Extreme Medical Bills

Are we going to force doctors to charge less?  How about we outlaw lawyers so malpractice goes down and then medical costs so as well?

We need to have some serious healthcare reform, but having a floor for charges doesn't make sense.  No matter what you charge for the service the basic costs of the medical equipment and doctor's training, malpractice insurance, etc isn't going to go down anytime soon.  What would really help is if judges would throw out frivilous lawsuits, part of the reason our doctors charge so much is to pay for their malpractice insurance because of sue-happy patients who blame the doctors for everything.  Take OBGYN's for instance, I'm not sure what the figure is today but I know a few years ago (~5) in MD OBGYNs had to pay on the order of $250K/year for malpractice insurance alone.  So that means that they have to at least make $250K/year just to pay that bill, tack on the rent on their office space, medical equipment, plus their salary so that they can live and you can see why they charge so much per patient.

I admit malpractice insurance is obscene and terribly unfair to physicians. However, the "frivolous" lawsuits are minimal and do not reflect by any stretch the major costs of medical domain. Nor am I advocating "cheaper" service; but there certainly ought to be humanitarian intervention for the serious ill who cannot cover catastrophic costs.

No, they are a major part of it.  Over 80% of malpractice suits are frivolous.  based on a false presumption that doctors are gods.

And lowering costs is your only real option.  Reducing quality can be done, but then do you really want to?

And this is exactly why OBGYN malpractice insurance is so high.  The slightest birth defect is blamed on the OBGYN rather than genetics or any number of factors involved during gestation.  Yes there are some birth defects that are directly caused by the doctor screwing up, but they are few and far between.

And until God becomes a doctor, they will make mistakes.

Very true.  And unless the doctor is grossly neglegent (operating while intoxicated, amputating the wrong limb, etc) then they shouldn't be sued for every little mistake they make.

There are enough frivolous ones with big buck awards that make it so.  It is not a conspiracy of insurance companies.  It is a fact of life.  Edwards did not get rich by altruistic means - or by his sexual prowess.

You're lumping all frivolous litigations as medical. Ain't so.

Going from one extreme to the other would do no good - remove malpractice and you remove an incentive for doctors/hospitals to try and ensure they give the best treatment. Lawyers do have a role to play in the economy, even if it is likely much too large atm than it should be.

As for the general issue of health, IMO there are several options. Firstly you could have compulsory health insurance. Alternatively you could have universal health care for major afflictions. Another option would be to restrict losses claimed by hospitals/doctors to an individuals assets (and possibly a (small) maximum proportion of their income), with the government then footing the remainder of the bill, or similarly have the government take on the bill where the individual is unable to pay it back immediately, and then seek repayment from that individual up to the amount that the individual is able to contribute, until it is paid off (or written off). None of the options are perfect, but I feel that either one of them is more preferable to the situation where people are allowed to die because they lack the funds for life saving treatment. Now as to your 'capped charge' idea I don't think it would work - firstly how do you determine what this capped charge would be? Is it based on age? On income? On wealth? Any one of these would make it unfair for others. For example lets say you base it on income - I decide to not get health insurance to increase my disposable income, and spend that money on accumulating more wealth than a similar person who gets health insurance. We both suffer injuries, but thanks to my low income I have the amount I have to pay capped, even though I had plenty of assets to cover the cost. Base it on wealth and you have the problem of pensioners having to sell their homes to meet a medical bill, and struggling to cope on their low income. On the other hand your suggestionto allow the spreading of payments over time for a person with insufficient assets to meet it up front has merit, and I'd support government help on this issue. For example the government could offer a relief scheme where they will take on the individuals medical bills, and in return that person has to pay so much of their income to then repay their debt (to the government).

No one said that frivilous lawsuits were the only cause of high malpractice insurance, but they are primary contributors to high malpractice since most hospitals/doctors are more willing to settle a case out of court even if they aren't at fault for an injury to avoid the bad press that a court case would bring.  Hell you see examples of this every single day, just turn on the tv and watch the ads for various law firms asking if you think you or a loved one have certain medical problems (like cerebal palsy), if you do contact the law firm and they might be able to sue the pants out of the doctor that delivered you or your loved one claiming that they are to blame.  It is our culture of finding someone to blame for every little thing that goes wrong in our lives rather than either owning up to our own mistakes or chalking it up to bad luck. 

No matter how you cut it if the judges out there would be more willing to toss out frivilous medical lawsuits then malpractice insurance would go down which would cause medical costs to decrease in turn.

Whatever...the humanitarian issue remains:no one should have to bear financial disaster because of illness.   

What is financial disaster?  Giving up your cable, Cell, and 2nd car? That really is subjective since no one has to bear financial disaster today if you consider how well they can live without paying a dime.  Better than Obama's brother.

Prior to the subprime crisis about half of home foreclosures were due to medical catastrophe.If you have seen people go through this you might better understand that it goes much further than your somewhat feeble attempt to trivialize the issue.

If they chose not to obtain insurance (which in turn helped to allow them to live in a nicer house), why shouldn't they be made to sell that house if they then need to pay for the medical costs? Obviously it shouldn't go to the extreme where they have no-where to live, but I don't see why people shouldn't be made to downgrade as a result, since the decision to not take insurance is essentially a risk - if it goes well you get the benefit of not having paid the money for nothing, if it goes badly then you get hit with a massive bill. If the government was to then bail you out for a large amount of that cost in situations where you could afford it (via selling your house) it would mean you could benefit from the full upside and only face a small part of the downside - the same sort of problem that will be caused by the recent company bail-outs as an aside!

Sometimes its not a choice. Medical Insurance is expensive for those who do not get it through their employer and supplementary insurance for those in copay situations can be expensive as well. Im fortunate enough to be able to have full coverage but it costs me twice as much as what my mortgage used to be. If I was young and just starting out in the career path that I followed in the past I would not have been able to afford both a house and medical insurance.

Losing a house can be much more than just a downgrade. Medical catastrophe doesnt lead to downgrading to a lesser expensive house. It leads to taking all the equity in a house and ruining your credit as well. It is more expensive in many markets to rent so some are often left with a situation that truly spirals out of control.

There is a large percentage of the population that get denied insurance because of preexisting conditions. Not such a big problem in the past when it was possible to stay with the same company or union for over 20 years but that scenerio is much less likely these days and is one of the reasons why there are so many people who are uninsured these days.

Your going to start seeing a large rise in this problem in the next couple of years because people wont be able to borrow as much or at all againt their house to prevent the worst from happenning (even if the medical expenses are not all that extreme) until both the credit and housing markets stabilize.

How do you know I have not?  You presume way too much. 

But that is not a financial disaster, and there is something called Bankruptcy, and homesteading.  Not really bad all in all.  And certainly not a disaster.l  As evidenced by the people that have been trhough it 3 and 4 times, not just ones.

And buying a house is not?

Look at some of the states. Some don't provide any exemtion to real estate for bancruptcy or homesteading declarations.

You might not be with me. I might understand the problem from both sides of the fence, but I dont see the lawn being green for quite a few years. Give it a few more years. As the number of uninsured rises a lot of people will realize that they are paying for the uninsured with their own insurance premiums anyhow. The taxpayer is already paying for those who are in the highest cost group so it won't be long before the only ones fighting it are those within the industry.

It depends on someone's income. I suspect it is for anyone who is near or below the median income.

I still think it should be mandatory just like auto insurance.