[Oe List ...] OE Digest, Vol 65, Issue 70

[Jack Gilles]

David,

I think you need to think twice before writing personal attacks on a  
person you don't obviously know well and I would hope you would  
consider an apology to Don.  Those of us who have had the honor of  
knowing Don well know him to be both a compassionate and generous  
human being who has donated his money, time and most important, his  
doctoring skills all over the world.  So for you to paint him as  
lacking compassion because of his expressed views is terribly wrong.   
Don needs no defense but he has some valid concerns.

Don is not advocating denial of wheelchairs to those who need it.  He  
does object, as we all should, to the scam that gets these things paid  
for at 2, 3 or 4 times what the supplier paid for it and often for  
people who don't need them.   Secondly, I have often heard people cite  
your 2% statistic on tort cost, but there is a documented trend of  
young doctors avoiding GP and other fields due to what they have to  
pay each year for malpractice insurance.  I think the 2% doesn't  
include all the extra tests done to cover possible suits.  We live in  
an ever increasing litigious society so some fair adjustment needs to  
be made so that doctors can practice and new doctors can be attracted  
to needed fields of practice and people who are wronged are fairly  
compensated.  There is room for different points of view and solutions  
without loosing any degree of compassion.

Peace,

Jack Gilles


On Sep 9, 2009, at 5:36 PM, David Walters wrote:

> It is interesting that you would liken the providing of lift chairs  
> and electric wheel chairs to the high cost of medical liability  
> insurance. As one who suffered thru 4 years of mobility problems  
> with no health coverage that would cover either those two items, I  
> can speak with some authority. Your over wrought concern for the  
> cost of providing such items demonstrates your lack of human  
> compassion for those who have not had to the good fortune that you  
> have always enjoyed.
>
> As for the cost of liability insurance. the best data I can find is  
> that it constitutes 2% of all medical expenses. To correct the  
> problems that drive this cost, most people in your profession wave  
> the tort reform banner, What this means is a "throw the baby out  
> with the bathwater" approach that would stop virtually all  
> malpractice suits. That means that even those with legitimate cases  
> will go the same way as frivolous cases. Again, a lack of compassion  
> for those who truly suffer from the malpracitce of those in your  
> profession.
>
> The current opposition to healthcare reform is rooted and grounded  
> in the  Republican ideology that was birthed in the midst of right- 
> wing religious ,movement of the 70s and 80s that gave us Ronald  
> Reagan as its patron saint. This same mindset manifest itself  
> yesterday where the school children of the county I live in were not  
> allowed to here President Obama speak to them about doing good in  
> school and working hard at growing up to productive citizens.
>
> What this country needs is a comprehensive intentional, futuric  
> model for a healthcare system that cares of all of our citizens.  
> None of the so-called leaders of the House and Senate on both sides  
> of the aisle have proposed anything that comes close. Excerpt for  
> the bill voted out of the the late Teddy Kennedy's committee, which  
> strangely, no one is talking about.
>
> This list is composed mainly of a group of people that once  
> proclaimed that the moral issue of our times is the 95-5% split or  
> the out of balance Economic triangle. I believe that the current  
> issue of healthcare reform is a subset of the same issue.
>
> David Walters
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> The article by Feldman that you cite points to one of the most  
> important factors producing the high cost of American health care:   
> liability insurance for doctors, hospitals, pharmaceutical and  
> medical device manufacturers.  I would add to this the unregulated  
> advertising of prescription drugs that encourages people to self  
> diagnose and demand that their doctor prescribe something they have  
> seen touted on TV, not to mention the electric wheel chair industry  
> spawned by a bureaucratic decision to provide coverage.  Remember  
> the recliners that would stand you up, if you had trouble getting  
> out of your chair?
>
> Doctors and hospitals have had their reimbursement reduced by  
> Medicare stepwise in several reform efforts, and probably cannot be  
> squeezed much more.  Several specialties have seen their training  
> programs under filled because of the long training required coupled  
> with reduced reimbursement.  Only 70% of the residencies in cardiac  
> surgery filled this year.  Residencies in Dermatology and Plastic  
> Surgery are over subscribed because much of their services are not  
> covered by Medicare and private insurance, but are on a cash basis,  
> reducing collection costs.  Family practitioners and Internists are  
> having a very difficult time.  Many rely on nurses and physician  
> assistants to monitor routine problems, freeing them for more  
> difficult tasks, like the paperwork required by Medicare and insurers.
>
> I am not optimistic that requiring insurance companies to take all  
> comers, regardless of pre-existing conditions would somehow reduce  
> costs.  It would simply increase everyone else's premiums.  I know a  
> couple of self-employed people, who maintain a health savings  
> account, have a high deductible catastrophic policy that is  
> affordable and pay their own routine medical costs out of pocket.   
> They are highly motivated to stay well, and do.  People are  
> motivated to seek only absolutely essential care when they have to  
> pay for it.
>
> The status quo is overly expensive, but the currently proposed  
> legislation, H.R. 3200 will not reduce costs without addressing tort  
> reform which will not only reduce costs to physicians and hospitals,  
> but also drugs and devices, and reduce the overuse of xrays, and  
> tests in practicing "defensive medicine".
> .
>
> Don Elliott
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