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Real cost of malpractice not as big as advertised

By | September 8, 2010, 7:26 AM PDT

During the health care reform debate one of the big points made by conservatives was that malpractice costs are a big contributor to health inflation.

Get rid of big jury awards, they said, reduce the fear of defensive medicine, and overall medical costs can fall. One Republican Congressman said malpractice represents 26% of our total medical bill.

(The courtroom illustration is from BNET’s Ken Terry, in a March article urging malpractice reform.)

Turns out he’s off by a factor of 10. A study from mostly Harvard-based researchers for the journal Health Affairs puts the total annual damages at more like $55.6 billion. Not trivial, but more like 2.4% of total medical costs, not 26%.

Moreover, most of that cost was for defensive medicine rather than jury awards, the authors concluded. Some $45.6 billion went to tests and drugs that may not have been necessary, but were probably done to avoid mistakes and lawsuits later on.

That means the actual cost of all the malpractice litigation going on in the U.S. each year is about $10 billion. This is in line with a 2002 study indicating malpractice premiums were 3.2% of the average physicians’ revenues, with rates from 1987-2002 rising at half the rate of other costs.

Trial lawyers trumpeted the report, and the authors said that the biggest savings in the system won’t come from capping awards or eliminating defensive medicine, but from changing the industry’s business model.

While one Republican Senate aid hit upon the size of the defensive medicine bill, $45.6 billion, the report showed malpractice awards total only $5.72 billion and attorneys share in expenses of just $4.13 billion.
In a $2.5 trillion medical system, that’s a rounding error.

Critics may also seek to discredit the report by discrediting its authors:

  • Atul Gawande, a surgeon and New Yorker contributor whose book The Checklist Manifesto urges more procedural support be given experts, who tend to rely too much on on their knowledge and not enough on their understanding.
  • Michelle Mello, a health policy researcher perhaps best known for her support of special “health courts” to replace the current malpractice system.
  • Amitabh Chandra, an economist whose focus is on health care cost drivers and productivity.
  • David Stuttert, an Australian expert on the intersection of the legal and health systems.

You see, since three are from Harvard, one is a foreigner and most of them have foreign-sounding names, they must have a secret liberal bias which makes everything they do or write completely bogus.

That may work, politically, in the short term, but at the cost of diminishing the credibility of all medical and scientific studies, without which no medical progress is possible.

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Dana Blankenhorn

About Dana Blankenhorn

Dana Blankenhorn was a contributing editor for SmartPlanet from 2009 to 2010.

Dana Blankenhorn

Dana Blankenhorn

Contributing Editor, Healthcare

Dana Blankenhorn has written for the Chicago Tribune, Advertising Age's "NetMarketing" supplement and founded the Interactive Age Daily for CMP Media. He holds degrees from Rice and Northwestern universities. He is based in Atlanta.

Follow him on Twitter.

Dana Blankenhorn

Dana Blankenhorn

Dana Blankenhorn has been a technology reporter since 1982, a business reporter since 1978, and a writer for as long as he can remember. His Schwab IRA has a few tech stocks in it, most notably some Intel and Applied Materials bought over 10 years ago. But the vast majority of his tiny fortune (emphasis on the word tiny) is invested in mutual funds. He presently writes for no one else but ZDNet, SmartPlanet and himself. But if you've got an opportunity let him know. If he takes the gig he"ll first add it to this disclosure page.

He writes for SmartPlanet and is not an employee of CBS.

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0 Votes
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RE: Real cost of malpractice not as big as advertised
If we could cut the costs of malpractice and the costs of fraud (insurance or medicare), then there would be some real savings. Several billion dollars would pay for a lot of medical help for a lot of people. Rounding error or not. Or could be used to reduce the deficit in the first place.
Posted by dhays
8th Sep 2010
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dhays
The question is how much. And at what cost.

You want to eliminate all malpractice awards? You put your life at
risk each time you visit a doctor, and with no recourse.

Most malpractice awards are actually pretty low -- barely enough
to cover the cost of the mistake. The number of huge awards is
very small, and related to gross negligence being proven.

The annual deficit is currently about $1.3 trillion, by the way. A
year. All the costs of malpractice litigation and awards comes to
$10 billion. Eliminating the Bush-era tax cuts, by the way, cuts
$300 million from that each year.

Do the math.
Posted by DanaBlankenhorn
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
>> "they must have a secret liberal bias which makes everything they do or write completely bogus.

That may work, politically, in the short term, but at the cost of diminishing the credibility of all medical and scientific studies, without which no medical progress is possible."

I realize that you're being facetious, but global warming folks manipulated data to suit their idealogy... so did some in the media (Dan Rather comes to mind...). It's not like it hasn't been done before.

When you're dealing with "proven science" then manipluating data is no big deal.
Posted by bb_apptix
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
This report is typical of so many grossly biased reports all dressed up as fair reporting. The real cost to the medical consumer is completely left out of the equation, and that is, the expense physicians are forced to pay for malpractice insurance. It is certain that these extravagant premiums are factored into every bill emitting from practically any medical procedure a patient might be involved in, from a simple office call to heart surgery.

Deciding in advance that anyone who might disagree with the various named experts' conclusion is guilty of xenophobia or anti-elete tendencies is a sophomoric tactic to which no reporter with an ounce of pride or honesty would resort. This entire piece is not the statement of malpractice expense it is proported to be, but just another distorted attack upon conservatives. To wit, it is crassly political.

I'll tell you what, Dana, gather the total costs of malpractice, from a to z, without conveniently leaving out as many as necessary to make your baseless point, and you might be more able to look yourself in the mirror.
Posted by iouzero
8th Sep 2010
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Malpractice insurance
I have a friend who is graduating from medical school. How did
he pick what he wanted to focus on?

A balance between the cost of practicing in that area, and the
satisfaction he believes he would get from practicing.

He ruled out being a pediatrician because the cost of malpractice
insurance "were almost as bad as being a surgeon".

I may read the report to see how they account for what I've
always heard as "the cost to practice".
Posted by trent1
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
SO, By your figures and based on the nearly $100,000 that my brother pays in malpractice insurance, he should be making over $3 million a year. He could only wish. His malpractice insurance takes about 1/4 of his gross income which leaves him with about 1/10 th of that $3 million. We could only wish our doctors were only paying 3.2%. All of our bills would be lowered.
Posted by fitobetied
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
Reading the article and the response I believe the true "cost" is the insurance and I'm certain the profits for the insurance companies far out ways the benefits to the doctors or the percentage of costs to the consumer. The current scandals on Wall street are all about corporate greed, and the richest(thereby greediest?)companies in America are the big Insurance companies-banks borrow from them. Perhaps we should really focus on why the Insurance companies can charge the doctors so much.
Posted by DeannaBK
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
You see, since three are from Harvard, one is a foreigner and most of them have foreign-sounding names, they must have a secret liberal bias which makes everything they do or write completely bogus.

I don't understand why you are making this statement. So far, the only conservative response I have seen is this in the Hill Article (http://thehill.com/blogs/healthwatch/health-reform-implementation/117479-trial-lawyers-tout-new-report-on-cost-of-medical-malpractice):

The office of Sen. Charles Grassley (Iowa), senior Republican on the Senate Finance Committee, said Tuesday that "$45.6 billion a year sounds pretty significant."

"We?re not sure why that?s considered a drop in the bucket to the study authors," a Grassley aide said in an email.

That seems like a perfectly fair criticism. Your assertion that the study authors write will be considered "bugus" seems like a cheap attempt to preemptively discredit criticism -- EXACTLY WHAT YOU INSIST WILL HAPPEN TO THEM!

I think your journalism would benefit if you were a little bit more intellectually honesty.
Posted by kokoskmr
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
I'm with the excellent point by fitobetied. My wife had to find a new OB because the 2 female doctors she was using had to drop obstetrics (and now only gynecology) because of the outrageous cost of their liability insurance. The numbers cited from the report make no sense relative to this decision. They completely distorted their practice because of 3.2% of their cost? Here is a guess for you...Doctors who work for hospitals, the government, the military, and other large institutions do not buy malpractice insurance. So add in all of their $0's and you get a much smaller mathematicl impact without even vaguely dealing with the truth.
Posted by robertduncan@...
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
There are several reasons why I don't believe this study, and it has nothing to do with the authors being liberals (or not).
1) I repeatedly hear from doctors (and nurses) that malpractice insurance is driving them out of business.
2) Nowadays NO doctor ANYWHERE will diagnose you over the phone. You ALWAYS must come in for an office visit. So you have to miss work and pay your co-pay, both of which the study authors apparently consider to be inconsequential. Then when you get there, every single thing the doctor asks you during the office visit is information he could have obtained over the phone. WHY are you REQUIRED to come in? Because the malpractice insurance insists on it! There's no other reason.
Posted by dmm99
8th Sep 2010
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I'll be sure to pass this on to my Dr. friends & relatives this weekend...
...as I am sure they'll be amused to hear that the millions that
they've been collectively paying in malpractice insurance over the
last decade has been a but figment of their imaginations.
Posted by JohnMcGrew@...
8th Sep 2010
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Gee, who would've thunk it...
Dana, again, getting caught up in not doing his homework and just presenting the few "facts" which support his position while disregarding what the everyday doctor faces in the real world, as opposed to what some "researchers" would like people to believe.

What next? The economy is in full recovery mode and unemployment is really only about 2% to 3%?
Posted by adornoe@...
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
Why does this publication have a socialist shill on the payroll? Oh wait, I just found the answer. This publication is owned by CBS, so it just echos their liberal views.
Posted by ShortyStuff
8th Sep 2010
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fitobetied, robertduncan@...
The study did not state that malpractice costs represented 2.5% of
doctors' pay. It stated it represented 2.5% of the total cost of health
care, which includes many other things other than the doctor's fee.
Posted by DanaBlankenhorn
8th Sep 2010
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kokoskmr
The criticism is unfair because, while $45.6 b is a big number, it's
taken out of a total budget of roughly $2.5 t. And remember,
that's all the medicine practiced under the guise of avoiding the
actual $10 b cost of malpractice, which is roughly split between
plaintiffs and the legal system.

You will also note that one of the authors of the study has written
in favor of "health courts," which are aimed at avoiding the courts
in the determination of malpractice claims and, thus, reducing
those costs. In other words, she's a critic of malpractice costs and
premiums.

Is calling attention to a number that's 2% of a total and saying
"that's huge" unfair? Yes, I think on balance it is.
Posted by DanaBlankenhorn
8th Sep 2010
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JohnMcGrew@...
Millions.
Billions
Trillions.

Notice something about those terms? A billion is 1,000 million. A
trillion is 1,000 million.

You complain about "millions" paid in malpractice fees in a system
that consumes trillions.

Again, you may not believe it, but this is not a political point.
Trillions are a million times bigger than millions. A million. That's
1,000,000 times bigger.
Posted by DanaBlankenhorn
8th Sep 2010
0 Votes
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dhays
The question is, where are the big savings? If you're going to
solve any problem in a business system, you first ask yourself
where the big savings lie.

Chronic conditions. The business model of "fee for service."

If people just did what smart car buyers did -- pay for the regular
maintenance as a cost of owning the car -- we could save
hundreds of billions of dollars. A lot more than we could save by
even eliminating the malpractice system and giving doctors a
license to kill without penalty.
Posted by DanaBlankenhorn
8th Sep 2010
0 Votes
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ShortyStuff
This is something like the response I expected, which is why the
article appears so snarky. (I apologize for the tone.)

Bring back Millard Fillmore. (Even better, Bill the Butcher for
President. That's a "Gangs of New York" reference for those who
don't know.)
Posted by DanaBlankenhorn
8th Sep 2010
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DanaBlankenhorn
Why are you dodging the comments regarding the side-effects of the malpractice suits ... the high cost of malpractice insurance? Respond to iouzero, fitobetied, DeannaBK, robertduncan, and others who rightfully bring up this subject, and why you and the so-called "experts" so thoughtfully leave it out of the equation.
Posted by ShortyStuff
8th Sep 2010
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iouzero: here's a fact check from FL
Of all 7 doctors I have seen in the last 12 months, not one carries malpractice insurance. That includes two surgeons and 3 specialists. Note one. Nationally, I believe the published statistic of doctors who refuse to carry that insurance in states where this practice is allowed (by self bond or other means) is ~ 3/4 of all doctors.

Heck-- even my kids pediatrician doesn't carry it. What does that say?
Posted by kckn4fun
8th Sep 2010
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RE: Real cost of malpractice not as big as advertised
And so we have it. People so committed to a truism that they don't bother to read. Of don't bother to distinguish between individual & systemic. Whaddaya gonna do.
Posted by hoodedswan
8th Sep 2010
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Dana, that's "millions"...
...paid by just a handful doctors that I personally know. Multiply that
by, um, how many doctors are there in America? Half-a-million?

All of a sudden we are talking about billions.

But thanks for playing.
Posted by JohnMcGrew@...
9th Sep 2010
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Malpractice insurance vs. the cost of malpractice
Malpractice represents 2.5% of total health costs, not 2.5% of
doctor salaries.

Many doctors are able to "go naked" and avoid the cost of
insurance. Just be sure you bank that money, doc, because you
just went into the insurance business. Might I suggest an "excess
and overage" policy to take care of levels of coverage your
accrued savings can't meet?

Here's a little known fact. Insurers can layer coverage. The first
dollar costs a lot more than the 10 millionth. So if you put the
reported cost of your insurance into the bank, and add to it each
year, you've got the capital to take care of low-level costs and
can then seek coverage for higher-level costs that will be priced
more reasonably.

You say you put that money into your kids' tuition, and you just
got sued?

Sorry, doc.
Posted by DanaBlankenhorn
9th Sep 2010
0 Votes
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RE: Real cost of malpractice not as big as advertised
Other than Blankenhorn, the rest of the blog is still worth reading. Let's hope it doesn't get infected with the same type of political blathering and statistical manipulation. Dana, you seriously need to read more dystopic literature and question your faith in an all-controlling government. If you expected those kinds kinds of responses that you referred to, then you probably had some level of awareness of your projected bias, and therefore, had a responsibility (which you shirked) to do your best to trim that.
Posted by nick777
9th Sep 2010
0 Votes
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Yeah, "going naked" is the answer.
Perhaps that might be a good idea for a doctor with zero attachable
assets and $100k in student loan debt. But few of the doctors I
know got into medicine to be "in the insurance business" or to be
poor.

I'd love to see you deliver that line in a room full of doctors.
Posted by JohnMcGrew@...
9th Sep 2010
0 Votes
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JohnMcGrew@...
What I wrote was a warning against "going naked" for new doctors,
and an explanation of what it would really take for older doctors.
Posted by DanaBlankenhorn
10th Sep 2010
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nick777
I have no problem with whatever you think about me.

But do you know when you waste so much of your time with
personal attacks on my integrity you're making money for me?

If you think I'm Keith Olbermann, in other words, why are you
watching me? O'Reilly's on. Watch him.

That's the way a free market works. I don't get to decide how
others view my work. They're free to read or watch what they
want. But marketers can't tell the difference between viewers who
are fans and those just giving themselves agita. They look at
numbers.

And you're making my numbers look very good.
Posted by DanaBlankenhorn
10th Sep 2010
0 Votes
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RE: Real cost of malpractice not as big as advertised
DanaBlankenhorn,

Apparently, some folks have strong opinions about the economics of medical malpractice and don't want to be confused by facts.
Posted by rwalker1x
11th Sep 2010
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rwalker1x: It's apparently you that is confused by the facts.
Apparently, some folks have strong opinions about the economics of medical malpractice and don't want to be confused by facts.

The facts, as presented by Dana and other supporters of "Obamacare" are just mostly opinions and ideologically motivated support for government intervention into the free-market system.

The fact remains that the majority of people detest any government intervention into healthcare and that same majority want's the bill repealed. Those are FACTS! Those are facts easily verifiable every day. Dana's ideology and opinions are not facts.

So, you don't even mention what Dana's facts are, All you're doing is being agreeable to Dana's versions of "facts". Do you have any real facts of your own, or are you just a follower that can't do any of his own thinking?

Do you follow the news at all? If you did, you'd find out what the real facts are.
Posted by adornoe@...
11th Sep 2010
0 Votes
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rwalker1x
Every crisis takes its own course, and the direction is usually
unrelated to the nature of the crisis.

In the case of our current crisis, it's lately gone into pure Fillmore-
ite Know-Nothingism. http://en.wikipedia.org/wiki/Know_Nothing
That's the right of advocates, to argue in any way they wish.

But extremism in the defense of liberty is a vice for with extremism
there can be no liberty. Moderation in the pursuit of justice is a
virtue because without moderation there is no justice.

Americans will eventually recognize the wisdom of this. The silent
majority is currently being drowned out by the crazy. I suspect the
crazy is creating its own backlash. But we'll see.
Posted by DanaBlankenhorn
13th Sep 2010
0 Votes
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Dana: you're absolutely right!
The silent majority is currently being drowned out by the crazy.

You have a point there, and, that silent majority has become very aware of the problems created by the loud majority and it's big government leadership, namely the democrats, and that same silent minority is beginning to get the upper-hand and the loud majority will get it's leadership kicked out of control this coming November.

The crazies, aka-the democrats, had control for too long and the silent majority is re-claiming it's country. Hopefully the new incoming leadership won't make the same mistakes that the democrats did with their big government policies which have virtually destroyed this country. If the same mistakes continue to be made, then the sane people in society, including the "tea partiers" (I bet that's making your head spin), will just continue removing that leadership each time around until we arrive at responsible government that is "by the people, of the people, and for the people".
Posted by adornoe@...
13th Sep 2010
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adornoe@...
That's what elections are about. And you're entitled to your own
opinion. But not your own facts. Republicans have run the
government for most of the last 40 years -- and their assumptions
about policy have shaped this country.

I believe those assumptions drove us into the ditch. Assumptions
about foreign policy. Assumptions about social policy.
Assumptions about economic policy. But most important,
assumptions about the intent of political adversaries, which your
posts have brought to the fore.

If you can't accept political opposition as honest and well-
meaning, then you really should not live in a democratic society.
Democrats accepted Bush as President, as much as many
disliked it. So grit your teeth and bear it. Or go elsewhere. Those
are the choices America gives us -- loyalty to the Constitution is
the only real obligation of citizenship.
Posted by DanaBlankenhorn
16th Sep 2010
0 Votes
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Dana: you're completely wrong, and as usual, very delusional...
That's what elections are about.

Oh, wow! I had no idea.

You must have read that somewhere and now you're doing us a favor by sharing it with us. I'll have to write that somewhere so I won't forget. wink

And you're entitled to your own opinion.

Oh my, another gem from the guru of liberty. I had never heard that one before either. Thanks a bunch!

But not your own facts.

That's true.

But, the one creating his own facts in this and every other post is YOU.

I use the facts, and you can't dispute the facts. But, you apparently keep coming up with your own facts. Like in this whole post of yours. How hypocritical of you!

Republicans have run the government for most of the last 40 years

That's total, unadulterated garbage, In other words, A TOTAL LIE!!!

While it may be true that people with "Rs" next to their names have been in the presidency more than the "Ds", the fact is that, democrats have controlled congress a lot more than republicans in the last 40 years and even more in the in the last 100 years.

Take a look at the last 65 years:

http://uspolitics.about.com/od/usgovernment/l/bl_party_division_2.htm

The democrats had control of the house, since 1970 (40 years), for 29 of those years, while republicans only had control for 12 years.

When it comes to the senate, republicans had "control" for 24 of those years and democrats had 16.

But, as we all know, spending is decided for the federal government by members of congress. The president can suggest spending programs, and the administration will administer a lot of the spending that's approved by congress and voted on by the president. But, democrats had control of the spending strings for most of those years, even with republican presidents on board.

And then, when you consider the presidency, yeah, republicans with "Rs" nest to their names had the presidency for 28 of those 40 years, and democrats had 12.

But, when one considers how the presidents performed as far as suggesting and voting for spending, the democrats have an edge because both Bushes were very socialistic when it came to big government spending. So, if you take both Bushes and add them to the big government side (the progressive big spenders), you end up with socialists, aka, the democrats and RINO presidents, tipping the balance towards democrat control and high government spending. Thus, if you add those 12 Bush years to democrat presidency years, you end up with "progressives" in control more than conservatives, with democrats/progressives leading with 26, and conservatives trailing with 14. Remember that it's not the label that counts; it's how they vote and how they behave while in congress or in the presidency, that counts. So, though you may think that Bush was the "enemy", he was actually, when it comes to spending and social programs, one of you. That applies to both Bushes. Remember the first Bush's blunder with his "read my lips, no new taxes"? He turned right around and voted for higher taxes right after that. That sounds like a democrat to me; but, he had an "R" with his name to label him as a republicans, but to me, that "R" just meant "RINO" (republican in name only).

-- and their assumptions about policy have shaped this country.

It is the progressive policies which have harmed this country, whether those policies came from democrats or republicans. But, most big government programs came from democrats, and mostly from FDR and Lyndon Johnson, and Clinton, and Carter, and now Obama. The biggest spending program from republicans came under the last George Bush, with his Medicare Part D program.

I believe those assumptions drove us into the ditch.

You are falsely attributing policies to names only, and to congressional/presidential terms only. You have to examine the actions in relation to what it did to the country, and if you were to be honest about it, you'd admit that it was progressive and socialist programs that put us into the ditch. Think outside strict party lines and outside labels, and you''ll come up with a clearer truth.

Assumptions about foreign policy.

You're talking generically here. And, when it comes generic thinking, one can get away with making all kinds of silly statements.

So, tell me, have the democrats made any assumptions in regards to foreign policy? Or is it just a republican "problem"?.

When it comes to foreign policy, one has to remember that a strong foreign policy, coupled with a strong military, is what's kept the U.S. secure and strong the world over. That kind of policy came from republicans. So, even generically speaking, republicans have done the right thing in foreign policy to keep us safe and strong, while the democrats are always perceived as weak. Prime exhibit: Obama and his apology tours and his continued weakness when dealing with foreign threats, such as Iran and North Korea, and even China and Russia lately. Somewhere along the way, in the future, we'll have to pay a high price for the democrats' weaknesses again.

Assumptions about social policy.

You love social policy, don't you?

But, it's the big government social programs which have devastated what used to be the strongest economy the world had ever seen. So, Dana, old buddy, you're wrong again!

Assumptions about economic policy.

You love that word assumption. But, you're full of wrong assumptions.

Economic policy, that is driven by "do good and feel good" social programs is what's devastated the economy. So, when it comes to economic policy, even a lot of democrats are beginning to come around to understanding how the stupid social programs have killed the country and it's economy.

But, most importantly, even the majority of people have come to realize that the biggest harm to the economy has been government intrusion into the free-market, with high taxes to support big social programs, and heavy regulations that harm the free-market system.

That's why so many people are angry and are ready to throw out the bums. Too bad the biggest bum of all has to be tolerated for 2 more years.

So, Dana, old buddy, you're wrong once again!

But most important, assumptions about the intent of political adversaries, which your posts have brought to the fore.

There are no assumptions about the intent of the political adversaries. Especially when those adversaries state very clearly what their intentions are when they reach government, and when they propose any bills in congress.

What's the matter? Aren't you paying attention.

Are you somewhat under the same kind of "trust us" type of government that Nancy Pelosi advocates? Remember her statement regarding support for the healthcare bill where she said: "You'll have to vote for the bill in order to find out what's in it after it's passed". So, it sounds like you want "intents" to be left up to guesswork by the voters. In that case, the voters will have to vote in a politician and then find out what the politician/representative's "real intents are" after he gets to congress. What a concept! "What a maroon!".

If you can't accept political opposition as honest and well-
meaning,

I can, but not from democrats! Honesty is not in their dictionary and neither is it in yours.

And "well-meaning" has ruined the country with so many big and wasteful and damaging government programs.

Try replacing "well-meaning" with "ruinous and wasteful and not well-thought-out", and you'd arrive at the real truth.

then you really should not live in a democratic society.

You are so blind that you aren't capable of realizing that it is YOU that can't see that, it is the democrats that are trying to take away our freedoms and "representative" government, oftentimes by telling us that "it's for the good of the people, or the country, or the children". Haven't you ever heard, or realized, that, the bigger government gets, the more freedoms we lose? That is the way it always works and that is an undeniable fact. And it's something that you have a hard time understanding.

Democrats accepted Bush as President,

Hell no, they didn't!

Democrats tried to steal Bush's election from the beginning, and they spent a month doing it. And then they kept going by trying to do recounts after Bush had been sworn in.. And, after he was inaugurated and long after that, they continued calling him an "illegitimate president". They kept trying to knock him down for the whole eight years. Heck, even you tried back then and even now, to knock him out as being illegitimate or out of touch. So, you have been caught in another huge lie, once again.

The historical record about what the democrats did to Bush is on paper and on many hard drives all over the world. So, your attempt to re-write history is not going to work at all.

Hey, Dana, old buddy, we're not dummies out here. But, you should check your memory banks because they're either failing you or are scrambling your recollection.

as much as many disliked it.

And, many still dislike the idea that Bush was president, and that includes you, who never misses the chance to denigrate anything and everything he ever did.

The thing that you never realized is that, Bush was really more like one of you than one of us. Hate and obfuscation can oftentimes prevent you from seeing straight.

So grit your teeth and bear it.

That's a very stupid way to operate.

No one should ever be counseled to "grit and bear it" if they are in huge disagreement with what's happening around them.

So, according to you, if the president and congress, suddenly decide that, "for the good of the country", that all industries will be nationalized, that we should just "grit and bear it"? If the president suddenly decides that, taxes will be raised to 90%, for individuals and businesses, should we just "grit and bear it'? That is so stupid on so many levels that's it's not even worth responding to it. You would be so at home in Cuba or Venezuela or North Korea, or the old USSR. You really sound very ignorant that it's become so sad, with all due respect.

Or go elsewhere.

Sorry! But...

I'm not going anywhere.

We, that's me and all the "tea partiers" and as many conservatives and libertarians as possible, and all of those that believe in our constitution and our freedoms, are the ones who are going to start taking back our country in November.

It is you that should start looking for a place more suitable to your ideology and politics. It is your ideas and that of the democrats that are foreign to what this country was meant to be. So, it is you that is intrusive and unwelcome in this country. It is you and those like you that don't belong here.

Those are the choices America gives us -- loyalty to the Constitution is the only real obligation of citizenship.

What a bunch of hogwash!

You and the democrats have not been loyal to the constitution. You and your party, with its ideology and its huge spending, and its many social programs, and the many liberal laws and regulations, have made this country virtually unrecognizable in comparison to what it used to be or was intended to be. In fact, it's your ideology that has made Krutschev's warning to America become almost reality. He said "we will bury you", but you and the democrats didn't need Krutschev to do the work for you because you've turned this country into a virtual socialist country, like the old USSR used to be. You've virtually destroyed the best country that ever was.

Your so-called opposition, me included, are the ones trying to make the constitution relevant again. It is your party that has continually contemptuously referred to the constitution as being unfair, and that they will either make it irrelevant or change it. Are you living in a cave somewhere where you can't receive the news or the useful information? Have you been following the news at all?

You live in an alternate reality world. I keep comparing your thinking process to that of the Taliban, who believe that they are the ones who know how life should be, and that they have the guiding hand of God on their side. But, their minds are so far gone that it's virtually impossible to deprogram them from their ways and their ideology.

So, because you are so far gone from reality, the only thing the American people can do is to defeat your side at the ballot box and hope that you are boxed-in and away from normal society and normal thinking.

And, hey, the bottom line is that, your "facts" are not real facts, and you only have wishes and/or lies backing up your posts.

BTW, did you notice how I backed up my "facts" with links to the information, or with facts which can easily be looked up? That's a hint to you, by the way.

All that you had was mostly talking points and attacks and derisive but untrue statements.
Posted by adornoe@...
17th Sep 2010
0 Votes
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adornoe@...
Hope you enjoyed your rant.

To return to the subject. All malpractice costs, including defensive medicine excused by fears of malpractice claims, comes to 2.5% of total health care spending. Of that total, 60% represents defensive medicine, 20% is what victims get, and 20% is what lawyers get. (That's .6% of medical costs going to victims, .6% going to lawyers, and 1.3% going to defensive medicine.)

In other words, malpractice costs don't explain medical inflation. There are other explanations for medical inflation.

Professional researchers, people who examine these questions academically, without an agenda (unlike, say, you) say the lack of diagnosis of chronic conditions, and the failure to do anything about incipient chronic conditions, are one big cause of medical inflation.

You don't have an answer for that. Never did. Never tried to. Just told those victims to go die in a corner somewhere.

Get past the political. That attitude is inhumane in the extreme. It's the way Michael Vick treated dogs. You treat poor people the way Michael Vick treated animals.

I won't accept that. I know we can do better. I know because every other western country does better. That is, they spend much less than we do, get better results, their citizens live longer.

Those are the facts at issue here. All you've offered, all you've ever offered, is polemics. And while you can fool some of the people all the time with polemics (like JohnMcGrew) and all of the people some of the time (like Sarah Palin does) you can't fool all of the people all of the time.

Eventually facts will out. It took 45 years of Cold War for facts to win out against Soviet Communism. I suspect it will take less with you, because in our time all those who want facts have access to facts.
Posted by DanaBlankenhorn
18th Sep 2010
0 Votes
+ -
Dana: no matter how much spinning and lying you do, you're still
Hope you enjoyed your rant.

Yeah, I sure did. You're always a joy to do battle against.

How about you? I?ll bet you were fuming.

But, rants are most enjoyable when I?m speaking the truth while destroying your arguments at the same time.

I?ll bet you weren?t expecting for someone to actually call you out on all of your misrepresentations, and your untruths, and your lies.

You might want to call it a ?rant?; I call it a thorough whipping against your bias and lies.

To return to the subject.

So, when you find yourself at a loss for words, you want to restart the conversation?

All malpractice costs, including defensive medicine excused by fears of malpractice claims, comes to 2.5% of total health care spending.

Statistics and polls. One has to choose to go with what might seem expedient at the moment when all else is fails.

Look, the statistics that most matter lately about government controlled healthcare, aka: Obamacare, is that, the majority of the people are against it, and they were against it all along, and they will continue being against it. Heck, even some democrats who voted for Obamacare, are now running scared and talking about repealing Obamacare in the next congress; and the rest of the democrats that voted for Obamacare who are not mentioning "repeal", are running so scared that they dare not mention their votes nor the bill on the campaign trail for the November election.

So, why aren?t you talking about ?that reality?? Oh, yeah, could it be that it wouldn?t be politically expedient to tell the truth?

Of that total, 60% represents defensive medicine, 20% is what victims get, and 20% is what lawyers get. (That's .6% of medical costs going to victims, .6% going to lawyers, and 1.3% going to defensive medicine.)

So, why aren?t you talking about the many negatives about government healthcare, aka: Obamacare? I?ll bet that you will never mention the negatives, will you? How about, it will make getting healthcare more expensive, and companies will drop people from their company paid plans, and people will be mandated by government, for the first time in history, to purchase a service or product. How about, as a result of companies having their expenses going up because of mandated healthcare and higher premiums, that unemployment will rise as a result of many companies having to lay off people in order to make up the difference.

In other words, malpractice costs don't explain medical inflation. There are other explanations for medical inflation.

Ok then, why aren?t you talking about those other inflationary items? Why aren?t you talking about how the democrats always block any proposals for across state lines competition for the purchase of healthcare plans? Why aren?t you talking about the very high cost of regulations from government for a lot of the services provided by healthcare providers?

Professional researchers, people who examine these questions academically without an agenda

You must be one of the most na?ve people in the world.

Everybody has an agenda, including many researchers and academics involved in healthcare, especially a lot of people who depend upon government grants for research and/or their government jobs.

(unlike, say, you)

I never claimed to be unbiased.

I have, however, said that I would prefer for people to make their decisions outside of party lines and outside their ideologies. I still believe in that.

On the other side, you are the most biased and unbending posters that I?ve ever had the displeasure of having a discussion with.

say the lack of diagnosis of chronic conditions, and the failure to do anything about incipient chronic conditions, are one big cause of medical inflation.

Yeah, right!!! That?s just more of your na?ve mentality.

The lack of diagnosis and treatment of chronic conditions is not necessarily the reason for the high cost of healthcare or malpractice insurance. Wasteful and redundant spending, like using many specialists and performing a lot of clinical but unnecessary examinations, and the cost of government regulations, have a lot to do with a lot of the high cost of healthcare and malpractice insurance.

Doctors wouldn?t bring up the cost of healthcare if they, for example, didn?t have to refer people to ?specialists? for further diagnosis and treatments. A lot of that extra work is done for defensive purposes by doctors fearing malpractice lawsuits.

So, it?s not just the cost of malpractice insurance that matters. It?s the associated cost of the extras that doctors have to perform, that bring up the cost of healthcare. Without the threats of malpractice lawsuits, perhaps malpractice insurance could?ve been lower, but the associated costs of the ?additional tests and treatments?, also brought up the high cost of healthcare. Without those additional demands brought into existence from the fear of lawsuits, healthcare and even malpractice insurance costs could?ve been kept much lower.

You don't have an answer for that. Never did. Never tried to.

You only see what you want to see. That makes you more blind than anyone who has ever lost complete vision in both eyes.

Just told those victims to go die in a corner somewhere.

That?s so plainly stupid.

What is it with people like you? Do you think that making such remarkably asinine statements is in any way going to win you the argument?

You?re not even being original.

You?re just copying from one of your radical lefties in congress who this year uttered one of the stupidest statements ever heard in congress. So, is Alan Grayson a hero of yours? 'Don't get sick, and if you do get sick, die quickly.'" So, how much more stupid can you get?

Get past the political.

Try to follow your own advice and perhaps you?d then get beyond your asinine ideology which believes that big government is best for the country and the people. Supporting government healthcare is mostly a political move by democrats, but, you?re too blind and ignorant to realize that.

That attitude is inhumane in the extreme. It's the way Michael Vick treated dogs. You treat poor people the way Michael Vick treated animals.

It is the attitude of people like you that has caused so much damage to the country and its people. While some people believe that government handouts and government control of everything is the way to go, the real effect is that, more people become dependent and will never get a career or a regular job, more people become poor, more people end up homeless, more people end up with no hope at all. That's where you and the democrats don't realize that you're the ones treating people like "dogs". My dog and my three cats are dependent on me for everything. You and the democrats want to treat people the way I treat my pets, although my pets will have a much better life than the who become dependent upon government. Did you notice that this year, more people are in the poverty ranks than in the last 50-60 years? That's what relying on government results in.


More big government, in the form of government controlled healthcare, would cause more people to die than the current system we have. But, you?re incapable of doing any kind of analysis as to why that would be. At best, you?re just a surface thinker who can?t go deep into analysis of the issues. Your thinking is done with that big muscle in the center of your chest. No thinking can be possible from there. Good intentions don't bring people out of poverty and don't create healthy human beings.

I won't accept that. I know we can do better.

We can?t do any better at all if we keep heading in the direction in which you and the democrats think we should go. In fact, it?s that same kind of direction which has led this country astray for the last 80+ years.

More of the same is just pure insanity.

I know because every other western country does better.
What planet are you on? Would that be the planet of the blind and the brainless?

That is, they spend much less than we do, get better results, their citizens live longer.

Yet, all of those countries depend upon the U.S for a lot of their defense and for a lot of those services which you claim cost their citizens less. Whenever the U.S. subsidizes any of those countries, in any way, with costs or with our research or with our products or our services, their costs will be less than for us in the U.S. A lot of those countries might have lowered costs of many services, but at our expense. Meanwhile, try to compare apples against apples next time.

One more thing that you and a lot of other people always forget to do is to compare the size of our country against the size of those other countries. It is a lot easier to administer and hold down costs in a much smaller country that is also less complex. You cannot compare what happens in a country like Finland against what happens in a much bigger country like ours. Finland?s population, as an example, is about the size of one of our cities, thus, a lot easier to manage.

Those are the facts at issue here.

All that you presented is your version of the facts, which ends up being mostly spin on the real situations.

All you've offered, all you've ever offered, is polemics.

You got that partially right.

I do offer the opposite arguments to your spin and lies. Lies and spin are not facts, and they should not be allowed to go unanswered.
However, I do also offer the real facts, which you refuse to acknowledge because they would be detrimental to your ideological nonsense.

And while you can fool some of the people all the time with polemics (like JohnMcGrew) and all of the people some of the time (like Sarah Palin does) you can't fool all of the people all of the time.

The only fool in any of these discussions is one by the name of ?Dana?.

Where it matters the most, is with the ?real people?. You don?t have the real people in mind when you talk about ?people?. You?re talking about people like you, and about the most clueless in society who are swayed and easily lied to.

You are losing the argument, and you will take a big whipping come November from the voters, aka: the real people. Those voters have opened up their eyes and they can see through your lies and spin, which is the same as that of the democratic party.

Eventually facts will out.

The facts are, indeed, coming out. And the real facts are being heard. Your lies have never equated to the truth. That?s why the people are now realizing that they?ve been duped, and are now getting ready to throw the liars and the bums out.

It took 45 years of Cold War for facts to win out against Soviet Communism.

You really are very ignorant.

The cold war was a series of events involving threats and diplomacy which did, indeed last some 40+ years.

But, if it were up to the democrats, the cold war would?ve been lost a long time ago by the U.S. and in favor of the USSR. In fact, for many years, there were many progressives and democrats who wanted to be like the USSR. And those people are still with us, and they call themselves progressives and socialists, and democrats and liberals. The politics and ideology they practice is very close to what defined the old USSR, namely, big government control over the economy and the people. You are one of them, but, you're too far into the ideology to even realize how you're part of the problem.

You are not smart enough to realize how similar ?YOUR? party is to the old USSR. And, don?t give me that garbage about you not being ideological. You support exactly the same views as the progressives in every one of their issues. You may want to deny it, but like they say: ?if it sounds like a duck, and walks like a duck, and walks like a duck, then by golly, it is a duck!?. You are a duck, aka, a progressive democrat that for all intents and purposes, is very much a communist. You can?t fool me and you?re not fooling anybody else.

I suspect it will take less with you, because in our time all those who want facts have access to facts.

You are like the person who can?t see the forest for the trees.

You are also like the liberals who live in their liberal enclaves all over the country, and have never met the real opposite side. You are the kind that talks about never having met a republican voter, but that's because there aren?t any around you. If they don?t exist in your neck of the woods, then they?re not real. It?s the same with your ideology. If you?ve never thought like the opposition, you?ll never understand why they are so adamant that they?re the ones that are right and you are wrong.

Unlike you, I have been on both sides of the arguments. In fact, I?ve been on many different sides of the argument, not just the two. So, I very well understand your side of the arguments, and I also very well understand all the ?other sides? of the arguments. You haven?t grown beyond what you grew up with. I was brought up a liberal, in very liberal grounds up in Manhattan, and the Bronx, and Harlem, and Brooklyn. Yet, after examining what was all around me, including the neighborhoods and what was causing the poverty and the people to continue voting for ever larger government intrusion into their lives, I realized that, what was wrong was the politics that was buying votes through the promises of taking care of people through government largess, and not really through improving people?s lives through their own hard work and own initiatives. The democrats were and still are about making sure that the people become dependent upon government for everything in their lives. The democratic party would be the beneficiary of people becoming ever more dependent upon government.

Government controlled healthcare is nothing but the latest prize to be captured by democrats, which will further make people more dependent on government to provide for them. That?s the agenda, and that?s what you are defending. If you understand the agenda and support it, then you are a very big part of the problem
.
Statistics are not the problem, nor is understanding them part of the solution.

It doesn?t even matter if healthcare was 100% free, and didn?t cost a dime to anybody or any company or any government. But, government is very inefficient, and very wasteful, and when they get involved in anything, costs always go up, no matter how much spinning is done, or how many lies are told.

The big picture, which includes healthcare, and the totality of all government controlled social services, is the problem. Therefore, I will never give an inch.

What is needed is for the country to get back to the constitution, and to enforcing our bill of rights. Under the constitution, a lot of what government has undertaken in the last 100 years is illegal.

Healthcare is illegal through its mandate that everybody has to purchase health insurance, under penalty of law if they don?t.

So, Dana, old buddy, it is you again, who is on the wrong side of what America really is about. You, more rightfully than me, belong in that communist heaven that you accuse me of wanting. But you are too blind and too committed to your ideology to even begin to realize the problems with your way of thinking.

Regarding the high cost of malpractice insurance, here?s a more honest article about the real costs:

http://blogs.reuters.com/great-debate/2009/08/06/reduce-the-high-cost-of-medical-malpractice/

Here?s parts of it:

The next time you take your child to a doctor, scrutinize carefully the doctor?s bill.? What it won?t tell you is that an average of 10 cents out of every dollar you pay goes to the malpractice insurance doctors must have to protect themselves in case a patient sues them.

Malpractice premiums cost some doctors many tens of thousands of dollars a year, not because an individual doctor has a history of making mistakes, but because in some states juries make excessively generous awards knowing that insurance companies pay.

Medical specialties with the highest premiums include obstetrics and neurosurgery.? Malpractice insurance premiums for obstetricians range from $200,000 per year in high-cost states to $20,000 annually in low-cost states.? Resolving a suit takes at least three years, taking physicians? time away from the practice of medicine.

According to Towers Perrin, a global professional services firm, malpractice litigation costs $30 billion a year , and, since 1975, direct costs of litigation avoidance have grown at more than 10 percent annually.

But that?s less than half the story. To avoid being sued, doctors view patients with two sets of eyes.? One set is the caring, compassionate, medical professional.? The other set is a defensive strategist, looking at an individual who tomorrow may call a lawyer to sue. ? And, to be fair, sometimes doctors make avoidable, even negligent mistakes and injured patients are entitled to be compensated for their losses, and perhaps for some pain and suffering.

The defensive strategist dominates medical practice today.? Doctors use excessive tests and other procedures to avoid lawsuits, and stay out of certain areas of medicine?most notably obstetrics.? The net result is higher costs for medical care.

There?s a comment below the article worth quoting and which points to the unmentioned problems:

Sounds like everyone is confusing costs. Doctors are generally constrained in charges by insurance company?s price schedules which are calculated as a percentage of Medicare fees. Malpractice fees are indeed high but are not directly able to be passed on to patients but are part of business overhead for doctors. The cost of malpractice insurance may only be $10 billion but that doesn?t take into account unneeded testing such as bloodwork, MRI,PET scan, CT that has resulted in ?intensity creep? across the entire medical landscape. Ask your friends who have gone to the ER for a headache or abdominal pain and probably 95% had a CT. These are only a few categories of cost that will continue to increase unabated without some different malpractice approach.
Posted by adornoe@...
19th Sep 2010
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