We’re Definitely Screwed

I had an interesting discussion the other night with an M.D. who’s been taking my course. We got to talking about the healthcare system, insurance, and the government. Ah, what a fascinating topic!

I’m guessing that most if not all of my readers have health insurance, even if it’s not the greatest policy in the world. I have a hard time believing that people who don’t have jobs read here very often.

I’ve long thought that the number one problem for healthcare in America is the stupid lawsuits that drive up the cost of insurance, which in turn makes doctors charge more to cover their premiums. When this M.D. was in private practice, his liability insurance was $260,000 a year. At the time, he made about $2,000 for every baby he delivered. That means he didn’t even pay for his INSURANCE until he’d delivered 130 babies. You do the math. You just can’t carry on like that.

He said that he’d long felt the same way – it’s the lawsuits (the bad ones, I mean) that drive up the costs. But he said working in a state hospital system has changed his opinion. Government run hospitals have another problem besides liability insurance.

They are bureaucratic, lumbering, retarded, process-free breeding grounds for mistakes and ineptitude. He said working there is like a comedy of errors – little mistakes cascading into big mistakes. In fact, if he wants to see which biopsies he’s performed in a given week require immediate attention, he can’t even pull up records that way – he has to look one at a time through each and every record and manually pull the bad ones out – EVEN THOUGH the records are all electronic.

He said that in the current system, there’s no free market competition among doctors. The requirement for working in a state hospital is that you don’t get them sued. You could be the worst doctor on earth, or could be just “sliding by” and no one holds them accountable.

My M.D. friend’s suggestion was very simple – make doctors comIncredipete by restructuring the system. The free market system automatically lowers costs and increases innovation – all you have to do is look at other commercial industries to see that. Doctors would be motivated to be the best because otherwise they would have no patients. Innovation and process control would eliminate needless errors, which would reduce lawsuits, which would lower insurance premiums, which would lower overall healthcare costs, which would mean lower insurance premiums for US.

Still, I believe we have to get our “punitive damages” under control with legislation. It’s absolutely ridiculous that if someone is injured or killed by malpractice, his family can get eleventy google jillion dollars, even if the injured/killed person only made 40 grand a year. I think it’s completely fair to award direct medical costs plus the person’s expected lifetime earnings. We could leave it to the actuaries to decide what that was… (i.e. salary + inflation x the number of expected years of life for that individual).

Mr. M.D. also said he saw a direct correlation between malpractice suits against him and the family’s financial situation. People who were on the brink financially were much more likely to try and get money out of him, even in many cases where there was NO medical science in existence that could have changed the adverse outcome.

However, if the government takes over healthcare as the Dems want to do, instead of a free market, we’ll have a tax-funded monopoly that will underpay doctors, causing people to not go into medicine, and they will have to ration care as they do in Canada and the UK.

I don’t know about you, but I don’t want the government telling me I can’t PAY for an operation I need because a alcoholic hobo needs the same operation and there aren’t enough surgeons to go around.

  11 comments for “We’re Definitely Screwed

  1. April 30, 2008 at 10:34 am

    The litigious nature of our society is ruining EVERYTHING. Health insurance, auto insurance, employer liability insurance… it’s disgusting. Until lawmakers make it more difficult for these frivolous lawsuits to continue, insurance is going to continue to skyrocket. (But then, you’ll have smarmy lawyers fighting that tooth and nail, and the cycle of greed continues.)

    I am completely against universal health care. It’s bad enough that I can’t count on social security for retirement, I shudder to think what would happen if the government was in charge of my health, too. I think that is the most retarded solution to this problem imaginable.

  2. April 30, 2008 at 12:18 pm

    Andria, did we just stumble upon a truth so universal, so impeccable, that you and I actually agree on something political?

  3. Keith
    April 30, 2008 at 12:31 pm

    Blame the Insurance companies for wanting to settle. Blame the bureaucrats for raising the costs with paperwork. Blame people for wanting the “latest and best” even when it doesn’t work as well. Blame the kids for keeping grandma on life support long after her case was hopeless. Blame the crack addicts who routinely visit the ER and never pay. Blame the doctors and new moms who schedule C-sections to keep tee-times and vacation days. Blame the subset of doctors who try to cut competition from lower priced competitors. Blame the government and insurance companies that cut doctors fees so they feel pressured to conspire. Blame. . . boy this list is getting long!

    Basically, the problems with health care in America are the Americans themselves. We could do state-run care, but we’d bureaucratize it till the black market would be the best health care. Actually, if you look around it already kind of is! There are “health care providers” right now that are illegal in this country but are given equal bill with M.D.’s in other countries (like England, Germany, and Sweden). In many cases, the non-medical model of health care works better, but we Americans don’t really believe in it. Maybe that is partially because the non-medical variety also requires personal responsibility.

  4. April 30, 2008 at 1:09 pm

    Clearly this is a sign that the end is near.

  5. livieloo
    April 30, 2008 at 1:28 pm

    My cousin is in the armed forces and he admits that their “free” health-care is the worst ever. It’s slow and inefficient. By the time they figure out what’s wrong with you you’re better … or so bad off that they have to start the diagnosis process all over again.

  6. April 30, 2008 at 2:03 pm

    Geez, I don’t know guys. I grew up in England and I never had a bad experience with healthcare — unlike in the States. Then there have been the periods of completely involuntary unemployment during which I had to go to ER’s on two separate occasions. I am STILL paying-off hundreds of dollars to both hospitals AND the separate bills for the ER docs who “treated” me for all of 5 mins to the tune of $600. Juries tend to award huge settlements not so much as a favour to the Plaintiff but as punishment to the Defendant — aka Corporate America. Meantime, the insurance companies are not hurting any. Trust me, I’ve worked in insurance defense law too.

  7. syn_ack89
    April 30, 2008 at 2:17 pm

    I wonder why fixing healthcare seems to always to tied to insurance.

    You can get healthcare without insurance (at least smaller stuff) by negotiating with the doctor. It’d be nice if insurance went back to being a safety net for big illnesses and people just paid cash for regular care and smaller stuff.

    Now that wouldn’t work because the system is so out of wack, but it’s a dream of mine.

  8. Incredipete
    April 30, 2008 at 4:19 pm

    syn_ack89, I agree with you wholeheartedly. HSAs and HRAs are the best idea to come out in years.

  9. May 1, 2008 at 7:12 pm

    Hope you got your hatches battened down! It is tornado season!!

  10. Incredipete
    May 1, 2008 at 8:36 pm

    No kidding! That was a heck of a storm!

    We covered up the cars with blankets to protect them from the hail. Yeeehaaa!

  11. May 5, 2008 at 8:42 am

    All of you shut up. It’s inefficiencies in the healthcare and Rx business that keep me employed. No go take tainted medicines so I can send you a letter advising your next of kin that you made a bad decision!

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