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Thread: Does the US Health System need to be changed?

  1. #1

    Does the US Health System need to be changed?

    [B][SIZE="4"]Costly U.S. health system delivers uneven care: OECD[/SIZE][/B]

    WASHINGTON (Reuters) - The U.S. healthcare system is more effective at delivering high costs than quality care, according to a new study that found first-rate treatment for cancer but insufficient primary care for other ailments.

    The study, released on Wednesday by the 34-nation Organization for Economic Cooperation and Development, or OECD, said Americans pay more than $7,900 per person for healthcare each year -- far more than any other OECD country -- but still die earlier than their peers in the industrialized world.

    The cost of healthcare in the United States is 62 percent higher than that in Switzerland, which has a similar per capita income and also relies substantially on private health insurance.

    Meanwhile, Americans receive comparatively little actual care, despite sky-high prices driven by expensive tests and procedures. They also spend more tax money on healthcare than most other countries, the study showed.

    An "underdeveloped" U.S. primary care system is plagued by shortages of family doctors and high rates of avoidable hospital admissions for people with asthma, lung disease, diabetes, hypertension and other common illnesses.

    U.S. survival rates are the world's highest among breast cancer patients and the second highest, after Japan, for people with colorectal cancer - due in part to effective early screening, the study showed. The study also said Americans experience generally good acute hospital care.

    "It's a very, very mixed pattern," said Mark Pearson, head of the OECD health division. "You get a very high quality of care for your money in some areas. Very poor quality, compared to other countries, in other areas."

    The quality and cost of the $2.6 trillion U.S. healthcare system are at the forefront of a rancorous national political debate over how to regulate and pay for treatment, particularly for the poor and elderly.

    The 2010 U.S. healthcare reform law, which seeks to control costs over time by altering incentives for doctors and other providers, faces a constitutional challenge in the Supreme Court, and Republican presidential candidates on the campaign trail have called for its repeal.

    LESS CARE, MORE MONEY

    Federal spending on Medicare and Medicaid, the government programs for the elderly and the poor, is also a leading target of efforts to narrow the yawning U.S. fiscal deficit.

    The OECD said U.S. public spending on healthcare reached 8 percent of the economy versus a 7 percent OECD average in 2009, the latest year for which comparison figures are available.

    A forum of developed nations set up to foster global development, the OECD said U.S. life expectancy of 78.2 years ranked 28th - just behind Chile's and well below the average of 79.5 years among member nations.

    The growth in U.S. life expectancy over the past half century is also below average, gaining only 8.3 years since 1960 compared with an 11.2-year OECD average.

    The United States was ranked fourth from the bottom for premature mortality, which focuses on deaths among younger people. The measure, which reflects dangers posed by violence, accidents and environmental hazards, puts America behind all others save Hungary, Mexico and Russia.

    Pearson said researchers believe national mortality rates increasingly reflect the quality of healthcare, though more than half of the equation is still believed to lie with other indicators including lifestyle and diet.

    Americans have fewer doctors and hospital beds, make fewer doctor visits, go to the hospital less often and stay for shorter lengths of time than about three-quarters of the other OECD countries.

    But the United States is at the front of the pack when it comes to costly medical procedures including knee replacements, MRI and CT scans and tonsillectomies.

    And it is consistently at the top of the cost chart for a number of procedures including caesarean sections, which are almost twice as expensive in the United States as in Germany.

    Pharmaceuticals also cost about 60 percent more than in a range of European countries.

    Pearson said one reason prices are higher in the United States is that the healthcare system lacks what other countries have: an effective government mechanism that acts to keep prices down.

    "That's simply not there in the U.S. system. So it's a structural defect," he said.

    (Editing by Gary Hill)

    [url]http://news.yahoo.com/costly-u-health-system-delivers-uneven-care-oecd-100509748.html[/url]

  2. #2
    [QUOTE]The study, released on Wednesday by the 34-nation Organization for Economic Cooperation and Development, or OECD, said Americans pay more than $7,900 per person for healthcare each year -- far more than any other OECD country -- but still die earlier than their peers in the industrialized world.[/QUOTE]

    The entire article is one big logical fallacy, a pretty obvious non sequitur argument. Pay more = Live Longer? No other factors involved? Not quite.

    Because we pay more does mean we will automaticly live longer. There are only a few hundred thousand other factors involved in health other than "how much you pay" that effects mortallity.

    Comparing a massive mixed genetic nation like the United States (300+ million people of every ethnicity on Earth) with a tiny, geneticly similar country like Switzerland (Under 8 million, 90%+ of a limited ethnic groups (French/Germanic)) is a laugh.

    If you'd like to compare apples to apples, try the Untied States vs. the EU as Whole. It's one of liberalisms favorite arguments, that tiny little one-ethnicity nations systems can be used as in on massive multi-ethnicity nations just as easily and at the same quality of results, when no evidence exists that that is the case.

    I notice they don't mention tax rates there vs. here either.

    I also love the criticisim of knee replacements, because of course it's a 1% vs. 99% argument yet again, evil rih ****s get new knees while the poor die, won;t anyone think of the poooooor!!!!

    With all that said, Obamacare is the one system I do not want, and a power I do not want the Federal Govt. to posess. Either a private system (as it was) or a fully public tax-paid system like the UK. Not this vague middle ground that gives the Feds the power "to regulate comemrce" by forcing individuals not involved in comemrce to engege in comemrce, in ways they do not choose to, without any actual limits on that power in place, for now or future use.

  3. #3
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    +1 'Fish

    One thing on cost. Maybe, just maybe the cost has a little something to do with fraud and ridiculous lawsuits and not the actual cost of care.

  4. #4
    [QUOTE=Piper;4248109]+1 'Fish

    One thing on cost. Maybe, just maybe the cost has a little something to do with fraud and ridiculous lawsuits and not the actual cost of care.[/QUOTE]

    Thats certainly a part, our society is an exceedingly litigious one, and I'm of the opinion that far too many foolish lawsuits not only are allowed to proceed, many often win. A tough spot for Doctors and Hospitals and yes, Insurance Companies, all of whom must hold massive amounts of insurance to protect themselves.

    But beyond that, a huge part of the issue of cost is advanced technology (As the article mentions, we do a hell of alot of CT Scans and the like, I've had several myself over the years for my poor health) and we often run directly to technology even in cases where it may not be appropriate. Same for medications, we're a "give me a drug, no matter the cost, give it to me NOW!" society as well. As a consumer, Americans have come to be demanding of their scans and drugs on demand, and I would agree thats a big part of the issue cost wise.

    But lets no be naiave here. Any time a IJF type posts an article of Healthcare, their political aims are clear. They want single-payor, Govt. paid, tax-payer-funded Universal Healthcare, and a system that prioritizes based on their political and sociological ideology policies first. To them, there is no evil greater than a rich man getting a treatement ahead of a pennliness homeless man. It's the biggest reason I don't trust Govt. Healthcare, because we have a Govt. who I wouldn't trust not to put political-based rationing into place within it, like say, african amercians come first in any equal situation, as a form of social justice and reparation. You know, like public college is now almost universally in their admissions.

  5. #5
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    [QUOTE=Warfish;4248121]But lets no be naiave here. Any time a IJF type posts an article of Healthcare, their political aims are clear. They want single-payor, Govt. paid, tax-payer-funded Universal Healthcare, and a system that prioritizes based on their political and sociological ideology policies first. To them, there is no evil greater than a rich man getting a treatement ahead of a pennliness homeless man. It's the biggest reason I don't trust Govt. Healthcare, because we have a Govt. who I wouldn't trust not to put political-based rationing into place within it, like say, african amercians come first in any equal situation, as a form of social justice and reparation. You know, like public college is now almost universally in their admissions.[/QUOTE]

    I agree on the overuse of technology and pharma, and the reality is that is often because of gov't guidlines which frame insurance reimbursement (and also the aforementioned desire to cover ones arse in case of a lawsuit by doctors using every test available to prove they did everything possible).

    But the reality is in the Canadians who cross the border to pay cash for procedures and surgery because they are on a 5 year waiting list. Or the Irish who pay for private insurance for the same reason. Or the British men who don't receive treatment for prostate cancer because it was diagnosed too early.

  6. #6
    [QUOTE=Piper;4248129]I agree on the overuse of technology and pharma, and the reality is that is often because of gov't guidlines which frame insurance reimbursement (and also the aforementioned desire to cover ones arse in case of a lawsuit by doctors using every test available to prove they did everything possible).

    But the reality is in the Canadians who cross the border to pay cash for procedures and surgery because they are on a 5 year waiting list. Or the Irish who pay for private insurance for the same reason. Or the British men who don't receive treatment for prostate cancer because it was diagnosed too early.[/QUOTE]

    My mum's in the UK System. Wait lists and non-treatment are certainly problems, meaningful ones.

    However, in her case, she'd get nothing here in the States.

    The issue in a nutshell right there.

  7. #7
    Tort reform is an absolute necessity. Med-mal insurance costs are ridiculous, especially for practitioners in fields that can lead to huge damage awards (OBs, particularly). Non-economic damages should be capped.

  8. #8
    [QUOTE=doggin94it;4248156]Tort reform is an absolute necessity. [/QUOTE]

    There are states that already have various types of tort reform, but costs haven't really been controlled by these laws.

    [url]http://www.cbo.gov/doc.cfm?index=5549&type=0&sequence=1[/url]

  9. #9
    Hospital charges are totally out of control. One reason is they are required to treat everyone especially those without insurance. Guess who pays.
    A couple years ago I went to a hospital at my orthopedic's order. Was told it was $4500. No thanks, I have a high deductable plan. Called my insurance agent and he went through the list and directed me to an imaging center - $905. Same activity.
    Certain areas now have surgical centers organized by doctors. They perform the more routine operations for 25% of hospital charges.
    The key is - no insurance or payment - no service.

  10. #10
    Why does everyone here get so defensive when a study points out some of the defeciencies in our health care system?

    The article accurately points out that the US "[QUOTE]is at the front of the pack when it comes to costly medical procedures including knee replacements, MRI and CT scans and tonsillectomies" and that the US is "consistently at the top of the cost chart for a number of procedures including caesarean sections, which are almost twice as expensive in the United States as in Germany.Pharmaceuticals also cost about 60 percent more than in a range of European countries."[/QUOTE]

    Does anyone deny this? This is driving up our health care costs needlessly. If we fix these problems, we will see a dramatic cut in spending. Isnt that what the right keeps crying about? We spend too much.

    And Fish, maybe you skipped or ignored this part of the article:
    [QUOTE]Pearson said researchers believe national mortality rates increasingly reflect the quality of healthcare,[B] though more than half of the equation is still believed to lie with other indicators including lifestyle and diet[/B].[/QUOTE]

    No one is saying that the mortality differences is simply because of the health care availability alone, but it is a factor. Its not like we are finishing 3rd or 4th in mortality statistics. We are finishing 28th and 4th from the bottom in infant mortality. Infant mortality is directly affected by perinatal care which we appear to be lackig in.

    BTW have you been to France or Germany lately? The population is nowhere near as homogeneous as it once was. So this argument is slowly fading.

    Stop making excuses. Our system needs to be fixed.

  11. #11
    [QUOTE=bitonti;4248309]There are states that already have various types of tort reform, but costs haven't really been controlled by these laws.

    [URL]http://www.cbo.gov/doc.cfm?index=5549&type=0&sequence=1[/URL][/QUOTE]

    [QUOTE]The studies examined by CBO have empirically tested whether reforms undertaken by the states in recent decades have had a measurable impact on tort activity and its effects on economic performance.[B] A number of those studies have found that state-level tort reforms have decreased the number of lawsuits filed, lowered the value of insurance claims and damage awards, and increased insurers' profitability as measured by payouts relative to premiums in the short run[/B].
    [/QUOTE]

    More, from that article's summary of the studies:

    [QUOTE] As a package, reforms enacted between 1985 and 1987 significantly reduced insurers' losses, with a less dramatic decline in premiums, which yielded an overall drop in loss ratios.[/QUOTE]

    [QUOTE] States that enacted tort reforms had lower Medicare spending for hospitalization of elderly patients with heart disease and heart attacks, with no significant increase in adverse health outcomes. Those states also had lower malpractice claims. "Direct" reforms helped to lower some of the costs of claims, whereas "indirect" reforms actually increased several measures of claims costs.[/QUOTE]

    [QUOTE][B]Caps on Noneconomic Damages [/B]

    Four of the studies analyzed the effect of caps on noneconomic damages. One of those, a 1999 study by Mark J. Browne and Robert Puelz, [B]found that those caps led to lower noneconomic insurance claims by victims of automobile bodily injury and significantly reduced the probability that they would file a lawsuit[/B]. The other three studies--by Kenneth Thorpe (2004), Patricia Born and W. Kip Viscusi (1998), and W. Kip Viscusi and coauthors (1993)--[B]found that insurers' profitability, as measured by their losses for either their general liability or medical malpractice lines, or both, increased after the reform,[/B] although the study by Viscusi and coauthors found no significant effect on loss ratios. [B]Two of the three studies found that premiums also declined significantly for at least some insurance lines[/B]; the third found no significant effect.
    [/QUOTE]

    You were saying?

  12. #12
    [QUOTE=kennyo7;4248444]Why does everyone here get so defensive when a study points out some of the defeciencies in our health care system?[/quote]

    Honest answer, probably one part nationalism, one part "we're all somewhat well off here at JI, and the system works fine for us".

    [QUOTE]Does anyone deny this? This is driving up our health care costs needlessly.[/QUOTE]

    I wouldn't deny it drives up the cost. I wouldn't deny in many cases high-cost-tech/ddrugs are called for too soon or inappropriately.

    I would question your claim of "needlessly" however, given your past posted views regarding many procedures that improve quality of life, and your political viewpoints. I would also question your right to define what I get done as needed or needless in the first place, if I can afford my coverage that pays for it. I don't believe you have the right to determine what coverage I can or cannot aquire in a free market, or what that coverage should cover for me.

    [QUOTE]No one is saying that the mortality differences is simply because of the health care availability alone, but it is a factor.[/QUOTE]

    Not a major foctor, for those responsible enough to prioritize and aquire health coverage.

    For those who do not, I'm sure lack of care is a major issue. I just don't care to the same degree you do. If they want coverage, get a job, and prioritize buying coverage. Or go utilize the Govt. prohrams that exist.

    You'd be surpised how many who qualify for State help for care under the current system don't apply or recieve it. Ignorance and Govt. failure to educate them is no excuse.

    Do not demand my tax dollars to pay for your coverage. Obviously, this is a core idealogical disagreement between myself and most State-Power Social Welfare Liberals.

    [QUOTE]We are finishing 28th and 4th from the bottom in infant mortality. Infant mortality is directly affected by perinatal care which we appear to be lackig in. [/QUOTE]

    I'd be curious to see a breakdown of this by state, race and economic group. I'm going to guess it's almost exclusively poor, uneducated inner city african american/hispanics and poor, uneducated rural whites/hispanics that lead these child mortality stats.

    Poor. Uneducated. Those are the factors. In a nation with an extensive universal public school system that bars no one entry, and no limit on personal potential to make money if you're willing to put in the effort 9and pay your taxes), there is no excuse for being either.

    My father landed here poor as poor comes, and totally uneducated. All three of his kids lived, and he died prosperous (of sorts). My living example is better than others hypothetical excuses re: limitations and obstacles.

    [QUOTE]BTW have you been to France or Germany lately? The population is nowhere near as homogeneous as it once was. So this argument is slowly fading.[/QUOTE]

    The article quoted Switzerland, so I referenced Switzerland.

    [quote]Stop making excuses. Our system needs to be fixed.[/QUOTE]

    And we know what your fix is. Universal Taxpayer Funded Political-based Healthcare. I respectfully disagree, but I'd be open to seeing it tried. Like any liberal Govt. system, a smart man will still get the most out of it if they get past the ethical issue of getting soemthing for nothign at the expense of others.

  13. #13
    [QUOTE=kennyo7;4248444]

    No one is saying that the mortality differences is simply because of the health care availability alone, but it is a factor. Its not like we are finishing 3rd or 4th in mortality statistics. We are finishing 28th and 4th from the bottom in infant mortality. Infant mortality is directly affected by perinatal care which we appear to be lackig in.
    .[/QUOTE]

    Terrible stat to rely on - we report as "infant death" any baby, of any gestational age or size, that dies after exhibiting signs of life (heartbeat, pulse, breathing). Other states do not report as "infant death" babies that die after being born prematurely, babies that die after being born exceedingly small, or babies that are born with a heartbeat but never breathe.

  14. #14
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    [QUOTE=doggin94it;4248472]Terrible stat to rely on - we report as "infant death" any baby, of any gestational age or size, that dies after exhibiting signs of life (heartbeat, pulse, breathing). Other states do not report as "infant death" babies that die after being born prematurely, babies that die after being born exceedingly small, or babies that are born with a heartbeat but never breathe.[/QUOTE]

    Not to mention that our better health care and money spent on health care is bringing more babies to near-term which gets included in our birth statistics. It is a flawed statistic as this article explains.

    [URL]http://www.slate.com/articles/health_and_science/medical_examiner/2007/03/baby_gap.html[/URL]

    [QUOTE]America's real infant-mortality problem.
    By Darshak Sanghavi | Posted Friday, March 16, 2007, at 7:10 AM ET
    | Posted Friday, March 16, 2007, at 7:10 AM ET Slate.com

    The surprising truth about America's infant-mortality rate.

    Last year, a widely distributed report from the group Save the Children, funded by the Bill and Melinda Gates Foundation, tied the United States with Malta and Slovakia for the second-worst infant-mortality rate among developed nations (at about six per 1,000 live births). "I'm always amazed to see where the United States is," a Rand researcher said of the list. "We are the wealthiest country in the world," a Save the Children spokesperson agreed, yet many "are not getting the health care they need."

    Comparing infant mortality rates between countries is fraught with uncertainty—after all, it's hard to argue that every country's figures are reliable. But it's still worth asking what more we can do to stop babies from dying. Defined as death before one year of age, infant mortality frequently gets framed in the United States as a problem of insufficient health-care funding. In December, for example, a New York Times column blamed it on the lack of a single-payer health insurer. However, a closer look reveals the counterintuitive possibility that high infant mortality in the United States might be the unintended side effect of increased spending on medical care.

    Infant deaths in poor nations are roughly six times more common than in developed areas and result mainly from easily treated infections like diarrhea in the first few months. By contrast, the majority of deaths in developed countries result from extreme prematurity or birth defects that kill a newborn in the first few days or weeks of life. According to a 2002 analysis by the Centers for Disease Control and Prevention, at least a third of all infant mortality in the United States arises from complications of prematurity; other studies assert the figure is closer to half. Thus—at the risk of oversimplifying—infant mortality in the United States principally is a problem of premature birth, which today complicates just over one in 10 pregnancies.

    To reduce infant mortality, then, we need to prevent premature births, and if that fails, improve care of premature babies once born. (Prematurity is also linked to other problems; for example, it's the leading cause of mental retardation and cerebral palsy in children.) But modern medicine isn't good at preventing prematurity—just the opposite. Better and more affordable medical care actually has worsened the rate of prematurity, and likely the rate of infant mortality, by making fertility treatment widespread. According to a 2006 Institute of Medicine report, the numbers of women using assistive reproductive technology doubled from 1996 to 2002. At least half of their pregnancies culminated in multiple births (twins or more), which are at high risk of premature delivery.

    Meanwhile, no amount of money or resources seems to reduce the rate of preterm births. Take prevention: Of numerous strategies, an inexhaustive list includes enhanced prenatal care, improved maternal nutrition, treatment of vaginal infections, better maternal dental care, monitors to detect early labor, bed rest, better hydration, and programs for smoking cessation. But, as well described in an erudite 1998 review in the New England Journal of Medicine by researchers at the University of Alabama, none of these strategies has had a substantial impact on the risk of preterm birth in clinical trials. (Of course, some of them, like better prenatal care, may be good for other reasons.) Despite a doubling of health-care spending as a portion of the gross domestic product since 1981, the rate of preterm birth has jumped 30 percent.

    If preventing early birth is impossible, can we improve treatment of preemies? One promising way to reduce death after premature birth is a dirt-cheap steroid shot for mothers in preterm labor. Endorsed for over a decade by the National Institutes of Health and the American College of Obstetrics and Gynecology, the shot is one of the only maneuvers proven to help preemies before they are born. The injection jump-starts the fetus's lungs, so the baby is better prepared to breathe when born. Unfortunately, because of substandard practice, at some hospitals only about half of eligible women get the shot.

    That leaves lots of sick preemies for the neonatologist. Most preemies depend on advanced neonatal care for survival. And there have been advances, particularly the discovery of surfactant to treat immature lungs. However, just as better funding for infertility treatment worsened premature-birth rates, more money quite possibly may harm the quality of neonatal intensive care.

    How can that be? Today, neonatal intensive care is extremely lucrative, on average costing tens of thousands of dollars per preterm child. Neonatologists are among the highest paid pediatric subspecialists, and neonatal intensive-care units (NICUs, for short) are hospital cash cows—which is why the units are proliferating wildly nationwide. Yet in a startling 2002 New England Journal of Medicine study, David Goodman and his colleagues showed that the regional supply of neonatologists and NICUs bore no relation to actual need, implying that some doctors and hospitals set up shop simply because there was money to be made. More disturbingly, areas with more beds and doctors don't have lower infant-mortality rates. The authors ominously suggest that "infants might be harmed by the availability of higher levels of resources." They argue that the availability of a NICU may mean that infants with less-serious illnesses may be admitted to one and then "subjected to more intensive diagnostic and therapeutic measures, with the attendant risks."

    Too many NICUs are also bad for babies because hospitals that handle a high volume of sick preemies have better outcomes. A 1996 study in the Journal of the American Medical Associationconfirmed this, concluding that concentrating high-risk deliveries in a smaller number of hospitals could reduce infant-death rates without increasing costs, and other studies have since concurred. (Increasing evidence suggests that experienced, high-volume centers may also save more full-term newborns with major birth defects, like congenital heart problems.)

    Throwing money at unproven programs for preventing prematurity, or at cash-cow NICUs, won't improve America's infant-morality rate. Instead, it's critical to follow the data—which suggest that we need fewer, not more, hospitals to take care of the sickest babies. One reasonable suggestion is to cut funding for neonatal intensive care, since the money now is too good to encourage economies of scale (i.e., a few hospitals with high-volume NICUs). Another strategy, endorsed by patient-safety organizations like the Leapfrog Group, is for insurers to steer patients only to high-volume centers. Less money and less patient choice sound heretical—but, in this case, eminently sensible.

    [/QUOTE]

  15. #15
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    [QUOTE=kennyo7;4248444]Stop making excuses. Our system needs to be fixed.[/QUOTE]

    Agreed. Parts of it do.

    But it doesn't need to be replaced by a system that administers care based on the whims of government wonks with zero qualifications in most things.

  16. #16
    [QUOTE=doggin94it;4248464]
    You were saying?[/QUOTE]

    im so happy insurers profitability increased. really that's great.

    and the studies that showed no effect, i guess they didn't warrant the bold tag

    tort reform is a decent common sense idea but to claim it is some sort of panacea for cost control is wishful thinking. the costs are high for other reasons besides lawsuits.

  17. #17
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    [QUOTE=Piper;4248504]Agreed. Parts of it do.

    But it doesn't need to be replaced by a system that administers care based on the whims of government wonks with zero qualifications in most things.[/QUOTE]

    It's amazing that any discussion of health care reform is viewed as opposition to it. Some people really believe that there is only one way to skin a cat, and that [I]their[/I] way, however illogical and counterproductive, is that only way.

  18. #18
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    [QUOTE=bitonti;4248538]im so happy insurers profitability increased. really that's great.

    and the studies that showed no effect, i guess they didn't warrant the bold tag

    tort reform is a decent common sense idea but to claim it is some sort of panacea for cost control is wishful thinking. the costs are high for other reasons besides lawsuits.[/QUOTE]

    says the guy that constantly harps that we just need to do [I]something[/I]

    we've already seen how Obamacare has the [I]reverse[/I] effect on cost control. yet you still want it.

    amazingly inconsistent.

  19. #19
    [QUOTE=bitonti;4248538]im so happy insurers profitability increased. really that's great.

    and the studies that showed no effect, i guess they didn't warrant the bold tag

    tort reform is a decent common sense idea but to claim it is some sort of panacea for cost control is wishful thinking. the costs are high for other reasons besides lawsuits.[/QUOTE]

    I suppose you missed the part about premium's dropping?

    You also miss the point a bit about cost controls. Lower med-mal premiums mean services can be billed at lower rates. Less liability means less CYA tests, which means more savings. It's not [B]the[/B] answer, but if you think there's any one "answer" that can fix everything, as opposed to an accumulation of small but necessary steps, you're living in a fairy tale. And tort reform is one of those small but necessary steps - and there's no real reason to oppose it.
    Last edited by doggin94it; 11-23-2011 at 02:03 PM.

  20. #20
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    [QUOTE=doggin94it;4248563]I suppose you missed the part about premium's dropping?[/QUOTE]

    bit can not be held responsible for the accuracy of his posts. maybe you missed that.

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