Talk of The Villages Florida - View Single Post - Two Questions I Would Ask
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Old 08-16-2009, 01:44 PM
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Originally Posted by Villages Kahuna View Post
If I were to battle my way thru a crowd and attend one or more of the town hall meetings being held this month, I'd ask two simple questions.

I think everyone will agree that the cost of healthcare is growing at a rate that cannot be sustained by our economy. Experts say that 1/6 of the total GDP is now spent on healthcare and that within a decade or so, that number will grow to 1/3 of our total GDP. Right now we spend a little more than $7,000 per person per year for healthcare; that will grow to about $14,000 in a decade or so. About 40% of that spending is by Medicare. COST is the problem that has drawn so many people into the partisan and disagreeable debates on reform measures being considered by Congress.

While I haven't really decided on what the truth is regarding reforms being proposed and partisan allegations being made, I haven't heard either of the following two questions being addressed at all.

First, if I understand what's being spent per year on healthcare, it's around $3 trillion this year. I've heard estimates that 20% of all Medicare reimbursements are fraudulent. So if Medicare fraud could be eliminated, savings in the range of $240 billion could be achieved with no change whatsoever in any other healthcare factor. (Medicare expenditures are about 40% of the total in the U.S. per year and growing as more Boomers reach Medicare age.) My question: Why doesn't any of the proposed reform legislation include criminal penalties against doctors, hospitals and other Medicare providers? Such penalties could provide for both both jail time, stiff fines and permanent loss of rights to bill Medicare in the future. (It would be nice if the medical licenses could be withdrawn from convicted doctor/perpetrators, or severe licensing penalties be imposed against hospitals, but those are state issues.)

Second, I've seen estimates that medical tort reform in the form of caps on awards, "loser pays", that sort of thing, would result in savings of $150 billion per year. My second question: Why has medical tort reform been ignored in any version of the proposed legislation?

If these two issues were addressed by new laws, nothing else would have to be changed to achieve what has been estimated as almost $400 billion per year in savings. That's a 13% reduction in healthcare expenditures without changing any other factor now being debated in the proposed legislation. There are other savings to be achieved, of course, the cost curve has to be "bent" as the experts propose. But just these two new laws would cut costs about 13% with nothing else being changed.

Would I get a direct answer from any of the 435 whose town hall meetings I might attend? Doubtful. Why? Again, just two answers to match the two question: the powerful American Medical Association and hospital lobbies, and the even more powerful trial lawyers lobby.

Government FOR the people? Pfisssh!
Regarding Question One, criminal law exists already. 18 USC Section 1035 (http://caselaw.lp.findlaw.com/script...le=18&sec=1035) is on the books at the federal level. Calls for fines and/or up to five years' imprisonment.

Regarding Question Two, we've discussed this one many times. Damages caps have not alleviated the "defensive medicine" problem anywhere where caps are law.

I would also add this compound question, As almost every elected official touting this plan has no: 1) experience in ever running any kind of business, 2) training or experience in delivery of services at the local or national level, or 3) credentials of any kind in health care; what gives them the confidence to believe HR 3200 will work, and that any US government agency has the wherewithal to provide the management and oversight detailed in HR 3200?