[nodak3]

Great discussions going on medical insurance! I don't want to hijack those threads with other questions. (Whatever system you have, employer based insurance, socialized medicine which is insurance by taxes, or open market insurance you still have a form of insurance.)

How do you propose we deal with these areas to lower costs:

1. Overuse of malpractice suits. Surely some suits are justified and some drs are horrible. But some folks DO sue over every bad outcome medicine cannot overcome. How do we restrict the latter without tossing out the justified suits?


2. Overuse by lifestyle choice. How do we contain the rising costs of healthcare for those who choose recklessness (drug abuse, smoking, all those nasty sexually transmitted diseases) or fail to take care of themselves (obesity, lack of exercise, failure to get routine screenings even if insurance covers them)?

3. Overuse plain and simple. Let's admit it--almost all of us are guilty there.
Maybe we refuse to get rid of our animals although highly allergic and expect insurance to pay for the dr and the meds. Maybe we aren't in the tiny number of folks with primary gerd due to a birth defect, but just overeat the wrong stuff, wear tight britches or girdles, and want insurance to buy us nexium so we don't have to pay for prilosec. Maybe we know if we lost those 20 lbs our dr says we can toss the blood pressure med, but we just love our pizza.

4. Unwillingness to pay our fair cost. This one strikes across the board, rich and poor and everything in between. How do we deal with the people who can afford cable, cell phone, horses as pets, internet, bottled water, designer jeans, that new gun, or whatever hays their wagon but scream they cannot afford insurance or whatever their deductible of whatever size does not pay?

5. And finally, how do you set parameters on cost effectiveness? Do you give grandpa at 95 the same high tech treatment to prolong life as you would a 45 year old, or 15 year old? If there isn't enough $$ in the system to provide everyone with everything, how will you prioritize?

Give it your best shot--if you were great high poobah of all things legal, medical, and governmental, what would your system look like?

 

[watcher]

Great discussions going on medical insurance! I don't want to hijack those threads with other questions. (Whatever system you have, employer based insurance, socialized medicine which is insurance by taxes, or open market insurance you still have a form of insurance.)

How do you propose we deal with these areas to lower costs:

1. Overuse of malpractice suits. Surely some suits are justified and some drs are horrible. But some folks DO sue over every bad outcome medicine cannot overcome. How do we restrict the latter without tossing out the justified suits?

I saw this somewhere and it made me think. . .medical courts. Where you have experts who look at the cases and decide if the problem was due to malpratice (a doc over looking clear simptomes), criminal neglect (a drunk doc allowed into the OR) or whatever.

Then you have sliding scale of 'pay outs' based on the person's loss. For example if I lose a finger on my left hand its not as great of a loss for me than it would be for a lead guitarist in a multimillion dollar a year rock band.

You could also put in a loser pays system. This would take a lot of the 'bad' cases out of the system. As it stands today it cost an insurance company less to pay thousands of dollars to someone than to go to court, even if they win the case. So a "if you don't win I don't get paid" lawyer can file 500 $10,000 cases a year, take 10% of the judgments and only have to take one or two cases a year to court. And he'd make $500,000 a year. And if the insurance company doesn't settle and the lawyer wins the case there's a good chance the jury will award millions of dollars and he really hits the jack pot.

With a loser pays system a lawyer isn't going to take a case he doesn't think has a very good chance of winning because if he loses he's going to be facing a huge bill from the insurances' law firm.

2. Overuse by lifestyle choice. How do we contain the rising costs of healthcare for those who choose recklessness (drug abuse, smoking, all those nasty sexually transmitted diseases) or fail to take care of themselves (obesity, lack of exercise, failure to get routine screenings even if insurance covers them)?

Simple, if you take care of yourself you pay less for insurance. If you smoke, drink, skydive you pay more for insurance.

3. Overuse plain and simple. Let's admit it--almost all of us are guilty there.
Maybe we refuse to get rid of our animals although highly allergic and expect insurance to pay for the dr and the meds. Maybe we aren't in the tiny number of folks with primary gerd due to a birth defect, but just overeat the wrong stuff, wear tight britches or girdles, and want insurance to buy us nexium so we don't have to pay for prilosec. Maybe we know if we lost those 20 lbs our dr says we can toss the blood pressure med, but we just love our pizza.

Make it cost to do these things; see above.

4. Unwillingness to pay our fair cost. This one strikes across the board, rich and poor and everything in between. How do we deal with the people who can afford cable, cell phone, horses as pets, internet, bottled water, designer jeans, that new gun, or whatever hays their wagon but scream they cannot afford insurance or whatever their deductible of whatever size does not pay?

Make the individual RESPONSIBLE for himself. If you don't want to spend the money for insurance fine, just don't expect anything other than emergency life saving medical care w/o cash on the barrel head.

5. And finally, how do you set parameters on cost effectiveness? Do you give grandpa at 95 the same high tech treatment to prolong life as you would a 45 year old, or 15 year old? If there isn't enough $$ in the
system to provide everyone with everything, how will you prioritize?

As long as grandpa had money or insurance to cover the cost of the treatment then he'd get treated. If he didn't, well its sad but we can't afford to give everyone everything.

Give it your best shot--if you were great high poobah of all things legal, medical, and governmental, what would your system look like?

Just off the top of my head. . .

In my system each individual would be responsible for themselves. The government would have funds to provide emergency life saving care which a person would be required to pay back based on their income. If you have an outstanding balance your tax refund or other 'bonus' government checks would be used to pay down that bill.

Health insurance premiums would be 'pre tax' dollars or tax deductible.

The government would back, but not run, a (or several) NPO's to provide low cost basic catastrophic medical insurance. These polices would run for one year, from 1 JAN to 31 DEC w/o being prorated. IOW, if you bought your policy on 29 DEC you'd pay the same as someone who bought theirs on 1 JAN, this would encourage people to buy early. If your treatment was expected to run into the next year you would be required to buy a policy for that year or pay for the rest of the treatment yourself.

Insurance would be regulated by the federal government, all state regulations would be removed and any company could sell in any state.

Business would not be allowed to provide health care coverage directly to their employees but would be allowed to reimburse the employees' insurance cost.

 

[mnn2501]

The place I see a lot of waste is in end of life care. When my mother was dying, the last 7 days of her life ran up over $400,000 in hospital/medical bills-- (all medicare with no supplimental insurance, so everyone paid for that). When the doctors finally told us there was no hope on day 6, we asked them to make her comfortable, but no more medical care other than to ease her pain - with all the tubes pulled she faded away within 24 hours.
I guess my question is, did it really take them 6 days to figure that out? She was 84 and in very bad shape. Had my brother not happened to check on her when he did she would have passed in her home without going therough the 6 days in intensive care, with breathing tubes, catheters, feeding tubes, etc etc etc

My point is, if there is no hope, then let people die with dignaty, not hooked up to every machine medical science has thought of just to extend life a few more days and miserable days at that.

 

[The Paw]

Great discussions going on medical insurance! I don't want to hijack those threads with other questions. (Whatever system you have, employer based insurance, socialized medicine which is insurance by taxes, or open market insurance you still have a form of insurance.)

How do you propose we deal with these areas to lower costs:

1. Overuse of malpractice suits. Surely some suits are justified and some drs are horrible. But some folks DO sue over every bad outcome medicine cannot overcome. How do we restrict the latter without tossing out the justified suits?

No fault insurance which caps both the size of the award, and the percentage an attorney can claim as fees. Manitoba uses this for auto insurance claims, and the lawyers screamed bloody murder but our car insurance rates are among the lowest in North America.

2. Overuse by lifestyle choice. How do we contain the rising costs of healthcare for those who choose recklessness (drug abuse, smoking, all those nasty sexually transmitted diseases) or fail to take care of themselves (obesity, lack of exercise, failure to get routine screenings even if insurance covers them)?

Invest in public health education and preventative programming, including harm reduction strategies. Reconcile ourselves to the fact that even though people sometimes make poor personal choices, they should still receive health care. Not treating them just amplifies the problem created by lifestyle. Oh, and ban trans-fats.

3. Overuse plain and simple. Let's admit it--almost all of us are guilty there.
Maybe we refuse to get rid of our animals although highly allergic and expect insurance to pay for the dr and the meds. Maybe we aren't in the tiny number of folks with primary gerd due to a birth defect, but just overeat the wrong stuff, wear tight britches or girdles, and want insurance to buy us nexium so we don't have to pay for prilosec. Maybe we know if we lost those 20 lbs our dr says we can toss the blood pressure med, but we just love our pizza.

The single largest overuse in a single payer system is people using emergency rooms for non-emergency issues. I would put a walk-in clinic on-site next to each emergency room, and non-emergent cases would be referred there.

4. Unwillingness to pay our fair cost. This one strikes across the board, rich and poor and everything in between. How do we deal with the people who can afford cable, cell phone, horses as pets, internet, bottled water, designer jeans, that new gun, or whatever hays their wagon but scream they cannot afford insurance or whatever their deductible of whatever size does not pay?

Single payer system. More cost effective, funded from tax revenues so it gets paid before decisions people make about discretionary spending. Renders it a non-issue. I know I am belabouring the point, but the U.S. could fund 100% of the cost of a single payer system from its government expenditures on the patchwork of Medicaid and Medicare currently existing. If you eliminated both employer and employee premiums, people could have health care and designer jeans.

5. And finally, how do you set parameters on cost effectiveness? Do you give grandpa at 95 the same high tech treatment to prolong life as you would a 45 year old, or 15 year old? If there isn't enough $$ in the system to provide everyone with everything, how will you prioritize?

This is the tough one. We had a case in Manitoba where the doctors wanted to take an 89 year old Orthodox Jew off life support, as he was essentially in a coma. The family took the position that it contravened a principle of his faith, and wanted heroic measures to keep him alive. The family got an injunction against the hospital preventing the removal of life support. The government (as the single payer) stayed out of the debate, and left it as a question of medical ethics. The courts were reluctant to give doctors that authority, and the man eventually died before the case made it to the Court of Appeals. I think we should encourage people to make appropriate end-of-life choices where the quality of life is so poor, but I am not sure I would mandate it. I am glad in our area it is decided as question of medical ethics, and not as a question of coverage.

 

[EDDIE BUCK]

The place I see a lot of waste is in end of life.

My point is, if there is no hope, then let people die with dignaty, not hooked up to every machine medical science has thought of just to extend life a few more days and miserable days at that.

I agree,and most if not all of the folks I've known in their last days want it that way to. I think this should be discussed in every family and once everyone knows the others wishes, it will be much better for the family to make those decisions, knowing they did the right thing for the one in question. Making that decision and not knowing their wishes is to great a burden for most folks to carry. My self included. Eddie

 

[where I want to]

Part of the problem with lawyers is that they can get money by threatening to sue even if everyone knows there was nothing substantially incorrect done. A decision is made on whether it would be cheaper to pay them off rather that go through the process- so there are a lot (many many) cases where money is paid out even though a party is innocent.

But there is plenty of blame with doctors too- when my father was dying, the doctors didn't tell us. They just gave him a transfusion which perked him up for awhile while they transferred him to a nursing home- we were all so pleased he was getting better and were making plans for bringing him home but it only lasted a day then left us trying to cope with his illness in the nursing home. He was "dumped" and the doctors refused to treat him after that- he was left to a nursing home doctor who only breezed through once in the week he took to die. He had plenty of insurance and resourses but I think was too much of a losing proposition for the doctors to care for him.
Then there was my mom- when the doctor talked about her passing soon with my sister at her bedside (mom had been in a comma at age 86 for 2 weeks) my mom's eyes popped open and she asked what their plan was, said no to an operation and lived another three years. Medicine even for the old is not an exact science. Treat or not ??????

It's always a fine line between making a good or bad decision.
The main thing is that a general standard of treatment be agreed upon by society and we live with that subject to updates and changes.

All people should be expected to pay something based on a sliding scale both for the insurance plan and the actual treatment.

Fraud on both sides actually prosecuted- both doctors and patients- jail time not fines only.

An arbitration system that is fair, fast and binding.


But what about "experimental" treatment at huge cost? This is the sort of decsion needing done before it happens.

I would like to see basic costs for routine preventative care, shared cost for hospital stays, drug price negotiated and investment in training doctors and nurses and other needed medical people. And no student loans or subsidies for lawyer education.

 

[Lizza]

1. Overuse of malpractice suits. Surely some suits are justified and some drs are horrible. But some folks DO sue over every bad outcome medicine cannot overcome. How do we restrict the latter without tossing out the justified suits?

First, great thread Nodak3. I like the idea of some sort of medical court and caps. Didn't John Edwards make his money on medical malpractice suits, that should be an indicator we need to nip those in the bud!

2. Overuse by lifestyle choice. How do we contain the rising costs of healthcare for those who choose recklessness (drug abuse, smoking, all those nasty sexually transmitted diseases) or fail to take care of themselves (obesity, lack of exercise, failure to get routine screenings even if insurance covers them)?

I personally like the idea of preventative medicine. My suggestions would be things like quit smoking classes/help or nutritionist meetings for health and exercise programs. Preventative medicine and programs I think are the key to this. I saw something that WIC (women infants and children) SAVES the state $3 for every $1 the program spent. As for the complete idiots, well, I do think we still need to offer them basic care for the good of our communities.

3. Overuse plain and simple. Let's admit it--almost all of us are guilty there.
Maybe we refuse to get rid of our animals although highly allergic and expect insurance to pay for the dr and the meds. Maybe we aren't in the tiny number of folks with primary gerd due to a birth defect, but just overeat the wrong stuff, wear tight britches or girdles, and want insurance to buy us nexium so we don't have to pay for prilosec. Maybe we know if we lost those 20 lbs our dr says we can toss the blood pressure med, but we just love our pizza.

I don't think we can regulate good behavior but I do think some of this can be helped with preventative medicine. Also remember that Canadian Health Care does not actually pay for any medicines (only in the hospital from what I understand, not a Canadian, so someone can certainly correct me if I am wrong). You can see my post on the "why we can't do better" health thread on why our medicine is so much more expensive than Canada, basically we too can bring down these costs so that we won't have to choose between food and medicine.

4. Unwillingness to pay our fair cost. This one strikes across the board, rich and poor and everything in between. How do we deal with the people who can afford cable, cell phone, horses as pets, internet, bottled water, designer jeans, that new gun, or whatever hays their wagon but scream they cannot afford insurance or whatever their deductible of whatever size does not pay?

I don't know how many more ways of saying this, we already are paying as American's for health care for everyone, we just aren't managing in any sort of responsible way. :bdh:

5. And finally, how do you set parameters on cost effectiveness? Do you give grandpa at 95 the same high tech treatment to prolong life as you would a 45 year old, or 15 year old? If there isn't enough $$ in the system to provide everyone with everything, how will you prioritize?

I would think this would be up to the doctor and family. How do you regulate something like that? I remember when my FIL was diagnosed with stage 4 lung cancer, the doctor told us to go home, make him comfortable. Anything they could do would only add a few months of very poor quality life. I think the ideas around end of life care need to change (I remember watching something about a movement by seniors to avoid excessive end of life treatment).

Give it your best shot--if you were great high poobah of all things legal, medical, and governmental, what would your system look like?

I hope there is someone more qualified to write an actual plan! I remember this summer a doctor had wrote a book on how to fix our health care (yes, without spending anymore money) and his ideas sounded good - saw him on the Today Show. I don't even remember what his book was called though. If I had to take a stab at it I would say something similar to Canada's with some of their problems fixed. I honestly don't know all their problems but I have great faith that America can do something. We are a wonderful country with brilliant minds, I have faith that we can come up with plan.

 

[MeanDean]

It's not about blue backgrounds, nor green, nor purple.

It's about "what activity" do you want your users to engage in?

Whatever design decisions you make must support that idea singularly.

 

[Jenn]

Great discussions going on medical insurance! I don't want to hijack those threads with other questions. (Whatever system you have, employer based insurance, socialized medicine which is insurance by taxes, or open market insurance you still have a form of insurance.)

How do you propose we deal with these areas to lower costs:

1. Overuse of malpractice suits. Surely some suits are justified and some drs are horrible. But some folks DO sue over every bad outcome medicine cannot overcome. How do we restrict the latter without tossing out the justified suits?

Not that malpractice are criminal suits, but a lay jury is NOT a jury of a doctor's peers. We need (the laws changed to permit this) for a panel of expert judges to decide malpractice cases and limit payouts to predetermined ones, not swayed by juries' responses to glib attorneys. And like the aviation system; a no punishment system for reporting problems before there is a lawsuit or perhaps even a mishap/injury. We do have it for impaired doctors- how about for impaired hospitals/ORs/ERs ie "we are so shortstaffed it is likely we will overlook a patient soon"

2. Overuse by lifestyle choice. How do we contain the rising costs of healthcare for those who choose recklessness (drug abuse, smoking, all those nasty sexually transmitted diseases) or fail to take care of themselves (obesity, lack of exercise, failure to get routine screenings even if insurance covers them)?

Tough to bill folks for their behavior- how about sin taxes. As a nonsmoker and minimal drinker the only ones that will pinch me are some valid ones on calories or other measure/dissuader of eating too well

3. Overuse plain and simple. Let's admit it--almost all of us are guilty there.
Maybe we refuse to get rid of our animals although highly allergic and expect insurance to pay for the dr and the meds. Maybe we aren't in the tiny number of folks with primary gerd due to a birth defect, but just overeat the wrong stuff, wear tight britches or girdles, and want insurance to buy us nexium so we don't have to pay for prilosec. Maybe we know if we lost those 20 lbs our dr says we can toss the blood pressure med, but we just love our pizza.

Take out the incentive to get the drug free with a more costly overall doctor's visit- maybe all drugs paid same way, OTC or prescribed? Limiting direct to patient advertising and drug reps lobbying doctors will help. If possible again a convenience tax on drugs of conveinece if we can inexpensively tell which/when. Also a small copay- enough to make you notice and not value your doctor's/nurse's time as worthless since it's free to you. Except maybe for elder and child health care since some folks would buy a pack of cigs before they'd spend that much to get their sick child checked over.

4. Unwillingness to pay our fair cost. This one strikes across the board, rich and poor and everything in between. How do we deal with the people who can afford cable, cell phone, horses as pets, internet, bottled water, designer jeans, that new gun, or whatever hays their wagon but scream they cannot afford insurance or whatever their deductible of whatever size does not pay?

Tax us all or require participation some other way- no choice. Noone can be certain they won't need insurance and insurance costs least for each when all participate. Penalties so when you're caught shirking you pay- back payment and penalty/interest if you've been avoiding participation for years. Handle health care like a common good- military, police, fireservice, highways... Through real estate or payroll tax? Sales tax?

5. And finally, how do you set parameters on cost effectiveness? Do you give grandpa at 95 the same high tech treatment to prolong life as you would a 45 year old, or 15 year old? If there isn't enough $$ in the system to provide everyone with everything, how will you prioritize?

We have to ration care. Set up panels to decide how we will, and then stick to the rules. No infertility treatment? Seems terribly unfair to the infertile couple. No dialysis over 60? Again seems even harsher- justify the choices and have an unassailable council standing behind their decisons.

Give it your best shot--if you were great high poobah of all things legal, medical, and governmental, what would your system look like?

Other issues: malpractice costs should be covered by govt not doctors- docs who cost too much in malpractice vs their peers need to be made to stop working. If docs will make less money they must receive free education and or relief from loans they currently have, some pay off to the older docs who bargained for $200K plus as their pay drops to GS15 if direct govt employees.

 

[kasilofhome]

Triage at emegency rooms. Not that sick. Wait over there get a number and have a nurse in that room monering the room and rechecking for for need.

Have a non emgency doctor there that will see people on a sliding scale.

I have the fortune of dealing with the Alaskan Native Medical Center - Free medical care for my son. He was very sick when he was young. They do triage and it is great. Not knowing about the Native care before my son I only heard how bad it was. LONG waits. Sitting for hours with out seeing a doctor with only a stupid nurse checking on you every few hours. I was scared to use it and avoided it but when he qualified to use it I had paid cash for his expenive care for many months. I felt forced to go there and I went with a chip on my shoulder.

Wow, it was the best care in the world. Yes, there were alot of emgency room vists (no more than when I paid cash) but the triage method was great. Only once was I sent to the "second" waiting area and I was pleased that that time he was NOT that sick and even asked if I could deal with it at home. Twice while doing the emgency triage apond entring the hospital I was rushed right in the first bed with a triage nurse rushing to get a doctor asap while demanding to know my childs weight (no time to weight - to get some drug dose ready for the moment the doctor would get there and order it.

Knowledge and caring can make a difference. My dh would go to the emegency room for a hang nail ---I am the only driver so trust me he only goes when really needed. Working with the dr's can save a lot of visits.

For ds the dr's trained me on how to use meds, when to use them, gave me spare meds to control ds's siduation for home future use, I was instucted to call in when I needed to use them and to call in about once an hour while treating him at home. (they would call if I got busy) they would make the call if they wanted him brought in or to wait for a reg office visit. I am sure that this saved alot of money.
Educate and that includes bluntly informing those with wasteful minor issues that it is minor and that this is an emergency room for true emergency's and that those with nonemegency issues will wait till there is NO other persons in need of true emgency care and that all true persons who come after them with true need will be ahead of them.

MAKE IT not worth their while to come in for a cold.

 

[fordy]

.............Doctors , Lawyers , Cops , and all other groups of professionals should be subject too INdependent Review panels madeup of ordinary citizens who can remove them from their area of expertise . All members within these groups almost never initiate any action against one of their fellow members when it is obvious to them that a Member is practicing their profession in a hazardous manner . They are simply INcapable of enforcing a a set of laws that ensures that ALL members are pursuing their profession with the highest level performance expected by the public . , fordy

 

[mylala]

If a cop beats someone should his jury be made up of only police officers? If a corporation knowingly harms people with it's products should their jury be made up of only corp executives? I don't understand the thought behind doctors need a doctor jury. No thank you!

 

[Jenn]

Triage at emegency rooms. Not that sick. Wait over there get a number and have a nurse in that room monering the room and rechecking for for need.

Have a non emgency doctor there that will see people on a sliding scale.

I have the fortune of dealing with the Alaskan Native Medical Center - Free medical care for my son. He was very sick when he was young. They do triage and it is great. Not knowing about the Native care before my son I only heard how bad it was. LONG waits. Sitting for hours with out seeing a doctor with only a stupid nurse checking on you every few hours. I was scared to use it and avoided it but when he qualified to use it I had paid cash for his expenive care for many months. I felt forced to go there and I went with a chip on my shoulder.

Wow, it was the best care in the world. Yes, there were alot of emgency room vists (no more than when I paid cash) but the triage method was great. Only once was I sent to the "second" waiting area and I was pleased that that time he was NOT that sick and even asked if I could deal with it at home. Twice while doing the emgency triage apond entring the hospital I was rushed right in the first bed with a triage nurse rushing to get a doctor asap while demanding to know my childs weight (no time to weight - to get some drug dose ready for the moment the doctor would get there and order it.

Knowledge and caring can make a difference. My dh would go to the emegency room for a hang nail ---I am the only driver so trust me he only goes when really needed. Working with the dr's can save a lot of visits.

For ds the dr's trained me on how to use meds, when to use them, gave me spare meds to control ds's siduation for home future use, I was instucted to call in when I needed to use them and to call in about once an hour while treating him at home. (they would call if I got busy) they would make the call if they wanted him brought in or to wait for a reg office visit. I am sure that this saved alot of money.
Educate and that includes bluntly informing those with wasteful minor issues that it is minor and that this is an emergency room for true emergency's and that those with nonemegency issues will wait till there is NO other persons in need of true emgency care and that all true persons who come after them with true need will be ahead of them.

MAKE IT not worth their while to come in for a cold.

I've heard great things about the Alaskan Native Medical Centers- that they've reformed with patient input and are as you describe. Wonder if the complainers are recalling the previous bad system or are abusers of the current improved system. Recall all that this is socialized medicine, just in the tribal (socialized) tradition and of course at a smaller scale than all of America.

 

[Jenn]

If a cop beats someone should his jury be made up of only police officers? If a corporation knowingly harms people with it's products should their jury be made up of only corp executives? I don't understand the thought behind doctors need a doctor jury. No thank you!

I don't want a doctor jury- hey the injured party might similarly need a jury of people injured by doctors- but 12 nonmedical, nonexperienced with medical issues folks can make illinformed decisions. Judges- ie nonmedical but with long experience in such cases- can sort out patients with a terrible outcome but not the doctors' fault (which usually get huge awards from lay juries because they are suffering and need some money- but why should innocent doctors have to pay that money) from those where the doctor is at fault and deserve some compensation no matter the severity of the bad outcome. Plenty of babies sadly are born with problems- ofttimes the obstetrician just happens to be the doctor there when this is discovered and could not possibly have prevented this. A 'good' lawyer though can convince some juries that the doctor and nurse who delivered caused the birth defect that was actually present at 3 months in the uterus.... And of course the poor baby needs lifelong care so no lay jury wants to deny them the lots of money needed. 'Course that's just my biased opinion that 12 people off the street might not be able to understand what I've studied for 7+ years 70 hours a week, and maybe we should get folks (judges) with some training in doing so.

 

[mylala]

I don't want a doctor jury- hey the injured party might similarly need a jury of people injured by doctors- but 12 nonmedical, nonexperienced with medical issues folks can make illinformed decisions. Judges- ie nonmedical but with long experience in such cases- can sort out patients with a terrible outcome but not the doctors' fault (which usually get huge awards from lay juries because they are suffering and need some money- but why should innocent doctors have to pay that money) from those where the doctor is at fault and deserve some compensation no matter the severity of the bad outcome. Plenty of babies sadly are born with problems- ofttimes the obstetrician just happens to be the doctor there when this is discovered and could not possibly have prevented this. A 'good' lawyer though can convince some juries that the doctor and nurse who delivered caused the birth defect that was actually present at 3 months in the uterus.... And of course the poor baby needs lifelong care so no lay jury wants to deny them the lots of money needed. 'Course that's just my biased opinion that 12 people off the street might not be able to understand what I've studied for 7+ years 70 hours a week, and maybe we should get folks (judges) with some training in doing so.

Should we also get a panel of expert judges to be jury in all other suits? Should there be a panel of judges with expertice in chemical waste when someone is sued for improper disposing of it? Should there be a expert judge panel in policing when a police officer is sued for excessive force? I work in the Public sector and can get sued for my actions or non-actions on a daily basis. Doctors are not alone in this.
Like I said, no thank you.

 

[watcher]

Should we also get a panel of expert judges to be jury in all other suits? Should there be a panel of judges with expertice in chemical waste when someone is sued for improper disposing of it? Should there be a expert judge panel in policing when a police officer is sued for excessive force? I work in the Public sector and can get sued for my actions or non-actions on a daily basis. Doctors are not alone in this.
Like I said, no thank you.

Do you think 12 people on jury duty could be taught enough engineering to be able to tell if a jet engine failed due to a design flaw or due to a manufacturing defect when both sides have experts testifying it wasn't the fault of who ever they were being paid by?

Bring it down to something simple. You have a case where a suture failed and caused some harm to someone. You have one expert saying because of the condition of the tissue the size of the thread used was too small and there were not enough sutures. He has a nice power point presentation (PPP) with picture and charts to make his point. A few days later you have another expert come in and tell you the condition of the tissue made it necessary for the doctor to use that size thread and number of sutures. He also has a PPP with pictures and charts. Sitting in the jury box are 12 people none of which have anything more than a high school diploma and are FORBIDDEN to do any independent research on their own. Do you think they have the ability to even start to know which expert is correct? Or must they base their decision on how they feel?

Add to that the fact several of them probably think insurance companies are evil, money hungry companies and doctors make too much money anyway. What are the odds of the doc winning?

 

[Jennifer L.]

Iproblems- ofttimes the obstetrician just happens to be the doctor there when this is discovered and could not possibly have prevented this. A 'good' lawyer though can convince some juries that the doctor and nurse who delivered caused the birth defect that was actually present at 3 months in the uterus.... And of course the poor baby needs lifelong care so no lay jury wants to deny them the lots of money needed. 'Course that's just my biased opinion that 12 people off the street might not be able to understand what I've studied for 7+ years 70 hours a week, and maybe we should get folks (judges) with some training in doing so.

The whole problem with everything to do with US healthcare is the insurance industry. Period. Get rid of insurance companies that operate for profit and the rates for everything would drop. Let the governement or a private NOT for profit organization handle what health insurance is now. Everyone pays in, no free lunches. No insurance through employment. You'd see prices drop to a more reasonable level.

The problem is not with the stupid people off the street (there, I said it for you). The problem is the people on the street know the doctor has insurance and so what? no one is hurt but the insurance company. And no, they aren't "stupid", they just have it ingrained in them right now that "someone else" pays. I could hardly believe my ears, but I've heard people *itch that with health insurance paid through work they went to the doctor and had to pay a $10 co-pay! Imagine! The nerve! Being asked to pay a co-pay! A whole $10! And this was a woman who was intelligent and worked in healthcare herself (took care of invalids in their home, health insurance was through her husband's company where he was a skilled mechanic).

If I ran things there would be NO health insurance through work. This entitlement that everyone feels would be over with. Health "insurance" would be a tax that you paid in with your income taxes. The number of huge awards for malpractice would disappear, and there would be instead reasonable amounts based on actual costs. Baby born with problems caused by the doc? No, you didn't win a $100,000,000 lottery, you'd get a reasonable middle class income for life for the kid if it was that messed up.

Get rid of the insurance industry in health care. I can't wait for this country to wake up on this one.

 

[Jenn]

BTW I do NOT feel that malpractice is the problem with, or the cause of the high expense of, the health care system. Just that if we WANT to curb malpractice (I think it's just a red herring, though in some states the high cost of it is driving out doctors especially in the expensive malpractice specialties) that is one way. But to consider 'oil experts' deciding if the oil company has harmed a private citizen- well still I don't think doctors are as corrupt and organized as the oil companies... but I see why a lay jury seems preferable to most folk.

 

[kasilofhome]

I servered on jury duty on a long case about a subject that one should have knowledge about in coming to a decision. We had the first 3 days that was only about the terms and mechanics of a piece of equipment. This knowledge was needed. That was the only time that I served and so I thought that that was the norm.

 

[mylala]

Do you think 12 people on jury duty could be taught enough engineering to be able to tell if a jet engine failed due to a design flaw or due to a manufacturing defect when both sides have experts testifying it wasn't the fault of who ever they were being paid by?

Bring it down to something simple. You have a case where a suture failed and caused some harm to someone. You have one expert saying because of the condition of the tissue the size of the thread used was too small and there were not enough sutures. He has a nice power point presentation (PPP) with picture and charts to make his point. A few days later you have another expert come in and tell you the condition of the tissue made it necessary for the doctor to use that size thread and number of sutures. He also has a PPP with pictures and charts. Sitting in the jury box are 12 people none of which have anything more than a high school diploma and are FORBIDDEN to do any independent research on their own. Do you think they have the ability to even start to know which expert is correct? Or must they base their decision on how they feel?

Add to that the fact several of them probably think insurance companies are evil, money hungry companies and doctors make too much money anyway. What are the odds of the doc winning?

So you believe a specialized group should be made up for a jury in every industry in every jurisdiction? Professional jurors? Wouldn't that be like self-policing, and self-discipline? If that worked, well wouldn't that just be utopia.
If you have a group of people trained by doctors to understand all that doctors go through...the good and bad, and put in a good deal of time with doctors to fully understand their job, both the medicine side and personal side, they will develop a sense of belonging with the doctors, a comraderie(sp?) with them. They see how stressful the job is, how life and death decisions are made...will they not be sympathetic to the doctors side before the trial even starts? So you would have a group trained by the medical field, which makes them an extension of the medical field policing, and rendering judgement on the same field. Like I said...no thank you.