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  1. #79
    BamaNation Hall of Fame CharminTide's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    IIRC, malpractice insurance for professions like ob-gyns and anesthesiologists can run closer to $100k per year.
    I was curious and did a quick search. The median malpractice claim payment for an adult anesthesiologist was $90,000 in 1993, and $111,000 for a pediatric anesthesiologist. Corrected for inflation, that's almost $200,000 today.

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  3. #80
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    Often, inflated payments from private insurance make up any difference. It used to be that some hospitals and practices tried to maintain a certain ratio of privately insured patients to Medicare patients, primarily to ensure they didn't have to eat the excess. This same buffer is used when an uninsured patient gets care and cannot pay their medical bills.
    But, isn't this instance more of a shift in cost rather than a reduction? It just seems like so much of this is a shell game.
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  4. #81
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    IIRC, malpractice insurance for professions like ob-gyns and anesthesiologists can run closer to $100k per year.
    That is correct. The more specialized the higher the cost of malpractice insurance. My brother in law is a CRNA and he told me the anesthesiologists he works for ALWAYS is complaining about the high cost of his premiums. Also, the cost of premiums can vary significantly from state to state. Louisiana is crooked, and always has been so it wouldn't surprise me if surgeons in the state weren't paying some of the highest in the country.
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  5. #82
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    I was curious and did a quick search. The median malpractice claim payment for an adult anesthesiologist was $90,000 in 1993, and $111,000 for a pediatric anesthesiologist. Corrected for inflation, that's almost $200,000 today.
    Quote Originally Posted by Bamabuzzard View Post
    That is correct. The more specialized the higher the cost of malpractice insurance. My brother in law is a CRNA and he told me the anesthesiologists he works for ALWAYS is complaining about the high cost of his premiums. Also, the cost of premiums can vary significantly from state to state. Louisiana is crooked, and always has been so it wouldn't surprise me if surgeons in the state weren't paying some of the highest in the country.
    If a mistake is made, then restitution should be made. But, I've heard plenty of stories where the surgical staff is working on a very sick patient and he dies on the table. Without surgery the patient would have died. The doctors did their best, but they are not God. A lawsuit filed by the family comes in short order. At some point, admitting you're loved one treated his body like cesspool for 40 years is the honest thing to do. This shouldn't be a money grab. Would you rather the doctors not have tried? Because risk aversion on the part of the doctors is an understandable reaction at some point.
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  6. #83
    BamaNation Hall of Fame CharminTide's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    But, isn't this instance more of a shift in cost rather than a reduction? It just seems like so much of this is a shell game.
    Definitely. But the idea is that if (essentially) everyone were on Medicare, there would not be a built-in private insurer buffer to allow this cost shifting. If there were no uninsured patients, the contingency of medical bankruptcy would not need to be covered either. Overall U.S. healthcare expenditures would decrease. Medicare will not pay $900 for your neighbor's C-Pap accessories, and no one else of consequence would still be in the market, so medical device companies would not be able to overcharge them and offset this. They'd simply have to adapt to a lower revenue stream. Same deal with procedures, and hopefully prescription drugs.

  7. #84
    BamaNation Hall of Fame Chukker Veteran's Avatar
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    Re: ACA holding...

    I know there is some legislation that shields gun manufacturers from being sued over their products.
    But it's open season on suing doctors?

    There ought to be a way to lessen the risk of frivolous suits against doctors while maintaining accountability for malpractice. That would, in turn, lessen malpractice insurance rates.

  8. #85
    BamaNation Hall of Fame Bodhisattva's Avatar
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    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    Definitely. But the idea is that if (essentially) everyone were on Medicare, there would not be a built-in private insurer buffer to allow this cost shifting. If there were no uninsured patients, the contingency of medical bankruptcy would not need to be covered either. Overall U.S. healthcare expenditures would decrease. Medicare will not pay $900 for your neighbor's C-Pap accessories, and no one else of consequence would still be in the market, so medical device companies would not be able to overcharge them and offset this. They'd simply have to adapt to a lower revenue stream. Same deal with procedures, and hopefully prescription drugs.
    Gotcha. Well, I hope a balance can be struck so that patients get timely, quality care and there's still the incentive for production of better drugs and medical equipment.
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  9. #86
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    Re: ACA holding...

    Quote Originally Posted by Chukker Veteran View Post
    I know there is some legislation that shields gun manufacturers from being sued over their products.
    But it's open season on suing doctors?

    There ought to be a way to lessen the risk of frivolous suits against doctors while maintaining accountability for malpractice. That would, in turn, lessen malpractice insurance rates.
    I think there are mechanisms in place on the state level. I talk trash about Louisiana but they do have a cap on lawsuits. In 2016 I sat on a jury for a malpractice suit in which a guy had basically treated his body like utter crap for 30 years, had hyper tension for 15 years and wanted to sue two cardiologists, the hospital and anyone they could find for over $1.5 million. Each person on the jury had a binder of this guy's medical records for the majority of his adult life. The problem wasn't the cardiologists he was trying to sue, but rather the way he treated his body and ignored his health. When the roosters came home to roost, the doctors did the best they could with the situation they were dealing with. They saved the guy's life, basically gave him another 15 years to live. But there we were wasting taxpayers' dollars and everyone's time.
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  10. #87
    BamaNation Hall of Fame CharminTide's Avatar
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    Re: ACA holding...

    Quote Originally Posted by Bodhisattva View Post
    Gotcha. Well, I hope a balance can be struck so that patients get timely, quality care and there's still the incentive for production of better drugs and medical equipment.
    That's always the goal. Public Health teaches the (increasingly controversial) concept of the Iron Triangle, which identifies the basic pillars of healthcare as quality, cost, and access. The idea is that changing to one or two of these pillars will affect the third. It's all about finding the proper balance.



    Bit of a tangent, but I'm all about the U.S. leading the world in medical drug research and device development. We cured hepatitis C a few years ago. I know a few people who worked on the team that did it, and their work is amazing. But I don't think the promise of corporate drug research requires us to submit to the pricing whims of pharmaceutical companies while the rest of the world aggressively negotiates deals on the very same prescription drugs. Even though I think research is the key to the future, I cannot support a situation where America largely subsidizes global pharmaceutical R&D, yet is increasingly unable to afford the very drugs we help develop.

  11. #88

    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    Definitely. But the idea is that if (essentially) everyone were on Medicare, there would not be a built-in private insurer buffer to allow this cost shifting. If there were no uninsured patients, the contingency of medical bankruptcy would not need to be covered either. Overall U.S. healthcare expenditures would decrease. Medicare will not pay $900 for your neighbor's C-Pap accessories, and no one else of consequence would still be in the market, so medical device companies would not be able to overcharge them and offset this. They'd simply have to adapt to a lower revenue stream. Same deal with procedures, and hopefully prescription drugs.
    It is - without question - the most logical solution. I have pushed back against universal healthcare for years simply because I've known far too many on medicare and under VA care that weren't allowed many of things I'm allowed under private insurance - but I certainly pay for that privilege.

    Ultimately, it's just a matter of time before single payer is the standard in the US - the sooner we move, the sooner we can work to refine it.
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  12. #89

    Re: ACA holding...

    Quote Originally Posted by CharminTide View Post
    That's always the goal. Public Health teaches the (increasingly controversial) concept of the Iron Triangle, which identifies the basic pillars of healthcare as quality, cost, and access. The idea is that changing to one or two of these pillars will affect the third. It's all about finding the proper balance.



    Bit of a tangent, but I'm all about the U.S. leading the world in medical drug research and device development. We cured hepatitis C a few years ago. I know a few people who worked on the team that did it, and their work is amazing. But I don't think the promise of corporate drug research requires us to submit to the pricing whims of pharmaceutical companies while the rest of the world aggressively negotiates deals on the very same prescription drugs. Even though I think research is the key to the future, I cannot support a situation where America largely subsidizes global pharmaceutical R&D, yet is increasingly unable to afford the very drugs we help develop.
    My brother was cured of HepC due to this drug - the cost was to be something like $100k for the course of treatment (which was only a few months, iirc) while the same exact medication was sole for tens of dollars in India. Amazing, stunning breakthroughs like this need to remain funded, but there's no reason why the cost should be so outrageous here and so cheap elsewhere.
    Oderint dum metuant - Lucius Accius

  13. #90
    FB|BB Moderator NationalTitles17's Avatar
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    Re: ACA holding...

    The reason it is so expensive here and cheap elsewhere is basically the socialistic model. We are the richest country in the world. We pay more to subsidize those who can't. Shrug.
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  14. #91
    Senior Administrator TIDE-HSV's Avatar
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    Re: ACA holding...

    Quote Originally Posted by NationalTitles17 View Post
    The reason it is so expensive here and cheap elsewhere is basically the socialistic model. We are the richest country in the world. We pay more to subsidize those who can't. Shrug.
    When I look at the bottom lines of Big Pharma, I have to take some issue with this...
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