So, if the damn democrats are going to barter away all our gains in the sausage making process (4.00 / 2)

we should being asking for more at every step of the way.

If they want to push for tort reform, perhaps we should push for something just as drastic, like offering physicians a public option for malpractice insurance.

So, yeah, insurance CEOs get tort reform, and insurance companies have to pay less on damages, but in return, doctors get a PO for malpractice coverage.

I mean, how about making the other side think about paying too high a cost for a change?  

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by: willf @ Thu Nov 12, 2009 at 02:40:38 AM UTC

Absolutely (0.00 / 0)

Insurance companies ALWAYS claim that increases in liability insurance are just tracking claims. Well bullshit, it wasn't an eff-ing coincidence that both physicians and home builders got hit with huge increases at the same time a few years ago just after the stock market took a big hit.

When their portfolios take a hit they make up for it with premium increases to the degree that they can get away with it.
___________________
CBO projects that overall spending on actual medical care would drop 0.3% if a package of tort reform proposals forwarded by Hatch actually passed. There would be an additional 0.2% in savings for physicians in malpractice premiums and a portion of that ends up in the Treasury as taxable income. For that we just toss away patient rights?

As somebody pointed out perhaps the best thing we could do for tort reform is to pass health care for as many people as we can cover with a plan that has no annual or lifetime limits, that would take care of that portion of an award designed to provide for lifetime care, which I suspect is the motive for a lot of lawsuits anyway, and maybe could eliminate some of the adversarial nature of the current system.

But the Republican plan does the exact opposite, it eliminates the big awards that might allow some seriously disabled person to live a life of reasonable dignity while offering no insurance protection at all.

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by: Bruce Webb @ Thu Nov 12, 2009 at 03:27:39 AM UTC

[ Parent ]

There are plenty of ways to have fewer lawsuits (4.00 / 1)

that don't involve limiting the right to sue. If health providers turn over information freely, and explain what happened to patients, there would be fewer lawsuits, for example, because filing a lawsuit is often the only way to find out if a health care provider did commit a tort.

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

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by: David Kaib @ Thu Nov 12, 2009 at 04:25:47 AM UTC

[ Parent ]

Military providers cannot be sued (0.00 / 0)

trust me, we practice better medicine because of it.

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by: Paul Goodman @ Thu Nov 12, 2009 at 02:46:44 AM UTC

Why on earth woud we trust this unsubstantiated statement? (4.00 / 1)

This rule is because government makes the rules, not because it makes for better care.  

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

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by: David Kaib @ Thu Nov 12, 2009 at 04:22:07 AM UTC

[ Parent ]

For the record (0.00 / 0)

I suspect that military providers provide great medicine because they don't involve the profit motive - I do think they provide excellent models for health care, I just don't think it's because of the lack of liability.  

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

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by: David Kaib @ Thu Nov 12, 2009 at 04:37:17 AM UTC

[ Parent ]

It's really hard to take you seriously Mike (4.00 / 3)

after you maligned progressives for being willing to draw a line in the sand on this bill. I say this as someone who wholly agrees with you on tort reform.

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by: bmull @ Thu Nov 12, 2009 at 03:53:35 AM UTC

Hard to measure (0.00 / 0)

You're right that the costs of malpractice insurance, etc. don't amount to much in the aggregate. However, it's very hard to measure additional tests that are run in certain specialties due to a culture that encourages defensive medicine. The main reason for excessive tests and procedures is of course the misaligned pay-for-service payment system. However, defense medicine plays some role in specialties like OB/GYN. For OB/GYN, the actual costs of malpractice insurance vary widely by state. Illinois has the highest in the country. As a result it's hard as hell to recruit these doctors to the state. This creates quality issues, especially in rural areas where there are a shortage of family practice doctors (for reasons that have nothing to do with malpractice). What you're left with is virtually no doctors to deliver complicated pregnancies in many areas. So yes, malpractice in a general aggregate sense is a non-issue. However, it's hard to measure some of it's effects, which go beyond malpractice into gray areas of culture that are confounded with largely misalignments in payment and the profit motive of providers. It has indirect effects on supply of physicians, even if it doesn't raise prices for the consumer all that much (if at all). This can potentially hurt access to care. Of course blunt instruments like strict caps are probably not the answer to something this nuanced.  

Demockracy.com

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by: kvandyke @ Thu Nov 12, 2009 at 05:50:35 AM UTC

The problem is that limiting liability for everyone (4.00 / 1)

will not solve that problem, while there are ways to solve that problem that do not violate the right to bring a lawsuit. Anesthesiologists faced high insurance premiums, but by putting energy and resources into determining how to provide better care they were able to reduce injuries, make it easier to tell when someone committed a tort, and thereby reduce lawsuits and premiums.  

On the other hand, liability limits have not brought down premiums.

There are solutions to these problems, but limiting liability is not one of them.

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

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by: David Kaib @ Fri Nov 13, 2009 at 01:14:28 AM UTC

[ Parent ]

What are progressives doing about Stupak? (4.00 / 1)

I have been pleased at the unity of progressives in working together to fight off the truly awful Stupak language in the Senate, and then in conference committee.

All we have so far, that I know of, is Boxer and Baucus saying Stupak won't make it into the Senate version.
http://www.huffingtonpost.com/...

and Rep. Debbie Wasserman Schultz (D-Fla.),the Democrats' chief deputy whip, saying Stupak will be stripped in the final House version.

http://thehill.com/blogs/blog-...

Who's going to change their mind, and why? Does this mean it didn't really have to be in the first House version in order to pass?

I get it. The Dems are only looking out for women's best interests. Giving us a wake-up call?

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by: Upward and Onward @ Thu Nov 12, 2009 at 06:42:07 AM UTC

why are we against tort reform? (0.00 / 0)

i have an idea...why don't we limit the percent lawyers can receive in any award to 5%. are progressives against that? give the money to the victim not the lawyer. it would change the game and still allow victims the right to sue.

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by: aiko @ Thu Nov 12, 2009 at 13:20:10 PM UTC

Sounds like a good answer to me. (0.00 / 0)

But nah, it'll never work - it's too logical  

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by: jan4insight @ Thu Nov 12, 2009 at 19:02:40 PM UTC

[ Parent ]

That would ensure that regular folks couldn't get lawyers (0.00 / 0)

in expensive or risky cases.  It would leave the right to sue intact in theory and in tatters in practice.

What purpose does that serve? Why are lawyers who make money providing legal services to the poor and middle class a problem? Would you suggest similar 5% limits in any other area of the economy?

I don't get it.

Politics is the art of the possible, but that means you have to think about changing what is possible, not that you have to accept it in perpetuity.

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by: David Kaib @ Fri Nov 13, 2009 at 01:10:35 AM UTC

[ Parent ]

ever heard of a public justice lawyers? aclu? get over yourself. (0.00 / 0)

providing legal services to the poor is one thing....taking 50+% of the award is another. its bullshit.

i trust that we will remain a litigious society no matter how little lawyers get. weird thing about america is that we price point arms, hands, toes, and brain cells...no other culture does that.

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by: aiko @ Sat Nov 14, 2009 at 22:35:59 PM UTC

[ Parent ]

Title should be: "Beating Back Further Compromise" (0.00 / 0)

Because it accentuates the fact that the bill was pre-compromised from the outset and its is more accurate as many of the "bad compromises" have been accepted, not beaten back.

With ya on tort reform, though.

I'd suggest a triggered tort reform mechanism. The caps on settlements only go into effect when some ridiculously high level of law suits are compensated beyond what is considered justified. I'm sure someone can design an arcance system that will make the trigger a tough pull. The GOPpers probably have a boilerplate version.

"It sounds wrong...
     ...but its right."

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by: SpitBall @ Thu Nov 12, 2009 at 14:09:59 PM UTC