On 31-8-2009 22:21, Jeremy "UncleHoot" Praay wrote:
> "andrel" <a_l### [at] hotmailcom> wrote in message 
> news:4A9### [at] hotmailcom...
>> Another factor that you did not include is the professional standard of 
>> doctors. In general they won't do unnecessary procedures. Those few that 
>> do and are found out are kicked out of the profession. Not because of the 
>> fraud, though that is a factor, but for unprofessional conduct.
>>
>> The trick of insurance is to punish those who let unnecessary procedures 
>> happen. If your car insurance pays such bogus repairs as in your example, 
>> it has to raise the amount people have to pay for the insurance. That will 
>> result in people going to other companies and there fore a loss of money. 
>> Another thing is that regularly someone brings a car with the same problem 
>> to different garages and publishes what they charge. Most firms don't like 
>> it when they appear in a paper showing that they charge 10 times a much 
>> than a competitor.
>>
> 
> Actually, there were no "bogus" repairs in my example.  The "spec" 
> (specification) for rotors pretty much requires that you get your rotors 
> replaced, perhaps every 5 years or so.  Realistically, they can last much 
> longer, but the lawyers get involved and due to some lawsuit have made the 
> spec state that the rotors must have less than X millimeters or wear.  I'd 
> love to have the ability to say, "Thanks, but I'll take my chances," but 
> it's not an option.  They cannot do a brake job without swapping out the 
> rotors too, but they can send me on my merry way without replacing my 
> brakes.  Doing so would open them up to a lawsuit (at a minimum) and 
> possibly criminal negligence, if I somehow died as a result.
> 
> It's similar in hospital situations.  The doctor can be 99% certain that you 
> don't have cancer (which is good enough for me), but because of that 1% 
> uncertainty, he has send you to have test after test, just to make sure that 
> he doesn't get sued by you for missing some step along the way.
> 
> Obviously that's where the lawyers come in, that I initially referred to. 
> But my original point is that we'd still be up in arms, if our insurance 
> wasn't paying for it.  Whether it's a private insurance company, or 
> government footing the bill, we could care less.  Give me every test out 
> there, because I want to be absolutely certain that I don't have cancer.  In 
> fact, test me every year.  I don't care because I'm not paying for it (so we 
> say).
> 
> Would a co-op help in this example?  It could help to some extent, but I 
> really don't think it would have a huge impact.  Whether we pay out of our 
> pockets (directly), or pay an insurance company (indirectly), or a co-op, I 
> think we're still stuck in this same mentality.  Add to that the malpractice 
> issues, and it's greatly compounded.  I really don't know how we could get 
> out of this short of some legislation that people would consider "insane". 
> If some new machine that costs 50 million dollars will save 10 lives per 
> year, then we have to have it, and we demand that our insurance pay for it. 

My point was that if you organize it in such a way that people don't 
feel the pain you have implemented it wrong.
Your other point is IMHO simply that you have let things go out of hand 
and now the lawyers are dictating what happens in hospitals and not the 
doctors (who have taken an oath and have professional standards) nor the 
patient (who has the most to gain or loose). So don't blame the doctors 
or the people that try to reform health care and start solving the real 
problem.
Suggestion: here it is in most cases illegal for a lawyer to do a case 
on a 'no cure no pay' base. Try that for starters. I am pretty you won't 
be able to pass a law like that because some of those who did such cases 
have enough money to influence a couple of re-elections. Therefore I 
suggested that you may have to start with freeing your political system 
from 'gifts' by companies and wealthy people.

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