealthy.

If you have hope in one and dog doo in the other, which one gets filled sooner?
Its not even to 'get wealthy'. Physicians are leaving MA because they are LOSING money.
Any time the govt tries to control costs or limit wages, shortages and rationing are the inevitable result.
Physicians are human beings too. They want to earn a decent living, raise a family, etc.
Why should anyone expect and demand that a physician work for free?
Some demand teachers should be better paid because of their important work. Why shouldn't physicians?
Modernmystic
1 / 5 (3) Mar 21, 2011
Malpractice isn't really a cost of healthcare.

Who pays for it?
Financially, the practitioner's insurance policy.


Who pays the practitioner's insurance policy? Who are those costs deferred to in the end?
Modernmystic
1 / 5 (7) Mar 21, 2011
ryggesogn2, I'm starting to think you and I are going to disagree on nearly everything.

I don't buy into the infallibility of 'the market', and simply because we don't live in a society where an alternative is possible, doesn't mean I wouldn't prefer it. Personally, I would love to live in a system where people worked for the good of humanity, rather than profit. Idealistic? Sure.


It's not idealistic at all, it's a sadistic nightmare where everyone is a slave to everyone else. Ever ask yourself how you're going to deal with people without a system of incentive, money, or profit?

I'll give you a guess, you put bullets in it...
Byagam_Gokulden
5 / 5 (3) Mar 21, 2011
That's your opinion.


A doctor doesn't need to be a multi-millionaire. Moderation is healthy, while greed is never a good thing.

"But new figures show ... happens to be a particularly urgent demand for geriatric specialists."
http://www.rnw.nl...shortage
Maybe the Netherlands should pay more or change the rules.


That view is definitely skewed, there are a stable amount of doctors in the NL even if we could probably use a few more. Achieving this would be easy too since there are only a maximum of 2800 students let in to all universities to study Medicine each year, a strategy that was chosen to maintain high quality output.

Geriatric demand is due to aging of the nation: people are living much longer due to increased health. There is little you can do about this since it isn't a field most physicians would readily enter. Higher salaries could be good incentive, but I for one still wouldn't be interested.
ryggesogn2
1 / 5 (7) Mar 21, 2011
There is little you can do about this since it isn't a field most physicians would readily enter.

Why? Don't Dutch physicians want to help old people?
Is this the motivation for the promotion of euthanasia?
Byagam_Gokulden
5 / 5 (2) Mar 21, 2011
If you have hope in one and dog doo in the other, which one gets filled sooner?
Its not even to 'get wealthy'. Physicians are leaving MA because they are LOSING money.
Any time the govt tries to control costs or limit wages, shortages and rationing are the inevitable result.
Physicians are human beings too. They want to earn a decent living, raise a family, etc.
Why should anyone expect and demand that a physician work for free?
Some demand teachers should be better paid because of their important work. Why shouldn't physicians?

What about all the other professions which are just as if not more important than physicians? Pharmaceutical and biomedical scientists, chemists, physicists, the very scientists who improved medical science? Why don't these people deserve higher pay?

When I compare my curriculum to theirs, theirs was usually far more difficult apart from the patient contact. I happen to be studying physics as well and I can tell you that medicine requires far less work
Calenur
5 / 5 (4) Mar 21, 2011
It's not idealistic at all, it's a sadistic nightmare where everyone is a slave to everyone else. Ever ask yourself how you're going to deal with people without a system of incentive, money, or profit?

I'll give you a guess, you put bullets in it...


It's unfortunate for everyone you feel that way.
Byagam_Gokulden
5 / 5 (3) Mar 21, 2011
There is little you can do about this since it isn't a field most physicians would readily enter.

Why? Don't Dutch physicians want to help old people?
Is this the motivation for the promotion of euthanasia?


Its the doctors choice: if you want to become a GP, surgeon or whatever you aren't going to settle for another specialization.
Remember that most doctors are young people with big dreams.

Most old people are only still alive because healthcare has drastically improved. Patients over 80 don't get treated with the same urgency as kids and adults, since most of their problems are age-related, not to mention their higher death risk. When its time to go, its time to go. There is little point in trying to keep an 80+ year old alive knowing they aren't gonna improve, unless of course they still have a strong will to live.

Also euthanasia is legal here, but is only permitted after utmost examination of the patient by a euthanasia specialist, usually a GP or geriatrician
Modernmystic
1 / 5 (4) Mar 21, 2011
It's not idealistic at all, it's a sadistic nightmare where everyone is a slave to everyone else. Ever ask yourself how you're going to deal with people without a system of incentive, money, or profit?

I'll give you a guess, you put bullets in it...


It's unfortunate for everyone you feel that way.


It's now how I FEEL, it's how such a system would work...it's how such systems HAVE worked as a matter of historical record. And it's time to stop coddling socialist psychopaths and start pinning them down on exactly HOW their "idealistic" philosophy's are going to survive head on collisions with human nature...

How are you going to get cooperation if you don't offer someone money (profit), or some other form of good or service? What's your other magical option that isn't based on naked aggression?
Modernmystic
2 / 5 (4) Mar 21, 2011
I'll give an example:

I want to opt out of social security. I refuse to cooperate with a half baked pyramid scheme set up by an idiotic tin plated quasi-dictator in the 30s.

I'd like to not pay any further in the system, I'd like all my stolen money refunded (with interest), and I expect no benefits when I hit 65.

You have a problem with that? Why or why not?
Thrasymachus
3.4 / 5 (5) Mar 21, 2011
I have a problem with that. For one thing, you're not 65 yet, so you can't tell us anything about what you'll expect to get then. Talk to me about what you expect when you're starving under a bridge somewhere, suffering from incontinence, pneumonia, and arthritis so painful you couldn't even hold an aspirin, not that you'd be able to afford one.

And even if you think you're willing and able to make that choice for yourself while you're sitting in the relative and temporary comforts of youth and adequate wealth, I'm not willing to let you because your being in such a state is a terrible risk to everyone else who comes anywhere close to you. You think rats or a pack of feral dogs are a danger to public health? They're nothing compared to a legion of sick, dying and homeless people.

Finally, as the article notes, the costs of malpractice insurance are not greatly influenced by the size of awards. Rather it is the insurance company's investment/marketing strategies to blame.
Thrasymachus
4 / 5 (8) Mar 21, 2011
I'd also like to comment on this absurd conservative tendency to divide the world into "us vs them." Of course insurance costs, and indeed every cost is ultimately passed on to the patients. But ultimately everybody's a patient, including doctors and insurance company managers, so your "insightful" distinction is moot.

Malpractice insurance, just like all insurance, is subject to a flaw which causes a market to generate perverse incentives. The only insurance that works even moderately well, and that doesn't also inflate the price of the thing they are insuring, is wholly public insurance, like SSI, or markets that are so heavily regulated that they may as well be wholly public, such as auto insurance.
Modernmystic
1.6 / 5 (7) Mar 21, 2011
I have a problem with that. For one thing, you're not 65 yet, so you can't tell us anything about what you'll expect to get then. Talk to me about what you expect when you're starving under a bridge somewhere, suffering from incontinence, pneumonia, and arthritis so painful you couldn't even hold an aspirin, not that you'd be able to afford one.


Typical scare tactics. Tell you what, shove em. Save the blatant emotional pleas and idiotic logical fallacies for someone else. I'm not buying today.

I'm not willing to let you because your being in such a state is a terrible risk to everyone else who comes anywhere close to you.


Again scare tactics and hypothetical bullshit. Save it. Western civilization didn't collapse before it, it's going to be fine if I'm not a part of it.

And this "you're not willing to let me" is the bullet thinig I was speaking to earlier...and you gave me a 1 on the post for pointing out the obvious. F***ing hypocrite.
Modernmystic
1.7 / 5 (6) Mar 21, 2011
I'd also like to comment on this absurd conservative tendency to divide the world into "us vs them."


Puhleeeeeease. You leftists prigs are FAR better at that than any conservative dreamed of.

Of course insurance costs, and indeed every cost is ultimately passed on to the patients. But ultimately everybody's a patient, including doctors and insurance company managers, so your "insightful" distinction is moot.


No it isn't you totally missed the point. The point is that since indeed we ALL are patients we ALL pay for frivolous BS lawsuits that inflate the cost of HEALTH CARE. That same health care which someone said malpractice suits didn't effect the cost of (one of the more idiotic things I've read on this board in a while).

The question isn't do we all bear the costs of health care, the question is what's inflating the costs...
Thrasymachus
3.4 / 5 (5) Mar 21, 2011
And the answer to that is clear, just look at the industries relating to health care, and look at who's increasing their prices at the same time they're recording record profits. The two biggest offenders are insurance companies and pharmaceutical companies, and in that order.
Modernmystic
1.8 / 5 (5) Mar 21, 2011
And the answer to that is clear, just look at the industries relating to health care, and look at who's increasing their prices at the same time they're recording record profits. The two biggest offenders are insurance companies and pharmaceutical companies, and in that order.


The malpractice insurance companies are raising their premiums because we need tort reform in the worst possible way.

As far as raising costs, well they'll be raised until people stop buying, just like anything else. The problem is that since insurance companies aren't allowed to truly compete thanks to government regulation these costs have been extremely artificially inflated.
ryggesogn2
1 / 5 (8) Mar 21, 2011
I'd also like to comment on this absurd conservative tendency to divide the world into "us vs them."

Maybe there is hope. You have the absurd part correct, but the "Us vs them" is the classic socialist, class warfare cry based upon the false concept that if one becomes wealthy they do so by stealing it making others poor.

What is the profit margin of health insurance companies?
"Overall, the profit margin for health insurance companies was a modest 3.4 percent over the past year, according to data provided by Morningstar. That ranks 87th out of 215 industries "
http://money.usne...villains
Byagam_Gokulden
5 / 5 (5) Mar 21, 2011
you don't get it, socialism stands for minimum equality for EVERYONE, only the government has a bit more power to make the tough decisions and take care of the people which gives them some extra benefits. However I fail to see how that is different from ANY current Western society.

You are somehow equating socialism to communism and sticking by your stance of fascism/nationalism with a tendency of individual anarchism.
Skeptic_Heretic
5 / 5 (5) Mar 21, 2011
You are somehow equating socialism to communism and sticking by your stance of fascism/nationalism with a tendency of individual anarchism.
Marjon/ryggesogn2/Mr. Swenson, does that very, very often. He's straight out of the McCarthyism era.
Skeptic_Heretic
5 / 5 (5) Mar 21, 2011
The malpractice insurance companies are raising their premiums because we need tort reform in the worst possible way.
I agree, we do need serious reform in our legal system on the whole, however, it can be shown to not be a cause for the rise in malpractice insurance premiums. The rise in malpractice premiums has come from the clinical trial pharmacology arena. For example, a study that Mr. Swenson made me aware of used experimental synthetic blood on humans before it had begun clinical trial, without consent. That was a big one.
ryggesogn2
1 / 5 (9) Mar 21, 2011
socialism stands for minimum equality for EVERYONE,

Minimum equality of what?
the government has a bit more power to make the tough decisions

Like encouraging old people to let their doctors kill them?

Socialism/communism/fascism ARE equivalent.

"economic and social equality can only be achieved at the expense of political equality"
"There is only one way to make all people even approximately economically or socially equal, and that is through the forcible redistribution of wealth and the legal prohibition of social distinction. "
http://www.thefre...quality/

If socialists don't like being compared to communists and fascists, maybe they should stop acting like them and respect the individual's property rights. But then they would no longer be socialists, would they.
Caliban
5 / 5 (2) Mar 21, 2011
As a doctor, I can directly relate some of my costs to malpractice. [...]they asked for, I will get sued and I may very well lose, since the jury is laypeople, not doctors. Even if I win, my insurance will go up.


@martalli,

Not picking on you here, but I wanted to use your post as a way of relating your concerns and also those of Swenson/rygesson/marjon/ aka mangy, along with Modern Mystic.

It should be plain to all of you that the reason malpractice insurance is so expensive is simply by virtue of the fact that it is issued by a for-profit system.

How much do you think it would cost an individual physician if it was, for instance, universal risk?

How much if it was universal risk + experience rated?

Answer: a hell of a lot less than it does now, and for the same reasons that there is such wild variability in the cost of ANY private insurance, health or otherwise.

Imagine how much cheaper it would be if it was operated as a not-for-profit enterprise. contd
Caliban
5 / 5 (3) Mar 21, 2011
contd

That is the problem, in a nutshell. When insurers are more concerned with their profit margins than the value they return to their customers per dollar premium, then costs rise, regardless of quality of care/service delivered. Period.

As long as insurance is driven by the profit motive, insurance costs will remain high, and rise ever higher, and the insurance companies will spend all the money that they could be using to lower the costs of premiums and expanding service to instead continue to do everything in their power to create artificial distinctions in risk pools, contradictory regulation/legislation, and derail any efforts to universalize or socialize insurance, for the plain and simple reason that it would mean a loss of those sweet, sweet premium dollars that flow in ever increasing rivers into the owner/manager/shareholder bank accounts.

Simple.

So, if you wish to blame someone for the ridiculous expense of malpractice or other insurance, blame insurors.
Skeptic_Heretic
5 / 5 (6) Mar 22, 2011
Socialism/communism/fascism ARE equivalent.
But only if you live in a world of paranoia and "us vs. them" thinking. Only if you had never actually inquired into anything the talking heads on US radio were telling you in the 50's-70's. Only if you were one of the kids who thought hiding under your desk really would save you from a nuclear explosion.

You should seriously see someone about your outbursts.
ryggesogn2
1 / 5 (8) Mar 22, 2011
But only if you live in a world of paranoia and "us vs. them"

It is the socialist who engages in 'us vs them' thinking. It is the socialist who believes the economic 'pie' is fixed and profit steals from the poor.
It is the classical liberal, the capitalist who knows that wealth is created. Free markets increase the size of the 'pie' creating more wealth and more opportunities for wealth creation for 'them' and for 'us'.

For all physicians out there, in the book 'Blink', the author discusses research that suggests the reason patients sue is they don't like their doctor. Their doctor was not nice, did not respect them as human beings. The lesson for physicians is that those who treat their patients as customers, who respect the the patient, are sued less often.
Modernmystic
1.6 / 5 (7) Mar 22, 2011
It should be plain to all of you that the reason malpractice insurance is so expensive is simply by virtue of the fact that it is issued by a for-profit system.


No. The blatantly obvious reason malpractice insurance is so expensive is because there are far too many malpractice lawsuits. The more you get sued, the higher your rates and eventually ALL rates are.

Simple.

The fact that this relates to the overall cost of health care is blatantly obvious too. The only thing that's really debatable is the degree to which it effects overall costs...
Thrasymachus
4.2 / 5 (5) Mar 22, 2011
Pay attention MM, the studies have been done looking at just how much malpractice awards affect the price of malpractice insurance. And the answer is not much. Rising malpractice awards are responsible for only about 2% of the increase in the price of malpractice insurance. Almost all the rest of the increase can be attributed to the insurance company's managers losing the pool of premium dollars by playing the stock market and by marketing practices in selling policies such as churning and overselling.

Modern insurance companies do not make a profit by selling more policies and collecting more premiums than they have to pay out. They make a profit by taking the premiums and gambling with them in the market. The whole of the insurance industry is just a scam to get small amounts of money from a whole bunch of people to make a big pile of money they can use to game the markets. The promise of payouts to policyholders is just the hook.
ShotmanMaslo
3.7 / 5 (6) Mar 22, 2011
ryggesogn2 - you are such an ignoramus its not even funny.

Minimum equality of what?


Equal access to basic necessities like food, shelter, healthcare, education.

"There is only one way to make all people even approximately economically or socially equal, and that is through the forcible redistribution of wealth


Yes. Where is the problem? Are you saying right to property should be more important than basic right to live (which equals right to basic necessities)?
ShotmanMaslo
4.3 / 5 (6) Mar 22, 2011
If socialists don't like being compared to communists and fascists, maybe they should stop acting like them and respect the individual's property rights. But then they would no longer be socialists, would they.


Learn the difference between socialism and social democracy capitalism. Sweeping everything which is not radical libertarianism under "socialism" bracket is really showing your ignorance.

The only situation where property rights should not be respected is when you have a choice between upholding right to property or right to basic necessities. Unless you want to claim we should infringe upon right to basic necessities in such case (which would disqualify you in the eyes of any normal person), you are a "socialist" by your definition.

It is the socialist who engages in 'us vs them' thinking. It is the socialist who believes the economic 'pie' is fixed and profit steals from the poor.


Strawman. Modern social democrats dont believe such nonsense.
ryggesogn2
1 / 5 (7) Mar 22, 2011
Learn the difference between socialism and social democracy capitalism.

Both attempt to plan the economy. Whether it is tyranny of a majority or a committee, it is still a tyranny.

Equal access to basic necessities like food, shelter, healthcare, education.

Everyone has equal access in the USA. What you really mean is you want the govt to take money from some to pay for food, for education for health care for others. But then you have a dilemma, what is the minimum 'access' to food, to education, to health care?
Should everyone have a 32" flat screen TV and basic cable, a cell phone or I-phone or....?

Are you saying right to property should be more important than basic right to live

What right to you have to force someone else to pay for your food, your house, your health care? I you have that right then everyone has that right and no needs to work.
ryggesogn2
1 / 5 (7) Mar 22, 2011
"According to the Office of Management and Budget, "human services" Social Security; Medicare; health-expenditures; education, training, employment, and social services; veterans benefits; and the euphemistically-named "income security" (i.e., unemployment benefits) were consuming 4 percent of America's GDP in 1949.

By 1976, this figure had increased to 11.7 percent. In 2009, it was consuming 15.3 percent of GDP. Currently, 75 percent of human services spending was on Social Security, Medicare and "income security" in short, the core welfare state.

America now seriously risks seeing its burgeoning welfare costs suffocating the productive sector of the economy that makes social welfare possible in the first place. Incidentally, it won't be the rich who suffer. It will be the poor.

From The Detroit News: http://detnews.co...HLgFhuxU

"
As Thatcher said, socialism is great until you run out of other people's m
ShotmanMaslo
4.2 / 5 (5) Mar 22, 2011
But then you have a dilemma, what is the minimum 'access' to food, to education, to health care?


That depends on the consensus of the society, and also the economic limits of the state. I think its far better to try to solve this "dilemma" than having people who do not have access to basic necessities.

What right to you have to force someone else to pay for your food, your house, your health care?


The same right you have to steal food from someone rich when you are hungry. Natural right. True natural right, which says right to life, THEN right to liberty, THEN right to property. Not how libertarians twisted it - right to property first, and everything else afterwards.

I you have that right then everyone has that right and no needs to work.

you are assuming people would be OK with living the whole life on food stamps and no money to spare, and receiving only minimal retirement. And you can condition welfare with at least part time working for the public.
ryggesogn2
1 / 5 (7) Mar 22, 2011
That depends on the consensus of the society,

So 50%+1 can vote to steal from the minority. That's a consensus in a democracy.
The same right you have to steal food from someone rich when you are hungry.

Not under a rule of law.

assuming people would be OK with living the whole life on food stamps and no money to spare,

That is not an assumption, it is an observation.
The other observation is the govt bureaucracy that supports the welfare state wants to grow in staff, power and funding. The Dept of Ag administers food stamps and school lunch programs. The funding in those departments is much larger than traditional ag.
ryggesogn2
1 / 5 (7) Mar 22, 2011
Another observation regarding food stamps and subsidies is that such subsidies can enable black and gray market economies.
If people can get the govt to pay for 50-75% of their needs they can run a few scams on the side and make up the difference, tax free of course.
Skeptic_Heretic
5 / 5 (5) Mar 22, 2011
If people can get the govt to pay for 50-75% of their needs they can run a few scams on the side and make up the difference, tax free of course.
So by this logic, if the government paid 100%, there would be no crime, so we could shift all that money being spent on the various wars on poverty, drugs, crime, rape, etc and divert the funding into the people's educations allowing them to achieve without assistance.

It's amazing how quickly you obliterate your own arguments.
Lorax_2nd
not rated yet Mar 23, 2011
Um... so anyway. Getting away from the poison pen and back to the article...
The subject (Mehlman) is arguing that malpractice reform (e.g., award caps) won't greatly reduce healthcare costs.
Even if one were to grant that (and I think the arguments are specious re: defensive medicine), what about the more fundamental question: are current malpractice laws effective, by any measure? An insightful, even gripping, article on malpractice is by Dr. Atul Gawande 'When Doctors Make Mistakes' in the New Yorker, 2000.
I will aver that most people feel malpractice law, as implemented, is a disservice to patients, doctors and the public.
So, OK, even if the current system weren't THAT burdensome: shouldn't we still try to improve it? (Of course, two camps will appear, diametrically opposed on the solution... sigh)
Lorax
(a person deeply believing in care and generosity to those in need, AND that greed and profit [i.e. creating valuable services to my fellow man] makes us all richer)
Skeptic_Heretic
5 / 5 (2) Mar 23, 2011
.So, OK, even if the current system weren't THAT burdensome: shouldn't we still try to improve it?
Of course, but don't start tilting at windmills about how it's a magic bullet for healthcare costs. It isn't, not by a long shot.

(a person deeply believing in care and generosity to those in need, AND that greed and profit [i.e. creating valuable services to my fellow man] makes us all richer)
I think you need to re-read your Seuss book.
ryggesogn2
1 / 5 (6) Mar 23, 2011
So by this logic, if the government paid 100%, there would be no crime,

100% if what? NO one ever has 100% of their needs and wants satisfied because they always change.
If food stamps cover a basic minimum in food they don't cover steaks or wine or beer or cigarettes or caviar or...

How is 'progressive's' 50 year war on poverty going? Have they won the war? But why win the war? It keeps so many govt personnel employed and keeps politicians in power.
Skeptic_Heretic
5 / 5 (4) Mar 23, 2011
100% if what? NO one ever has 100% of their needs and wants satisfied because they always change.
Needs don't change. Wants do. At no point in time did I mention wants.

If food stamps cover a basic minimum in food they don't cover steaks or wine or beer or cigarettes or caviar or..
Your point?
How is 'progressive's' 50 year war on poverty going?
How're your wars on terrorism and drugs going?
Have they won the war? But why win the war? It keeps so many govt personnel employed and keeps politicians in power.
Because the only time true evil can ever be done is when good men do nothing. THen again, you're all about doing nothing, aren't you.
ryggesogn2
1 / 5 (7) Mar 23, 2011
Needs don't change.

Of course they do.

I am all for doing something to combat the evil of socialism/statism. SH and others here defend that evil.

Why is it evil? It demands the use of coercive force of state to control the lives of others.
Thrasymachus
4.2 / 5 (5) Mar 23, 2011
Q: When is the use of the coercive force of state to control the lives of others justified?
A: In three conditions: To compel the payment of just taxes, to compel the payment of civil awards or criminal fines or punishments awarded due to successful proof of the defendant's having illegitimately used some form of coercive force against the victim/plaintiff that has been legally recognized as illegitimate, and to prevent said transgressions from occurring.
Margon's A: Never! The government should never be allowed to use coercive force against its citizens (narrowly, "Constitutionally" defined). Only the individual citizens should have the unlimited and unrestricted right to use coercive force.
Skeptic_Heretic
5 / 5 (5) Mar 23, 2011
Needs don't change.

Of course they do.
Name one need that changes.
I am all for doing something to combat the evil of socialism/statism. SH and others here defend that evil.
I'm warning you.
Why is it evil? It demands the use of coercive force of state to control the lives of others.

You dispute the use of force until you need it. Who was it who was speakinga bout his idyllic days as a young man on a farm in an agricultural commune?

Some of my views might be socialist or akin to social democracy but your views are utterly totalitarian.

Just a word fo warning. If reality really was the way you want it, if you got exactly what you profess you want, you'd rather quickly end up with nothing.

The law protects you more than it does those who have nothing, if that were to change, you would very quickly find yourself with nothing.
kaasinees
4 / 5 (4) Mar 23, 2011
Why is it evil? It demands the use of coercive force of state to control the lives of others.

So you are calling the law evil?
If you dont like to be protected from crimes - that can steal your property or even your life - why dont you move to the jungle? You have all the freedom todo so and probably also the money since you come here spitting out nonsense how you have all the right to protect your property whatever means.
ryggesogn2
1 / 5 (8) Mar 23, 2011
So you are calling the law evil?

Depends upon the law doesn't it?
"Partial plunder, universal plunder, absence of plunder,
amongst these we have to make our choice. The law can
only produce one of these results."
"legal plunder may be exercised in an infinite multitude
of ways. Hence come an infinite multitude of plans
for organization; tariffs, protection, perquisites, gratuities,
encouragements, progressive taxation, free public
education, right to work, right to profit, right to wages,
right to assistance, right to instruments of labor, gratuity
of credit, etc., etc. And it is all these plans, taken as a
whole, with what they have in common, legal plunder,
that takes the name of socialism."
http://mises.org/...elaw.pdf
ryggesogn2
1 / 5 (7) Mar 23, 2011
I'm warning you.

About what?
You support legal plunder as described by Bastiat and state planning as described by Hayek.
I fully support the negative law as described by Bastiat which protects the rights all individuals, equally, from state.
Caliban
5 / 5 (5) Mar 23, 2011
I fully support the negative law as described by Bastiat which protects the rights all individuals, equally, from state.

No, mangy -you clearly support ANY set of rules that will let you have your way. This is what is most apparent from your posts, and your desire to opportunistically pervert and/or distort any even slightly supportive ideology to argue that end only serves to make it plain to everyone here just how smarmy your personal -much less political/social/moral- "principles" must be.

How's a snake get out its skin?

Skeptic_Heretic
5 / 5 (3) Mar 23, 2011
I'm warning you.

About what?
The legal rammifications of slander. I do know who you are.
You support legal plunder as described by Bastiat and state planning as described by Hayek.
Define your term so that your misunderstanding may be made bare for the public to consider.
I fully support the negative law as described by Bastiat which protects the rights all individuals, equally, from state.
Yes, which also enables individuals to seize fropm one another under threat of force. The negative liberties you encourage will result in your destitution as you are not of sufficient ability to defend yourself from others. That is very obvious as seen in discussions here.
ryggesogn2
1 / 5 (5) Mar 23, 2011
The legal rammifications of slander. I do know who you are.

I have encouraged you to be more skeptical. Of course if you choose that route you will have to go public and identify yourself. The proper term is libel, not slander. And you will have to prove that you are not a populist socialist that supports a regulatory state. Prove, not just assert.

I have made reference to Bastiat' The Law many times. Look it up for yourself.

The negative liberties you encourage will result in your destitution as you are not of sufficient ability to defend yourself from others

You obviously didn't read The Law.
ryggesogn2
1 / 5 (5) Mar 23, 2011
"Bastiat explains the call for laws that restrict peaceable, voluntary exchange and punish the desire to be left alone by saying that socialists want to play God. Socialists look upon people as raw material to be formed into social combinations."
"If a government is strictly limited to protecting mens rights, then peace prevails, and men can go about working to improve their lives, associating with their neighbors in a division of labor and exchange.
But government can also be turned against those whom it
is meant to protect in their property. There can arise legal plunder, in which the powers of government are used by various individuals and groups to prevent rivals from competing, to restrict the domestic and foreign trading opportunities of other consumers in the society, and therefore to steal the wealth of ones neighbors. This, Bastiat argues, is the origin and basis of protectionism, regulation, and redistributive taxation."
http://www.fee.or..._Law.pdf
ryggesogn2
1 / 5 (5) Mar 23, 2011
"When law and force keep a person within the bounds of
justice, they impose nothing but a mere negation. They oblige
him only to abstain from harming others. They violate neither
his personality, his liberty, nor his property. They safeguard all of these. They are defensive; they defend equally the rights of all."
"But when the law, by means of its necessary agent, force,
imposes upon men a regulation of labor, a method or a subject of education, a religious faith or creedthen the law is no longer negative; it acts positively upon people. It substitutes the will of the legislator for their own wills; the initiative of the legislator for their own initiatives. When this happens, the people no longer need to discuss, to compare, to plan ahead; the law does all this for them. Intelligence becomes a useless prop for the
people; they cease to be men; they lose their personality, their liberty, their property."
The Law, Bastiat.
Skeptic_Heretic
5 / 5 (1) Mar 24, 2011
You obviously didn't read The Law.

You obviously didn't understand it.

The Law can be summed up very easily. "The rights of my fist end at the point of your nose." That's Bastiat's 'The Law' in a nutshell. The problem you bring into the discussion is when you attempt to reinterpret Bastiat and assume that his philosophy moved beyond this incredibly simplistic construct of society.
ryggesogn2
1 / 5 (5) Mar 24, 2011
A typical socialist response, 'society' is too complex to be left to individuals. 'Society' needs 'planners' to ensure its survival. If not for govt planning and control, society would collapse. Is that what you say SH?
GSwift7
1 / 5 (1) Mar 24, 2011
You're all missing a HUGE part of the equation, which I notice the original article also left out of the discussion (perhaps intentionally? ..since they did bother to dig up a year old study in response to a bill, I assume this is political).

The President of CNA Disability Insurance explained this to me one day while we were having a smoke together while I worked there as a claims adjuster: Insurance companies do not make their money through premiums. They are basically investment speculators. They keep a cash reserve on hand, as is required by law, and they invest all the other money they have in different time blocks. They will try to plan for their investments to mature in a sequence that allows them to roll them over and skim off the profit to cover operating expenses like claims. Think of you premiums as more like payments into an IRA or mutual fund, and you claims are like a loan you take against your own money, but you never get to see that retirement nest egg, they do.
GSwift7
1 / 5 (1) Mar 24, 2011
continued:

So, as inflation increases, the gains on long term investments suffer. Also, if the investment markets take a hit, like from a 9/11 event (as happened when I worked at CNA) or as happened with the recent recession, an insurance company may need to generate cash to maintain their legally mandated cash reserve. Then you have either a rate hike, or they sell off either a chunk of unmatured investment or a branch of the company (that's why I'm not an adjuster any more).

So, how does malpractice figure into this? It is just one factor among several other key factors, so the independent fluctuations of each factor will prevent the cost of premiums from following any one factor alone. Sometimes the condition of the financial markets will have a delayed effect on premiums rather than an immediate one as well. The key to the malpractice piece is the cash reserve. The more law suits you expect to have and the larger the payout, the larger that cash reserve needs to be.
GSwift7
2.5 / 5 (2) Mar 24, 2011
continued:

In a given year, the insurance company will look at how many people they have in a whole bunch of different demographic breakdowns (lawyers tend to sue a lot, so they count high) and they estimate how many claims and law suits they might have. They "know" that for x number of insured they will have y law suits. Without a limit on the max compensation they will need to keep a much larger cash reserve. As you know, money that sits is actually money that is shrinking (even without inflation), so it's a huge cost for them. If you set a limit on the max compensation then you can free up a larger portion of their assets for reinvestment. It gives them a bigger safety net in case of a 9/11 event or something. It is not simply a matter of direct versus indirect costs versus quality of care as the political shill above is suggesting. You are being misled, on purpose I think.

You wanna see premiums go down? Fix the housing market and investment banking problems.
ryggesogn2
1 / 5 (6) Mar 24, 2011
"Socialism, like the old policy from which it emanates,
confounds Government and society. And so, every time
we object to a thing being done by Government, it concludes
that we object to its being done at all. We disapprove
of education by the Statethen we are against education
altogether. We object to a State religionthen we
would have no religion at all. We object to an equality
which is brought about by the State then we are against
equality, etc., etc. They might as well accuse us of wishing
men not to eat, because we object to the cultivation of
corn by the State."
'every one of these politicians does not hesitate
to assume that he himself is, under the names of
organizer, discoverer, legislator, institutor or founder, this
will and hand, this universal initiative, this creative power,
whose sublime mission it is to gather together these scattered
materials, that is, men, into society."
Bastiat understood people and politicians quite well.
SH? Apparently not so much.
GSwift7
3 / 5 (2) Mar 24, 2011
Sorry, I know this is long-winded. Just about done.

I still haven't really explained the whole picture about how those law suits will effect the premiums by way of the cash reserve. Remember when I said that the cash reserve is mandated by law? Oh, that's right. You can change the law suit situation all you want, but if you don't also change that cash reserve requirement, then you haven't impacted the insurance company's ability to generate cash flow very much, if at all. The reason the Texas thing wouldn't matter is because the insurance company keeps a reserve on a company-wide account, not State by State, by the way. So one state out of fifty isn't going to change the cash reserve requirements noticably, if at all.

It only takes one claimant who gets 100 million dollars in order to blow out the whole cash plan. A limit on max awards would be a stabilizing factor like laws that prevent a run on a bank or a stock stampede crash.
Skeptic_Heretic
5 / 5 (3) Mar 24, 2011
A typical socialist response, 'society' is too complex to be left to individuals. 'Society' needs 'planners' to ensure its survival. If not for govt planning and control, society would collapse. Is that what you say SH?
No, practice your reading comprehension. Society is emergent. Government must be flexible to suit the needs of the society. Without infrastructure, society decays. Government is as yet the best means of providing for public infrastructure and society creates and controls government.

@gs,

You wanna see premiums go down? Fix the housing market and investment banking problems.
So as I said above, malpractice and tort reform are bank problems, not a healthcare problem.
ryggesogn2
1 / 5 (6) Mar 24, 2011
Government must be flexible to suit the needs of the society.

The most flexible govt is one that is limited and simply protects property rights. This enables in individuals to be flexible. Companies and people are restricting their participation in the economy because they don't know how 'flexible' the govt will be with their money.

Mal-practice insurance IS a health care issue as it adds to the cost of health care

society creates and controls government

The same society that wants to live at the expense of others as Bastiat described using legal plunder, aka socialism, supported and endorsed by SH.
Modernmystic
1.3 / 5 (7) Mar 24, 2011
So as I said above, malpractice and tort reform are bank problems, not a healthcare problem.


By that logic nothing is a healthcare problem. We don't have problems with healthcare, just problems with the economy. Uh huh.

Just because all economic activity is interrelated doesn't mean you can stretch a point as far as you'd like to suit your political view of the landscape.

Let me ask you this...did we have no tort/malpractice problems before the housing/economic crash?
ryggesogn2
1 / 5 (8) Mar 24, 2011
"Senate Majority Leader Harry Reid took a swipe at billionaire industrialists Charles and David Koch in a fund-raising email on behalf of the Democratic Senatorial Campaign Committee Thursday, even though the DSCC accepted $30,000 from Koch Industries just last year.

Read more: http://dailycalle...HYxbKHNz
"
Given how SH attacked and lied about Koch Industries, we know what party he supports.
Skeptic_Heretic
4 / 5 (4) Mar 25, 2011
By that logic nothing is a healthcare problem. We don't have problems with healthcare, just problems with the economy. Uh huh.
So are you content to ignore 4 posts above where I outlined the problems within the Healthcare system? When you do this bandwagon bullshit it really makes you look like an idiot. I know you're not an idiot. Read the entire conversation before you jump in, dick at the ready.
Given how SH attacked and lied about Koch Industries, we know what party he supports.
Try again Mr. Swenson.

ryggesogn2
1 / 5 (6) Mar 25, 2011
So are you content to ignore 4 posts above where I outlined the problems within the Healthcare system?

What outline?

SH did lie, and acknowledged the lie, about Koch Industries hiring a power plant manager in WI.
Skeptic_Heretic
5 / 5 (3) Mar 25, 2011
SH did lie, and acknowledged the lie, about Koch Industries hiring a power plant manager in WI.
No, Koch is indeed hiring plant managers in WI. My misconstrusion was in regards to the contract company who was offering the position being a component of Koch industries.
What outline?
Let's start with this post.
I pay you less for each xray you perform, so you perform more xrays to compensate, this increases the use of your xray facilities, requiring expansion more personnel, more expensive equipment, increasing hospital costs per xray. Makes perfect sense if you actually are interested in studying the economics of the situation.
Read the whole comment thread.
ryggesogn2
1.2 / 5 (6) Mar 25, 2011
Koch is indeed hiring plant managers in WI.

You provided no evidence. Just your lies.

Why and how could your x-ray facility expand if it did not make a profit on its product? Expansion requires profit to expand. The only way it could stay in business is to lower the cost of x-rays.
Skeptic_Heretic
5 / 5 (2) Mar 25, 2011
Koch is indeed hiring plant managers in WI.

You provided no evidence. Just your lies.

Why and how could your x-ray facility expand if it did not make a profit on its product? Expansion requires profit to expand. The only way it could stay in business is to lower the cost of x-rays.
You got a 2 for that post because I misclicked.
ryggesogn2
1 / 5 (6) Mar 26, 2011
Koch is indeed hiring plant managers in WI.

You provided no evidence. Just your lies.

Why and how could your x-ray facility expand if it did not make a profit on its product? Expansion requires profit to expand. The only way it could stay in business is to lower the cost of x-rays.

How does your x-ray lab stay in business if no one pays enough to keep them in business? Socialist subsidy?
Skeptic_Heretic
5 / 5 (3) Mar 26, 2011
Why and how could your x-ray facility expand if it did not make a profit on its product? Expansion requires profit to expand. The only way it could stay in business is to lower the cost of x-rays.
Read what you wrote again and tell me you're being serious. You have never, ever owned a business in your entire life, have you? You certainly don't seem to understand how businesses work. I'm starting to doubt you've read any of the literature you profess as even a complete imbecile wouldn't write what you did after thumbing through those works.
ryggesogn2
1 / 5 (6) Mar 26, 2011
When customers refuse to pay a higher cost for a product, the business must find ways to cut costs to meet consumer demand or they will go out of business.
Unless the business can make up the loss somewhere else. If a hospital must have an x-ray dept and they are not compensated for the full the cost of the x-ray, the hospital must cover those costs by raising prices elsewhere.

And your lie that Koch Ind was hiring a powerplant manager in WI still stands.
GSwift7
3 / 5 (2) Mar 28, 2011
My fiance is a doctor of physical therapy. She deals with a big part of why healthcare costs are so high. My previous post was about insurance premiums, not health care costs. They are related, but as I said above, the cost of premiums isn't exclusively linked to the cost of care.

In my fiance's business, she deals with a lot of very old people. She says that the private ambulance services are abused to the point that it should be criminal. Another good example is when for-profit healthcare companies will extend the length of care beyond what is needed or practical. For example, she had a fight with her boss about releasing a patient. She said that the patient didn't need physical therapy, because the patient was only expected to live a number of days or weeks at most. It was just causing the patient unneeded pain and extremely costly ambulance rides from the hospital to the physical therapy clinic. She won the argument after speaking to the family, who agreed after she explained it
GSwift7
2.3 / 5 (3) Mar 28, 2011
The providers frequently do things that aren't needed, in order to keep their doctors, like my fiance, 100% billable. They see the doctors, ambulances, EEG and CAT machines, etc. as money printing presses. If you had a money printing machine, wouldn't you want it running 24/7? That's what they are doing. My mom worked for a medical billing company in NJ 20 years ago. She said she saw stuff added onto bills all the time. I bet if you got law enforcement to take a really good look at healthcare provider abuses and started prosecuting, you'd see the costs go down quite a bit. I'm not even talking about the anti-litigation medicine. That's at least somewhat justified. Trust me, there's plenty of stuff that's just plain fraudulent, and nobody watches them.
ryggesogn2
1 / 5 (5) Mar 28, 2011
nobody watches them

Why doesn't the govt care?
Govt department use the amount of money they control as a measure of power. Uncovering fraud and waste will undercut their power.
Skeptic_Heretic
5 / 5 (2) Mar 28, 2011
When customers refuse to pay a higher cost for a product, the business must find ways to cut costs to meet consumer demand or they will go out of business.
Never played monopoly, eh?
Unless the business can make up the loss somewhere else. If a hospital must have an x-ray dept and they are not compensated for the full the cost of the x-ray, the hospital must cover those costs by raising prices elsewhere.
Or simply shutting down the x-ray department.
And your lie that Koch Ind was hiring a powerplant manager in WI still stands.
Well it wouldn't be a lie if it stands would it? Exactly. Because Koch has been hiruing for plant managers in WI. Sorry to burst your bubble. Maybe repeating that to yourself will make you feel warm and mushy inside.
ryggesogn2
1 / 5 (5) Mar 28, 2011
Because Koch has been hiruing for plant managers in WI.

Sorry, your word has no value.
GSwift7
2.3 / 5 (3) Mar 29, 2011
When customers refuse to pay a higher cost for a product, the business must find ways to cut costs to meet consumer demand or they will go out of business.

Never played monopoly, eh?


As you know, I work at a bread factory (major household name), and our prices are too high, so our sales are way down. We're looking for ways to cut costs so that our customers don't stay at Baltic Ave. In Monopoly, you don't have a choice where you land. In a store you can decide exactly what you buy and how much. In this case, I would have to say that ryggesogn2 has a point.

However, the following is a good example of sociopathic ranting:

Why doesn't the govt care?
Govt department use the amount of money they control as a measure of power. Uncovering fraud and waste will undercut their power


You are a little scary sometimes, you know.
Skeptic_Heretic
5 / 5 (3) Mar 29, 2011
In Monopoly, you don't have a choice where you land. In a store you can decide exactly what you buy and how much. In this case, I would have to say that ryggesogn2 has a point.
You missed the point. If there was only one bread vendor, your employer, what would your competition be? What would your price incentive be? Etc.

He continually sets up these impossible hypothetical to attempt to impress his very simple understanding of business mechanics into reality. The issue with his methodology is that it is akin to me telling you how to do your job. "I have no idea what your job is, what it entails, or how it should be done, BUT I HAVE AN OPINION SO I MUST TYPE IT ON THE INTERNETS." That's the problem with Mr. Swenson.
GSwift7
2.3 / 5 (3) Mar 29, 2011
lol, yes. sociopathic as I said, but occasionally he copies and pastes something relevant.

He's not half as bad as kasines, or whatever his name is. That guy could be a terrorist or something. He's certainly a bit over the edge.

Once in a while I read a site called Terra Nova. It is a site focused on scientific studies of online interaction. There have been many studies about why people act the way they do online. It's an interesting field, I think.
GSwift7
3 / 5 (2) Mar 29, 2011
Note: on Terra Nova it's the actual researchers posting, more like a group blog, as opposed to sites like this one who only deal with press releases.
Skeptic_Heretic
5 / 5 (2) Mar 29, 2011
Once in a while I read a site called Terra Nova. It is a site focused on scientific studies of online interaction. There have been many studies about why people act the way they do online. It's an interesting field, I think.
I think it is the same thought process that creates mob mentality. People assume that what happens on the internet can never get back to them. A 'what happens in vegas, stays in vegas' mentality so to speak.

That's half the reason why I search out these people. Typically their responses become more reasoned and intelligible when you bring their real identity into it. In Mr Swenson's case he simply went the rest of the way down the rabbit hole. Not someone I'd like to meet in person due to his rather perturbing disconnects from reality. Sad fact is he lives less than 10 miles from me.
GSwift7
3 / 5 (2) Mar 29, 2011
I once played an online video game and made it to the top 5 of the leaderboards for a while. One of the other top 5 guys turned out to live within sight of my home, and worked at a pizza place around the corner. Once we figured that out, we met once for a beer. He seemed normal online, but turned out to be one really creepy dude in real life. My parents own a book store, and there's one customer who is an old cat lady who doesn't interact with people enough. She's really scary to talk to sometimes too. Without normal human interaction, so that you have people to bounce ideas off of and get feedback, it's astounding what happens to a person's brain in a very short time. I experienced a little bit of that once while working in an isolated office where I sometimes wouldn't talk to anyone at work for a whole week. It doesn't take long before you start talking to yourself and have trouble adjusting to face to face conversations.
ryggesogn2
1 / 5 (5) Mar 29, 2011
SH likes to hunt people down and threaten them, but unlike Swifty and Valentine, SH likes to hide.
I suspect he does so because he projects what he would do to people onto others. SH assumes people will treat him the same way if he dares to publicly identify himself.
From SH's profile:
Other Interests: "Marjon alternate Screennames: Bigjon, ryggesogn2 "
Contact Information: "Physorg League of Christian Misology(beware their idiocy): mabarker, kevinrtrs, quantum conundrum, getgoa, freethinking, marjon, jjoensuu, RIL, Twitch"

Obsessed much?
Caliban
5 / 5 (2) Mar 29, 2011
SH likes to hunt people down and threaten them, but unlike Swifty and Valentine, SH likes to hide.
I suspect he does so because he projects what he would do to people onto others. SH assumes people will treat him the same way if he dares to publicly identify himself.
From SH's profile:
Other Interests: "Marjon alternate Screennames: Bigjon, ryggesogn2 "
Contact Information: "Physorg League of Christian Misology(beware their idiocy): mabarker, kevinrtrs, quantum conundrum, getgoa, freethinking, marjon, jjoensuu, RIL, Twitch"

Obsessed much?


Demented much?

Skeptic_Heretic
5 / 5 (2) Mar 30, 2011
SH likes to hunt people down and threaten them, but unlike Swifty and Valentine, SH likes to hide.
So when I gave my real name on another thread, that was hiding? Why don't you cite a few of these threats, liar.
Obsessed much?
You spend a lot more time talking about me than I do about anything. I'd suggest that you're projecting. Stalking is a crime Mr. Swenson.
ryggesogn2
1 / 5 (5) Mar 30, 2011
SH likes to hunt people down and threaten them, but unlike Swifty and Valentine, SH likes to hide.
So when I gave my real name on another thread, that was hiding? Why don't you cite a few of these threats, liar.
Obsessed much?
You spend a lot more time talking about me than I do about anything. I'd suggest that you're projecting. Stalking is a crime Mr. Swenson.

What's your real name?
Post it on your profile for all to access at any time.
Skeptic_Heretic
5 / 5 (2) Mar 30, 2011
What's your real name? Post it on your profile for all to access at any time.
I posted it prior but here it is again. James Wyant, not to be confused with the optics professor/author.

Now tell us where and when I've made threats.
ryggesogn2
1 / 5 (5) Mar 30, 2011
What's your real name? Post it on your profile for all to access at any time.
I posted it prior but here it is again. James Wyant, not to be confused with the optics professor/author.

Now tell us where and when I've made threats.

Since you disagree with Valentine, you intimate that you would tell his employer what he was doing.
You suggest you would contact the voters of Chelmsford.
Why do you feel the need to intimidate and insult?
If you believe being called a socialist is insulting, good. But then you turn around and defend their policies so it is the truth.
One name is as good as another, so I won't believe what you say.
Skeptic_Heretic
5 / 5 (2) Mar 30, 2011
Since you disagree with Valentine, you intimate that you would tell his employer what he was doing.
No, since Valentine is in a regulatory discovery position, he should not be advocating a politicized anti-scientific stance. Calling the GAO isn't a threat.
You suggest you would contact the voters of Chelmsford.
And inform them of your actual stances on the various issues that would have impact on your office. That would be called disclosure. Do you feel threatened when people know your opinion? That also isn't a threat.
Why do you feel the need to intimidate and insult?
Again, if you're intimidated by the potential of your viewpoints being public knowledge, perhaps you should keep them private (read: not online).
If you believe being called a socialist is insulting, good.
It isn't.
But then you turn around and defend their policies so it is the truth.
What I consider an issue is abject generalization and your threats of violence.
ryggesogn2
1 / 5 (5) Mar 30, 2011
Advocating that the govt follow the Constitution and protect individual property rights threatens violence?
It is the govt that is pure force and such force SH is not afraid to unleash upon those he disagrees with.
I want limited govt power and SH wants unlimited govt power.
SH defends Pol Pot and I condemn all socialist tyrannical violence.
Skeptic_Heretic
5 / 5 (2) Mar 30, 2011
Advocating that the govt follow the Constitution and protect individual property rights threatens violence?
No but when you get going you type some nasty stuff. You once advocated for the death of anyone who supported a carbon tax and the potential for violent overthrow from the government is commonplace from you.
It is the govt that is pure force and such force SH is not afraid to unleash upon those he disagrees with.
You keep saying this but I'm not employed by any government. You,sir, are a different matter seeing as you do derive benefit from government employment.
I want limited govt power and SH wants unlimited govt power.
No I don't. Stop lying.
SH defends Pol Pot and I condemn all socialist tyrannical violence.
Not once has that happened, and you've advocated tyrannical violence many times.
ryggesogn2
1 / 5 (5) Mar 30, 2011
You once advocated for the death of anyone who supported a carbon tax

Never have.
Not once has that happened,

More lies from SH.
Skeptic_Heretic
3 / 5 (2) Mar 30, 2011
More lies from SH.
In that case prove your claim. A link to the conversation will do nicely.
ryggesogn2
1 / 5 (5) Mar 30, 2011
SH: "Actually that's bullshit, and I think you already know it.
Pol Pot didn't kill millions in Cambodia, ..."

Me:Now SH is defending Khmer Rouge:
"the Khmer Rouge regime was responsible for the deaths of approximately 1.7 million people by execution, starvation and forced labor."
http:/www.cambodia.org/khmer_rouge/

http://www.physor...firstCmt

And there is this non-violent wish from SH:
Skeptic_Heretic
Feb 18, 2011

Rank: not rated yet
Marjon, I think this world would be a better place if your mother had gotten an abortion.
Caliban
5 / 5 (2) Mar 30, 2011
Put a sock in it, Swenson. Your pathology, while illuminating, still gets tired after running on for so long.

And the rule of thumb is: don't write anything online that you wouldn't want attributed to you in a news story.

I've read a few of your posts that make it understandable why you may be feeling a little shivery.

What a drag for you.

ryggesogn2
1 / 5 (4) Mar 30, 2011
don't write anything online that you wouldn't want attributed to you in a news story.

Take your own advice. But much of what you write would have to be edited for vulgar language.

So you agree with SH that Pol Pot is misunderstood?

I suggest you drive down Middlesex ST in Lowell, MA with a sign to that effect.
Caliban
5 / 5 (2) Mar 30, 2011
don't write anything online that you wouldn't want attributed to you in a news story.

Take your own advice. But much of what you write would have to be edited for vulgar language.

So you agree with SH that Pol Pot is misunderstood?

I suggest you drive down Middlesex ST in Lowell, MA with a sign to that effect.


Among a number of other things, I agree with SH that you are a moron, and a two-bit hustler. Perhaps I should drive through Lowell displaying a sign to that effect?

Caliban
5 / 5 (2) Mar 30, 2011
Upon further consideration, I can't recall SH referring to you as a moron or a two-bit hustler.

My bad.

Skeptic_Heretic
5 / 5 (2) Mar 30, 2011
SH: "Actually that's bullshit, and I think you already know it.
Pol Pot didn't kill millions in Cambodia, ..."
That isn't defence, it's an accurate statement.
Me:Now SH is defending Khmer Rouge:"the Khmer Rouge regime was responsible for the deaths of approximately 1.7 million people by execution, starvation and forced labor."
http:/www.cambodia.org/khmer_rouge/
As I stated in that thread, the starvation was largely due to the actions of the US. It's all there for anyone interested in reading it.
And there is this non-violent wish from SH:
Skeptic_Heretic
Feb 18, 2011

Rank: not rated yet
Marjon, I think this world would be a better place if your mother had gotten an abortion.

So are you afraid I'm going to go back in time and force your mother into an abortion? My statement there is rather obvious. 'If you weren't around, I think the world might be a better place'. Not a threat contained within.

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