Monday, September 21, 2009

Why I'm not the one to fix health care

Yeppo, health care needs to be fixed.

Somewhere along the line, I'm convinced we're going to have to take a leap of faith. And hope those dealing the cards are smarter than the average bear. My dilemma is when and where to jump.

I need more when told a public option will force competition among health care providers. Perhaps that would be enough if we were talking simple one-on-one competition. But I know enough (some say to be dangerous) to know it's not that simple.

The corporation my husband lately retired from provides some health care (I won't say all, we pay our part, a part that is dramatically rising BTW) for more than 30,000 employees and I don't know how many retirees.

The corporation offers a handful of health care plans, each by a different insurance company. However, the corporation is actually self insured, meaning, simplistically, that the health care providers really only administrate. The company pays the bills.

That's the extent of my understanding. I'm sure it's a lot more complicated than that. But even knowing that much tells me that simple competition between insurance companies is not, well, simple. At least in this case, the insurance company is only the middle man. Here, apparently, the public option is competing with the profits of not only the insurance company, but the underlying corporation's pockets.

Here's hoping all I've been hearing about solutions is purposefully being dumbed down for my benefit.

I apologize for all the cliches. They're the haven of a struggling mind, doncha know.

Sunday, September 20, 2009

Pop Goes the (tort reform) Weasel?

Tort reform has been flicked around frequently as one part of the solution(s) to rising health care costs.

I’m not sure many are thinking past knee jerk reactions. Again.

As a former reporter with many of those years covering primarily state and federal civil courts, there are some givens when it comes to medical malpractice suits.

  • A percentage of medmal suits are iffy at best, purely frivolous at worst. Filed by those looking for a fast buck.
  • Medical malpractice insurance companies, in a vast majority of those cases, settle both good and bad suits mostly on a cost to defend vs. cost of possible large damage awards, rather than merits of cases. Defense lawyers and trial costs are astronomical. Even more so than those of plaintiffs’ attorneys, if you discount the percentage of awards the latter take. And the defense costs sometimes outclass in fee structure even with plaintiffs’ attorney percentages counted. Those above, especially share holders, looking for a large, fast buck. Get the picture?

If tort reform becomes more prevalent than it already is, say tort damages limited by federal laws rather than a handful of states, there could be a yet-to-be voiced cause and effect.

Fit the above points with a cap on damages. The logical next step in this bottom-line-is-all scenario is:

  • Medical malpractce insurance companies, faced with known caps on damage awards will settle even more cases without looking at merits.
  • Plaintiffs’ attorneys (especially the infomercial buying, unscrupulous kind) will quickly read the writing on the wall. Leading to:
  • Even more iffy and frivolous medmal suits will clog insurance defense attorneys’ case loads and, in many cases, court filing desks.
  • Those cases will then be settled by bottom line insurance companies on their defense costs vs. settlement calculations.

“Round and round the cobbler’s bench, the monkey chased the weasel…”

Bet your bottom dollar medical malpractice insurance costs will not go down. And neither will medical care (read: healthcare) costs.

Simple, knee jerk reactions seldom solve long term problems, do they?

Second chorus:

We haven't even begun to discuss those truly wronged by the medical community, who deserve and need large awards, wrongs and injuries caused by medical professionals, some of whom make mistakes because they are overworked and underpaid by insurance companies and share holders looking for the large, fast buck....