wmed.com Blog

The health care reform bill is a “trial lawyer’s dream” according to Insurance Information Institute (I.I.I.) President Robert P. Hartwig speaking at the National Underwriter/Ernst & Young 21st Annual Executive Conference for the Property and Casualty Industry.

The Congressional Budget Office estimates that $54 billion can be saved by implementing medical malpractice tort reform, but the authors of the bill left out any such reforms. This figure does not include the huge cost of practicing defensive medicine generated by the demands of the current tort system.

Trial lawyers are protected by Section 2531 of H.R. 3962, the Affordable Health Care for America Act. This empowers the Secretary of Health and Human Services to pay states that enact laws to hold down the cost of medical malpractice but “a state is not eligible for the incentive payments if that state puts a law on the books that limits attorneys’ fees or imposes caps on damages.”

The impact of tort reform can be dramatic. After Texas capped pain and suffering damages at $750,000 in 2003, the number of malpractice lawsuits dropped abruptly. Lawsuits in Harris County (Houston and environs) plunged by 50 percent. In California, pain and suffering damages cannot exceed $250,000. Attorneys may collect no more than 15 percent of malpractice awards over $600,000.

Mr. Hartwig stated that the authors of the current health care legislation are insuring that “this is an era of no tort reform.”

This is a summary of what the government has created for us. The House bill is 1,990 pages or about 400,000 words. That’s $2.24 million per word for the estimated 10-year cost of $894 billon.

For comparison:

Declaration of Independence in 1776: One page
United States Constitution in 1787: 4 pages
Emancipation Proclamation of 1863: 5 pages
Social Security Act of 1935: 64 pages
Civil Rights Act of 1964: 8 pages
War and Peace: 1,296 pages
King James Version of the Bible: 1,024 pages
Torah 80,000 words on a scroll

The health care bill is written in extreme legalize that most people cannot understand. Here is an example paragraph.

“(a) Outpatient Hospitals – (1) In General – Section 1833(t)(3)(C)(iv) of the Social Security Act (42 U.S.C. 1395(t)(3)(C)(iv)) is amended – (A) in the first sentence – (i) by inserting “(which is subject to the productivity adjustment described in subclause (II) of such section)” after “1886(b)(3)(B)(iii); and (ii) by inserting “(but not below 0)” after “reduced”; and (B) in the second sentence, by inserting “and which is subject, beginning with 2010 to the productivity adjustment described in section 1886(b)(3)(B)(iii)(II)”.

In more simple terms: “This section is described as dealing with incorporating productivity improvements into market basket updates that do not already incorporate such improvements.”

Now do you understand it?

The bill will be passed with the majority of legislators never having read it.

If you want to try here is the link:

http://health.burgess.house.gov/UploadedFiles/House_HCR_bill.pdf

It is not clear how many people will actually benefit from this program. It is clear that billions of dollars will be spent, not on health care, but on the large government agency and the legal cost to interpret and apply this very complex legislation.

The current flu pandemic is caused by a virus from the Influenza A family and further identified as H1N1.  Influenza A is a specific genetic type of virus found in birds, swine, and humans.  It is the most common cause of flu in humans.

There are two specific chemical compounds found on the surface of the influenza virus. The first compound “Hemagglutinin” locks the virus to the cell surface so that the virus can enter the cell and cause infection.  The second compound “Neuraminidase” helps release the virus from a previously infected cell so that the virus can spread.  There are 16 known types of hemagglutinin and 9 known types of neuraminidase.  These number types are used to subclassify the flu virus such as H1N1.  Drugs that inhibit neuraminidase are used to treat influenza.

The severe flu pandemic of 1918 was of type H1N1.  The current flu virus appears to lack the virulent features that produced an over reaction of the immune system causing widespread illness and death.

There has been much media attention about the death of a 17-year-old girl with relapsing leukemia denied insurance coverage for a liver transplant.   This tragic event should offer an opportunity for an intelligent discussion of transplant policies.  Instead there has been the threat of criminal charges against those involved in the transplant decision process.  Another big problem is those people with knowledge; experience and perspective are remaining silent because of fears of being drawn up in an irrational debate.  Politicians have jumped into the debate with little knowledge of transplant issues but offering lots of draconian and impractical solutions. Read the rest of this entry »

There is no question that a medical education is a rigorous experience with tough mental and physical challenges. The training period is great preparation for the real world life of a physician. Working long hours compacts years of experience into the training period. There is also no question that many physicians in training are chronically fatigued and overtaxed beyond the point of diminished performance. No one can argue with the adverse effects of fatigue on performance. Experts point out the impressive safety record achieved by the airline industry that limits pilots to about 80 flight hours a month. In an effort to combat the negative effects of fatigue on the training experience, academic medicine has now limited physicians in training to 30 consecutive work hours and an 80-hour workweek.

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For many years people gather at a place to live, work, and have mutual protection and support. Eventually a group of people at this place gets unhappy. They have ideas that could make things better. They start causing trouble. This new group either leaves voluntarily or they are driven out.

The new group moves away and starts a place using new ideas. Most of the time this new group fails but sometimes they are successful and the new place becomes much better than the old place.

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Many people now equate a doctor with a health care provider. Indeed, bureaucracy has forced most doctors to function as health care providers even though they were trained to be doctors. The following points help remind everyone of the difference.

1. A doctor has a name.
.. A health care provider has a number.

2. A doctor makes decisions based on years of training and experience.
.. A health care provider must call for authorization and approval.

3. A doctor attends those in need.
.. A health care provider requires a valid insurance card.

4. A doctor prescribes the best drug available.
.. A health care provider must use the insurance company formulary.

5. A doctor brings comfort to the patient and family.
.. A health care provider cannot bill for these services.

6. A doctor does what’s best for the patient.
.. A health care provider must follow insurance company guidelines.

7. A doctor delivers care exceeding expectations.
.. A health care provider delivers the services specified in the
.. contract.

8. A doctor is rewarded by the patient.
.. A health care provider is reimbursed by the fee schedule.

9. A doctor is chosen.
.. A health care provider is assigned.

———— The Editor

The first dedicated hospital in the United States opened in 1751 in Philadelphia. Started by the Quakers, and headed by Benjamin Franklin and Dr. Thomas Bond, Pennsylvania Hospital’s mission was to care for the sick who lacked proper home care. Today, there are about 7000 hospitals in the United States delivering general and specialized health care. Half of these hospitals have less than 100 beds. In addition to this primary mission, many hospitals offer education and training for medical personnel, and conduct vital medical research.

Visit Pennsylvania Hospital

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Its hard to find fault with the authors of the Constitution of the United States. Even in retrospect they did an amazing job outlining in a few pages the structure of a government that has been successful for over two hundred years. Its hard to blame them for a lack of emphasis on health care in the organization of the new country. The people of 1787 cared no less about health than we do, but had pitifully few tools to use. Only primitive knowledge was available about sanitation, disease and nutrition. Health care consisted of a few basic items; a varied diet, fresh air, water, and sanitation. The humoural theory of disease was still in vogue (it was 1881 when Louis Pasteur established the germ theory of illness). Government involvement in health care consisted of only a few people caring for sick and injured sailors. The Public Health Service would evolve from this agency but much later in the history of our country.

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You’ve been feeling sick lately, bedridden at home and unable to work. Your doctor diagnoses a serious illness but luckily he is able to prescribe a medication, which controls the disease and can return you to a normal life. He explains its benefits and the low risk of side effects.

After having the prescription filled, your pharmacist asks if you want to purchase the supplemental “Pill Insurance”. Noticing your confused look, he offers the following explanation.

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