Monday, January 25, 2010

ELIMINATING MEDICAL MALPRACTICE INSURANCE PREMIUMS: THE PROPOSAL YOU NEVER SAW


Georgia's Second District Congressman Sanford Biship patiently responded to dozens of questions over several hours at a town hall meeting in August of 2009: will Congress' failure to enact meaningful tort reform doom a public option making health insurance affordable for all?


If you are a physician shelling out tens of thousands of dollars annually for malpractice insurance, you should be screaming at your Congressman and senators right now. Why? Because floating around the House of Representatives last Fall was a proposal that would have eliminated all of your premiums- you would have paid $0- had it been incorporated into the health care reform bill. It was never adopted- not even debated- or you would have heard about it before reading this op-ed column.

The proposal was stunning in its simplicity and effectiveness: the current hodgepodge of state tort laws which allow injured patients to sue their physicians, but only if they can prove their doctor has done such a poor job that he or she breached the standard of care, would have been replaced by a single national system that used a workers compensation style no-fault system. Under the no-fault proposal, doctors, hospitals, and drug manufacturers would no longer need any malpractice insurance. The national system would have been funded with a one percent sales tax on all medical goods and services (at $2.3 trillion, the annual contributions would have been $23 billion, far more than is currently paid out annually in malpractice settlements and jury awards). Injured patients would no longer have to prove fault; they wouldn't even need to hire lawyers. Doctors would no longer have to engage in wasteful defensive medicine. And specialists in areas like ob-gyn would stop fleeing their practices because of crushing insurance premiums.

So what happened? Why didn't this proposal get a fair airing in Congress? Beats me. On September 30, 2009, Congressman Sanford Bishop of the 2nd district in Georgia sent a copy of the article outlining the proposal (it had appeared in a Georgia statewide legal newspaper, The Fulton County Daily Report, in 2004) to key legislators and committee chairs in the House of Representatives, including John Conyers, Henry Waxman, and Melvin Watt. He also sent a copy to David Cook, the president of the Medical Association of Georgia. And it was never heard from again.

Had the malpractice reform proposal been brought up before a relevant committee and included in the final bill put out by the House, it would have accomplished several goals of the reformers: it would have cut health care overhead costs by tens of billions, both directly in the form of insurance premiums and indirectly by reducing the billions spent annually in unnecessary tests by physicians practicing defensive medicine. It would have provided a fairer and more efficient system of compensating patients injured from medical procedures, by misdiagnosis, or by side effects from medicine. All injured patients- not the very few who collect under the current system- would receive compensation without having to prove fault or engage in lengthy and expensive lawsuits. And politically it would have given numerous Republicans in the House (even Joe Wilson!) and Senate strong motivation to vote for a health care reform bill that included the tort reform which they have been strenuously demanding. As the current Senate battle has proved, getting even one Republican to vote against a filibuster of the bill would have been enough to secure a single payer system or a public option. It's hard to imagine any Republican representative or senator going back home and explaining to angry physicians, hospital executives, and pharmaceutical company lobbyists why they turned down an opportunity to completely eliminate medical malpractice insurance premiums and the omnipresent fear of being sued.

The proposal also included a better mechanism than the current system for identifying and publicizing bad doctors, scary hospitals and dangerous drugs: all of the awards would be published on the internet, including the injury sustained, the medical providers involved, and the amount of the no-fault award (with one exception: unlike the current system with publicly filed lawsuits, the privacy of the patients would be protected) . Before going to a doctor, entering a hospital, or using a prescribed medicine, the patient/consumer could get that information with a click of a mouse.

Too bad the proposal never got a hearing. Had it ever been put forward and included in the final bill, it would have guaranteed the passage of effective health care reform legislation that would have cut overall costs in the industry while improving care and providing more access to consumers.

Saturday, January 16, 2010

HOW TO ATTAIN PERFECT SAFETY IN AN AGE OF TERRORISM



Benjamin Franklin once noted, “They who can give up essential liberty to obtain a little temporary safety deserve neither liberty nor safety.” Someone later added, “And in the end will get neither.”

"Terrorism" is defined as "the use of violence and threats to intimidate or coerce, especially for political purposes." It is also "the state of fear and submission produced by terrorism or terrorization."

The goal of terrorists is to invoke a "state of fear" that will cause people to act in a way the terrorists desire.

The USA Patriot Act provides that anyone who gives material aid or comfort to the terrorists is a terrorist and should be treated accordingly.

Charles Krauthammer writes that al Qaida "is a fanatical religious sect dedicated to establishing the most oppressive medieval theocracy and therefore committed to unending war with America ..." and which opposes "individual liberty" and "social equality." He argues that we will be at greater risk of future al Qaida terror attacks if we close the prison camp at Guantanamo or if we afford rights guaranteed by the Constitution to persons accused of terrorism.

Thomas Sowell agrees with Mr. Krauthammer: "Terrorists are not covered by the Geneva convention for the simple reason that they do not abide by the Geneva convention. They are enemy combatants and you do not turn enemy combatants loose to go back to killing Americans while the war is still on-- not if you are being serious."

Mr. Krauthammer and Mr. Sowell want Americans to be afraid because of past acts of terrorism. They want Americans to curtail our Constitutional freedoms out of fear of future acts of terrorism. They oppose affording human beings who are accused of furthering the goals of the terrorists public trials on American soil. They oppose due process of law, the right to counsel, impartial juries, and the exclusion of confessions coerced through torture- all basic rights which are essential to a free country.

The only logical conclusion is that Mr. Krauthammer and Mr. Sowell are giving aid and comfort to the stated goals of the terrorists, in that both men want Americans to be so afraid that this will no longer be a country "with liberty and justice for all." (For those who are irony impaired, that quote is from the Pledge of Allegiance.)

Therefore, Mr. Krauthammer and Mr. Sowell should be detained at Guantanamo as enemy combatants, interrogated with enhanced interrogation techniques to discover their links to al Qaida, and held without trial or access to counsel until the War on Terror is declared over (which, at the current rate of success, should occur sometime in the 23rd century).

Friday, January 15, 2010

Liberal vs. conservative party? People prefer competence


"conservative" commentator gasbag Jonah Goldberg taken down a peg in his own newspaper (it runs his column, anyway)


http://blogs.usatoday.com/oped/2010/01/letters-liberal-vs-conservative-party-people-prefer-competent.html


(This letter appeared in USA Today on January 11, 2010)


Commentary writer Jonah Goldberg makes an error common to professional pundits: He assumes that elections and their aftermath are all part of a big football game, with the American people being the ball. Sometimes we're at the 50 yard line, sometimes to the left of it, sometimes to the right. But to him, it's all just a game, with only two teams: the Reds (Republicans) and the Blues (Democrats). The only winners and losers are the political parties in elections ("For liberalism, it's hangover time," The Forum, Tuesday).

But the people are not a football. We're humans with real lives and real pain. We don't care who "wins" or who "loses" the political games when we have a whopping hospital bill for a sick child that we can't pay that will force us into bankruptcy; when our jobs are in jeopardy; when our families have soldiers on deployment facing death or dismemberment.

We don't want a liberal or a conservative government; we want a competent government. One to rein in out-of-control health care costs and make the care affordable for all. One to oversee a banking system that doesn't jack up fees or self-destruct, requiring hundreds of billions of taxpayer dollars to bail it out. We want a president and Congress that don't needlessly expend the lives of American soldiers out of fear of losing the next election.

And we need political analysts who focus more on competence, or lack of it, than on which political party is advancing the football.

James Finkelstein
Albany, Georgia (oui, c'est moi)

This letter inspired at least two people- one from Maryland, one from Florida- to take the time to look up my office phone number and call to compliment me on the ideas expressed.

Thursday, January 07, 2010

a South Georgia Author



Bill the Congressional Candidate in 1992; Bill the hot shooting basketball player circa 1983

Thirty years ago (!) I was running for public office and a young reporter for the Albany Herald interviewed me. That was back in the days before cable television news (CNN was brand new and not available very many places), before the Internet, before newspapers began going the way of the dinosaur.

The reporter- Bill Lightle- was a pleasant surprise. Erudite, well spoken, no deep South Georgia accent. I found out later he was an all around superb athlete at the local high school (Albany High) who excelled at football and basketball.

We ended up becoming friends, and I played basketball with him and his younger brother, Jim, over the years in the early 1980's at the local YMCA.

More than a decade later, in 1992, the tables were turned a bit, as Bill ran for Congress in our newly created/redistricted district. He was a good candidate, put on a hell of a campaign, but in the end, old timey politics won out (perception beats competence almost every time, unless an extraordinary situation like a depression or other disaster strikes) and Bill lost.

Bill became a teacher at Lee County High School, where I coached the mock trial team a couple of years. He was extremely popular with students there, as he was when he moved on to college teaching.

When his first book came out- Made or Broken: Football & Survival in the Georgia Woods, I scarfed it up, read it, and got a terrific appreciation of some of the local history- both sports and politics- of the area before I had moved here.

Here's a review, courtesy of Bill's website:


http://www.blightle.com/


Bill Lightle's first book, Made or Broken: Football & Survival in the Georgia Woods, is set in the racial tension of the Deep South in the 1960s. The story follows a group of young men on their experiences at the notorious Graves Springs football camp. The agony of the grueling practices and the fears of hazing were a legend about to be realized by the team's sophomore players. Lightle vividly decribes how players endured the two weeks of humiliation and abuse in the rich swampland of Southwest Georgia through mutual support and camaraderie. "Players 'fell out' as the expression was used because of the lack of water and what we had to go through during those practices," Lightle said. Made or Broken is a touching story of a young man's experiences of trial, friendship, and the racism in Albany, Georgia.

Bill's got a second book out,now, MILL DADDY, THE LIFE AND TIMES OF ROY DAVIS, which recounts the story of a South Georgia mill worker who grew up in the early 20th century, and who employed Bill and his friends four decades ago when teenagers weren't quite so afraid of hard work (no video games, no IPODs, no texting).

If you get a chance, give either of those books a read. You won't regret it.

Saturday, January 02, 2010

COMPLEX THINKING... FOR AMERICANS, ANYWAY


Here's a brainstorm from two guys- Noam Chomski and Nir Rosen:

http://www.youtube.com/watch?v=dW0eiPiuUuk&feature=fvsr

If you want Muslims to not want to kill you, then stop killing them.

Wish I'd thought of that.

Oh wait. I did. And so did a few million other sane people.

Here's another thought: for one moment, imagine that someone else was doing to us what we are doing to them. Suppose that a family down your street has a criminal or two in it. Suppose they rob a bank and kill a bank guard. Suppose a predator missile is launched against them, and takes them out, plus your three kids who were playing in the yard of the house next door. How would you respond?

Or suppose you couldn't drive to the bank, the grocery store, the city hall, without going through checkpoints with foreign troops speaking a different language, with a different religion, who occasionally had to shoot and kill members of your community for their (the troops) own safety.

Or suppose those troops occasionally bashed in the door to your home, or your neighbors' home, and carried off a few of the teenagers or young men to a prison where they were held, never charged, not given a hearing of any kind, tortured, kept for months or years, and the country that was holding them refused to even acknowledge their existence or promise them a hearing. Ever.

I guess that might be something that would make you unhappy and would make you want to support any organization, no matter how unpalatable, that was dedicating to killing them or ridding your country of them.

I'm just sayin'.