Doctors’ Fear of Lawsuits Trumps State Malpractice Tort Reforms

August 7, 2013

  • August 7, 2013 at 9:24 am
    youngin' says:
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    That’s because caps are a stupid idea pushed by people who haven’t spent more than 5 minutes thinking about it. You think the doctor would rather be sued for $5M insted of $25M?

    • August 7, 2013 at 1:47 pm
      DW says:
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      Um, yes. Would you rather have your insurance policy limits at risk or that plus your personal assets?

      • August 7, 2013 at 2:11 pm
        youngin' says:
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        I don’t think it’s going to affect whether I order an MRI when a kid comes in with a mild concussion.

        • August 7, 2013 at 2:43 pm
          InsGuy says:
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          Who said anything about a kid with a concussion? I think the article mentioned a patient with a headache. BIG difference.

          • August 7, 2013 at 3:33 pm
            youngin' says:
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            You’re right, bad example probably. My point is that doctors don’t want to be sued, period. Unless and until we have a mechanism for weeding out frivolous claims from their very origins, doctors will keep ordering unnecessary tests.

    • August 7, 2013 at 2:21 pm
      Dave says:
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      Obamacare will take care of this. Once medical care rationing begins Obamacare will decide what tests are necessary and who gets them. If you are too old or too sick, forget certain tests for certain people. An offshoot of his death panels. I don’t know who the lawyers will sue then, maybe Obama.

      Or we can have caps on punitive damages and let doctors be doctors and be guided by the best interests for their patient instead of protecting themselves from amblance chasers by over-prescribing care. You clearly don’t understand the issue.

      • August 7, 2013 at 2:42 pm
        Agent says:
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        You are right Dave. Under Obamacare, the $716 Billion with a B taken from Medicare will not permit much treatment for retired persons. The physicians will be required to give end of life counseling to their patients instead of trying to treat them. Take a pain pill senior patient and go home. We cannot treat your illness and by the way, no hip replacement for you.

        • August 7, 2013 at 4:18 pm
          Ron says:
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          Agent,

          Why do you take the time to tell us that billion begins with a B? Maybe you need the clarification, but we already saw the B in billion.

          • August 7, 2013 at 4:40 pm
            Agent says:
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            Ron, I did that for “emphasis” since Progressives like you don’t know the difference between a million, billion or trillion. You would probably say – After all, what possible difference does it make?

          • August 9, 2013 at 9:57 am
            Ron says:
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            Agent,

            That is appropriate when speaking, not typing, for emphasis because all three end in “illion”. Someone listening may have not heard which letter you began with and only heard the “illion” part.

            I guess I am not a Progressive then since I know that one billion is one thousand millions and one trillion is one thousand billions.

            I would say that would make a significant difference.

            By the way, when Representative Paul Ryan was speaking of reducing Medicare by about the same amount as President Obama, to what was he referring?
            http://www.politifact.com/truth-o-meter/statements/2012/aug/15/stephanie-cutter/ryans-plan-includes-700-billion-medicare-cuts-says/

            This is one of my issues with Republicans. They say President Obama will not cut entitlements, but still criticize him when he does. Besides, the cuts are only to insurance and pharmaceutical companies and hospitals, not beneficiaries.

        • August 9, 2013 at 2:44 pm
          Nebraskan says:
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          There was no death panel for the ACA. It was misrepresented by Rush Limbaugh to scare people into thinking something that wasn’t true to begin with. And I hate to tell you this, but all Insurance Companies are death panels. giddy-up WAIT! I just read Agent’s comment….and he is describing EXACTLY what Limbaugh WANTS you to believe! Hey 84 year old with dementia! let’s get you on an operating table and put a 10-year battery in your heart to keep it going so you can sit like a vegetable for the next 10 years and occasionally get violent toward your spouse because you don’t realize who or where you are!!!! That’s MUCH better than giving you the choice! This way, you live forever and I make money hand over fist doing expensive surgeries!

      • August 8, 2013 at 9:52 am
        Libby says:
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        Dave – you are ridiculous with your death panels comment. You obviously know nothing about the ACA or how it works, so you really show your ignorance whence speaking of it. It only makes you look like a fool.

        • August 8, 2013 at 5:23 pm
          Dave says:
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          Socialized medicine always leads to a rationing of medical care. Some bureaucrat decides which procedures are allowed and who gets them. And some people die because of it. Which is why until now people who live under socialized medicine and who can afford it come here for the best care available rather than their own country. People who understand basic economics (liberals are typically clueless) understand this concept. And maybe these death panels are not called such, but the result is the same. People will die because of Obamacare and its rationing of healthcare. It is you who looks like a fool. You must be sad they found and fixed GWB’s heart blockage sick individual you are.

          • August 8, 2013 at 7:08 pm
            Don't Call Me Shirley says:
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            “Some bureaucrat decides which procedures are allowed and who gets them. And some people die because of it.”

            That’s the way it’s been for many years. But at least the bureaucrat CEO’s get their millions, so it’s cool.

          • August 9, 2013 at 10:12 am
            Agent says:
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            Dave, I saw a new article on The Hill that Howard Dean, former head on the DNC is now on record opposing the Independent Payment Advisory Board aka Death Panels of Obamacare. He says that it will limit care for seniors by reducing reimbursement to doctors for Medicare patients. Gee, do you think? Taking $716 Billion out of Medicare to fund Obamacare might have a tendency to do that. Democrats are worried about their mid terms and are running from Obamacare now.

  • August 7, 2013 at 2:15 pm
    peter bakker says:
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    How about increasing a doctor’s fee income by requesting more “tests” since he is treating a a low reimbursement medicare patient…

  • August 7, 2013 at 2:26 pm
    youngin' says:
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    You clearly didn’t read the article. Never let facts get in the way of your narrative!

  • August 7, 2013 at 2:54 pm
    InsGuy says:
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    Really, I think all of you are over-reacting on the health care issue. Do you really think the majority of states are going to be able to start enrollment October 1? And the one’s that do, do you really think they are prepared, from an IT perspective, to handle the required through-put they’re going to need?

    Maybe in Montana where there are 989,000 ppl (or 6.79 ppl/sq mi.) But what about NY where there are 19,378,102 ppl (or 397.84 ppl/sq mi.)?

    • August 7, 2013 at 3:17 pm
      Agent says:
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      Insguy, it is well known that the Exchanges are months behind and they have not tested the IT for security. The hackers will have a field day getting into their system and stealing identities.

  • August 7, 2013 at 3:04 pm
    Scott says:
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    Youngin’ – me thinks you’re the one who is completely missing the point here.

    No one disputes an MRI for a probable concussion; rather, its the battery of tests ordered on an 60 year old, overweight and out of shape individual who smokes two packs a day and is complaining of shortness of breath/chest pains.

    If said patient goes home and dies three months later while mowing his yard, the doctor and hospital will be sued because they did not do every test under the sun to “prevent” this.

    It all falls under Medicare/Medicaid which YOU and I pay for – all because greedy, ambulance-chasing attorneys feed off of scenarios like this.

    You don’t want tort reform? Fine – then put a cap on the fees an attorney can charge/take – say a 10%-12% limit, and this stuff will go away.

    • August 7, 2013 at 3:18 pm
      youngin' says:
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      I didn’t say I didn’t want tort reform. I said that caps are ineffective (so did the article). Of course the two have become synonymous, but that doesn’t make them the same thing.

      Capping attorney’s fees seems like a good start. I would like to see other measures put in place that make it harder to get frivolous claims off the ground in the first place. If doctors are less afraid of getting sued in the first place, it might actually influence their practices.

      • August 7, 2013 at 3:48 pm
        Agent says:
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        Youngin, I don’t know what state you are from, but here in Texas, we did Tort Reform for doctors/clinics some years ago with caps and it seems to have worked well since the frivolous suits have dried up, awards are reasonable and malpractice insurance rates have come down. No wonder doctors come here to practice in droves. I still think there are far too many tests ordered, but old habits are hard to change. There are also so many specialties that often two or more doctors are needed to treat a patient and each run their own tests.

        • August 8, 2013 at 9:39 am
          Libby says:
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          Actually, Agent, you’re wrong again. The top five states by number of doctors per capita are: 1. MA; 2. MD; 3. NY; 4. CT; 5. RI. Texas ranks 42nd. So much for your DROVES of physicians… You rank slightly higher than AR, AZ, IA, ID, MS, NV, OK, & WY.

          • August 8, 2013 at 9:40 am
            Libby says:
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            Oh, I might add – the top five states are BLUE states.

          • August 8, 2013 at 10:08 am
            FFA says:
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            Libby, I don’t see in Agents post where it states there are more docs in TX then in other states. All I am reading is that they are moving there. I had a med group pack up and leave IL 3 years back. I don’t recall where they ended up, but I do remember the South West was on their radar.

            If TX version of Tort Reform is working there, other states need to take note / action. Especially here in IL. Several years back, I quoted Med Mal for an OBGYN coming out of med school for this group. $75K in 05-06 before she even saw a patient.

          • August 8, 2013 at 10:21 am
            Libby says:
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            Well, FFA I suppose you have a point if Texas was ranked 50th a few years ago. But I think if you had doctors flocking there by droves, you would rank a little higher than 42nd in the nation. Agent always exaggerates and shoots from the hip, rarely citing any credible source or verifiable fact.

            But just to prove my poing (unlike Agent) please see the attached link:

            http://www.tortdeform.com/archives/2006/11/whats_up_doc_not_the_number_of.html

            And a quote:

            “In sum, the 2003 Texas reforms transferred a lot of wealth from malpractice victims, their families, employers, and health insurers to physicians and their liability insurers. This was the main object of the 2003 reforms, and the reforms achieved it. But the reforms have not increased physician supply, which grew at a sub-par rate in the post-reform years. The facts show yet again how wealthy and concentrated interest groups use the political process to advantage, at the expense of groups whose members are anonymous and dispersed.”

          • August 8, 2013 at 10:36 am
            Libby says:
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            “The facts show yet again how wealthy and concentrated interest groups use the political process to advantage, at the expense of groups whose members are anonymous and dispersed.”

            The Republican way…

          • August 8, 2013 at 11:37 am
            FFA says:
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            Libby, I don’t understand why you begrudge people for living the American Dream – becoming filthy rich. Same opportunity is available to everyone that lives here.
            You are living proof that obstacles can be over come.

          • August 8, 2013 at 11:48 am
            Libby says:
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            I don’t begrudge anyone that works hard and becomes filthy rich. What I mind are rich people that use their wealth to circumvent the same avenues most “normal” people have to travel. They have loopholes, or buy their way into our out of situations. They use politics to swing things their way regardless of the effect on others. That’s what I begrudge. Profits at all costs and the consequences be damned. Bain Capital is a perfect example of this philosophy I so despise.

          • August 8, 2013 at 11:54 am
            FFA says:
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            NAFTA is one big reason firms like Bain Capitol have had the success level they have had – exporting American Jobs.
            My understanding is that Rahm Emanuel was a key player in that. If you recall, Rahm was OBamas right hand man.

            I guess I don’t see party lines. I see people that have hurt us.

          • August 8, 2013 at 12:11 pm
            Libby says:
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            If you don’t see party lines, then why are you a Republican and not an Independent?

            Regarding NAFTA – U.S. President George H. W. Bush, Canadian Prime Minister Brian Mulroney and Mexican President Carlos Salinas, each responsible for spearheading and promoting the agreement, ceremonially signed it.

            In addition, NAFTA only addressed trade in North America. While some jobs are going to Mexico, the bulk are going to places like China and India.

          • August 8, 2013 at 12:16 pm
            Libby says:
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            NAFTA was purely a conservative idea, opposed by liberals.

            “In the US, Bush, who had worked to “fast track” the signing prior to the end of his term, ran out of time and had to pass the required ratification and signing into law to incoming president Bill Clinton. Prior to sending it to the United States Senate, Clinton introduced clauses to protect American workers and allay the concerns of many House members. It also required US partners to adhere to environmental practices and regulations similar to its own.”

            We don’t have the same agreements with China and India.

          • August 8, 2013 at 12:23 pm
            FFA says:
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            I don’t really see the party lines. As you know, I have never been a fan of Quinn.
            Now, I see him on the news, I stand up and Clap!!!
            As far as I can tell, he is the only person in Springfield looking to resolve the problem with the pensions.
            So, I guess I am Independent. Fact is, next election, I will vote against everyone that is currently in office no matter the party. I do live in Illinois. So, I guess I will exercise my right to vote multiple times.

          • August 8, 2013 at 12:39 pm
            FFA says:
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            And one more point – NAFTA and the China Trade agreement need to be stepped on. Wiped off the books. No one in DC – Rep or Dem or independent – can see that this has hurt – not helped Americans.

            I hate dealing with Call Centers who’s service reps can barely be understood. Just dealt with one of them yahoos on Wells Fargos’ behalf. Why don’t them morons understand Continuous Until Cancelled???

          • August 8, 2013 at 1:05 pm
            Libby says:
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            Well, if you like Quinn why would you vote him out? Because he’s a Democrat?

          • August 8, 2013 at 2:12 pm
            FFA says:
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            two week of activity does not make up for the time he spent doing nothing. Of course, if this tactic works, I may have to rethink things.
            Every time I seemingly made up my mind with no exceptions, I get a curve ball thrown at me and I need to rethink things. Quinn has thrown a curve ball at every one in IL. I can get behind him on this one that’s for sure. If you get the job done, you get paid.

            For all you research wizzes out there, has anything like this ever happened??? Gov holds pay checks of the legislatures???

            As it sits right now, I am holding the line – vote everyone out.

          • August 8, 2013 at 10:41 pm
            Dave says:
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            “NAFTA was purely a conservative idea, opposed by liberals.”

            And signed into law by Bill Clinton. Get your facts straight Libby. Or continue to follow Saul Alinsky’s liberal play book which says lie, lie and lie again until people believe its the truth. You liberals disgust me.

          • August 9, 2013 at 10:42 am
            Agent says:
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            Libby, your imbecilic comments do not cut any ice with me. I am on the ground seeing what is going on and not in your government websites. The hospital systems are adding numerous doctors, mostly foreign born to supplement their staffs and there is a lot of construction going on with hospitals expanding their facilities. This trend started after Tort Reform was passed in this state and it has created a much better atmosphere for doctors to practice their profession.

          • August 9, 2013 at 2:05 pm
            Libby says:
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            I didn’t say who SIGNED it, I said whose idea it was. It was a done deal by the time Clinton got it.

            NAFTA was signed by President George H.W. Bush, Mexican President Salinas, and Canadian Prime Minister Brian Mulroney in 1992. It was ratified by the legislatures of the three countries in 1993. The U.S. House of Representatives approved it by 234 to 200 on November 17, 1993. The U.S. Senate approved it by 60 to 38 on November 20, three days later. It was signed into law by President Bill Clinton on December 8, 1993 and entered force January 1, 1994.

            Now get your facts straight you fascist pig.

        • August 8, 2013 at 2:13 pm
          Mike End says:
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          Agent,
          I checked out your claim that doctors have been coming to Texas in droves as a result of the 2003 tort “reform” legislation. The AMA collects the data on the number of doctors in relation to state populations in a publication called “Physician Characteristics and Distribution in the US.” From 2010 to 2011, the number of doctors in Texas per 100,000 people increased 9%. The number of doctors in the U.S. per 100,000 people during that time increased 12%. The number of doctors per population in Minnesota increased 20% during those years. Minnesota has never had a cap on damages in medical malpractice cases. In 2000, Texas was ranked #44 in number of doctors per population. In 2011, Texas was ranked #43. The numbers do not bear out your claim of doctors coming to Texas in droves.
          As someone pointed out, most of the states with the highest numbers of doctors per population do not have caps on damages in medical malpractice cases. Those states include District of Columbia (#1), Rhode Island (#4), New York (#5), Connecticut (#6), Vermont (#7), Minnesota (#8), and New Jersey (#9), Pennsylvania (#11), New Hampshire (#12), Oregon (#13), and Illinois (#14).
          As you may know, Texas, with all of its restrictions on the rights of people injured by medical negligence, has about the highest health care costs in the country. The health care costs in McAllen, Texas, are double the costs in Rochester, Minnesota, home of the Mayo Clinic. Texas has a $250,000 cap on noneconomic damages. Minnesota has never had a cap. See “The Cost Conundrum: What a Texas town can teach us about health care” The New Yorker, August 22, 2009 (available on line).
          Since restrictions on the rights of people injured by medical negligence do not seem to affect health care costs, we must ask ourselves whether such laws, which restrict the rights of any of us who should be injured by medical malpractice, should be enacted.
          Contrary to many of the comments, it is actually very difficult for a person injured by medical malpractice to recover compensation for his or her injuries. In an article published in April 2011 in the medical journal Health Affairs, the authors determined that there were 1,503,323 people who died or were injured by medical errors in the U.S. in 2008. The National Practitioner Data Bank data show that there were only 8,419 payments made to people injured by doctor negligence in 2011. That calculates to one payment for every 179 injured people.
          Perhaps you will be happy to know that the number of injured people receiving compensation for doctor negligence has decreased every year from 2001 through 2011, from 15, 898 to 8,419, a decrease of 47%.
          Look at the numbers and ask yourselves if making things more difficult for injured people to recover compensation is a good thing. If you or a family member should suffer a lifelong debilitating injury because of medical malpractice and you are unable to find a lawyer willing to take you case because of restrictions on recovery, you will see firsthand that letting big government artificially set limits on recovery is not a good thing.

        • August 9, 2013 at 4:14 pm
          Nebraskan says:
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          http://locumlife.modernmedicine.com/locum-life/news/clinical/locum-tenens/what-are-friendliest-states-physicians-here-are-americas-best-

          Kind of an old article, but I think this is what Agent was getting at:

          1 TEXAS

          Why doctors love it here: The Lone Star State offers the best of all worlds for physicians: a variety of cities with excellent medical centers, no state income tax, great compensation, and low real estate costs—an average single-family home in the Dallas-Fort Worth area sold for $135,700 in the first quarter of this year. Tort reform in 2003 makes Texas a leader in low-cost malpractice liability insurance despite being the second-most-populous state in the nation. Texas’s median annual malpractice liability insurance rate is $16,655 (compare to $21,052 in New York and $32,328 in Florida).

          Why you might not: Almost one-quarter of Texas’s population was uninsured in 2007, according to the Kaiser Family Foundation, and less than half of its residents had employer-sponsored coverage. Hot, humid weather dominates the southern portion of the state.

          • August 9, 2013 at 4:27 pm
            Libby says:
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            That sounds like a blurb from the Chamber of Commerce, not statistics and facts.

  • August 7, 2013 at 6:56 pm
    FFA says:
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    For those that don’t write Med Mal, the term is Defensive Medicine. Doctors are practicing Defensive Medicine – ordering every test under the sun on the one in a million possibility that it may be. My doc used to call in a script for me

    Tort reform has been shot down in Illinois. Springfield passes it knowing full well state supreme ct is going to shoot it down.

    Only way to stop the frivolous law suites – in my opinion – is to implement the English system of Tort. Caps wont stop the frivolous. It will only limit what they can get.

  • August 7, 2013 at 8:30 pm
    jw says:
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    The article/study found no change in defensive medicine even in states with caps. Well, duh! The doctors don’t want ANY suits because their med mal rates will go up or the insurer might just cancel, doesn’t matter if the damages are capped or not.

  • August 8, 2013 at 2:40 pm
    No Doubt says:
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    Part of this thread was really interesting to me and I thought I’d comment. So one state taking docs from another state is kind of an empty conversation as its largely a zero sum game.
    We have been importing docs from other countries-and for that matter engineers actuaries and other of the harder science fields for several decades so we aren’t making enough ourselves in the U.S.
    On the other hand, we import very few attornies as we have an abundance of them that our own law schools produce. And it seems like there has been an expansion in capacity of law schools since I was going to school so guess what, we are producing attornies who end up as paralegals or baristas at your local Starbucks for instance as there aren’t enough real jobs out there for attornies, but we keep on grinding them out nonetheless.
    Speaking just to doctors and nurses, if we REALLY wanted to increase the supply of medical profeessionals, then we need to encourage the creation of new schools and training facitilites in our universities and technichal. In this instance, it might be a good thing for our various federal and states governments to expand the capacity of doctors and nurses at public universities and if need be, spread out a little seed money to start up some new teaching hospitals in states where there is a doc shortage.
    Its not an immediate solution, but if we started this now, then over the course of the next decade we might just see a decrease in the cost of health care as far as what the doctor and nurse part of the equation is concerned and possibly too achieve a better a better level of care.
    Now that is actually a great way of spending tax $$$$ and letting the free market take over from there.

    • August 8, 2013 at 5:48 pm
      FFA says:
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      No Doubt says -“On the other hand, we import very few attornies as we have an abundance of them that our own law schools produce”.

      Maybe we should have included the exporting of attorneys in NAFTA and the China Trade Agreement???

      As it goes to imported Docs, they get sued above their Med Mal limits, they can always go back home.

      My Lawyer friend tells me day one Law School spent making sure everyone knows how to Calculate 33%.

      • August 9, 2013 at 10:45 am
        Agent says:
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        500 attornies at the bottom of the ocean is a start FFA.

        • August 9, 2013 at 11:09 am
          FFA says:
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          Lake Michigan in my neck of the woods…

          Lawyer falls into shark infested waters and don’t get attacked. Why??? Professional Curtsey.

    • August 9, 2013 at 9:57 am
      Agent says:
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      In our area, the two big hospital systems put announcements in the paper all the time of new doctors associated with their system. Almost 100% of them are foreign doctors who immigrated here. They are mostly Indian or Pakistani. Seldom do I see an American citizen doctor in these announcements. American doctors seem to be the ones who are closing their practices or selling them or merging with a bigger practice. They see the handwriting on the wall.

  • August 8, 2013 at 3:41 pm
    James O'hare RPLU AIC AIS says:
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    It seems that referring a patient to the ER for headache and chest pains meets the standard of care and is not related to fear of suit. If you don’t do it, not you become a target. Defensive medicine should be the standard but health care costs prevent this due to lack of interstate competition, related to McCarron Ferguson act of 1948. This act/law protects the turf of the HC companies like blue cross. Can you currently shop HC coverage in Maine? No you can’t and if you did the competition would bring the premiums to a realistic level. We dont have HC in the US it is just catastrophe coverage. We could do better but the lobby in DC has a death grip on health Care. This is the proximate cause of the problem. Regards Jim

  • August 8, 2013 at 5:56 pm
    Tom says:
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    While I am not saying the tort system could not be revised in a way to make it more fair and less stressful, this study screams out that the researchers started with a theory and tried to prove it…but seemed to end up contradicting their own conclusions. In terms of socialized medicine rationing care, we have a three-tiered system of care in the U.S. (commercial insurance and Medicare; Medicaid; and, no insurance) and care is rationed in all of them. Plaintiff’s attorneys will tell you that if two people are rolled into the ER at 3:00 a.m. with non-specific abdominal and chest pain, the insured patient will get different (not necessarily better) treatment than the uninsured patient will get. That has nothing to do with fear of malpractice.

    • August 9, 2013 at 12:19 pm
      Agent says:
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      Tom, the county hospital emergency room has to take them all whether insured or not. Often, the patient that screams the loudest will be taken first and they are the uninsureds. I had to take my wife in a few years ago, we had all the required insurance and they made her wait a very long time when she had a lot of pain while they took many of the uninsured that showed up afterwards. They were moaning and groaning so they were whisked right back to the treatment rooms. I finally had to complain loudly to get their attention.

    • August 12, 2013 at 8:00 am
      jw says:
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      I doubt anyone is still reading this thread, but I’m going to reply anyway….

      Tom, the doctors in the ER do not know whether the patient has insurance or not. In fact, the only people who do know are the registrars. Just because attorneys say something is true, doesn’t make it true.



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