Deep pockets, insurance, damages, device mfgs and pharma.

Post #327,152 by folkert 6/1/10 10:35:31 AM Reply	Deep pockets, insurance, damages, device mfgs and pharma. First off. Malpractice insurance is the single largest line item on any Doctor's expense. Limiting soft-tissue damages period will take care of 95% or more of this cost. Device MFGs will benefit from that same limits. No more deepest pockets syndrome. Pharma will also benefit from the same limits. No more deepest pockets syndrome. End service providers (EMT, Hospitals, Doctors) will also benefit from the same limits. No more deepest pockets syndrome. All that to say, If we then do not mandate reductions in device costs, medication costs and service costs... we will never see any relief. First step is nationwide law limiting soft tissue damage. Second step is to piss off the Device MFGs and Pharma. Once that is done mandate reductions in pricing for drugs and devices, to real margins... not like they are now.
Post #327,155 by beepster 6/1/10 10:47:45 AM Reply	Who defines what "real" is? in the "real" margins definition. And if you take away the early patent protection margins, who funds the cost of the research that developed these items? Tort reform is a nice thought...and all know its a problem...but real improvement never seems to gain any legs in Congress. This is not an endorsement of status quo as much as it is trying not to break the model that helps generate continuous improvement in the science. I will choose a path that's clear. I will choose freewill.
Post #327,175 by folkert 6/1/10 12:22:28 PM Reply	Not talking about Early Patent stuff. What I am talking about are things that are 20-30 years old in design having a cost of about $400 to the device manufacturers, but the healthcare facilities are being charged $40,000 per device. Plus they then have a service contract of about $9-$11K per year... which is really just a swap out service now. Which the re-man'd device taking its place costs a total of $200 to R&R in China. That is what I am talking about. Also, what about Pharma, many have recently gone through and re-monitized their existing drugs and cranked up "miracle life saving" drug. A case I know about as a friend in Wisconsin had a son with a syndrome. (can't remember the name right off). The syndrome has a known and well established one time injection that effectively cure the syndrome period. The drug has been in use since the 60s. It is effective and complete. Total cost for the one time injection 5 years ago was about $9200. What insurance company is going to say no to a proven and effective solution. Well based on that thinking... I hope you see where i am going. Two years later, his Daughter came up with the same thing. (Come to find out he had it when he was a kid also). They of course approved the injection. Total cost two years later? Over $27,000. This was ONE Drug out of many they have done this to. Sorry. I have no sympathies for the shit storm coming to them soon.
Post #327,162 by boxley 6/1/10 10:59:44 AM Reply	how did torte reform work in texas and alaska no deep pockets allowed in either place. http://www.dallasnew...nce.681a6428.html Texas health insurance costs have risen 7 times faster than incomes http://www.stateheal...p=52&cat=17&rgn=3 higher in all respects in alaska. torte reform is only a small part of the problem.
Post #327,164 by beepster 6/1/10 11:03:51 AM Reply	Don't see where your posts are related to your subject here box. Neither reference torte reform as a cause of the problem...and Alaska is (as you know) a special case in a lot of respects simply due to geography. I will choose a path that's clear. I will choose freewill.
Post #327,166 by boxley 6/1/10 11:09:58 AM Reply	Texas has torte reform as well as alaska very low limits for pain and suffering in both places. According to greg the cost of health care should be dramatically lower because of that.
Post #327,168 by beepster 6/1/10 11:24:12 AM Reply	Actually, thinking he means the cost of insurance for the DOCTOR will be cheaper, not for the patient. I will choose a path that's clear. I will choose freewill.
Post #327,170 by boxley 6/1/10 11:27:05 AM Reply	which is then passed to the consumer which should result in all around lowered cost.
Post #327,167 by Another Scott 6/1/10 11:12:50 AM Reply	Your malpractice numbers don't make sense. Malpractice costs more than salaries? I don't think so. http://money.cnn.com...are_doctor_costs/ Schreiber, who employs two nurse practitioners, agreed to break down the costs associated with running his practice. He spends about $60,000 a month on "fixed costs" to run his practice. "That's more or less my breakeven point," he said. "If I spend more, I'm in the red for the month." Business costs include rent, payroll, utilities, medical and office supplies. Because he maintains electronic health records for his patients, Schreiber also pays for equipment maintenance and other management services associated with patient billing. Fixed costs for a private practice also include malpractice insurance. He pays about $7,000 a year for himself and $2,000 each for his two nurse practitioners. Schreiber admits that his cost for malpractice insurance is relatively low, compared to specialists such as ob/gyns, who pay upward of $100,000 a year. (Rx for money woes: Doctors quit medicine) Finally, his fixed costs include benefits to cover his employees, including himself. Those costs go against the $800,000 or so in revenue, which includes about $100,000 in income, he said his practice collects in a given year. Nearly a third of that money, the sum that would be cut 21%, comes from Medicare. (Of course, Congress is never going to cut doctor's salaries that much in one fell swoop.) I can't believe that any practice has malpractice insurance costing more than physician salaries. It would be enlightening to see otherwise. Cheers, Scott.
Post #327,171 by beepster 6/1/10 11:27:19 AM Reply	What, you think... 100k/year is too much and Congress should cut it? I will choose a path that's clear. I will choose freewill.
Post #327,172 by Another Scott 6/1/10 11:32:46 AM 6/1/10 4:04:49 PM Reply	Yes, that's exactly what I think. Of course. :-/ [edit:] Just to be clear: I was trying to be snarky. I have no particular knowledge why some malpractice insurance rates are so high. I didn't address that. I was trying to point out that numbers I've seen indicate typical malpractice rates are not the dominant expense in a doctor's office. Even in practices where they are spending $100k for insurance, I would bet that salaries are higher. I could be wrong, of course. FWIW. Cheers, Scott. Edited by Another Scott June 1, 2010, 04:04:49 PM EDT Expand All History
Post #327,201 by beepster 6/1/10 5:43:44 PM Reply	Are you talking about insurance rate,,, or the docs income? Docs income is 100k in the example given. I will choose a path that's clear. I will choose freewill.
Post #327,204 by Another Scott 6/1/10 6:20:02 PM Reply	I made an assumption. My comment was about insurance. The excerpt said some doctors pay $100k for insurance. You asked whether $100k was too high. I assumed you were talking about insurance. You weren't? You really need to use more words in your posts.... ;-) Cheers, Scott.
Post #327,206 by drook 6/1/10 7:03:27 PM Reply	What's the opposite of "benefit of the doubt"? You were responding to his comment, "Of course, Congress is never going to cut doctor's salaries that much in one fell swoop." That was a response to the article he quoted, which discussed the possible impact of proposed Medicare changes on one doctor's net profits. For your question to be meaningful, you had to assume that Scott's goal was to reduce doctor salaries. You then had to conclude that his comment was not a statement of fact, but stating a problem. When you assume the worst of intentions, and use those assumptions to turn analysis into argument, you make it impossible to have a reasonable discussion. Challenging your opponent on every statement of fact may be a good rhetorical device, but it doesn't lead to common ground. It's a sign that winning the argument is more important than understanding each other. -- Drew
Post #327,214 by Ashton 6/2/10 12:53:43 AM Reply	When you state it that clearly you violate the Human EventsÂ Rulez !111!! (once summarized by one Newt Gingrich: his little working notes somehow found their way into the meeja -- they were All about How To Do [do just what you are suggesting is most often the Beep n'Bill Game.] This is quite beyond stupid rhetorical badinage -- it is about making actual discourse, to some fucking Purpose [Any fucking Purpose]: impossible. Which, as with WOPR's [machine] comment in That Movie: "The only way to win this [War] Game is Not to play.." er, qed? I could almost see voting for Palin in 2012 on the grounds that this sorry ratfucking excuse for a republic, this savage, smirking, predatory empire deserves her. Bring on the Rapture, motherfuckers! -- via RC
Post #327,217 by beepster 6/2/10 7:31:25 AM Reply	ok dad;=) I will choose a path that's clear. I will choose freewill.
Post #327,219 by drook 6/2/10 9:00:44 AM Reply	Damn whippersnapper -- Drew
Post #327,220 by beepster 6/2/10 9:03:54 AM Reply	Well HE started it! (we have had a dr income discussion before, HONEST) I will choose a path that's clear. I will choose freewill.
Post #327,189 by altmann 6/1/10 3:48:07 PM Reply	Re: Your malpractice numbers don't make sense. Some numbers from a 2005 article (And a partial reason for why they are so high): Malpractice insurance premiums vary widely from state to state. Florida is the highest-premium state, with an average 2004 premium of more than $195,000, followed by Nevada, Michigan, the District of Columbia, Ohio, Massachusetts, West Virginia, Connecticut, Illinois and New York. The 10 lowest-premium states are Oklahoma, at about $17,000 on average, and Nebraska, South Dakota, Minnesota, Indiana, Idaho, North Dakota, Wisconsin, Arkansas and South Carolina. ... The reasons for the rising costs in this specialty are myriad, but Ransom notes that a partial explanation is that Âeverybody wants and expects a perfect baby,Â leading many people to sue when the reality doesn't match their expectation. http://www.med.umich...ge/2005/obgyn.htm
Post #327,190 by Another Scott 6/1/10 4:05:19 PM Reply	Thanks.

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