Malpractice, Healthcare Costs, and Tort Reform
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- เผยแพร่เมื่อ 1 มิ.ย. 2014
- For better or for worse, whenever many are asked about how they would help control spending in the US health-care system, tort reform always seems to be one of the first things offered as a solution. That's because there's a malpractice crisis! And tort reform will cure it! Except, neither of those things is really true. Watch and learn why not.
Those of you who want to read more and see references can go here: theincidentaleconomist.com/wor...
John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics
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In Sweden we handle very, very few things through legal claims by one or more individuals against an organisation. Instead the government acts as intermediary. In the particular case of medical malpractice this means that any citizen can file a complaint that will be investigated by the government. If they find the complaint valid the doctor in question might be fined, lose their license or receive a warning. The person filing the complaint would never receive more money than they lost due to the malpractice and often nothing. Because everyone involved see the system as a way to make healthcare better, not as a way to get revenge or make gains.
Fuck you and your sane system!
Good, don't change that. Don't fall into our trap.
Sounds great but it would be terrible in the US because our government is corrupt and would just get bought out by insurance companies and nobody would ever get compensation
There is a misconception that, in the US, you can bring a lawsuit and get a windfall. While there are rare instances where this is the case, usually involving some form of punitive damages, it is generally not the case. Most of what you recover in a lawsuit is what you actually lost, out of pocket expense, lost wages, future medical costs, etc.
The remaining amount you get is compensation for some sort of damage you suffered, e.g. pain and suffering, or mental anguish. While this does not directly reflect a monetary cost the plaintiff suffered, it does correspond to a real cost that that the plaintiff suffered, especially when the pain is ongoing. While it is easy to think of this as a windfall, I suspect that, in most situations, the defendant would much rather pay the money than suffer a comparable injury.
The movie Extract had a good example of this. The plot revolves around a lawsuit brought by an employee who lost a testicle in an on-the-job accident. The employee's attorney was demanding some dollar figure in settlement to represent the employees pain and suffering. When the employer claimed the amount was unreasonable, the attorney offered to withdraw that part of the claim if the employer would just crush his own testicle in a door jam. The employer, unsurprisingly, did not take the attorney up on that offer.
Walker Lewis While this is true, the system has its flaws. One of them is abuse. It's easier to diagnose physical impairment, but not so much mental/emotional impairment, epsecially trauma. Not only that, but then you have to somehow quantify it monetarily, which I think is a bit meh...
It's a dangerous push-and-pull, and the argument could be made either way. For those deeply affected, though, I will say this; *No amount of money can fix it* sometimes. As a result, the system fails for those it truly desires to help.
I had a case of this just recently. My 8 mo old daughter had a bit of a hive. But since it seemed to spread a bit, we decided to go to an urgent care (paid a ridiculous $50 after insurance). The doctor recommended we get an ambulance and get her to a hospital even after epinephrine shots. We repeatedly told him that she never seemed to have trouble breathing and her hives were already starting to fade. Even the nurse said she's fine after listening to her lungs. In the end, we had to sign a "against medical advice" and drove ourselves to a nearby hospital and waited at the parking lot for 2 hours just in case. But I can imagine lots of parents falling victim to the scare and end up paying an unfathomable amount of medical bill.
Dr. Carroll, I just want to say your show is amazing! Every single week you take something I think I know about and turn my knowledge upside down. Especially as a pharmacy student and healthcare worker, you have made me so much better at having intelligent conversations about the system we work in here in the US. Thank you so much!
Can't wait for your GMO episode!
Being pro-GMO myself, surrounded in friends and family that oppose it, rarely for logical reasons (that's not to say that all arguments against are illogical), I am looking forward to seeing someone approach the subject with actual research, as oppose to rhetoric.
LordMarcusX Diana Peña HisRoyalCarlness Partyyyyy
Spoiler: They're safe.
HisRoyalCarlness The comments section is going to be horrifying though,I expect, It wouldn't surprise me if all the anti-GMo organic groups share the video around to get their followers to swarm the comments.
My grandfather died from a stroke that could have been prevented, he was having TIA's which can be a huge alarm warning of a coming stroke. Out hospital turned him away. He died because of them. I tried to find a lawyer to sue the hospital but none would take my case. Not enough money and not an easy enough case to proove. There is no justice for victims of medical malpractice / ❤negligence. Its been almost 2 years and i still cry about it almost every night. My grandather served in the airforce, he helped develop Atlas missile defense system, volunteered with our local police, he was a teacher, a brother, a father, a husband; and he died because the doctor at pur local ER said he suddenly had a "history of dementia" when they have access to his medical history and NOWHERE prior to this visit did it say he has dementia. And i cant sue because no one would take my case and in California your time to file a medical malpractice lawsuit is limited to 1 year. Thats not justice. There is no justice.
I think part of the problem is that when many people hear the term 'tort reform' they don't know what it actually means and thus mistakenly think it addresses those issues you mention.
Dr, Carroll has really come into his own with these vlogs. My 78 year old physical therapist father, who couldn't send an email if the world depended on it, figured out the iPad enough to not miss a single Triage video. Even when he may disagree with some odd point, we both love the dinner table conversations these generate.
When I saw that next week was GMO I fist pumped the air.
I was on a jury in a malpractice case. Trying to figure out what had gone wrong at what time and if anyone was to blame was very challenging. When you look for reforms in the "system" one additional problem is that lay people (all of whom have good intentions) are asked to decide on issues about which we know nothing. Do we understand nuclear physics? Unlikely. Do we understand the principles of great medical care vs. substandard care? Also unlikely. I would hope that someone could come up with solutions to that as well.
But, more to the point, I had heard about the Texas experience before. I had not realized that other states had also not reaped any benefits. Thanks for presenting the facts.
The biggest problem here is that in the US there is a culture of suing anyone and anything that could have potentially done something wrong to you on principle, whether that claim is true or not.
The judicial system should be reformed in a way that prevents defendants from fronting the costs of being in a trial unless they're found guilty, because there are a LOT of cases in which a non-guilty defendant is forced to resort to pay a "friendly" accord simply NOT to have to go to court.
Very clear-cut examination of the facts. Good info.
I feel smart when I watch this stuff.
Absolutely fascinating!
Thank you! The people who insist that tort reform is the key to cost control are unbearable. Doctors don't change the way they practice solely because of tort reform.
I wanna know what happened in 2006 to make that curve in the Texas graph bend upward more sharply.
Doctors are forced to buy malpractice insurance from private for profit insurance companies. This insurance cost doctors a lot. Doctors are then forced to charge a lot to pay for the insurance. This leads to private for profit insurance companies to raise rates for health insurance, which is also mandated that people have to buy. So on one had doctors are gouged by insurance companies, which then allows the same insurance companies to gouge people for health insurance. Since malpractice cases are rare all the money doctors pay is pure profit for insurance companies. Combine that with private for profit insurance that does not pay for anything and you got one heck of a rigged system.
I think the problem is the for profit parts.
Azathoth43 "B-b-b-b-ut free market!"
There are different companies for doctor's malpractice insurance and people's health insurance...they aren't at all the same. The largest insurance company offering doctor's insurance in California is The Doctor's Company, which is run by doctors, so it's doctors screwing doctors.
I don't believe there is any direct correlation in the raising of health insurance rates just because doctor's malpractice rates are high.
july1962
The high rates for doctors force high fees for service. Service is proved by insurance companies. This forces high rates for health insurance. Look at the profit margin for both kinds of insurance. The numbers are astronomical.
thatsnotagoodidea Yes, but insurance companies say no to doctor's rates. It's like this whole theory of defensive medicine where doctors are ordering extraneous tests just to be safe...most insurance companies won't pay for the first test, let along for multiple unnecessary tests, so who's paying for them and why are patients agreeing to them?
Why is this late? I was looking forward to it all yesterday!
My idea for malpractice insurance reform was that it can be eliminated entirely by making the only payable suit/settlement option be to be "employed" by the hospital -- to be paid a living wage as if they were an employee of the hospital, rather than an enormous sum. This way, their budget would not be affected by much any more than it would be to add one additional employee, and there is no fear of a bizarrely high lawsuit reward and no need for insurance. A hospital could simply make the addition of a living wage according to the patient's needs to their payroll, instead of an giant lump sum that would require an insurance agency in the first place.
Tort reform always makes me hungry. It sounds delicious.
"I'll take a Cherry Tort please."
I always think of the pasta... Tortellini.
Some of the healthcare issues HT goes into aren't that interesting to me. I TOTALLY love this show though, because out of all the Vlogbrothers projects it's the one that really teaches principles of empiricism, scientific literacy and critical reading in a way that's applicable to just about everything.
So much, yes.
Can you post a video about the basics of health insurance?
I can't wait to vote for this guy.
I am so excited for next week's episode. My wager: the hippie tears will flow like a river through the comments.
i feel like you guys may be disappointed. similar to many peoples issues with the episodes on organic food and the other on artificial sweeteners.
Evan Minarik If he uses an evidence-based approach like he has been, I'm super excited to hear what he has to say!
Honestly I don't think they are inherently bad. I just don't think you should trust companies that fight tooth and nail to keep their processes hidden to manipulate things you will be assimilating into your genetic code :p.
You are kinda literally what you eat.
Just think back to when companies said Cigarettes were good for you and Doctor Recommended. This kinda shit will happen once they DO make a GMO change that is terrible, it won't be admitted until far too many people die.
Otherwise, corn that grows more plentifully, cows that fart clean oxygen, or whatever else that would be pretty sweet are fine by me.
GMO does equal bad, but not being clear what protein included might lead to allergy. It's all stuff that responsible testing would tease out.
Problem I have with GMO aren't heath mainly but with patenting and ownership issues. Curious to where he goes.
Regardless I hope that we can't even keep gmo and non-gmo seperate is a problem that not remarkably encouraging.
sweet sweet statistics, love this channel
Question, are the insurance companies behind the support of tort reform? They appear to benefit greatly when it has been implemented.
Are there any good studies that compare how malpractice insurance is conducted in other countries? I keep hearing anecdotally that doctors in Europe almost never get sued and their malpractice insurance premiums are just a fraction of what they are here. So how does Europe accomplish this?
Will you please do a healthcare video about Australia?
This is the third or fourth video about what will not fix the cost problems in US medicine. I would LOVE a video entitled "Things that, if feasible, would significantly reduce the costs of medical treatment in the US."
A single payer system. He already went over that. A single payer system would bring down costs considerably since it increases negotiating power. If every American were on medicaid/medicare we'd save a butt load of money. And those programs aren't that efficient. By copying what every other nation is doing and institute a single payer system for healthcare, we'd save a huge amount of money and a lot of lives.
***** Where did he go over that? Not in the discussion of the US Healthcare system. Not in the discussion of some of the single-payer systems (like England/France). Let's not confuse "France pays much less" with "The US would pay much less if they had the French system." Neither implies the other.
There is an awesome series of blog posts on this question from Aaron (theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/), but I think a video that faces the question head-on would be awesome.
May have been addressed already, but out of curiosity, what other types of reforms are being advocated for?
I am curious as to how one determines that a case has merit if it is never brought to court or evaluated in any other objective way.
What I'm really curious about is why there aren't mutual insurance companies for medical liability. This'd mean in situations where there is tort reform the profits that the insurance company sees would be rebated to doctors and/or represented in lower premiums.
So is medical malpractice primarily written by for profit insurance companies? If so, why aren't mutual companies more prominent in that market?
Are there any health benefits to toilet seat covers in public restrooms? When did we start having them?
good q
So then what does = cost control? Or is there not really a good answer to that because there are just too many variables?
The people I've heard discussing Tort reform often discuss the solution of the losing party paying the full legal costs of the winning party, thus - the argument goes - discouraging people from bringing forward cases they are unlikely to win. How does this reform impact malpractice suits?
0.1% is still 2.5 billion dollars though (55 bill ~ 2% -> 5.5 bill ~ 0.2% ->2.5 bill ~ 0.1%). Even if it puts an enormous amount of money in insurance companies' pockets, if it still reduces the cost by even a tiny bit, then it should be worth it.
This is assuming that there are no negative side-effects of doing so since the only one suggested was that doctors don't get savings but insurance companies do.
Dear Healthcare Triage,
How about an episode about non-adherence? Patients who get prescriped drugs sometimes don't take them because they forget or don't want to take them. What are the health benefits of taking drugs on time? How much money goes to waste because of this? I think it's an interesting subject to cover!
I agree with the video as the Tort Reform does not equal cost control.
+Bubbles 007 After listening to the statistics mentioned, it is clear that the overall purpose of Tort Reform is not doing what it was
intended for. Doctors still continue to practice defensive medicine due to the fear of being sued for malpractice. I find it interesting that the concept of cost control for Tort Reform is still being used even though that is not the actual outcome. To me, it seems that people need to go back to the drawing board to figure out another way to reduce healthcare costs. Of course, the insurance companies keep the savings and leave the premiums for doctors at an extremely high rate. Therefore, the issue is still not solved and the insurance companies are keeping the profits from the situation. As mentioned earlier, we
need to reevaluate the outcomes and find new alternatives to reduce healthcare costs, since the Tort Reform is clearly not accomplishing that goal. It is also disheartening to hear that many valid malpractice cases go unheard of while the cases that do get noticed aren’t valid. Looking at the burden of costs for these cases, this is another discrepancy that must be addressed in the future when improvements are attempted to be made in the healthcare system.
I think you forgot the complete other half of this subject. I know you wanted to keep it pertinent to damage caps, but I think tort reform looks more.... evil, not to be sensational, when you consider other situations. I researched this extensively in college, and it was only a few years ago so my research is relatively up to date. This is going to be a long comment, but I think a lot of it needs to be said. You can read around the EDIT sections:
1) Tort reform is more than just setting caps on damages; in fact, its usually a combination of three or more things: caps on damages, or the maximum money one can be rewarded, making filing lawsuits more difficult, and privatizing lawsuits.
2) Caps on damages are obvious; it's an attempt to reduce the maximum penalty a court can place on a company found at fault, however the way this works is essentially lied about to get people's opinion to change. You see, this was born out of the Hot Coffee incendent, when a woman named Stella Leibeck sued McDonalds for serving coffee above temperatures that can cause 3rd degree burns in less than 3 seconds without proper warning. Contrary to popular belief, Ms. Leibeck only sued for less than 10,000, or the relative cost of her medical bills and time lost at work.
EDIT
The coffee, within 15 seconds, was able to burn through her skirt and tights, through all layers of her skin to eventually settle about 2 inches into her quadriceps and surrounding muscles reaching as far down as her hamstrings and sat at scolding temperatures in her muscle for another 30 seconds leaving more than a square foot of her muscle fully exposed. Google images for it. She had to be immediately hospitalized and was not discharged until a month later where she missed another few months of work. She was not driving or even moving when this happened contrary to popular belief. Even if you think spilling the coffee on herself was her fault, McDonalds was serving their coffee more than 40 degrees hotter than almost all over drive through chains that served coffee with absolutely no warning about the coffee at being nearly the boiling point of water, while again most other chains put some kind of hot liquid warning on their cups. If I invited a woman over to my house and my coffee put her in the hospital for a month needing skin graphs and rehabilitation for walking, I would be more than willing to give her a blank check. This is me interjecting my opinion, but I think when you put it in that personal of a context it shows how the court would come to the conclusion McDonalds would have to award her damages in some way.
/EDIT
The court assesed a 20-80 percent liability, with McDonalds being 80% liable. Whenever a class-action lawsuit is brought against a court and the acused is guilty, not only does the guilty party have to pay the request amount by the plantiff, but the jury can independently assign something called punitive damages, or damages the court applies on top of reported damages as a way of punishing guilty parties. The court sided with Ms Leibeck so hard they assigned somewhere over 2 million dollars in punitive damages EDIT or the total revenue McDonalds receives from just two days of selling coffee/EDIT, and this is where the lying starts. Tort reformists will not tell you the difference between regular damages and punitive damages and will attempt to construe their explanation in a way that it makes it sound like they are the same thing and that the plantiff can assign even a basic damages figure that large, when in reality one cannot. This is actually how many frivolous cases are weeded out - cases where reported damages are way to expensive for the reported injuries, judges are usually pretty quick about getting those cases out the door. Furthermore, Tort reformists will also not tell you judges have the ability to reduce punitive damages assessed by a jury, and in this case the judge brought the punitive damages from 2m to 600k. Even worse, tort reformists don't tell you in any malpractice or lawsuit, the parties have the ability settle out of court for an independently and privately agreed upon amount. McDonalds settled for way less than 600k, I promise.
3) The other way Tort reformists try to attack the "problem" is they simply try to make filing a lawsuit more difficult, either by suggesting ridiculous requirements to even get a lawsuit going, such as having to present a physical injury to a judge (even though your injuries may have healed; Tort reformists won't tell you about that little loophole), or some other ridiculous requirement that is ultimately unnecessary because a judge can already independently dismiss cases deemed frivolous, so it's essentially trying to fix a problem that's already fixed. Coupled with the average cost of a lawsuit on either end, plantiff or defendant, and this is obviously not the right choice. In states where this has been implemented, malpractice lawsuits have gone down, but reported injuries during medical care have not only not gone down, but up, essentially making it too hard for those who really need to be able to sue due to the economic destruction malpractice can cause for the victim.
4) Companies also try to privatize lawsuits, something which is it's own complicated subject. A short explanation is you are asked to sign a contract that stipulates in the event of malpractice, you must settle in an out-of-court mediated meeting. What those companies don't tell you when you sign is that THEY get to pick the mediator, and they have quite the tendency to pick those who pick their side, leading to an even more out-of-whack real-malpractice to reported-malpractice ratio. Were looking at the defendant winning more than 90% of the time; if you get into privatized court, you're pretty much screwed. There have literally been cases of a company letting their employees literally, not exaggurationg, rape another employee and never go to jail for it or pay a fine because the employee signed a settle-out-of-court waiver and the company chose a mediator who just walked in the room, sat down for 5 minutes in silence, and then walked out giving that company the good old green check. Mean while, this woman was dealing with extensive medical and psychological support costs due to her violent raping (she required stitches; I'll be polite and won't say exactly where but essentially everywhere) and nearly went bankrupt because she couldn't get the company that hired her into court. Al Franken, the democratic senator, has done a lot of work on this problem and has made some great strides; in that particular example, Al Franken along with other supporters were able to get a law passed that allowed that woman to take the company to criminal court and eventually get her rapists thrown in jail.
Look, I'm definitely not somebody to try to paint an opinion as the "evil opinion," where everybody on one side of the fence is nothing but pure evil. I know there are many "average" people out there who think Tort reform is something that needs to be done, but in my experience their opinions almost always rely on mis-information or a complete lack of information and going off of nothing but what people are saying and not what's actually happening (never trust a lawyer! =P ). However, this is most certainly an indication of top-down belief, where the powerful are trying and somewhat successfully lobbying for law changes that benefit them way more than the people they convinced to support them. If you look at all the major players in the Tort reform movement, such as the Chamber of Commerce or lawyer advocacy groups, they are all people at the very top of the organization, and it is very difficult to find public appearances by these people debating their opinions; instead, it's much easier finding videos of people surprising them after board meetings on the streets and asking questions such as, "what is the rate of malpractice and frivolous lawsuits right now?" and I guarantee you cannot find a single video where they will give you straight statistic. Instead all you get from those people are, "it's a big problem," and "doctors are scared to practice," or, "the courts are over-saturated with frivolous cases," or the ever popular (I saw this a lot), "Frivolous cases lead to hundreds of billions of dollars of waste every year," all of which just aren't, or at least mostly aren't, true. I know because I looked for hours when I first researched this just to make sure that was no factual validity to the many of the claims they make, either on what is happening or what will fix what they think is wrong. Even for us tax payers, we get the short end of the deal; there are many examples of states with damage caps where due to the damage the malpractice did, such as brain damage that would make the victim dependent on full time care for the rest of the their life, the plantiff honestly needed more than 1m or 2m or whatever the cap is to live for the rest of their life, and what ends up happening is they hit the cap prematurely and you cannot sue a company for the same malpractice twice so they end up on the tax-payers pay-roll. EDIT and this is how tort reformist really allow companies to take advantage of the misinformation about the difference between punitive and regular damages. Without specifying the distinction, mislead lawmakers and voters support laws that limit BOTH regular and punitive damages instead of just punitive damages which could honestly help the situation and not hurt it, but that is speculation. /EDIT That is actually where a good part of malpractice caused ineffeciency is going, hitting the tax payer's wallets because of tort reform that allowed companies to skimp on responsibilities.
Again, I don't want to paint Tort Reform as the bad guy because as he mentioned, we do have malpractice waste and we should try to reduce it, but I've found almost all recent iterations of Tort Reform to rely on misinformation and a lack of statistics to gain support. Remember, if you don't get statistics with a citation right after it, they are probably trying to lie to you. That's why people like John and Hank Green and others try to be as transparent and complete with their citations as possible, so you know you have every right to look at how they support their theories under a microscope which tells you they probably aren't trying to rip you off. If all you get from one side is, "its bad" or "its super bad," without any real statistics or justification, be EXTREMELY suspicious.
Thank for saying what I simply couldn't.
elementface +
What is the best method besides Tort Reform?
One missed point is the direct effect of loosing ground to trial lawyers, leading to increased premiums, doctor flight, and reduced access to doctors. This has happened to every state that does not preserve the cap on pain and suffering.
California has traditionally had much cheaper malpractice rates than Florida due to this fact. This November a important vote may destroy this cap on pain and suffering leading to increased malpractice premiums and likely some doctor flight leading to reduced access to doctors.
www.noon46.com
Remove the ability for a private entity to sue for putative damages. You are not public authority so you don't get to fine anyone. If you want penalties then stipulate them in a contract. This is the core issue with the litigious behaviours that are seen in countries like the USA.
Australia does have issues with malpractice as well but that is mainly in obstetrics and the main problem is that there is no statutory limitation on tort. Nothing like a retired doctor going bankrupt at the age of 65 because they followed best practice 35 years ago and it turned out poorly. Malpractice insurance stops covering you when you stop making insurance payments. This means that as a practising specialist or surgeon you have to pay for the insurance for the rest of you life once you start practising.
Am I the only one who thinks "To the research!" should be accompanied by a Batman wipe - batman spinning logo - using a caduceus, en.wikipedia.org/wiki/Caduceus?
Super excited for next week's show. My guess: nothing terribly bad about them as a whole, but there may be ethical concerns with genetic engineering.
Did you ever discuss using 'loser pays' A.K.A. the English Rule?
The only solution that will truly change defensive medicine is a move to a New Zealand style no-fault system. No more expensive lawyers and judges, no more agony and pain, just simple compensation for anyone who is hurt- regardless of fault.
So let's hear some solutions!
Most insurance companies are for-profit and have no interest in seeking out ways to reduce premium costs. Even if they saw a reduction in their costs, their premiums wouldn't change. Premiums only change when the costs increase. As for-profit companies, they are always seeking new ways to make more money. Increasing the cost of premiums only benefits them, even if costs of claims go down, because they believe medical doctors can afford it. The only solution to this problem is to make all insurance non-profit, so their focus changes from money to their clients.
It feels like there was a section missing. When you asked "do doctors practice more defensive medicine in areas that have higher malpractice premiums?", it seemed like you didn't answer that question. Maybe an editing mishap?
No, there was the study that showed that passing tort reform (ie lower risk/lower premiums) barely changed practice.
Healthcare Triage Can you provide links to the reports in the descriptions of your videos?
Sean Ross-Ross
He did. Read it again.
Like many such attempts to cut spending, it all becomes a big gift to wealthy corporations, in this case, insurance companies.
injured individuals and the lawyers who represent them argue against tort reform, saying it will prevent patients from being protected against negligent physicians. Doctors, on the other hand, usually push for reform, saying it will protect patients from having to pay the high costs of malpractice insurance and perhaps even increase accessibility to some health care services. Why does this affect doctors and hospitals more than some others? How can states improve their medical malpractice laws?
+Mary K I did some research on this and it seems increases in medical malpractice insurance rates appear more dramtatic because, unlike most businesses, doctors and other medical providers operate under fee schedules mmandated by Medicare, health insurers and other third-party payers. The United Staes insurance market is intensely competitive, which has caused both dramatic increases and dramtic increases in insurance rates over time. Large increase in malpractice insurance over short durations of time are now extremely difficult to accept and incorporate into one's medical practice. To answer your second question, states can improve their medical malpractice laws by state courts should be encouraged to make greater use of their powers to set aside verdicts involving pain and suffering awards that disproportionate to community expectations. Tort commissions should be created to anually review tort awards and publish suggested guidelines to encourage uniform awards. There should also be a clear an convincing evidence for damages which should be rewarded only when there is a conscious or disreguard by the defendant of his or her obligations. Honestly its a lot of malpractice laws that are not talked about and they shoud be addressed.
If you're interested in learning more about how tort reform isn't the answer to anything, watch Hot Coffee. It's a very informational documentary you can see on Netflix. You may think you know the story of the old woman who spilled coffee from McDonald's on her lap and sued them, but you really don't.
I was really surprised to learn the truth about that old woman who spilled coffee from McDonalds. I was even more surprised at how some people refuse to believe the corporation was the bad guy in that story even after hearing the truth. Amazing!
Erin Howarth I wouldn't necessarily say McDonald's was the "bad" guy. They didn't do it intentionally, but they were liable. The problem is the poor woman is held up as an example of frivolous lawsuits when that's just not the truth. If you get third degree burns and require skin grafts from spilled coffee, it's clearly too hot.
DuffinCaprous
But is money the solution? Maybe in that case it was, maybe not. But unfortunately it seems like it's all about cash payouts, and not much about fixing the problem. How does a bunch of money make it all better?
McDonald's didn't burn their customer "intentionally," but MANY customers and employees were burned before a really big law suit motivated them to change a corporate policy.
culwin She didn't ask for a bunch of money. That woman only originally asked for enough to cover her medical expenses. It was the jury that decided to award her way more than she asked for, because they wanted to send a message to McDonald's.
Pardon the oversimplification, but basically it seems that the problem is that discovery and pretrial procedures do not filter out the non-meritorious cases, thus imposing a cap on damages--which comes after trial, is ludicrous. It targets a non-existent issue in the wrong stage of litigation.
When a lawyer goes after a a group on behalf of a patient, they often sue on many different level from the hospital to even doctor that had minor roles in care. In your percentages, how was this represented? One single case or multiple cases, one actual sued doctor? Also is that shot approach to lawsuit a myth doctors have?
Like i knew that in Americans could sue Doctors but i had no idea that doctors had to pay insurance etc. This whole healthcare system seems ridiculous
So when Florida enacted tort reform and insurance companies profits went up 4300% why didn't the insurance companies pass on the savings to doctors as some expected? My guess is that there are local monopolies in the insurance industry in Florida so when the insurance companies didn't lower their rates there was no competition for the doctors to go to. It seems to me that the solution is either antitrust so that the monopolists can't crush competitors or it is that the state create or sponsor competitors against the monopolists, like Medicare is at the federal level.
What is the solution then?
Aw shit, GMOs are next? I can't wait for that episode!
i've said it before and will say it again : i would buy t-shirt with "to the research!" on them.
i would love to hear your opinion on vegetarian, and vegan lifestyle
Added to the list...
Healthcare Triage
I hope you mean the shirt...
nikki kirk i hope for both!
there was a malpractice ad at the start of my video LOL
4300% increase in profit...no change in premiums.
Genius.
Jesus christ, insurance staying expensive no matter how much profits the insurance companies make? It's almost like some of these people have never actually dealt with a corporation before
Let an expert system make the decisions
I suppose that that explains why doctors get paid so much, they have to spend so much money to make sure that they don't get sued for malpractice. Tort reform obviously doesn't do much in helping healthcare costs. I think that it is crazy that doctors pay so much for malpractice insurance, being that the percentage of cases that actually go all the way through the process and win their claim is so low--2%. I would of thought that the rate was much higher, but with the outrageous cost of even attempting to sue for malpractice, it is obvious as to why these rates are so low.
Finally!!! tort reform is such BS
Just waiting in anticipation for the GMO video. I'm expecting so much arguing in the comments, it's palpable.
Kind of off topic, but could you possibly do a video on chronic illness and/or invisible illness? Or specifically Crohn's Disease and Ulcerative Colitis?
I have had Crohn's for 6 years now, and at 22 years old, I still find it difficult to explain to people what chronic means.
Just because I feel good today, that does not mean I'm "better". Tomorrow I could feel horrible. And no matter how I feel, I will still have Crohn's.
And it's not just a matter of my GI tract being messed up. My immune system is attacking my body. Many people with Crohn's have other health problems as well.
Most importantly, people do die from this illness. A girl in my support group on Facebook just recently passed and she was only 20 years old. I hate the phrase "Well, at least it's not cancer." Just stop. Don't compare two horrible things. They're both horrible in their own ways and it doesn't help to compare them in that way.
I guess I just always try to get more people to know about this stuff. But I'm not sure if it's exactly what you guys do on this channel. I figured it wouldn't hurt to ask.
Side note: Can I mention the horrific rare side effects of medication? Specifically the ones used for Crohn's (I'm sure there are plenty of horrific side effects in other medications, I'm just highly aware of these, for obvious reasons).
Humira is a medicine I take, a shot I give myself every two weeks. My chances of "serious infection" are increased because of the suppression of my immune system. Things like tuberculosis. Also, my chances of getting lymphoma or other "serious", "unusual", and "rare" cancers like hepatosplenic T-cell lymphoma. It "often" results in death. Also, two types of skin cancer, but they're "generally" not life-threatening if treated. And this is all because this medicine is a TNF blocker. I've been on different types of TNF blockers consistently for the past 5 years. So that's fun to think about.
But what really freaks me out is this new medication that has just come out. Tysabri. I've looked it up because my current cocktail doesn't seem to be working and I might have to drop Humira and try something else.
Tysabri increases your risk of getting progressive multifocal leukoencephalopathy (PML) which is a rare brain infection. "There is no known treatment, prevention, or cure for PML." It "usually leads to death or severe disability."
I know I just said I was on Humira and it has all these rare bad side effects, but those seem to have some sort of hope attached to them. This PML thing is just "yep that's it."...
I'm sorry for rambling, I'm sure no one has read this lol. I guess I have a lot on my mind right now.
The US Constitution provides trial by jury of PEERS. A doctor's peer might be a doctor. Not my Aunt Agnes, who would happily give away as much as she could to Frank's widow. This is a tricky problem. What we want to get away from, I think, is Justice is where you can buy it. Same for politicians.
least bias video i could find on this topic, thanks.
Easy solution: if someone brings a meritless case to the court system, THEY have to pay all fees. Okay, its not quite that easy, but if done right it would really help to clean up the systemic mess in our court systems.
That is the law in California. Civil Code 998. If a party makes a settlement offer under this code section and other party fails to obtain an award more favorable than that amount, they are responsible for costs.
My favorite type of tart is apple.
Hospitals are closing.
Honestly, watching from germany I cant relate or even unterstand most of the issues you have with healthcare in your country xD mostly cause all of it seems so completely alien to me or rather I cant understand how this system was ever thought of as a good idea in the first place... how come we hardly have any of these problems even up for debate and yet we pay waaay less and get better or equal care ? O.o
can't wait for the GMO debunking :3
I feel like you didn't do enough to emphasize the negative effects of caps on damages when it comes to legitimate victims. Capping payouts is a way of trying to make up for fraud and waste at the expense of honest people who've been hurt.
Someone is going to have to explain "defensive medicine" to me. I want my doctor to have an incentive to give me comprehensive care.
Now that you've used that fanfare, it must appear always.
I guess this stuff is interesting/important, but what I really want to watch is the medical science (physiological et cetera) in healthcare, not economics. I liked the artificial sweeteners video better (for example).
I hear you, but I get just as many comments asking for the opposite!
Healthcare Triage I enjoy both
Since they're the only educational channel I'm aware of that focuses specifically on healthcare, I think we could do with a little of both
The impression I get is that while there is a lot of information they would like to share, there is much more misinformation that needs to be corrected and addressed first.
Healthcare Triage
In my opinion you've been striking a good balance so far. The early episodes, after the initial few, did a very good job at bringing in a viewerbase and keeping them interested. Then after a few months we got the first few World Healthcare videos and since then you've been bouncing back and forth. I don't think there's a problem with this pace.
Healthcare Triage
This is interesting and I get where you are coming from on tort reform but I do have 1 qualm with this video. The entire practice of defensive medicine is to get more accurate results to prevent the likely hood of mistakes. Isn't this what we want doctors doing in general, being accurate and having multiple points of data to find the real issue and not just trust the patients description of the issue.
This seems like another issue of us evaluating cost over results and saying patients should only get Y time and X dollars spent on them to find the issue and after that if there is an issue it is too hard and move on. I understand you can't spend 8 hours a day and your entire budget on a patient but with the average doctor visit only getting around 19 minutes of care (based on a paper I read recently I don't know the accuracy myself) then I don't think it would be unreasonable to up that and get more accuracy by knowing your patience better.
Few ideas for videos
Doctor time with patient and accuracy
The best 30 minutes in general you can spend a day exercising
you spend a lot of time telling us about misconceptions but now I just know a lot of things you don't suggest to do instead of things you do suggest. Maybe more videos to suggest best or good practices related to health and medical industry
Thanks
My general thought is that they will probably be okay with GMOs, but Monsanto's application of them may be an issue. It's sort of like the climate change debate, which isn't actually a debate as there is no real debate in the scientific community that humans are the leading cause of global warming and climate change. What is debatable, in regards to climate change, is what to do about it socially, economically, morally and politically. In the case of GMOs, it is Monsanto's pure evil use of GMOs and enforcement of their patents and seed use (can't replant the same seeds the next year, prosecuting neighboring farms that accidentally get some of their seeds on their property or even bees dared to cross pollinate their plants with Monsanto's plants) that become a problem, along with Bayer's pesticides (imidacloprids and their potential relation to CCD) and some other large corporate issues that don't relate to if GMOs themselves are actually a problem, which causes people to blindly label GMOs themselves bad rather than separate issues caused by Monsanto/Bayer and the foodstuff that comes from GMOs... of course they may surprise me with saying the research isn't clear yet or something like that too. I'll look forward to it regardless of what their eventual findings are since I'm sure they'll look at the actual research and not let political/economic/social issues cloud their statements.
"Next: GMOs"
And there was much rejoicing.
Should say "GEOs" (Genetically Engineered Organisms) but whatever.
So what about a "loser pay" form of tort reform where, in the case of invalid or frivolous lawsuits, the plaintiff and his/her attorney have to pay for the cost of the defense? That would stop a lot of ambulance chasing trial lawyers from taking up frivolous claims if they have skin in the game. It also makes plaintiffs think twice before bringing bogus lawsuits to court.
The way it is now, it's a win-win for trial lawyers and plaintiffs and a lose-lose for health providers. There needs to be some incentive not to bring forth frivolous malpractice lawsuits. As it stands, there are none.
And what about allowing insurance companies to sell across state lines? If doctors had more choice when it comes to malpractice insurance, companies would have to compete for their business and premiums would go down.
You seem to focus on only one type of tort reform - settlement caps. There are other solutions to the problems that will drive prices down.
Pardon me if I've missed it but is "Tort" its own word or is it an acronym?
I literally cheered when I saw GMO's are next! So tired of this "organic, non-GMO" fad.
It's a concept in civil law which refers to a suit for the redress of wrongs committed by one person (called a tortfeasor) against another, and provides for the tortfeasor's liability to pay damages if he or she loses in court.
It's different from crimes in that it doesn't carry jail time, and can be proven with proof less than reasonable doubt, requiring mere preponderance of evidence. The party is liable for damages and not imprisonment-- but these can be substantial (though judges usually reduce them drastically).
Tort reform aims to place caps on the maximum damages awarded in a tort case. The argument is that the bigger issue is not that damages are too high, but that most meritorious tort claims (claims where a doctor really committed malpractice) never reach court, instead a lot of nuisance cases do.
In my assessment the problem lies more with pre-trial procedures being bad at filtering out bogus claims, and not that damages are too high. Doctors who genuinely malpractice should not benefit from a damage cap, but at the same time good doctors who just happened to work with an exceptionally litigious patient must not suffer through a bogus claim.
This video makes me start sweating! I need to move!
K BYYEEEEE AMERICA!!!
Second, how humiliating. :(
you tell 'em b0ss
Again you cherry pick to paint a limited picture. As your userbase grows so also grows your responsibility to provide comprehensive analysis. Tort and malpractice costs and their correlation to overall system cost is far nuanced than you so cleverly produce
If you are sure he cherry-picked data, then I am interested in looking at the other data which disproves his claims. If you can't, I'll assume there is none.
First!
In some parts of India, malpractice results in a mob beating the doctor. :P
Illegally of course.
Patients; who is worried about peons? Tort reform is for selfish doctors not patients.