Lawsuits filed by RAM attendees make me HOT

[simms3]

One of them, a family doctor, could only collect 30% of whatever he billed the insurance company no matter what his prices were or how fairly he charged.  In order to be paid fairly he had to charge one amount as his 'standard fee' and then gave huge 'discounts' when people paid with cash.

This is 100% true.  I think the national average for insurance reimbursements is actually closer to 70 or 80 %, though.  Just imagine Medicare/Medicaid reimbursements!  They are as low as 10-20% and average somewhere between 40-50%.  Now that is not a good thing for anyone, and that is a major reason why I don't trust the government to get involved in the healthcare industry.

Yea I guess out of the hundreds of insurance companies out there, of course there are some unscrupulous ones.  I also agree that it should be law that insurance companies do not turn away patients because of a pre-existing condition and that people should be able to shop around more for policies that might be cheaper or better (cross state lines...in Alabama for instance, people have 1 choice so it is essentially a monopoly), and I think people should have ownership of their policies so that they don't have to go through all that trouble every time they move or change jobs, and a host of other changes.  HMOs have largely backfired on their original purpose ironically, and even more ironically, the person that criticized them the most in recent years, Ted Kennedy, basically created them.

All that is not to say that insurance companies, which are for profit, are not evil for trying to profit.  If lawyers are socially allowed to make huge profits on their clients' claims, even if the claims are illegitimate, then insurance companies should be able to make whatever profit they can in the boundaries of the law and within morally just standards (most people break those, not just insurance companies, trial lawyers may be the biggest culprits).

All that this argument has come to is one side on the defense of their position and the other side criticizing the defense side's sources, as usual.  It's fun for a little bit, you have to pick your battles or you will wear yourself out on this board.  There is no way I am touching the debate on pensions, LoL.  And I still stand that we need to benefit the doctors as much as possible (not the insurance companies and DEFINITELY not the lawyers).  The doctors are the most "just" and reasonable people out of those groups, and they are the ones actually working to heal people.

[ChriswUfGator]

One of them, a family doctor, could only collect 30% of whatever he billed the insurance company no matter what his prices were or how fairly he charged.  In order to be paid fairly he had to charge one amount as his 'standard fee' and then gave huge 'discounts' when people paid with cash.

This is 100% true.  I think the national average for insurance reimbursements is actually closer to 70 or 80 %, though.  Just imagine Medicare/Medicaid reimbursements!  They are as low as 10-20% and average somewhere between 40-50%.  Now that is not a good thing for anyone, and that is a major reason why I don't trust the government to get involved in the healthcare industry.

Yea I guess out of the hundreds of insurance companies out there, of course there are some unscrupulous ones.  I also agree that it should be law that insurance companies do not turn away patients because of a pre-existing condition and that people should be able to shop around more for policies that might be cheaper or better (cross state lines...in Alabama for instance, people have 1 choice so it is essentially a monopoly), and I think people should have ownership of their policies so that they don't have to go through all that trouble every time they move or change jobs, and a host of other changes.  HMOs have largely backfired on their original purpose ironically, and even more ironically, the person that criticized them the most in recent years, Ted Kennedy, basically created them.

All that is not to say that insurance companies, which are for profit, are not evil for trying to profit.  If lawyers are socially allowed to make huge profits on their clients' claims, even if the claims are illegitimate, then insurance companies should be able to make whatever profit they can in the boundaries of the law and within morally just standards (most people break those, not just insurance companies, trial lawyers may be the biggest culprits).

All that this argument has come to is one side on the defense of their position and the other side criticizing the defense side's sources, as usual.  It's fun for a little bit, you have to pick your battles or you will wear yourself out on this board.  There is no way I am touching the debate on pensions, LoL.  And I still stand that we need to benefit the doctors as much as possible (not the insurance companies and DEFINITELY not the lawyers).  The doctors are the most "just" and reasonable people out of those groups, and they are the ones actually working to heal people.

The doctors are no "better" than the lawyers or insurers, that's another myth.

They scam the system with double-standard billing systems, just as Stephen has described, and as you have already acknowledged, in order to operate profitably in the cost-bloated present structure of the U.S. healthcare system. I'm not blaming them for it, the insurance companies have necessitated everyone acting this way. And again, you ought to quit knocking lawyers, since malpractice litigation actually accounts for less than 2% of healthcare costs, even according to your own cited sources.

So I'm not sure why, when I just cited the same sources you cited, which clearly indicate that the litigation expenses that you're laying blame on actually only account for 0.06%-2% of healthcare spending, you're somehow still blaming lawyers for the 114% rise in healthcare costs over the past several years.

So now that we've dispensed with that bunch of utter B.S., ironically enough using the very same sources you initially cited, perhaps you could do me the favor of explaining what justifies the other 113.4%?

And while you're at it, could someone explain why the entire republican party and several posters on this board are focused on 0.6% of the problem and ignoring the other 113.4%? I mean, forget your ideology here for a second, even if everyone in the country conceded every point in your argument and eliminated civil lawsuits altogether, it still wouldn't do a damned thing to actually fix the problem.

So I don't get it. Why the silly fixation?

[ChriswUfGator]

So read something which includes the actual facts, then tell me again how tort reform is going to fix healthcare...

http://www.cleveland.com/nation/index.ssf/2009/09/would_tort_reform_make_much_di.html

My favorite quote in the piece;

Why, then, the insistence on tort reform?

For one thing, it's more easily grasped than the more complicated arguments for health care reform.

And another good point;

There's no evidence that these caps on non-economic damages reduce the frequency of (malpractice) claims," said Chandra of Harvard.

And this pretty much sums up the true problem;

professor at the University of Pennsylvania and author of "The Medical Malpractice Myth," theorized that having "a common enemy" keeps insurance and pharmaceutical companies -- the real culprits behind rising costs, he said -- from fighting among themselves.

[stjr]

My original response was more focused on the original subject of liability insurance.  Somehow we got diverted to health insurance which is somewhat of a different animal.  On that, I think we can agree that insurance companies, lawyers, pharmaceutical companies, and medical providers are all in the game to profit handsomely.  The real losers are the policyholders who pay for all these players financial gains.  [By the way, doctors are best friends with lawyers when they profit from providing "expert" testimony about those "injuries" that are fully attributable to that "slip and fall" or workers comp claim against a business.  So, don't think the medical profession can't be guilty of driving up premiums derived from these cases too.]

Nothing wrong with profits if they are derived from a process transparent and efficient to their customers.  But, it really isn't anymore.  Who to blame?  Politicians working for an electorate looking for over-simplified answers and gimmicky solutions that really don't work for anyone and end up costing us even more money through super-complex administration (I think some medical providers today would place this far over the costs of malpractice threats and would share with the insurance companies that this is a common enemy to all health care costs) that fails to deliver on promised "value adds", unproductive and misguided regulatory enforcement, and political mandates such as making the insured pay or subsidize the uninsureds.  Add policyholders who don't ask questions or attempt to understand their coverages and what they are, or are not, getting for their money.  They expect to be paid for every problem life deals them, no questions asked.  Maybe the dumbing down of America is the real issue here.  (Although, in fairness, many policies are so complex today that it often may take a lawyer to understand one.  At least readable summaries should be required.)  

As you might expect, the populace wants cheap but perfect state-of-the-art medical care fully paid for by insurance companies while fully reserving the right to sue insurers and/or medical providers for any practices they disapprove of.  Add the political twist that no one in this country should be denied access to health care, a noble but expensive proposition.  Maybe, some of us are unrealistic at what it costs to deliver all this and/or unwilling to save and invest an appropriate amount in our own health.  I am constantly amazed to see people think nothing of spending thousands on maintaining a vehicle but unwilling to spend a few dollars on a copay for their health!

We need to "blow up" all the current systems and start over from scratch but, as the health care reform debate showed, while most can agree on that goal, too many special interests in every quarter vested in the status quo guarantee that the extensive changes needed will never come to be.  Instead, we end up with compromises that just compound the inefficiencies and costs of the existing systems.

[ChriswUfGator]

My original response was more focused on the original subject of liability insurance.  Somehow we got diverted to health insurance which is somewhat of a different animal.  On that, I think we can agree that insurance companies, lawyers, pharmaceutical companies, and medical providers are all in the game to profit handsomely.  The real losers are the policyholders who pay for all these players financial gains.  [By the way, doctors are best friends with lawyers when they profit from providing "expert" testimony about those "injuries" that are fully attributable to that "slip and fall" or workers comp claim against a business.  So, don't think the medical profession can't be guilty of driving up premiums derived from these cases too.]

Nothing wrong with profits if they are derived from a process transparent and efficient to their customers.  But, it really isn't anymore.  Who to blame?  Politicians working for an electorate looking for over-simplified answers and gimmicky solutions that really don't work for anyone and end up costing us even more money through super-complex administration (I think some medical providers today would place this far over the costs of malpractice threats and would share with the insurance companies that this is a common enemy to all health care costs) that fails to deliver on promised "value adds", unproductive and misguided regulatory enforcement, and political mandates such as making the insured pay or subsidize the uninsureds.  Add policyholders who don't ask questions or attempt to understand their coverages and what they are, or are not, getting for their money.  They expect to be paid for every problem life deals them, no questions asked.  Maybe the dumbing down of America is the real issue here.  (Although, in fairness, many policies are so complex today that it often may take a lawyer to understand one.  At least readable summaries should be required.) 

As you might expect, the populace wants cheap but perfect state-of-the-art medical care fully paid for by insurance companies while fully reserving the right to sue insurers and/or medical providers for any practices they disapprove of.  Add the political twist that no one in this country should be denied access to health care, a noble but expensive proposition.  Maybe, some of us are unrealistic at what it costs to deliver all this and/or unwilling to save and invest an appropriate amount in our own health.  I am constantly amazed to see people think nothing of spending thousands on maintaining a vehicle but unwilling to spend a few dollars on a copay for their health!

We need to "blow up" all the current systems and start over from scratch but, as the health care reform debate showed, while most can agree on that goal, too many special interests in every quarter vested in the status quo guarantee that the extensive changes needed will never come to be.  Instead, we end up with compromises that just compound the inefficiencies and costs of the existing systems.

You didn't read the prior link at all, did you?

You are still parroting the right-wing B.S. that simply isn't backed up by any data. How many links need to be posted showing that less than 2% of healthcare spending is related in any way to civil liability in general, and virtually nothing is related to "frivolous" lawsuits, while a 114% increase in healthcare costs has occurred which has nothing whatsoever to do with litigation, before you'll finally open your eyes on this one?

I'll say it again, even if the entire country agreed with every point in your incorrect argument, then wow...congratulations, it wouldn't do a damned thing to fix the problem, which isn't 0.6% it's the other 113.4%...

Litigation has nothing to do with it, the insurance companies have everything to do with it.

And P.S., expert witnesses are paid by the lawyers everyone vilifies, not by defendant doctors or insurance companies. Actually, if you factored the fees doctors receive for being expert witnesses in PI and medmal cases into the general healthcare revenue, I highly suspect that in aggregate they'd probably exceed the value of medmal jury verdicts. Meaning lawyers as a whole probably pay more into the current healthcare system than they take out.

Of course, none of which would be necessary anyway if insurance companies would fairly adjust claims.

"Tort Reform" is a non-sequitur, and makes no sense. You're removing all accountability from people who make mistakes, at the expense of the general public, and it won't do anything about healthcare costs. As I've demonstrated extensively already. The whole thing is an insurance-industry scam and has nothing to do with what's wrong with our current healthcare system.

[stjr]

You didn't read the prior link at all, did you?

You are still parroting the right-wing B.S. that simply isn't backed up by any data. How many links need to be posted showing that less than 2% of healthcare spending is related in any way to civil liability in general, and virtually nothing is related to "frivolous" lawsuits, while a 114% increase in healthcare costs has occurred which has nothing whatsoever to do with litigation, before you'll finally open your eyes on this one?

I'll say it again, even if the entire country agreed with every point in your incorrect argument, then wow...congratulations, it wouldn't do a damned thing to fix the problem, which isn't 0.6% it's the other 113.4%...

Litigation has nothing to do with it, the insurance companies have everything to do with it.

And P.S., expert witnesses are paid by the lawyers everyone vilifies, not by defendant doctors or insurance companies. Actually, if you factored the fees doctors receive for being expert witnesses in PI and medmal cases into the general healthcare revenue, I highly suspect that in aggregate they'd probably exceed the value of medmal jury verdicts. Meaning lawyers as a whole probably pay more into the current healthcare system than they take out.

Of course, none of which would be necessary anyway if insurance companies would fairly adjust claims.

"Tort Reform" is a non-sequitur, and makes no sense. You're removing all accountability from people who make mistakes, at the expense of the general public, and it won't do anything about healthcare costs. As I've demonstrated extensively already. The whole thing is an insurance-industry scam and has nothing to do with what's wrong with our current healthcare system.

Chris, what are you talking about?!   It is you who is not carefully reading posts here.  I have never said anything about litigation being a major factor in heath insurance premiums.  In fact, I stated that administrative costs and covering the uninsured where major factors in addition to everyone wanting the best, latest and greatest medical technology without wanting to contribute fairly to paying the freight for it.  And, I already defended a person's right to sue.

I believe everyone should have the right to sue and no one should be exempt as negligence, etc. can be found anywhere and much of the "quality", "safety", "reliability" and "fair dealing" in our services and products has been driven by fear of accountability in court.  But the bar should be high enough that the claimant and their attorney pursue only the stronger claims.  Not sure if "loser pays" cures that, but it might help.

Who to blame?  Politicians working for an electorate looking for over-simplified answers and gimmicky solutions that really don't work for anyone and end up costing us even more money through super-complex administration (I think some medical providers today would place this far over the costs of malpractice threats and would share with the insurance companies that this is a common enemy to all health care costs) that fails to deliver on promised "value adds", unproductive and misguided regulatory enforcement, and political mandates such as making the insured pay or subsidize the uninsureds.

Maybe, some of us are unrealistic at what it costs to deliver all this and/or unwilling to save and invest an appropriate amount in our own health.  I am constantly amazed to see people think nothing of spending thousands on maintaining a vehicle but unwilling to spend a few dollars on a copay for their health!

That doesn't mean the system isn't abused.  Every system has bad apples abusing it and the legal system is no different.  Nor are the medical providers, insurance companies, the government, or the policy holders.  Freeloaders can be found everywhere.  I didn't quantify that abuse. I just noted it happens and we need to wring it out of the system wherever we can.  Nowhere did I say this was a major cause of increased premiums.  Further, my comments about litigation only extended originally to liability claims and the joint benefits lawyers AND insurers derive from the claims process.

As to the doctors testifying, the fees paid for them to be expert witnesses is not the issue.   It's the cost to the casualty insurance system that their testimony generates, such costs going to pay ongoing medical expenses to said doctors. I merely questioned situations where this testimony exaggerates the claim to the cost of the system, and ultimately to the policyholder who pay the premiums that support it.   And, the testimony I was referring to was for liability and workers comp claims.  It had nothing to do with health insurance.

So, again, Chris, what the heck are you referring to?

[ChriswUfGator]

That doesn't mean the system isn't abused.  Every system has bad apples abusing it and the legal system is no different.  Nor are the medical providers, insurance companies, the government, or the policy holders.  Freeloaders can be found everywhere.  I didn't quantify that abuse. I just noted it happens and we need to wring it out of the system wherever we can.  Nowhere did I say this was a major cause of increased premiums.  Further, my comments about litigation only extended originally to liability claims and the joint benefits lawyers AND insurers derive from the claims process.

As to the doctors testifying, the fees paid for them to be expert witnesses is not the issue.   It's the cost to the casualty insurance system that their testimony generates, such costs going to pay ongoing medical expenses to said doctors. I merely questioned situations where this testimony exaggerates the claim to the cost of the system, and ultimately to the policyholder who pay the premiums that support it.   And, the testimony I was referring to was for liability and workers comp claims.  It had nothing to do with health insurance.

So, again, Chris, what the heck are you referring to?

I was referring to this portion of your statement.

To begin with, doctors' expert testimony doesn't "increase claims costs to the system." The claim is already whatever it is beforehand, the reason doctors testify for a plaintiff is generally to describe and prove it to a jury. What increases costs to the system are insurance companies that instead of paying claims, make bogus low settlement offers, or refuse to pay at all. That then necessitates the entire process of instituting a lawsuit.

And further, there is very little "abuse" in the system. At the end of the day, the buck stops at the jury box, which is generally filled with people like simms who are convinced that if they deny the recovery their insurance rates will go down. It's already incredibly hard to obtain any sizeable jury verdict in Florida, regardless of how badly injured and how badly disabled the victim may be for the remainder of their life expectancy.

This assumption that there is all this "abuse" as you put it, in the system, is just untrue and that impression is a product of the insurance companies' own making.

[Dog Walker]

Funny, if there are very few jury awards in Florida then how do the trial lawyers pay for all of the TV and billboard advertising?  Eddie Farah alone spends well over $1 million per year on advertising.

[Timkin]

Point !

[ChriswUfGator]

Funny, if there are very few jury awards in Florida then how do the trial lawyers pay for all of the TV and billboard advertising?  Eddie Farah alone spends well over $1 million per year on advertising.

Simple, he makes it work on volume.

He has a lot more clients than your typical attorney, due to the same advertising you mentioned. Your logic is the same as saying "Well WalMart's markups must be huge since they're making so much money" when in reality they're making the money on volume, not on making a huge profit on every single sale.

Again, all this anecdotal evidence is right-wing B.S. logic that doesn't hold up when you look at the actual data related to allegedly "frivolous" lawsuits. The truth is that it simply isn't a real problem at all. What it is, however, is a distraction from the real problems.

[buckethead]

Settlements?

[Dog Walker]

Of course settlements.  That's the dirty little dance that the  plaintiff's attorneys and the insurance companies have going and we all pay the price in our premiums.  The attorneys and the insurance companies are NOT opponents.

[Dog Walker]

But Stephen, they wouldn't be able to hold on to those tender parts if we weren't so frightened by the lawyers.  IMHO they are partners in an extortion racket.

AND my wallet is an extremely sensitive part of my anatomy! 

[ChriswUfGator]

But Stephen, they wouldn't be able to hold on to those tender parts if we weren't so frightened by the lawyers.  IMHO they are partners in an extortion racket.

AND my wallet is an extremely sensitive part of my anatomy!  

Lawyers don't "threaten" anyone. The threat is really to the public at large, when someone acts in a negliglent fashion, you're injured as a result, and then they or (more likely) their insurance carrier unilaterally declare that you're going to have to suck it up since compensating you for your loss would hurt profits. How is that fair to anyone?

You seriously make zero sense. I've already posted much of the actual data in this debate, and you keep coming back to nonsensical right-wing anecdotal B.S. that sounds halfway catchy but doesn't actually add up. I really am starting to believe the quote from that U Penn professor who said the attraction behind tort reform is that certain factions can't understand the more complicated issues.

[Dog Walker]

And I lent one of my vacant offices to a private investigator so he could videotape an "injured and disabled" client of a prominent law firm load heavy boxes on a truck.

There is little admirable in either camp and you are right about the insurance companies when it comes to injury claims.