Obamacare and no tort reform, Why healthcare costs skyrocketed, Why there is a doctor shortage, Obama and democrats in bed with attorneys and trial lawyers

“What I would be willing to do is to consider any ideas out there that would actually work in terms of reducing costs, improving the quality of patient care,”  “So far the evidence I’ve seen is that caps will not do that.”…Barack Obama

“Best case scenario: A high percentage of law school graduates, new attorneys, have already sold their soul to the devil or are in the process of doing so. Any auguments?”…Citizen Wells

“For our struggle is not against flesh and blood, but against the rulers, against the
authorities, against the powers of this dark world and against the spiritual
forces of evil in the heavenly realms”…Ephesians 6:12

What I am about to write about and explain is simple. It is very similar to governments taxing businesses. Doctors are businessmen as well as physicians.
When their cost of doing business rises, the costs are passed along to consumers, patients. It is that simple. The same applies to hospitals and pharmaceutical companies.

Doctors, just like any business person, must decide what service they will provide. They must weigh cost vs benefit and the current and potential risks they will take. Many areas of practice are too risky, especially in our litigious climate. This prevents many doctors from engaging in a type of practice or forces them to join larger groups.

This has been mostly downplayed or ignored by the mainstream media. News outlets like the NY Times have tap danced around the subject which is probably why some of my so called learned friends have been so ill informed. When George Bush brought up tort reform he was ridiculed. But Bush was right and he was not in bed with law firms and attorneys like Obama and the Democrats.

From the NY Times July 28, 2012.

“Doctor Shortage Likely to Worsen With Health Law”

“In the Inland Empire, an economically depressed region in Southern California, President Obama’s health care law is expected to extend insurance coverage to more than 300,000 people by 2014. But coverage will not necessarily translate into care: Local health experts doubt there will be enough doctors to meet the area’s needs. There are not enough now.

Other places around the country, including the Mississippi Delta, Detroit and suburban Phoenix, face similar problems. The Association of American Medical Colleges estimates that in 2015 the country will have 62,900 fewer doctors than needed. And that number will more than double by 2025, as the expansion of insurance coverage and the aging of baby boomers drive up demand for care. Even without the health care law, the shortfall of doctors in 2025 would still exceed 100,000.

Health experts, including many who support the law, say there is little that the government or the medical profession will be able to do to close the gap by 2014, when the law begins extending coverage to about 30 million Americans. It typically takes a decade to train a doctor.

“We have a shortage of every kind of doctor, except for plastic surgeons and dermatologists,” said Dr. G. Richard Olds, the dean of the new medical school at the University of California, Riverside, founded in part to address the region’s doctor shortage. “We’ll have a 5,000-physician shortage in 10 years, no matter what anybody does.”

Experts describe a doctor shortage as an “invisible problem.” Patients still get care, but the process is often slow and difficult. In Riverside, it has left residents driving long distances to doctors, languishing on waiting lists, overusing emergency rooms and even forgoing care.

“It results in delayed care and higher levels of acuity,” said Dustin Corcoran, the chief executive of the California Medical Association, which represents 35,000 physicians. People “access the health care system through the emergency department, rather than establishing a relationship with a primary care physician who might keep them from getting sicker.”

In the Inland Empire, encompassing the counties of Riverside and San Bernardino, the shortage of doctors is already severe. The population of Riverside County swelled42 percent in the 2000s, gaining more than 644,000 people. It has continued to grow despite the collapse of one of the country’s biggest property bubbles and a jobless rate of 11.8 percent in the Riverside-San Bernardino-Ontario metro area.

But the growth in the number of physicians has lagged, in no small part because the area has trouble attracting doctors, who might make more money and prefer living in nearby Orange County or Los Angeles.”
“The pool of doctors has not kept pace, and will not, health experts said. Medical school enrollment is increasing, but not as fast as the population. The number of training positions for medical school graduates is lagging. Younger doctors are on average working fewer hours than their predecessors. And about a third of the country’s doctors are 55 or older, and nearing retirement.

Physician compensation is also an issue. The proportion of medical students choosing to enter primary care has declined in the past 15 years, as average earnings for primary care doctors and specialists, like orthopedic surgeons and radiologists, have diverged. A study by the Medical Group Management Association found that in 2010, primary care doctors made about $200,000 a year. Specialists often made twice as much.”

http://www.nytimes.com/2012/07/29/health/policy/too-few-doctors-in-many-us-communities.html?_r=3&partner=MYWAY&ei=5065

The Times did not mention the cost of malpractice insurance or tort reform and blamed the problem on the aging baby boomers and alleged increased coverage from Obamacare.

From Forbes May 5, 2008.

“Reasons Not To Become A Doctor”

“The American Medical Association recognizes there are shortages in certain geographic areas and in certain specialties. Part of that is due to the aging population and a stagnant number of medical-school applicants.

But there are other significant reasons. They include the increasing costs of medical malpractice coverage, higher practice costs, lower insurance reimbursement rates and insurance-company restrictions resulting in less autonomy over how patients are cared for.”
“Reasons Not To Become A Doctor”

“But for potential physicians, there is a future of looming medical-school debt, which is higher than ever. Students who graduate from a public medical school have a median debt of $100,000; private-school students graduate with a median debt of $135,000, according to a 2003 study by the Association of American Medical Colleges. Compare that with 1984, when median debt for public-school graduates was $22,000 and private-school students was $27,000.

Monthly payment on a debt of $150,000 at the end of residency at an interest rate of 2.8% is $1,761, according to the study.

The amount of time it takes to pay off debt depends on the specialty. The average physician’s net income, adjusted for inflation, declined 7% between 1995 and 2003, according to the Center for Studying Health System Change. In order to enter the most lucrative specialties, like radiology, ophthalmology, anesthesiology and dermatology, doctors must continue with their training into their 30s. That means they can’t start chipping away at their debt–let alone make money–until a time by which their counterparts in law or business are usually prospering.

Meanwhile, getting sued by a patient is a major concern. Of course, doctors who make fatal mistakes and who are unqualified should be held responsible. But there’s evidence that the bulk of lawsuits brought are frivolous. Of all malpractice lawsuits brought to jury trial in 2004, the defendant won 91% of the time. Only 6% of all lawsuits go to trial; those that aren’t thrown out are settled. Only 27% of all claims made against doctors result in money awarded to the plaintiff, according to Smarr, president of the trade association for medical malpractice companies.

Regardless, doctors need to defend themselves against the possibility of damages–and that’s an extremely expensive proposition. It takes about four-and-a-half years from the start of a lawsuit to the end, and the average cost to the defense in legal fees was $94,284 in 2004, according to the American Medical Association.

Many states are trying to establish laws to protect doctors from baseless suits. Texas went from the state with the most lawsuits filed to the only state that wrote tort reform into its constitution after its citizens voted it into law. Since tort reform was enacted in 2004, the yearly premium doctors pay in Texas for malpractice insurance has dropped by 40%. Now, the most plaintiffs can recoup for emotional damages is $250,000 from doctors and $500,000 from hospitals. Most interestingly, the number of claims filed against doctors has dropped by about half.”

http://www.forbes.com/2008/05/05/physicians-training-prospects-lead-careers-cx_tw_0505doctors.html

From the Concord Monitor March 13, 2008.

“Cost of malpractice insurance forcing doctors to leave high-risk specialties

Lawyers benefit from huge damage awards”

“I am an emergency physician. I care for about 5,000 patients a year. I have been practicing for 12 years and thus have cared for roughly 60,000 patients.

I receive deep satisfaction from my job and the privilege of the “laying on of hands” as the physician-patient relationship is called in medical school. Most of the time, I rely on the good graces and expertise of the primary care physicians, surgeons and many other specialists to help take care of the people who come to me seeking help. However, recent trends suggest that our hospitals’ ability to deliver that care with the help of appropriate specialists is eroding.

A great deal of this quiet but steadily growing crisis is caused by the direct and indirect costs of medical malpractice. The article about the malpractice suit involving Dr. Eric Leefmans (“Man wins $1.75 million suit against area doctor,” Sunday Monitor, March 9) demands a response from the medical community.”

“In New Hampshire, many physicians are leaving as malpractice insurance costs soar. Specialty physicians have experienced a 50 percent increase in premiums from five years ago. The average premium is now close to $100,000 for obstetricians and neurosurgeons.

Soaring insurance costs

Concord and Manchester have seen a significant decrease in subspecialty coverage in the past five years, including neurosurgical and oral surgery coverage for call. Several small hospitals in the state practice without an anesthesiologist. Only one obstetrician remains to deliver babies in the northern part of the state. Locally, many subspecialty groups have had significant challenges recruiting new physicians to practice in this area. General surgery, one of the most coveted residencies just 10 years ago, now struggles to fill residency positions. Several recent studies and articles predict a significant and increasing gap between the demand and availability of physicians of all types.”
“Our medical system is going through significant difficulties, including increasing health insurance costs, a growing uninsured population, rising medical costs and loss of specialists and primary care physicians. However, the cost of malpractice contributes to those problems – while making less money available to care for the uninsured. The U.S. Department of Health and Human Services has estimated medical liability costs add $60 billion to $108 billion to the cost of health care each year. Interestingly, the estimated annual cost of covering all of the uninsured patients in the United States is $100 billion.”

http://www.concordmonitor.com/article/cost-of-malpractice-insurance-forcing-doctors-to-leave-high-risk-specialties?SESS0da5adf917ca993fd9972fb4069845a6=google&page=full

Why was tort reform not included in Obamacare?

From the NY Times March 23, 2000.

“To trial lawyers, especially those involved in the tobacco litigation, Mr. Bush has become their worst nightmare. He has made attacks on lawyers a campaign centerpiece, pointing with pride to his record in Texas of curbing civil litigation, capping legal fees and limiting jury awards.”

“To that end, while trial lawyers have long been heavy Democratic Party donors, the prospect of a Bush candidacy, along with the possibility that like-minded Republicans would retain control of Congress, has ratcheted up the stakes, and the donations.”

http://www.nytimes.com/2000/03/23/us/trial-lawyers-pour-money-into-democrats-chests.html?pagewanted=all&src=pm

Why Obama ignores tort reform?

Top Recipients, 2011-2012

Candidate	Office	Amount
Obama, Barack (D)		$12,116,092
Romney, Mitt (R)		$5,205,273
Gillibrand, Kirsten (D-NY)	Senate	$1,999,202
Nelson, Bill (D-FL)	Senate	$1,376,064
Warren, Elizabeth (D-MA)		$1,158,556

http://www.opensecrets.org/industries/indus.php?ind=K01

Don’t be fooled by the false logic arguments, Orwellian wordsmithing and smooth talking devil attorneys. I have spoken to many physicians over the years and they all echoed the statements of the doctor above.

Oh, and did I mention John Edwards?