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You are here: Home / Politics / Domestic Politics / Emergency Room Crisis

Emergency Room Crisis

by John Cole|  September 28, 20052:53 pm| 6 Comments

This post is in: Domestic Politics

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Mark Kilmer has a pretty interesting piece on the problems with underfunded hospitals, emergency room doctors, and immigration, all the while advocating for HR 3875, The Access to Emergency Medical Services Act of 2005.

It looks to me like the bill addressed the liability issue, but little else, which immediately sets off my early warning system radar. I simply don;t trust this Congress when they try to address crises, because every solution is the same- lawsuit protection and little else.

If I am wrong, let me know.

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6Comments

  1. 1.

    ppGaz

    September 28, 2005 at 4:15 pm

    Red State hysteria: “Some paying $100,000 annually” for malpractice insurance!

    Hmm. Can we see the cap plans and other relative stats on the practices of those doctors, please?

    I have a doctor who is seeing more than 300 patients a week. If he works 48 weeks a year, that’s 14,400 patient visits a year. I pay a $25 co-pay, and my plan pays his practice another $75 or so. So if he were in the $100k-premium club, his insurance would represent about 7% of the cost of my visit — if all his revenue came from patient visits. (But it doesn’t. He performs procedures every day that he can bill at about $5k a pop — I reckon he does 50-100 of these a month; that several million dollars a year just in procedure fees).

    If I rent a car and pay $100 in car rental fees, is $7 a large amount to pay for the insurance add-on? I don’t think so. So why is this a big deal if it’s a doctor’s office visit?

    I am really sick of seeing this issue demagogued by the GOP. Let’s cut the crap.

  2. 2.

    Steve

    September 28, 2005 at 5:36 pm

    Blaming the trial lawyers for everything may be a great political strategy, but it won’t fix any real problems. The proverbial “frivolous malpractice claim” has a relatively tiny effect upon insurance premiums. Look at the evidence – oh no, we’re told, premiums doubled from 2002 to 2003! But did malpractice lawsuits suddenly double? Obviously, malpractice lawsuits have been around for years, and you can’t blame them when the cost of insurance suddenly starts jumping.

    That’s not to say that some types of tort reform aren’t a good idea in their own right – there’s nothing wrong with caps on noneconomic damages, for example. I’ve tried to analyze this bill to figure out if it’s good tort reform or bad tort reform, but frankly, I can’t make heads or tails of it. Kilmer’s article is, uh, a little short on the actual substance of what the bill would do.

  3. 3.

    TallDave

    September 28, 2005 at 10:05 pm

    This is a sticky issue for a lot of reasons.

    The biggest, of course, is that it seems excessively cruel to allow the market to function normally in the healthcare industry. That would result in poor people dying because they can’t afford treatment that wealthier people can. While economic experience tends to indicate that it would also result in more cost-effective healthcare, that’s a cost/benefit ratio that most people would agree cannot be justified. On the other hand, having the gov’t take over an industry completely tends to have very negative conequences too. So we sit somewhere in the middle.

    Meanwhile, probably largely because of our intrusion into the market, health care prices and the % of GDP spent on healthcare continue to rise at unsustainable rates.

    Eventually we’re going to have to figure out a compromise that is humane, efficient, and sustainable.

    As for the malpractice insurance, this is another market distortion creating problems on the side of the equation that is voluntary: doctors faced with insurance rates that make their practice less profitable are simply choosing not to do riskier procedures, and tending to enter fields of surgery that are less prone to large malpractice awards. This means the riskier procedures will not only become even more expensive due to supply scarcity, they will increasingly be performed by the least rational economic actors. Not a comforting thought.

  4. 4.

    Steve S

    September 28, 2005 at 11:13 pm

    That’s not to say that some types of tort reform aren’t a good idea in their own right – there’s nothing wrong with caps on noneconomic damages, for example.

    What needs to happen is a medical review. I don’t have a problem with stopping frivolous lawsuits. Doctors are human, and sometimes things are forgotten. If a doctor doesn’t run some test which would have spotted that I had a rare disease. you know, that’s not unreasonable.

    But a surgeon starts operating and then realizes he has to run to the bank to cash a check, leaves and comes back in an hour… You know, maybe that surgeon ought to not be in this line of work if he’s not taking it seriously.

    Or a surgeon leaves a scalpal in a stomach. That probably should not happen.

    Or a doctor sells Botox treatment using their own concoction which wasn’t intended for medical use. you know, that’s pretty unexplainable and frankly I don’t think capping economic damages on that one is at all fair.

    We have malpractice because of quacks and snake oil salesmen. The Republican solution doesn’t deal with that. It let’s everyone off the hook, whether or not they were grossly incompetent.

    If the Republicans get their way… even I could profit by being a surgeon, and I have no knowledge of surgery.

  5. 5.

    ppGaz

    September 28, 2005 at 11:42 pm

    TallDave Says:

    This is a sticky issue for a lot of reasons.

    The biggest, of course, is that it seems excessively cruel to allow the market to function normally in the healthcare industry. That would result in poor people dying because they can’t afford treatment that wealthier people can. While economic experience tends to indicate that it would also result in more cost-effective healthcare, that’s a cost/benefit ratio that most people would agree cannot be justified. On the other hand, having the gov’t take over an industry completely tends to have very negative conequences too. So we sit somewhere in the middle.

    Meanwhile, probably largely because of our intrusion into the market, health care prices and the % of GDP spent on healthcare continue to rise at unsustainable rates.

    Eventually we’re going to have to figure out a compromise that is humane, efficient, and sustainable.

    As for the malpractice insurance, this is another market distortion creating problems on the side of the equation that is voluntary: doctors faced with insurance rates that make their practice less profitable are simply choosing not to do riskier procedures, and tending to enter fields of surgery that are less prone to large malpractice awards. This means the riskier procedures will not only become even more expensive due to supply scarcity, they will increasingly be performed by the least rational economic actors. Not a comforting thought.
    September 28th, 2005 at 10:05 pm

    So let’s see: Government “taking over an industry”, which I assume is your version of “guaranteed health care,” is bad, and high insurance costs are a big reason healthcare costs are rocketing upward. Hmm, I could have gotten that from Rush Limbaugh.

    But wait, there’s “hope”:

    Eventually we’re going to have to figure out a compromise that is humane, efficient, and sustainable.

    And how will we do that, Dave? Pray, tell.

    And by the way, Dave, it isn’t just “poor people” who are in trouble here. It’s also middle-class people, working class people, who don’t have insurance. That one gaffe by itself renders your entire post worthless AFAIC. If you don’t understand that, if you think that only “poor people” are screwed in the current situation, they you don’t get any of this.

  6. 6.

    Steve

    September 29, 2005 at 1:21 am

    What needs to happen is a medical review.

    I’m not sure what you mean by a medical review. If you mean the medical profession needs to do a better job of rooting out the incompetent doctors, that is absolutely the case.

    Or perhaps you refer to the aspect of tort reform where some states require a medical malpractice lawsuit to be reviewed by a panel of doctors at an early stage to determine whether it’s frivolous. I happen to think that’s a very good idea as well.

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