Socialized Medicine

[emily47017]

The fundamental difference is that HSAs are a use-it-or-lose-it proposition. MSAs allow you to roll over savings into your IRA.

if you read the fact sheet you would learn…

Unused funds (less the significant set-up, transaction, and management fees) roll over from year to year. At retirement, an individual can cash out an HSA by paying taxes on it.

and:

Health savings accounts purportedly solve this problem by forcing consumers to purchase health services “with their own money.” When patients pay for care out of private accounts, the theory goes, they will cut back on “frivolous” health services and demand price competition from doctors, hospitals, and other providers, thereby lowering costs. Both parts of the theory behind HSAs have proven false (1, 2).

You keep using things like this – and pretending that this is what I’m recommending. You did that when you said that “caps” on lawsuit awads wouldn’t affect costs – ignoring the fact that I never proposed “caps.”

vern, honey, you keep using things like this to pretend that i’m pretending. i already told you: the point of the malpractice article is to show that malpractice premiums are not as simple as one might think. have you read the article yet?

 

[vern_humphrey]

if you read the fact sheet you would learn…

and:

Different arrticle and different concept – note that this version of the HSA does not roll over into the IRA until retirement. Which puts last year’s savings at risk this year.

vern, honey, you keep using things like this to pretend that i’m pretending. i already told you: the point of the malpractice article is to show that malpractice premiums are not as simple as one might think. have you read the article yet?

Yep – and it didn’t discuss the points I raised.

Now lawyers can make any sophistic argument they like – but there are some $20 billion a year being syphoned out due to junk lawsuits – and insurance is paying for it.

Of course both sides in such cases want secrecy agreements – so it is easy to conceal how much junk lawsuits cost.

 

[emily47017]

Different arrticle and different concept – note that this version of the HSA does not roll over into the IRA until retirement. Which puts last year’s savings at risk this year.

same article – though perhaps you hadn’t noticed that i had linked to two articles in the same post.

“at risk” as in “can be used for health care in subsequent years”? “at risk” as in “being saved”? Your MSAs are the same bad policy by another name, and they smell just as rank.

Now lawyers can make any sophistic argument they like –

has thorough analysis of a complicated situation suddenly become sophistry? and actually the argument was being made by physicians, who had criticisms for all sides of the issue – lawyers, doctors, and patients.

i’m going to go change the strings on my harp and see if that doesn’t take some of the froth off my frustration. :hypno:

 

[vern_humphrey]

same article – though perhaps you hadn’t noticed that i had linked to two articles in the same post.

“at risk” as in “can be used for health care in subsequent years”? “at risk” as in “being saved”? Your MSAs are the same bad policy by another name, and they smell just as rank.

I thinnk you’re smelling your biased articles.

has thorough analysis of a complicated situation suddenly become sophistry? and actually the argument was being made by physicians, who had criticisms for all sides of the issue – lawyers, doctors, and patients.

Indeed it has – because it ignore some critical points. One of those is that certain specialties (obstetretics, for example) are being driven out of existance by high malpractice premiums. Now all the conditions for obstetritians are the same as for all other specialties – so why the difference?

i’m going to go change the strings on my harp and see if that doesn’t take some of the froth off my frustration. :hypno:

If you want to learn to play the harp, you won’t learn from biased sources.

 

[boppaid]

Thanks for answering, Vern. The trouble I’m having is that a lot of people I know who wouuld need some type of health care do not have an extra $20-$50 a month to contribute. How would they be covered?

There are some, I know, who need health care, who could afford a larger amount than that…about $100 a month. Would this work on your plan?

 

[vern_humphrey]

Thanks for answering, Vern. The trouble I’m having is that a lot of people I know who wouuld need some type of health care do not have an extra $20-$50 a month to contribute. How would they be covered?

There are some, I know, who need health care, who could afford a larger amount than that…about $100 a month. Would this work on your plan?

Any amount would work – since the amount you saved would be backed by a guarentee for the full amount. Your tax return would be the basis for calculating how much you had to save.

But economics is all about choices – when people say, “I can’t afford to pay $20 a month” many times what they really mean is “I choose to spend that $20 differently.”

 

[boppaid]

If any amount would work, then I can’t seem to find anything wrong with it… .

 

[vern_humphrey]

If any amount would work, then I can’t seem to find anything wrong with it… .

Of course, the amount is not determined by the individual – I can’t say, “I make $X millions of dollars a year, but I choose to put only $20 into my MSA. You make up the rest.” It’s based on a scale that applies to everyone, and the basic data comes from your income tax return.

 

[boppaid]

Of course, the amount is not determined by the individual – I can’t say, “I make $X millions of dollars a year, but I choose to put only $20 into my MSA. You make up the rest.” It’s based on a scale that applies to everyone, and the basic data comes from your income tax return.

So long as it looks at their income AND debts, I have no problem with it.

 

[emily47017]

Indeed it has – because it ignore some critical points. One of those is that certain specialties (obstetretics, for example) are being driven out of existance by high malpractice premiums.

tsk tsk. there it is, plain as day:

• The cost of malpractice premiums is less than
1% of total national health expenditures. In 2000, the
average premium was $18,400 per doctor per year,
but this varies by state and specialty — some
obstetricians and neurosurgeons pay over $100,000/
year. (AMA, Trends in the Physician Market, 2003)

 

[vern_humphrey]

So long as it looks at their income AND debts, I have no problem with it.

If interest on the debts is tax-deductable, yes. Otherwise, no.

If I make $X million dollars a year, I have no right to run up debts and expect others to bail me out, or pay my MSA for me.

 

[vern_humphrey]

tsk tsk. there it is, plain as day:

Yep, plain as day.
washingtonian.com/articles/health/2561.html

Hospitals 2005: Malpractice Insurance Affecting Our Doctors?
By Mary Clare Fleury

Are soaring rates sending DC doctors to the suburbs?

Along with his neighbors, Ed Shanbacker, executive vice president of the DC Medical Society, petitioned the DC Council about a dangerous intersection near their homes. After repeated pleas, they got the council’s attention–but not until a four-year-old had been hit by a speeding car.

Shanbacker thinks it will take a similar tragedy for local officials to address DC’s medical-malpractice crisis. “At some point, we are going to wake up and see that our hospital infrastructure has completely deteriorated,” Shanbacker says.

Medical professionals worry that high DC malpractice-insurance rates will drive more doctors to the Maryland and Virginia suburbs and lead to more hospital closures. Columbia Hospital for Women and DC General already have shut down.

The issue of medical malpractice and liability is complicated, particularly in the Washington area. The District is one of only two jurisdictions in the country–Delaware is the other–that has not enacted medical-liability tort reform that places some brakes on lawsuits. Unlike doctors in many other places, DC physicians can easily move their practices, or part of their practices, to another jurisdiction–to Maryland or Virginia–to reduce liability premiums without uprooting their lives and families.

This exodus of doctors, including some who have chosen to retire early because of escalating malpractice premiums, affects hospital closures and medical access for DC residents. Over the past two decades, hospitals have seen a decline in the average number of days patients spend in hospitals. As more physicians leave the District in search of lower insurance premiums, more hospital admissions leave with them.

Specialty Average premium in DC Average premium in Maryland Average premium in Virginia
General surgery $69,270 $64,919 $56,163
Ob-gyn $139,528 $143,477 $85,297
Orthopedic surgery $94,362 $64,919 $72,029
Neurosurgery $140,532 $94,359 $115,388

 

[vern_humphrey]

heartland.org/Article.cfm?artId=10370

Soaring Malpractice Premiums Bleed Doctors, Rob Consumers

Written By: Vicki Lankarge
Published In: Health Care News
Publication Date: January 1, 2002
Publisher: The Heartland Institute

Skyrocketing medical malpractice insurance premiums are wreaking havoc in communities throughout the United States.

In Beaumont, Texas, for example, the Texas Medical Liability Trust has increased its medical liability rates for all specialists a whopping 120 percent since 1999. It has become so bad in Beaumont that the Texas Medical Liability Insurance Association—the insurer of last resort for doctors with previous malpractice claims against them—is charging individual neurosurgeons upwards of $176,000 a year for a policy that caps malpractice payments at $1 million per occurrence with an overall total cap of $3 million per policy year.
The result? There is only one practicing neurosurgeon left in Beaumont.

“This is a scary thing,” says Kim Ross, vice president of the Texas Medical Association. “What if a patient has a car wreck, needs a neurosurgeon, and there’s none available? It’s an hour to Houston. That ‘golden hour’ [when treatment is most beneficial] is lost.”

It’s not any better in Pennsylvania, where 72 percent of doctors polled by the Pennsylvania Medical Society say they have deferred purchasing new equipment or hiring new staff due to sudden, steep increases in their medical malpractice insurance premiums. After absorbing increases between 21 and 60 percent for those premiums in 2001, doctors fear their rates in 2002 could jump another 70 percent.

The society says the hefty sums awarded in malpractice lawsuits are driving doctors’ medical liability premiums through the roof. Pennsylvania ranks second among states in terms of total payouts for medical litigation; New York is No. 1. (See accompanying chart.)

“The numbers are off the charts,” says Dr. Howard Richter, the Pennsylvania Medical Society’s president. “Combined judgments and settlements for fiscal year 2000 amounted to $352 million—roughly $30 per state resident and nearly 10 percent of the U.S. total.”

Jump in Jury Awards
Jury awards for medical malpractice claims jumped 76 percent from 1996 to 1999, according to the latest edition of “Current Award Trends in Personal Injury” by Jury Verdict Research.

As a result, many doctors and patient advocates in states that don’t have laws to limit the dollar amount of jury awards fear that increasingly large verdicts threaten their health care system by driving up medical malpractice insurance premiums.
To fend off litigation and cope with steep premiums, doctors ultimately are being forced to take defensive measures, such as:
 Practicing defensive medicine by ordering additional, sometimes unnecessary, medical tests. Insurers may be reluctant to pay for them, but doctors want them in order to protect themselves from lawsuits. According to the Quarterly Journal of Economics, such “defensive medicine” adds $50 billion per year to the nation’s overall health care spending.
 Deferring the hiring of new staff, or even downsizing staff, sparking patient backlogs and making it difficult for patients to get timely appointments.
 Ceasing to practice certain high-risk specialties, such as obstetricians/gynecologists who stop delivering babies because the threat of patient litigation is so high. Richter cites one obstetrics/gynecology group where insurance premiums nearly tripled in 2001 to $1 million. When two of their seven physicians stopped delivering babies, their rates were cut in half.
 Moving their practices to regions with lower medical malpractice insurance costs, or stopping the practice of medicine altogether. Regions with high liability costs may have difficulty attracting new doctors, creating a lack of consumer choice of physicians.

Situation Critical in Pennsylvania
Pennsylvania is one state reeling from the effects of the rise in jury awards for medical malpractice claims. Although the state does cap punitive damages, it does not limit “non-economic” jury awards, including damages assessed by juries for “pain and suffering,” by far the most common type of jury award.

The consequences of the take-no-prisoners approach to jury awards has caused malpractice insurance premiums to shoot up, particularly in the Philadelphia area, where Reed says trial lawyers are deeply entrenched and juries generous. The average annual practice insurance premium for a Pennsylvania physician in 1998 was about $35,000, according to the American Medical Association; Reed says a Philadelphia-area obstetrician is now paying upward of $87,000.

(Edited slightly to fit within 5,000 character limit)

 

[boppaid]

If interest on the debts is tax-deductable, yes. Otherwise, no.

If I make $X million dollars a year, I have no right to run up debts and expect others to bail me out, or pay my MSA for me.

Okay, then I wouldn’t vote for your plan. (Not that it’s been presented for vote anyway…what I mean is I **wouldn’t **vote for it.)

People make mistakes, and I don’t think they should go without health care because of financial mistakes…nor should their children. Especially when you think of all the young, foolish 18,19,& early 20s…every Tom **** and Harry is willing to lend them credit…then they mature and realize what they’ve done.

Yeah, if it weren’t for that little part of your plan, I’d be all for it. But I can’t be. Morally.

 

[boppaid]

every Tom **** and Harry is willing to lend them credit…

Okay…why is it starring my “Tom **** and Harry” phrase? Isn’t that weird?

Edited to add: Agh! it did it again!

 

[vern_humphrey]

Okay, then I wouldn’t vote for your plan. (Not that it’s been presented for vote anyway…what I mean is I **wouldn’t **vote for it.)

People make mistakes, and I don’t think they should go without health care because of financial mistakes…nor should their children. Especially when you think of all the young, foolish 18,19,& early 20s…every Tom **** and Harry is willing to lend them credit…then they mature and realize what they’ve done.

Yeah, if it weren’t for that little part of your plan, I’d be all for it. But I can’t be. Morally.

There is an old saying, “Making good decisions comes from experience. Experience comes from making bad decisions.”

It is no kindness to shield people from the consequences of their own decisions. If you decide to drop out of school, no consequences – we will support you. And we have a 30% dropout rate. If you have a child out of wedlock, no consequences – we will support you. And we have a 37% out of wedlock births.

 

[boppaid]

Consequences, yes. Saying no to food, shelter, and health care seems a bit harsh, no?

 

[vern_humphrey]

Consequences, yes. Saying no to food, shelter, and health care seems a bit harsh, no?

Arkansas is one of the poorest states in the nation. The county where I live is well below the state average for income. And yet, we manage to provide food, shelter and health care for people without relieving them of the consequences of their actions – if they are willing to learn and work.

 

[emily47017]

Okay…why is it starring my “Tom **** and Harry” phrase? Isn’t that weird?

Edited to add: Agh! it did it again!

let’s call him richard.

 

[boppaid]

Arkansas is one of the poorest states in the nation. The county where I live is well below the state average for income. And yet, we manage to provide food, shelter and health care for people without relieving them of the consequences of their actions – if they are willing to learn and work.

I am not opposed to that. However, with single parents, I would say that if they are going to school, they need help financially, so that they can make ends meet without being gone from their children 60+ hours a week. If they choose not to go to school, then I agree that they must be either working or actively looking for work to get any sort of welfare.