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    Posted: 06 September 2011 at 10:42pm
Could it spam a recent post atleast?
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wut?
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Edited by Evil Elvis - 06 September 2011 at 5:12pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 07 August 2009 at 12:06am
Chilling indeed.  What pepprdog is describing is the law in many countries, including the UK, which is otherwise the most similar to the US legal system.  And the results of this one difference are quite striking, and this would be one change that I am quite confident most Americans would object to if they fully understood the implications.
 
Let's say you got hit by a car while crossing the road.  Today, you get a settlement offer from the insurance company before you even get to the ER.  Why?  Because you could easily sue, which, as peppr pointed out, will cost the insurance company money no matter what happens. 
 
And if you don't like the offer, you can indeed sue - any number of lawyers will happily take your case, at no upfront cost to you. 
 
Either way, it is quite likely that your injuries will be covered, financially speaking, by the driver or his insurance.
 
Now let's say we have a British cost allocation system.  First off, no settlement offer from the insurance company.  They basically dare you to sue them.  And no plaintiff's lawyers banging on your door either - a corollary of the legal cost reimbursement is that contingent fees almost have to be illegal, so the plaintiffs' lawyers work on an hourly basis.  This, of course, makes plaintiff's work less attractive, so fewer plaintiffs' lawyers and less ambulance chasing.
 
And even if you find a lawyer, he will want a retainer before taking your case, since he is now working by the hour.  So to sue the insurance company, you need a $10,000 down payment on legal, plus the $30k+ each month through the trial.  Pretty much makes any claim for less than a couple of million not worth the money, and places the judicial system effectively out of the reach of 80% of Americans.  (And I note as a theoretical aside that there would very likely be serious constitutional issues with this.)
 
But let's say you have the cash and you find the lawyer.  You try the case.  You have a legitimate claim, and it's a close call, but in the end the jury finds for the defendant.  Bummer.  Oh, and by the way, you now owe the insurance company $500,000 for their legal fees.  Any time before tomorrow would be fine.
 
Chilling indeed.
 
We often put this type of loser-pays-all language in contracts between big companies - for the express purpose of discouraging litigation.  It is very effective even for the biggest of companies.  For most individuals it would render the courts completely useless.
 
So how do the Brits get by with this system?  Well, there is one major difference between life in the US and life in the UK:  socialized healthcare.  In the US, if you can't pay for the injuries resulting from your injuries, you either sue the tortfeasor or just roll up in a ball and die.  In the UK, you go to the hospital.  Reduced earnings from accident-resulting disabilities?  In the US, too bad so sad.  In the UK, government disability.
 
But shifting the cost burden is only one possible changeup.  A more exciting (and fundamental) change is to abandon the entire fault-based system.  In the US, everything is somebody's fault, and that somebody pays.  In some other systems, "fault" is not the central question.  This type of change WOULD significantly alleviate the cost of malpractice insurance, but it would also have many other exciting effects...
 
My point here is that the US legal system is the way it is not by accident but by evolution in response to the rest of US society.  You can't just make a big change to the legal system without understanding that there will be consequences beyond the intended.
 
"Tort reform" is just another example of a knee-jerk response from people who do not understand the justice system or have a dog in the race, like mandatory sentencing, or three-strikes laws, or California Proposition - well, pretty much all of them.  Unintended consequences will abound.
 
 

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote agentwhale007 Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 8:30pm
Originally posted by pepprdog pepprdog wrote:

You bring suit, you lose, you pay all the costs for both sides.


In my business I think we call that "chilling effect."
"So when Romney wins in a landslide, what will the liberal media do?"
This Ma**edited**hine Kills **edited**as**edited**ists.




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Post Options Post Options   Thanks (0) Thanks(0)   Quote pepprdog Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 8:02pm
Originally posted by Peter Parker Peter Parker wrote:

I think the real issue here is this term "tort reform."

This cost is built I to our entire legal system, and has nothing to do with medical malpractice. To really change the role of lawyer. And lawsuits in the US we would have to make some pretty drastic changes.

And my suspicion is that most people would not like those changes. "Tort reform" is a sop to the AMA, and would not really affect most people at all.




So you think reformation of the legal system relating to lawsuits is something most people wouldn't like? HMMMmmmm..... maybe in your crowd...heh, heh.....
Personally I would like to see a risk-reward system. You bring suit, you lose, you pay all the costs for both sides. Right now it's lopsided only benefiting the person bringing suit and almost always costing the person defending themselves even when that person is proven to have done nothing wrong. In these cases winning is still losing..........You lose time, money and suffer unnecessary stress.....
Maybe I needed to be more specific, "Medical Tort reform" would affect a lot of people in the medical professions.

Try this link about government "estimates";

http://downsizinggovernment.org/government-cost-overruns#sampling

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mack Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 4:56pm
OS's last post (regarding the letter from Dr. Janda) made me curious so I tried to follow the link to the health care plan and it didn't work.  Does anyone have an address that is valid for reading through the plans being considered, as opposed to just links to other people's thoughts on the plan?

Edit:  Disregard, I found a link that seems to work.

Second Edit:
Originally posted by oldsoldier oldsoldier wrote:


Written by Dr. Dave Janda    

Thursday, 23 July 2009

As a physician . . .

Section 102 has the Orwellian title, "Protecting the Choice to Keep Current Coverage." What this section really mandates is that it is illegal to keep your private insurance if your status changes - e.g., if you lose or change your job, retire from your job and become a senior, graduate from college and get your first job. Yes, illegal.

Having read this section (and developed quite a headache from trying to translate it from Bureaucratize to English) it seems to focus on "grandfathering" in those who already have their own coverage but denying that choice to those who get coverage after the implementation of the plan.  (In the year 2013, referred to as "Y1" throughout the document.)  I base this on the following statement from page 16 (line numbers omitted for ease of reading} :

(1) LIMITATION ON NEW ENROLLMENT.ó
   (A) IN GENERAL.óExcept as provided in this paragraph, the individual health insurance issuer offering
         such coverage does not enroll any individual in such coverage if the first effective date of coverage is
         on or after the first day of Y1.

Freedom of choice in health care coverage may also be impacted by the "grace period" applicable to employment-related insurance explained on page 17.  Essentially, it seems to give existing employer provided coverage 5 years to conform to the new standards.  To me this seems like being given the choice of using government coverage or keeping one's current coverage which has to match the government coverage within 5 years.  (In other words, this doesn't sound like a real choice.)

. . .  there is Section 1233 of The ObamaCare Plan, devoted to "Advanced Care Planning." After each American turns 65 years of age they have to go to a mandated counseling program that is designed to end life sooner.

This session is to occur every 5 years unless the person has developed a chronic illness then it must be done every year. The topics in this session will include, "how to decline hydration, nutrition and how to initiate hospice care." It is no wonder The Obama Administration does not like my emphasis on Prevention. For Mr. Obama, prevention is the "enemy" as people would live longer.

Admittedly I had a rough time with this section as it was written in a manner that was very hard to follow.  However, I did not get the impression that it was designed to promote euthanasia.  I was worried about the parts to be determined later such as the quality standards for end of life care being determined by a commission that would be formed after implementation of the law.  (This struck me as a "pass the law and we'll determine what it means later" section.)  This worried me because it does leave the door open for cost savings being generated by decisions which could lead to forcing people to decline treatment if the commission chose to implement "quality standards" that made surviving unbearable.

I rest my case. The ObamaCare Plan is hazardous to the health of every American.

There are definitely some worrisome things in the plan, but it is too early for me to agree/disagree with this statement.  I am planning on further review as long as my aspirin supply lasts.



Second Edit:  For those who say that everyone would pay less the "Surcharge on High Income Individuals" which is explained starting on page 197 would indicate differently.  It refers to additional taxes ranging from 1% to 5.4% of income based on various income brackets.


Edited by Mack - 06 August 2009 at 6:00pm
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 4:42pm
I think the real issue here is this term "tort reform."

people get fixated on the occasional big jury award, or hung up on big legal bills. That's fine, but you have to understand that "tort reform" won't change very much. All it would do it cap punitive damages, and the cap would be pretty high. That isn't a change that will drastically change the legal cos of doom business.

This cost is built I to our entire legal system, and has nothing to do with medical malpractice. To really change the role of lawyer. And lawsuits in the US we would have to make some pretty drastic changes.

And my suspicion is that most people would not like those changes. "Tort reform" is a sop to the AMA, and would not really affect most people at all.


"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 4:34pm
Originally posted by pepprdog pepprdog wrote:

Whoa!!!!!! Tort reform IS an issue for all doctors.


oh sure, it's an issue for doctors. They would like their insurance premiums to be lower. But that doesn't translate into a major contributor to the overall cost of healthcare, which it is not.

In fact, I am quite confident that the market could bear premiums quite a bit higher. It would be nice if malpractice insurance were cheaper (or would it...?), but they just don't really contribute that much to the total cost.    


Quote frivolous lawsuits are rampant


no, they are not. I guess it depends on what you mean by "frivolous," but by almost any definition his statement is not only false, but really, really false.

Quote Do you have any idea what it costs a doctor to have to leave their office in order to go to court?


Why yes, I do.


Quote In order to further the plan the lawyers will get the doctor committed to the court date and right before that date and sometime the day of court, have it changed, usually several times.


also false.

The occasional abuse does happen, of course, but presenting this as a widespread cost-running practice is simply false. If this happens regularly to doctors you know, then they need better lawyers.

Quote Donít you wonder about Sokolov and other nationally advertising ilk lawyers?


I don't know this Sokolov fella, but I would suggest to you that most of the national plaintiff's lawyers do mainly class action work, which is mostly irrelevant to malpractice insurance.

Quote You donít see how lawyers make millions tearing at the medical professionals, drug companies and hospitals? You donít see how this will make a difference in healthcare costs?


what I do see is that the amount spent by insurance companies and providers on legal fees suing each other FAR outstrips the amount they spend on defending malpractice claims. It isn't even close.

Quote I can tell many horror stories about the way the lawyers have treated many doctors, I personally know, in order to get a settlement when the physician has done absolutely nothing wrong.


told to you by physicians, no doubt. Somehow nobody ever starts their story of woe with "I made a mistake."

Quote Before you say too much, my father is an MD, my wife is an MD and my son plans on going to Medical School...... against our advice and I've been around longer than OS.


that's great.

Pretty much exactly half of my family are healthcare providers of some kind, mostly physicians. My prior firm is one of the top healthcare law firms. Some of my closest friends are top executives at health insurance companies.

My information is good.

Quote You guys that are all for socializing our healthcare need to talk to people that have actually been involved with Canadian or European medicine, especially the older ones. It is NOT what it is here, no where close. You think they have such a great system, you need to do more research.


Like I said in the other thread - been there, done that.


Quote Remember, there has never been a modern major government project that has come in at or under cost projections.......... they always estimate WAY too low.


wow - impressive claim. And one that is basically impossible to back up.



Edited by Peter Parker - 06 August 2009 at 4:36pm

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Post Options Post Options   Thanks (0) Thanks(0)   Quote oldsoldier Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 12:42pm
To compel a man to subsidize with his taxes the propagation of ideas which he disbelieves and abhors is sinful and tyrannical.


-Thomas Jefferson



Written by Dr. Dave Janda    

Thursday, 23 July 2009


As a physician who has authored books on preventative health care, I was given the opportunity to be the keynote speaker at a Congressional Dinner at The Capitol Building in Washington last Friday (7/17).

The presentation was entitled Health Care Reform, The Power & Profit of Prevention, and I was gratified that it was well received.

In preparation for the presentation, I read the latest version of "reform" as authored by The Obama Administration and supported by Speaker Pelosi and Senator Reid. Here is the link to the 1,018 page document:
http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-071409.pdf ;

Let me summarize just a few salient points of the above plan. First, however, it should be clear that the same warning notice must be placed on The ObamaCare Plan as on a pack of cigarettes: Consuming this product is hazardous to your health.

The underlying method of cutting costs throughout the plan is based on rationing and denying care. There is no focus on preventing health care need whatever. The plan's method is the most inhumane and unethical approach to cutting costs I can imagine as a physician.

The rationing of care is implemented through The National Health Care Board, according to the plan. This illustrious Board "will approve or reject treatment for patients based on the cost per treatment divided by the number of years the patient will benefit from the treatment."

Translation.....if you are over 65 or have been recently diagnosed as having an advanced form of cardiac disease or aggressive cancer.....dream on if you think you will get treated.....pick out your coffin.

Oh, you say this could never happen? Sorry.... this is the same model they use in Britain.

The plan mandates that there will be little or no advanced treatments to be available in the future. It creates The Federal Coordinating Council For Comparative Effectiveness Research, the purpose of which is "to slow the development of new medications and technologies in order to reduce costs." Yes, this will be the law.

The plan also outlines that doctors and hospitals will be overseen and reviewed by The National Coordinator For Health Information and Technology.

This " coordinator" will "monitor treatments being delivered to make sure doctors and hospitals are strictly following government guidelines that are deemed appropriate." It goes on to say....."Doctors and hospitals not adhering to guidelines will face penalties."

According to those in Congress, penalties could include large six figure financial fines and possible imprisonment.

So according to The ObamaCare Plan....if your doctor saves your life you might have to go to the prison to see your doctor for follow -up appointments. I believe this is the same model Stalin used in the former Soviet Union.

Section 102 has the Orwellian title, "Protecting the Choice to Keep Current Coverage." What this section really mandates is that it is illegal to keep your private insurance if your status changes - e.g., if you lose or change your job, retire from your job and become a senior, graduate from college and get your first job. Yes, illegal.

When Mr. Obama hosted a conference call with bloggers urging them to pressure Congress to pass his health plan as soon as possible, a blogger from Maine referenced an Investors Business Daily article that claimed Section 102 of the House health legislation would outlaw private insurance.

He asked: "Is this true? Will people be able to keep their insurance and will insurers be able to write new policies even though H.R. 3200 is passed?" Mr. Obama replied: "You know, I have to say that I am not familiar with the provision you are talking about."

Then there is Section 1233 of The ObamaCare Plan, devoted to "Advanced Care Planning." After each American turns 65 years of age they have to go to a mandated counseling program that is designed to end life sooner.

This session is to occur every 5 years unless the person has developed a chronic illness then it must be done every year. The topics in this session will include, "how to decline hydration, nutrition and how to initiate hospice care." It is no wonder The Obama Administration does not like my emphasis on Prevention. For Mr. Obama, prevention is the "enemy" as people would live longer.

I rest my case. The ObamaCare Plan is hazardous to the health of every American.

After I finished my Capitol Hill presentation, I was asked by a Congressman in the question-answer session: "I'll be doing a number of network interviews on the Obama Health Care Plan. If I am asked what is the one word to describe the plan what should I answer."

The answer is simple, honest, direct, analytical, sad but truthful. I told him that one word is FASCIST.

Then I added, "I hope you'll have the courage to use that word, Congressman. No other word is more appropriate."

Dr. Dave Janda, MD, is an orthopedic surgeon, and a world-recognized expert on the prevention of sports injuries, particularly in children. His website is noinjury.com.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mack Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 2:54am
Originally posted by Peter Parker Peter Parker wrote:

First off, you guys need to stop the gay pride parade posting.  Very headache-inducing.


Durn liberals . . .



. . . tryin' to limit muh freedom of ex-press-shun.







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woah, look who the cat dragged in ^^ :)

Originally posted by Peter Parker Peter Parker wrote:



First off, you guys need to stop the gay pride parade posting.† Very headache-inducing.



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Whoa!!!!!! Tort reform IS an issue for all doctors. Insurance premiums are outrageous, frivolous lawsuits are rampant and in order to avoid being taken to court for not doing an unnecessary test the bills are inflated in order to do their best to stay out of the legal system. Do you have any idea what it costs a doctor to have to leave their office in order to go to court? They canít close it so the employees are on the payroll while no income is being produced. In order to further the plan the lawyers will get the doctor committed to the court date and right before that date and sometime the day of court, have it changed, usually several times.
Donít you wonder about Sokolov and other nationally advertising ilk lawyers? You donít see how lawyers make millions tearing at the medical professionals, drug companies and hospitals? You donít see how this will make a difference in healthcare costs? I can tell many horror stories about the way the lawyers have treated many doctors, I personally know, in order to get a settlement when the physician has done absolutely nothing wrong.
Before you say too much, my father is an MD, my wife is an MD and my son plans on going to Medical School...... against our advice and I've been around longer than OS.
You guys that are all for socializing our healthcare need to talk to people that have actually been involved with Canadian or European medicine, especially the older ones. It is NOT what it is here, no where close. You think they have such a great system, you need to do more research. You want a degraded system, put the government in charge.
Remember, there has never been a modern major government project that has come in at or under cost projections.......... they always estimate WAY too low. Heaven forbid a politician tell the truth about real costs.
   Also think about the huge bureaucratic monster that will be needed to run this project..... Again something always underestimated or not figured in the initial cost estimates. They certainly can't run this with available medically trained, educated, government employees. Now weíll have a new, untrained huge bureaucracy at government wages on top of the system already in place and this is supposed to be cost efficient enough to save money and make things work more smoothly for the patient. History teaches us otherwise.

Don't get me wrong, I believe the systems needs a bunch of fixing but turning it over to a bunch of bureaucrats is not the way to go.....


Edited by pepprdog - 06 August 2009 at 1:03am

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 06 August 2009 at 12:05am
Heh - I certainly do try to stay away from courtrooms. 
 
But if you want to talk legal reform, let's look at the millions of dollars spent on legal fees by health insurance carriers, reinsurers, backoffice providers, intermediaries, clearinghouses - suing each other.
 
Now THAT is expensive stuff.  Specialty litigation is obnoxiously expensive.  And it adds nothing to the bottom line (for the companies, that is - it goes straight to the bottom line of what you pay in premiums).
 
You want to reduce the impact of litigation on healthcare costs?  Reduce the number of players in the field, by streamlining the system.

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote mbro Quote  Post ReplyReply Direct Link To This Post Posted: 05 August 2009 at 11:43pm
Originally posted by Peter Parker Peter Parker wrote:



I am not saying that "tort reform" is necessarily a bad idea, but I am saying that it would not make a meaningful difference in US healthcare costs.

Typical lawyer who doesn't even try litigation cases. You lawyers are all the same..

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Peter Parker Quote  Post ReplyReply Direct Link To This Post Posted: 05 August 2009 at 7:05pm
Man, I go away for a couple of days, and all hell breaks loose...
 
Originally posted by Mack Mack wrote:

Let me offer a hypothetical situation.  (Granted, it is vague, but given the vagaries related to the current health care discussions at the national level it is the best I can do.) 
  • There are people who can't afford health care.
  • There are people who can afford it and they currently pay for it.
  • The government plans to make health care available to everyone.
  • This means that you now have additional expenditures but, because the people who can't afford it still can't afford it, the additional money must come from somewhere.
  • Whether this somewhere is taxes on individuals or businesses or some other form of collection, the expense is eventually passed along to those who are already paying for their own healthcare.  I really don't see anyway that costs won't be increased for some.
  • The government could just charge less than the value of the service without raising taxes, but this would have a negative impact on the deficit.
    • An additional factor that will probably raise costs is the requirement that pre-existing conditions are not disqualifying factors.  (This disqualification is one of the ways that the private industry reduces costs to keep prices down.  Doing away with it can only increase expenses.  I should point out that I agree with this, but it is a cost factor that has to be considered.)
 
First off, you guys need to stop the gay pride parade posting.  Very headache-inducing.
 
On points - the highlighted bullet is worth, um, highlighting.  Because, as has been pointed out before, the government already IS providing healthcare to everyone.  We already HAVE socialized medicine.  We just have the worst and most idiotic socialized healthcare of all - in the sense that the government is now the provider of last resort, but does not provide any pre-emergency care.  That pretty much guarantees unnecessarily high healthcare costs.  It is certainly not the only cost, but it is a big one.
 
We could cut our healthcare costs quite a bit by not letting anybody into the ER without an insurance card.  But since I don't think that is on the table, we might as well get our money's worth and pay for some upfront care to lower the back-end costs.
 
 
Originally posted by Mack Mack wrote:

Originally posted by jmac3 jmac3 wrote:

Mack, I wasn't leaving raising taxes "off the table". I am saying taxes wuld HAVE to be raised. I just believe that a budget could be worked out that people would be paying those taxes but still coming out paying less than they were previously for insurance.


And I don't believe that is possible.  Or, to put it more correctly, those that can't afford it now will possibly end up paying less (which is more than the nothing they are paying now), but the remainder will have to be subsidized by others.  (Which would be paying more.)
 
I would suggest that not only is it possible, but it is almost inevitable. 
 
Right now, the US healthcare system is hideously inefficient, from a medical perspective.  This medical inefficiency translates directly into unnecessarily high costs.
 
The causes of this medical inefficiency are many - service-based payment structures, pre-existing condition cutoffs, employment-based insurance, multiple alternate (and incompatible) insurance providers, a lack of emphasis on preventive care and "wellness," a willingness to spend disproportionately on end-of-life care, excess machinery, ridiculous doctor/patient ratios, and, yes, lack of true universal access to healthcare.
 
I don't know that we have to have true universal coverage to fix the problem, but it certainly is a readily identifiable contributing factor.
 
 
Originally posted by FreeEnterprise FreeEnterprise wrote:

Want to lower health care costs? Tort reform... (for all of you educated in public schools, that means eliminating "windfall" lawyer payouts)
 
 
Another bogeyman.  While the entre US legal system is arguably a major contributor to a variety of costs (including healthcare), but this common claim just isn't true.
 
Think about it.  "Windfalls," almost by definition, are rare.  They are so rare, in fact, that they are but a drop in the bucket.  Overwhelmingly, the big payouts are for really ugly cases, and I suspect we as a society are not willing to give $50k to the guy who just had the wrong leg amputated and call it a day.  Lots of press is given to cases that appear out of whack - and they appear out of whack because they are rare.
 
I am not saying that "tort reform" is necessarily a bad idea, but I am saying that it would not make a meaningful difference in US healthcare costs.
 


Edited by Peter Parker - 05 August 2009 at 7:06pm

"E Pluribus Unum" does not mean "Every man for himself".

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mack Quote  Post ReplyReply Direct Link To This Post Posted: 04 August 2009 at 10:36pm
Originally posted by jmac3 jmac3 wrote:

Mack, I wasn't leaving raising taxes "off the table". I am saying taxes wuld HAVE to be raised. I just believe that a budget could be worked out that people would be paying those taxes but still coming out paying less than they were previously for insurance.


And I don't believe that is possible.  Or, to put it more correctly, those that can't afford it now will possibly end up paying less (which is more than the nothing they are paying now), but the remainder will have to be subsidized by others.  (Which would be paying more.)
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Post Options Post Options   Thanks (0) Thanks(0)   Quote jmac3 Quote  Post ReplyReply Direct Link To This Post Posted: 04 August 2009 at 9:32pm
Mack, I wasn't leaving raising taxes "off the table". I am saying taxes wuld HAVE to be raised. I just believe that a budget could be worked out that people would be paying those taxes but still coming out paying less than they were previously for insurance.
Que pasa?


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Post Options Post Options   Thanks (0) Thanks(0)   Quote Mack Quote  Post ReplyReply Direct Link To This Post Posted: 04 August 2009 at 8:58pm
No, it's more fun this way.  Tongue
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