|
FRINGE posted:New malpractice practice: Cut off someones leg "by accident"? 20 years minimum in prison for negligence and medical torture-equivalence for everyone involved. I'm not convinced it would dramatically lower the rate of catastrophic malpractice. I think we'd see a few people get more careful and more people get brutally tortured. This doesn't sound like justice to me. Do people who commit such egregious errors tend to have a pattern of malpractice, or is most malpractice a very rare mistake over the course of an entire career? If it's the former, then those people should absolutely be barred from working in medicine, but if it's the latter, I think we have to bring the cost of medical training and the potential future value of that trained person's work into the balance. In the latter case, maybe egregious malpractice would be best punished by mandatory assignment to a really undesirable workplace. (I know impoverishment sounds like a great approach, but I have trouble with the thought of indirectly punishing the family of a negligent doctor.)
|
#
?
Sep 29, 2014 18:22
|
|
|
|
| # ? May 11, 2024 14:48 |
|
|
The cost of malpractice insurance is an invisibly tiny sliver of overall medical costs to Americans. It could triple overnight and we would not even notice a difference in costs. It is an absolutely ridiculous red herring consistently trotted out by conservatives to redirect attention away from the actual thing that would save everyone in the country massive amounts of money while also providing much better care: a national healthcare system.
|
|
#
?
Sep 29, 2014 20:36
|
|
|
I agree that predatory billing is an issue, made possible by a lack of cost transparency. Increasing malpractice caps will not improve cost transparency in a consistent, meaningful way. It may punish good actors in a way not originally intended and possibly worsen transparency. I feel pretty confident saying that it will increase overall cost for the healthcare system. Doctors are human, and as a result are very bad at estimating the likelihood of rare events. Thus the perception that increased malpractice lawsuits are forthcoming will probably get doctors to order more unnecessary tests out of fear, whether you think that fear is founded or unfounded.
|
|
#
?
Sep 29, 2014 20:37
|
|
|
Leperflesh posted:The cost of malpractice insurance is an invisibly tiny sliver of overall medical costs to Americans. It could triple overnight and we would not even notice a difference in costs. It is an absolutely ridiculous red herring consistently trotted out by conservatives to redirect attention away from the actual thing that would save everyone in the country massive amounts of money while also providing much better care: a national healthcare system. The cost of defensive medicine and malpractice insurance adds up somewhere to 2-5% of total US healthcare costs, which are like 18% of the U.S. GDP. I wouldn't dismiss that as an "invisibly tiny sliver."
|
|
#
?
Sep 29, 2014 20:42
|
|
|
Guy Farting posted:The cost of defensive medicine and malpractice insurance adds up somewhere to 2-5% of total US healthcare costs, which are like 18% of the U.S. GDP. I wouldn't dismiss that as an "invisibly tiny sliver." But that 2-5% isn't the part that's been growing over the last few decades. That 2-5% is a tiny part of the problem of rising healthcare costs.
|
|
#
?
Sep 29, 2014 20:51
|
|
|
Leperflesh posted:The cost of malpractice insurance is an invisibly tiny sliver of overall medical costs to Americans. It could triple overnight and we would not even notice a difference in costs. It is an absolutely ridiculous red herring consistently trotted out by conservatives to redirect attention away from the actual thing that would save everyone in the country massive amounts of money while also providing much better care: a national healthcare system. From what I've seen, once Tort reform was added, it did jack poo poo to change the cost of malpractice insurance. Most of what I know comes from "Hot Coffee" so I hope it is honest.
|
|
#
?
Sep 29, 2014 20:53
|
|
Have you seen my apex seals? I seem to have lost them.
|
Guy Farting posted:The cost of defensive medicine and malpractice insurance adds up somewhere to 2-5% of total US healthcare costs, which are like 18% of the U.S. GDP. I wouldn't dismiss that as an "invisibly tiny sliver." Source please. My experience is that sources that give numbers this high invariably ignore large portions of total healthcare costs, or are based on incorrect measures of malpractice insurance costs. Just to not be lazy: This PDF from insurance-reform.org says payouts and premiums are each less than 1% of total insurance costs. This study from John Hopkins Medicine says that "defensive medicine" is much more of an issue than the actual premiums or payouts, to the tune of ~$60B a year, but does not give that figure as a percentage of overall costs (or state clearly what is included in 'overall costs'). This peer-reviewed, published manuscript says that "Overall annual medical liability system costs, including defensive medicine, are estimated to be $55.6 billion in 2008 dollars, or 2.4 percent of total health care spending." I think defensive medicine is "a problem", but in terms of the overall cost of medical care, it's not one worth focusing a lot of attention on. I'd rather have unnecessary tests than have millions of people uninsured, and the practice of massively inflating costs for the uninsured or underinsured, combined with the general practice of operating medical care as a for-profit industry, surely amount to many times more waste. And, tripling or quadrupling the actual cost of the insurance (which as I said is less than 1% of total costs) will not eliminate defensive medicine, because even an insured doctor does not want to be sued (or have the hospital that employs him be sued, which could lead to him being fired). Leperflesh fucked around with this message at 21:07 on Sep 29, 2014 |
|
#
?
Sep 29, 2014 20:54
|
|
|
quote:I'd rather have unnecessary tests than have millions of people uninsured This is not a dichotomous choice and we shouldn't be framing it as such. Agreed that everyone should be insured so we can continue to have serious discussions about healthcare costs in this country. quote:the practice of massively inflating costs for the uninsured or underinsured, combined with the general practice of operating medical care as a for-profit industry, surely amount to many times more waste. I absolutely agree, but the proposed bill does not address this issue.
|
|
#
?
Sep 29, 2014 21:50
|
|
|
It's basically a forest/trees argument. My thesis is that malpractice insurance is a red herring (and therefore we don't need payout limits because those only really hurt the victims of malpractice) and that it gets brought up a lot as a way of distracting the public away from the real problems with American healthcare.
|
|
#
?
Sep 29, 2014 22:29
|
|
|
That's my point as well. This bill is a big ol poke in the eye to healthcare providers. I think just keeping it focused on limiting opiate prescriptions (the original intent of the bill as I understand) would have been less controversial and could have been much more productive.
|
|
#
?
Sep 30, 2014 00:34
|
|
|
Guy Farting posted:The cost of defensive medicine and malpractice insurance adds up somewhere to 2-5% of total US healthcare costs, which are like 18% of the U.S. GDP. I wouldn't dismiss that as an "invisibly tiny sliver." Doctors Order More Lab Tests When They Own the Labs http://www.businessweek.com/articles/2013-07-16/doctors-order-more-lab-tests-when-they-own-the-labs Many studies have concluded that paying physicians for each service that they provide creates incentives for physicians to increase the volume of services, which also increases their income and society’s spending for health car http://www.ncbi.nlm.nih.gov/books/NBK22944/ The allure of profitable services has led to increased physician ownership of ambulatory surgical, imaging, and endoscopy centers and other freestanding facilities such as specialty hospitals. http://www.ncbi.nlm.nih.gov/books/NBK22944/ Lax regulations and fee-for-service payment make an irresistible mix for physician conflicts. http://www.managedcaremag.com/content/enduring-temptation-physician-self-referral  quote:Surgeries increased more rapidly among owners of ASCs “than their counterparts who didn’t have ownership status,” says John Hollingsworth, MD, a University of Michigan urologist and economist.
|
|
#
?
Sep 30, 2014 00:38
|
|
|
Thank you for the citations. I continue to agree with your points, but the proposed bill doesn't address this, which is my point. This bill doesn't get us anywhere closer to fixing the issues that you bring up. edit: I'm beating a dead horse at this point, but I hope you guys see that this bill is designed to create controversy and distract voters from thinking about real drivers of cost. However I am pretty confident in saying that this bill will do nothing to reduce cost of care. It could improve quality of care by reducing the frequency of doctor shopping for opiates, but it will also likely increase cost and paradoxically reduce quality of care by increasing the frequency of unnecessary lab testing. Guy Farting fucked around with this message at 02:38 on Sep 30, 2014 |
|
#
?
Sep 30, 2014 02:31
|
|
|
Guy Farting posted:Thank you for the citations. I continue to agree with your points, but the proposed bill doesn't address this, which is my point. This bill doesn't get us anywhere closer to fixing the issues that you bring up.
|
|
#
?
Sep 30, 2014 02:48
|
|
|
I don't understand why doctors getting drug tested is a bad thing. Is it because it's only supposed to humiliate lower-wage workers or something? Plus when there are glorious examples for doctors in the world like Dr. Suresh Nair maybe some drug testing now and then isn't necessarily a bad thing?
|
|
#
?
Sep 30, 2014 02:58
|
|
|
fits my needs posted:I don't understand why doctors getting drug tested is a bad thing. Is it because it's only supposed to humiliate lower-wage workers or something? Plus when there are glorious examples for doctors in the world like Dr. Suresh Nair maybe some drug testing now and then isn't necessarily a bad thing? Because, I believe that it requires drug testing when off duty. I don't care if my doctor smokes a joint after work.
|
|
#
?
Sep 30, 2014 03:00
|
|
|
nm posted:Because, I believe that it requires drug testing when off duty. I don't care if my doctor smokes a joint after work. Well I don't really either, but are you planning on voting against it then? You want people to not be able to get adequate compensation after a doctor's malpractice because you want him/her to be able smoke a joint after work?
|
|
#
?
Sep 30, 2014 03:06
|
|
|
I disagree. If this bill passes then CA will take a step backwards with regards to actually caring for harmed patients. We will further entrench the current system. Malpractice suits don't come anywhere close to making patients whole. And what about the patients who lose their cases but still deserve help? This bill ignores them. Errors will continue to happen. Instead of rewarding successful litigation, we should be studying errors to reduce their frequency. We could be voting on bills to increase patient safety research funding or mandating third party mediation following a medical error.
|
|
#
?
Sep 30, 2014 03:09
|
|
|
Guy Farting posted:I disagree. If this bill passes then CA will take a step backwards with regards to actually caring for harmed patients. We will further entrench the current system. Malpractice suits don't come anywhere close to making patients whole. And what about the patients who lose their cases but still deserve help? This bill ignores them. Rewarding litigation? We're making people whole for doctor gently caress-ups. Yes, money doesn't make up for it, but it sure helps more than nothing and a few words about how we'll learn not to do it again. An example not from medicine. My mother was shot in the 3rd grade by a bunch of rich assholes. She lost sight out of her right eye. She won a fairly substantial lawsuit against the parents. While this didn't bring her eye back, it did means she could go to college on the money and get a Ph.D. Is it as good as an eye, but it gave someone who was knocked down by someone else a leg up. Why do you doctors think you are deserving of more legal protection than cops, lawyers, firefighters, or anyone else? I agree we should do more to protect patients and make sure errors are reduced. Saying however that because we haven't done that we should prevent those injured by doctors from recovery makes as much sense as saying that we can't help the dreamers until we seal up the borders. Finally, if we even agree that the $250k cap made sense back when it was imposed, when that was the equivalent for a million dollars, how can you seriously oppose it declining in real terms every year? nm fucked around with this message at 03:44 on Sep 30, 2014 |
|
#
?
Sep 30, 2014 03:41
|
|
|
fits my needs posted:I don't understand why doctors getting drug tested is a bad thing. Is it because it's only supposed to humiliate lower-wage workers or something? Plus when there are glorious examples for doctors in the world like Dr. Suresh Nair maybe some drug testing now and then isn't necessarily a bad thing? Because drug testing isn't free and its a meaningless cost that will get passed on to customers. Also this: nm posted:Because, I believe that it requires drug testing when off duty. I don't care if my doctor smokes a joint after work.
|
|
#
?
Sep 30, 2014 03:43
|
|
|
YES MEAN YES http://www.npr.org/blogs/thetwo-way/2014/09/29/352482932/california-enacts-yes-means-yes-law-defining-sexual-consent?sc=tw quote:"Lack of protest or resistance does not mean consent," the law states, "nor does silence mean consent. Affirmative consent must be ongoing throughout a sexual activity and can be revoked at any time."
|
|
#
?
Sep 30, 2014 06:20
|
|
|
nm posted:Rewarding litigation? We're making people whole for doctor gently caress-ups. Yes, money doesn't make up for it, but it sure helps more than nothing and a few words about how we'll learn not to do it again. An example not from medicine. My mother was shot in the 3rd grade by a bunch of rich assholes. She lost sight out of her right eye. She won a fairly substantial lawsuit against the parents. While this didn't bring her eye back, it did means she could go to college on the money and get a Ph.D. Is it as good as an eye, but it gave someone who was knocked down by someone else a leg up. Sorry about your mom. Yes, I agree if a party literally maliciously shoots somebody in the eye with a gun, then the victim is due a large amount of money from the offending party. I don't think you can compare that scenario to the patient-physician relationship. quote:Why do you doctors think you are deserving of more legal protection than cops, lawyers, firefighters, or anyone else? I'm not sure what your point is here. Actions of cops and firefighters are sanctioned by the department and by proxy the government. Risk is generally diffused across the entire department and the government on some level, which can absorb higher costs. By contrast if a lone practitioner is on the receiving end of a malpractice suit, they assume sole responsibility. They and their insurance company are on the hook. The insurance company can probably absorb costs up to a point, but if the practitioner loses a large case then their premiums increase substantially and they could be forced out of the profession. You could argue that this helps filter out bad actors, but I argue that the current system does not differentiate between good actors and bad actors -- only between lucky and unlucky ones. Also I really don't know why physician drug testing was added to this bill without leaving exceptions for marijuana. Again, a big ol poke in the eye. vv Yes! Not the only reason but luck plays a big part! "only" was probably too strong of a word thanks for quoting me before I had a chance to edit it out Guy Farting fucked around with this message at 07:18 on Sep 30, 2014 |
|
#
?
Sep 30, 2014 07:08
|
|
|
Guy Farting posted:I'm not sure what your point is here. Actions of cops and firefighters are sanctioned by the department and by proxy the government. Risk is generally diffused across the entire department and the government on some level, which can absorb higher costs. By contrast if a lone practitioner is on the receiving end of a malpractice suit, they assume sole responsibility. They and their insurance company are on the hook. The insurance company can probably absorb costs up to a point, but if the practitioner loses a large case then their premiums increase substantially and they could be forced out of the profession. You could argue that this helps filter out bad actors, but I argue that the current system does not differentiate between good actors and bad actors -- only between lucky and unlucky ones. Yes, the only thing that is different between a doctor that looses a lot of malpractice suits and one that doesn't is luck  .
|
|
#
?
Sep 30, 2014 07:13
|
|
|
I'm a registered Democrat and I got my second political survey phone call of the year. They always seem to start mildly before they start asking leading questions that are biased towards the conservative candidate. Like would you vote for a candidate who votes with Obama as we spend our way towards record deficits, or would you vote for a candidate with real world business experience. \ I started getting calls from Democratic Party volunteers months earlier but those were calls asking if I was still going to vote and if I could volunteer some time to canvas or phone bank. Do California Republicans have to deal with the same sort of phone calls?
|
|
#
?
Sep 30, 2014 09:45
|
|
|
RandomPauI posted:I'm a registered Democrat and I got my second political survey phone call of the year. They always seem to start mildly before they start asking leading questions that are biased towards the conservative candidate. Like would you vote for a candidate who votes with Obama as we spend our way towards record deficits, or would you vote for a candidate with real world business experience. \ I started getting calls from Democratic Party volunteers months earlier but those were calls asking if I was still going to vote and if I could volunteer some time to canvas or phone bank. What interest groups have you on their mailing lists? That's usually how that happens, someone "middle of the road" sold their list to a R interest group or candidate and they sell amongst each other.
|
|
#
?
Sep 30, 2014 16:05
|
|
|
In California with our open primary system there's not much benefit to registering with a party rather than independent anymore, right? I've been registered I since ~1993 so I don't really notice.
|
|
#
?
Sep 30, 2014 21:07
|
|
|
Trabisnikof posted:What interest groups have you on their mailing lists? That's usually how that happens, someone "middle of the road" sold their list to a R interest group or candidate and they sell amongst each other. Off hand they'd include NAMI, a local environmental group, the American Red Cross. It's not like I don't let them know I'm very liberal Democrat and that I'll vote party line. Not because I necessarily support the candidates, but for convenience and the chance for my vote making a marginal difference. gently caress, I just remembered something. Sometime around 2002 I volunteered for a republican candidate in a solidly R district because he was less conservative than the incumbent he wanted to replace. The incumbent won handily. That was probably it.
|
|
#
?
Sep 30, 2014 21:19
|
|
|
Trabisnikof posted:Because drug testing isn't free and its a meaningless cost that will get passed on to customers. Reminder that drug testing is a hugely lucrative field that has been at the center of several controversies recently, due to it being an absolutely gigantic handout to those companies. Also, it's not like you aren't tested already in order to receive your medical license or if you happen to gently caress up and kill someone (in certain circumstances that indicate it). Additionally this testing would include alcohol mouthswab screening, which is meant to catch traces within 12 hours and can indicate up to 16-18. So it looks like doctors are all teetotalers now, not to mention a lack of provisions for marijuana which is almost even more laughable for indications. Finally, if they really wanted to be serious about this testing then it would also include other healthcare workers like nurses. Or EMT/paramedics. Or medical/lab technicians. Hell, why not include anyone holding public office? Each of their jobs affects the lives of vastly more of the electorate than any single doctor could ever hope to touch.
|
|
#
?
Sep 30, 2014 21:20
|
|
|
Leperflesh posted:In California with our open primary system there's not much benefit to registering with a party rather than independent anymore, right? We don't have an open primary for presidential primaries, and the Republicans only let registered Republicans vote in their primary. So if you want to game the Republicans you have to register -R. (I know people who do this for the comedy option)
|
|
#
?
Sep 30, 2014 22:55
|
|
|
California's presidential primary is so late that it is basically irrelevant. By the time we get to vote, the D and R national candidates are already fait accompli. I've thought about that whole "lol vote for the wrong Repub" but I seem to recall actually being allowed to do that as an I some years ago. I think the rule was that when I enter the voting place, as an I, I was allowed to ask for the ballot for any specific party? That might have changed though.
|
|
#
?
Sep 30, 2014 23:31
|
|
|
Leperflesh posted:California's presidential primary is so late that it is basically irrelevant. By the time we get to vote, the D and R national candidates are already fait accompli. Rs - only allow Rs to vote in their primary Ds - allow Ds and Is to vote in their primary Other parties - (I think) allow anyone to vote in their primary
|
|
#
?
Sep 30, 2014 23:49
|
|
|
Pete Rates the Propositions has started filling in his voting guide for this year. I agree with him most of the time (though not always), but even when I don't, his thoughts are informative. So far only one prop has details but I'm sure he'll fill in the rest in short order.
|
|
#
?
Oct 2, 2014 23:25
|
|
|
Hog Obituary posted:YES MEAN YES I gotta say, a lot of people on the internet are upset about this. It's pretty hilarious.
|
|
#
?
Oct 3, 2014 02:55
|
|
|
Family Values posted:Pete Rates the Propositions has started filling in his voting guide for this year. I agree with him most of the time (though not always), but even when I don't, his thoughts are informative. "At $1.1 million, it will be far higher than in any other state." Provides link to source that quickly shows that isn't true as many states have no cap. Mhum. . . .
|
|
#
?
Oct 3, 2014 03:14
|
|
|
Bizarro Watt posted:I gotta say, a lot of people on the internet are upset about this. It's pretty hilarious. The coorelation between hamburger/carl's jr avatars and bad comments and the NPR website is so goddamned choice...
|
|
#
?
Oct 3, 2014 03:17
|
|
|
nm posted:"At $1.1 million, it will be far higher than in any other state." I suspect that the link he provides is out of date. For instance, according to that link Alabama has no cap on non-economic damages, but Alabama enacted a $400k limit in 2009.
|
|
#
?
Oct 3, 2014 04:43
|
|
|
Bizarro Watt posted:I gotta say, a lot of people on the internet are upset about this. It's pretty hilarious. I don't get how hard it is to ask someone if they really want you to put your dick in them. How hard is that? Not the dick, the question.
|
|
#
?
Oct 3, 2014 05:05
|
|
|
Pohl posted:I don't get how hard it is to ask someone if they really want you to put your dick in them. How hard is that? Not the dick, the question.
|
|
#
?
Oct 3, 2014 05:17
|
|
|
TheOneAndOnlyT posted:Hell, you don't even need to ask "would you like to have sexual intercourse" like a robot (regardless how much internet nerds seem to think otherwise). If things start heating up with your partner, just ask them what they want to do. I'm pretty sure a woman saying she wants you to gently caress her is affirmative consent. poo poo, anyone that has a problem with this law is questionable. I've never once doubted that my partner was into it. How big of a fuckup does it have to be for you not to know your partner was willing? I don't understand why this law is bad, because holy poo poo, people that want to gently caress you will let you know.
|
|
#
?
Oct 3, 2014 05:43
|
|
|
TheOneAndOnlyT posted:Hell, you don't even need to ask "would you like to have sexual intercourse" like a robot (regardless how much internet nerds seem to think otherwise). If things start heating up with your partner, just ask them what they want to do. I'm pretty sure a woman saying she wants you to gently caress her is affirmative consent. Hell, "do you have any condoms/do you want me to get a condom" is a pretty reasonable question when things get heated (an uncomfortable silence is usually a huge blindingly obvious hint that maybe you should check in with your partner).
|
|
#
?
Oct 3, 2014 07:51
|
|
|
|
| # ? May 11, 2024 14:48 |
|
|
There are a lot of men who think you "wear down" a woman into sex with you. That the initial "no" or "get out of my face" or "I have a boyfriend" is a challenge they must conquer. These men are then frightened by the idea that they might have to actually get stated consent and then she might say no and then "all their work is lost because she changed her mind". Unfortunately, this is also the way romance is portrayed in a ton of media.
|
|
#
?
Oct 3, 2014 16:56
|
|