42 Responses to “MN GOP PRESS RELEASE: “REPUBLICAN PARTY OF MINNESOTA ANNOUNCES FORMATION OF HEALTH CARE COALITION””

1. Hector Says:
   August 25th, 2009 at 4:21 pm

   I am all for empowering individuals, but is that something the health care establishment will accept?

2. Jude Says:
   August 25th, 2009 at 6:15 pm

   Just one idea from you guys that hasn’t already shown not to work.

   Tort reform? Name one state that has lowered costs after tort reform? Missouri? Texas? Florida?

   I really cannot think of one Republican proposal that has been shown to actually lower costs and/or improve care except in special cases. Sorry special cases just don’t cut it.

3. Hector Says:
   August 25th, 2009 at 7:15 pm

   I believe Minnesota, where because of various legal restrictions, it isn’t that easy to bring a medical malpractice action, malpractice insurance rates are relatively low. While I think it’s pretty clear that Democrats will not accept medical malpractice reform as a part of a national comprehensive health care plan, I think it’s also true that the reason people bring malpractice actions is that they have expenses not covered by insurance. If those expenses are paid for, the strongest motivation for bringing a malpractice action is gone.

4. chile Says:
   August 25th, 2009 at 7:34 pm

   Jude: “Economists disagree on the precise burden of this legal fear, but some argue that it exceeds $100 billion a year.”

   http://online.wsj.com/article/SB124511987247017719.html

   Hector the moobat says: “I believe Minnesota, where because of various legal restrictions, it isn’t that easy to bring a medical malpractice action”

   What “various legal restrictions”? You find a lawyer who’ll take your case and you sue. No matter how frivolous your claims are, the med-mal insurer has to pay to defend it.

   Hector the moonbat also says: “I think it’s also true that the reason people bring malpractice actions is that they have expenses not covered by insurance. If those expenses are paid for, the strongest motivation for bringing a malpractice action is gone.”

   So the plaintiff is suing the doctor because he had out of pocket expenses? This has nothing to do with mal-practice.

   The “true reason” for bringing mal-practice is money. If a “loser pays” clause existed in the law, you’d see malpractice suits fall by more that 1/2.

5. Jude Says:
   August 25th, 2009 at 8:03 pm

   Chile
   I was merely stating that no savings have been shown when tort reform was implemented.

   If there was a level of independent arbitration before court the “loser pays” would certainly be something to consider. That and allowing records for doctors from out of state to be included.

   But as far as legal costs are concerned would you admit that the “best practices” review board currently proposed by Obama would go a long way towards reducing these costs also?

6. chile Says:
   August 25th, 2009 at 9:12 pm

   We don’t need ObamaCare to address malpractice frivolous malpractice law suits – a problem that Obama refuses to address for what it is.

   “Just hold onto your horses here, guys. . . . I want to be honest with you. I’m not advocating caps on malpractice awards.”

   http://online.wsj.com/article/SB124511987247017719.html

   “Best Practices” review board: No, I don’t think this will help one iota. Where such standards already exist in various states, Doctors who follow them to the tee, still get second guessed and still get sued.

   I wonder who Obama would appoint to such a board. Liberal doctors, like the Regina Benjamin? Do you recall that he named a mid-level campaign staffer – a kid with no automotive industry experience – to be one of his car czars?

7. Jude Says:
   August 25th, 2009 at 11:46 pm

   Chile

   Which is it? It is hard to keep track of which side you guys are on?

   “Insurer WellPoint Inc. said last month that liability wasn’t driving premiums.”

   What I really find objectionable is the co mingling of statistics that are used to arrive at these numbers. Malpractice not malpractice insurance have cost results in figures as high $400 million. Actual malpractice is not litigated all that frequently, studies pulished in JAMA and elsewhere have consistency shown that 98,000+ people die each year due to malpractice (major reason being wrong drugs or dosages being administered followed by misdiagnosis).

   Dont get me wrong I am not really blaming the medical profession. It is a complex and high stress environment with life and death decisions constantly.

   So the AMA wants caps on awards. Obama offers shielding doctors from liability if they follow “best practice” guidelines developed by physicians’ groups. That is call compromise and what is more get at the actual root of the problem.

8. Jude Says:
   August 25th, 2009 at 11:47 pm

   Sorry my link didn’t post
   http://www.bloomberg.com/apps/news?pid=20601087&sid=az9qxQZNmf0o

9. Hector Says:
   August 26th, 2009 at 6:05 am

   “So the plaintiff is suing the doctor because he had out of pocket expenses? This has nothing to do with mal-practice.”

   You are correct. The status of the patient’s insurance, whether he has the ability to pay, has little to do with whether doctors commit malpractice.

   “The “true reason” for bringing mal-practice is money.”

   Again correct. Lawsuits are typically brought in order to get money. Nobody brings lawsuits for the fun of it.

   “If a “loser pays” clause existed in the law, you’d see malpractice suits fall by more that 1/2.”

   Possibly but again, remember your earlier point. Lawsuits are brought to obtain money. Malpractice suits are brought because people don’t have it. Therefore a loser pays system might have less effect than you think because the patient is broke because of medical expenses, and therefore judgment proof.

   Where loser pays is concerned, my modest proposal is that it might be ok, if legal expenses are capped for both sides. The advantage defendants have in malpractice lawsuits is that as wealthy insurance companies, they have the ability to drive patient attorneys into the ground with costs. If you take away that ability, by setting limits on what each side can spend on a lawsuit, the playing field would be evened considerably, since the amount paid for losing a lawsuit would be far less than costs otherwise occurred. I think you will find that this is what typically happens in countries with loser pay systems.

10. Hector Says:
    August 26th, 2009 at 6:14 am

    “What “various legal restrictions”? You find a lawyer who’ll take your case and you sue. No matter how frivolous your claims are, the med-mal insurer has to pay to defend it.”

    In Minnesota you have to go through all sorts of stuff to bring a medical malpractice suit. This is why you never here of outrageous med mal judgments here, and incidentally why insurance premiums for doctors is relatively low.

    Medical malpractice cases are not only difficult to bring, they are also expensive, and since they are usually brought on a contingency fee basis, the bulk of those expenses fall on the attorney. A failed malpractice suit can break an attorney or a law firm. That being the case, there is no incentive at all to bring a frivolous case. What is far more common is for malpractice attorneys to turn down good cases but which are just not viable from a financial point of view.

11. chile Says:
    August 26th, 2009 at 6:29 am

    Moonbat Jude, What do you mean by “you guys” ? I have nothing to do with WellPoint, never have and probably never will.

    The Bloomberg article you cited throws in that one sentence statement, completely out of context with the original press release from which it was derived. In the original press release by Wellpoint in May, they say profits, old age and med-mal have little to do with increasing costs compared to:

    Advances in medical technology and subsequent increases in utilization.
    Price inflation for medical services that exceeds inflation in other sectors of the economy. Cost-shifting from people who are uninsured and those receiving Medicare and Medicaid to the private sector.
    High cost of regulatory compliance.
    Patient lifestyles, such as physical inactivity and increases in obesity.

    http://news.prnewswire.com/DisplayReleaseContent.aspx?ACCT=104&STORY=/www/story/05-27-2009/0005033081&EDATE=

    As far as the WellPoint press release, this was done as they are fighting a class action lawsuit for underpaying doctors. Doctors buy med-mal policies, Insurance companies do not. Wellpoint might have been trying to downplay the doctors med-mal expenses.

    When you read the Bloomberg piece, why did you ignore this?

    “About 10 percent of the cost of medical services is linked to malpractice lawsuits and more intensive diagnostic testing due to defensive medicine, according to a January 2006 report prepared by PricewaterhouseCoopers LLP for the insurers’ group America’s Health Insurance Plans. ”

    Why do we need ObamaCare in order to have “best practices” that shield Doctors from lawsuits?

12. chile Says:
    August 26th, 2009 at 6:40 am

    Hector, you make about as much sense as Hiram

    Once plaintiffs attorney notifies the Doctor or Hospital that they intend to sue, defendants attorneys start the clock on billable hours.

    If the defendant plays hardball, they’ll beat most every suit. The fact is, they usually settle because it’s cheaper than paying the legal fees that can drag out for years.

13. chile Says:
    August 26th, 2009 at 6:46 am

    Hiram, if you’re having trouble logging in. Try logging in and if you get bounced. Go directly back to MDE through your web browser while remaining in the same window. That works for me.

14. Hector Says:
    August 26th, 2009 at 7:56 am

    “Once plaintiffs attorney notifies the Doctor or Hospital that they intend to sue, defendants attorneys start the clock on billable hours.”

    I am sure that isn’t necessarily the case. Doctors and hospitals are often well aware when they are presented with malpractice issues, and there is no particular reason to wait for any sort of notice from an attorney before consulting an attorney of their own. But in any event, what I am modestly proposing is a shift away from the billable hours model of attorney fees.

    “If the defendant plays hardball, they’ll beat most every suit. The fact is, they usually settle because it’s cheaper than paying the legal fees that can drag out for years.”

    “If the defendant plays hardball, they’ll beat most every suit. The fact is, they usually settle because it’s cheaper than paying the legal fees that can drag out for years.”

    Going to trial, is in itself an act of hardball. And I believe defendants win most cases that go to trial. But in any event, my proposal to cap legal fees would totally eliminate the incentive for both sides to drag out lawsuits for years. That simply would not be financially possible.

15. Jude Says:
    August 26th, 2009 at 8:13 am

    Chile
    You are correct I should not have lumped you in. My frustrations got the better of me sorry.

    I did not ignore the 10% claim. Indeed I agree with it. I merely draw a different conclusion.

    The majority of that 10% figure is defensive medicine (80-90+%). If as studies have shown there are literally millions of cases of actual medical errors resulting in injury every year, the number of malpractice claims every year is minuscule. If the threat of a malpractice claim is forcing some defense well good something has to. Even the malpractice claims themselves support this 97% of all claims are associated with injuries. Independent studies have shown that at least 63% of those injuries were the result of errors.

    So where you see malpractice claims as the disease, I see them as the symptom of a much larger problem.

16. Hector Says:
    August 26th, 2009 at 8:22 am

    “Hiram, if you’re having trouble logging in. Try logging in and if you get bounced. Go directly back to MDE through your web browser while remaining in the same window. That works for me.”

    Thank you for the advice, but I probably comment too much any way. I figure the password troubles I have been having are the internet gods way of telling me that I should get a life.

17. chile Says:
    August 26th, 2009 at 8:58 am

    Moonbat Jude says: “So where you see malpractice claims as the disease, I see them as the symptom of a much larger problem.”

    Yes, Doctors make mistakes and the tort system helps ensure that they keep these to a minimum. We’re talking about tort reform, not tort elimination.

18. Jude Says:
    August 26th, 2009 at 11:08 am

    Chile

    We must have a very different view of solving problems. I have always found that papering over a hole in the wall makes it harder to fix.

19. Hector Says:
    August 26th, 2009 at 7:01 pm

    I just want to note that no one has responded to my proposal to accept loser pays in exchange for a cap on attorney fees to be applied equally to both sides. I think it’s a good deal for consumers, and I think it’s the rough equivalent of what happens in other countries which have a loser pay system.

    Any thoughts? Anyone?

20. chile Says:
    August 26th, 2009 at 8:20 pm

    Moonbat Jude, try using tape.

21. Chris Says:
    August 27th, 2009 at 12:57 am

    Jude,

    The notion that medical malpractice lawsuits don’t drive up health care costs is absurd. Check out this article about how med mal lawyers like John Edwards have created a crisis in North Carolina.

    http://www.washingtontimes.com/news/2004/aug/16/20040816-011234-1949r/

22. Hector Says:
    August 27th, 2009 at 6:14 am

    I see no one has responded substantively to my modest proposal of yesterday. Let me throw it out there once again.

    I would accept a loser pays system of paying costs in tort litigation, in exchange for a cap on those costs. This is roughly what happens in countries with loser pay systems.

    Would anyone take that deal?

23. Hiram Says:
    August 27th, 2009 at 6:24 am

    I see no one has responded substantively to my modest propsal.

    I would be willing to accept a loser pays system of allocating the costs in tort litigation, in exchange for a cap on those costs. This is roughly what happens in countries with loser pay systems.

    Any takers?

24. Jude Says:
    August 27th, 2009 at 8:14 am

    Chris

    Of course lawsuits drive up costs. Who would say any different?

    The point I am making is that the underlying cause is in the practice of medicine. That is probably due more to the speed of technology, increase in knowledge and the replacement of skilled trained professionals with lower waged “assistants”.

    When you actually get into the statistics at the bottom of the “Tort” reform arguments you are left with a very different understanding of the problem and its scope, at least I was.

    Most of the actual award money go to administration costs (lawyers, court cost, witnesses etc.) That would argue that a level of arbitration would be must more effective. Caps will more then likely to increase the number of cases. The economics of the malpractice industry pretty much guarantee that. Because it is probably something like 0.1% of potential cases are actually litigated. Loser pays would reduce the number of cases and put the focus only on the most egregious ones. But if caps are in place then the drive to correct the systematic errors is reduced or eliminated, which in turn will bring similar occurrences and increased litigation of them.

    Basically you will push these costs to the future while promoting more mistakes. Litigation and its threat is really the only systematic control in place. Making it easier for a rational business man to decide it is cheaper to absorb the costs of litigation then to increase the cost of care seems to me very shortsighted and poor medicine.

    If you institute national “best Practice” standards and shield practitioners with it then litigation becomes greatly reduced and is an additional effective self-correcting mechanism. Additionally it limits useless defensive medicine and translates those aspects of what we call “Defensive” into standard practice, which in turn reduces the actual number of errors.

    Tort reform after this system is in place then makes perfect sense as we can now make intelligent choices in building a sieve that separates the wheat from the chaff.

25. Jude Says:
    August 27th, 2009 at 8:45 am

    Be gone ’til next week so I’m not ignoring anyone.

26. Hector Says:
    August 28th, 2009 at 6:24 am

    Loser pays would reduce the number of cases and put the focus only on the most egregious ones.

    Not as much as you would think, actually. For one thing, as you note, very few cases actually get litigated. For another, the system already discourages the bringing of suits in numerous ways. For a third, plaintiffs bringing suit are typically broke, buried as they are under medical expenses. If they were assessed the costs of litigation, that would simply be another debt left unpaid.

    Again, my modest proposal is ignored. How about loser pays, but with a cap on costs?

27. Hiram Says:
    August 28th, 2009 at 11:47 am

    “Because it is probably something like 0.1% of potential cases are actually litigated. Loser pays would reduce the number of cases and put the focus only on the most egregious ones.”

    I think it’s very easy to overestimate the impact of a loser pays system. As the quote above says, very few malpractice cases ever go to judgment where presumably losers would be required to pay. And as a practical matter, since plaintiffs in malpractice cases are generally broke from medical expenses, they don’t have the money to pay for litigation costs anyway.

    I still have no takers and not much response to my modest proposal. Loser pays costs in exchange for a cap on those costs. Again, that’s roughly what happens in loser pay systems. Anyone interested in that deal?

28. Chris Says:
    August 28th, 2009 at 12:28 pm

    Hiram,

    I guess I don’t understand what it is you’re proposing. What do you mean by a cap on those costs? Are you suggesting that the losers pay only a small portion of attorney’s fees required to defend a medical malpractice case? If that’s what you mean by a cap on the costs, then you’re not proposing a serious loser pay system in the first place.

    Enacting tort reform not only saves doctors money on hugely expensive medical malpractice insurance it is to reduce the need for “defensive” medicine. In other words, ordering a bunch of tests to cover the doctor’s ass in terms of the diagnosis. The fewer defensive medical tests ordered, the lower the costs for the patient and their insurance companies.

29. Hiram Says:
    August 28th, 2009 at 1:07 pm

    “Are you suggesting that the losers pay only a small portion of attorney’s fees required to defend a medical malpractice case?”

    No, but those fees be limited, to say $10,000. I can assure you that places a much greater potential burden on plaintiffs than it does on the insurance companies that defend malpractice cases. But it would also mean a huge reduction in overall legal costs, and streamline the system. It would put huge pressure on attorneys on either side to properly evaluate their chances of winning a case. This is what happens elsewhere in loser pay systems. For anyone advocating loser pay, the tradeoff seems obvious and natural.

30. Hiram Says:
    August 28th, 2009 at 5:01 pm

    Enacting tort reform not only saves doctors money on hugely expensive medical malpractice insurance it is to reduce the need for “defensive” medicine.

    Minnesota is a state where it’s already difficult to bring a medical malpractice case, and as a result med mal insurance is pretty cheap here. A lot of states have enacted legislation restricting medical malpractice judgments in various ways, and they seem to be effective. I don’t know why Republicans, who are generally in favor of local control, reject that principle where medical malpractice litigation is concerned. I don’t, for example, think any of us would want Florida, to name one state, standards of medical care imported to Minnesota.

31. chile Says:
    August 28th, 2009 at 6:04 pm

    So Hiram, If $50,000 is spent to defend a frivolous lawsuit, the plaintiff would pay only $10,000 under your plan? The problem with that is that there is still $40,000 of expense incurred by the med-mal insurer.

    In liability insurance, actual loss payments and loss adjusted expense are combined into the loss ratio. Going forward, the med-mal insurer is going to use that $40,000 to calculate future med-mal rates.

    Loser pays should do two things, 1) discourage frivolous law suits. 2) reduce the negative financial impact for those who are forced to defend them. The Hiram plan does little to do either.

32. Hector Says:
    August 28th, 2009 at 7:28 pm

    No.

    Each side would be limited in the amount it could spend.

33. Hector Says:
    August 28th, 2009 at 7:36 pm

    1) discourage frivolous law suits.

    2) reduce the negative financial impact for those who are forced to defend them. The Hiram plan does little to do either.

    In fairness, loser pays should discourage frivolous positions on both sides. And truthfully, the possibility of paying $10,000 in costs would do virtually nothing to discourage insurance companies from maintaining frivolous positions. Defense of malpractice claims now can cost them hundreds of thousands of dollars. Even your proposed cost of $50,000 is about what it costs to open a file now.

    But to show my willingness to compromise and indeed bend over backward to accommodate the wonderful folks at insurance companies, I am willing to accept a cap of $10,000, in plaintiff’s expenses and a cap of $50,000 in insurer expenses.

    Is that better?

34. Hector Says:
    August 28th, 2009 at 8:00 pm

    By the way, there are lots of ways to deter frivolous plaintiff suits, and in the area of medical malpractice loser pay isn’t really one of them. Bear in mind that the typical medical malpractice plaintiff is broke. He has lost his job, probably lost his insurance if he ever had any, and deeply in debt. If he loses the lawsuit, in all likelihood, he will never have anything like the amount of money needed to pay the costs of the defense. So that’s why loser pays isn’t in reality very much of a problem for plaintiff’s. In my proposed trade, I am giving up hardly anything of real value. On the other hand, what I am asking for in exchange is very valuable indeed. Insurance companies know the facts I just stated very well. They know their plaintiffs are broke and that their attorneys are absorbing costs without a foreseeable payday. In the nature of litigation, insurance companies are in a position to drive up costs, that the companies can afford, and plaintiffs cannot. My proposed cap prevents that. In effect, it may well do what you say you want on the defendants side, prevent them in engaging in frivolous tactics and taking frivolous positions that they love so much.

    So on the whole, defense attorneys might have more problem with loser pays than plaintiff attorneys, but neither side might like it very much. The winners are the folks who are not attorneys, because quite simply it reduces legal costs, both for the plaintiff and the defendant.

    Given the fact that I have a legal background, you might find it surprising that I am proposing a solution, like this one that’s bad for lawyers. I will tell you why that is. The dog I have in this fight doesn’t have to do with malpractice cases. My interest is education and kids, and the more money that goes into the black hole that is the health budget in this state, the more money left over for schools.

35. chile Says:
    August 30th, 2009 at 8:37 pm

    “Bear in mind that the typical medical malpractice plaintiff is broke. He has lost his job, probably lost his insurance if he ever had any, and deeply in debt.”

    Really Hiram? Thats the “typical” plaintiff?

36. Hector Says:
    August 31st, 2009 at 6:12 am

    That’s not a typical plaintiff necessarily, but a typical malpractice patient.

37. Jude Says:
    August 31st, 2009 at 9:53 am

    In the discussion here about Malpractice and Tort reform no one has really addressed my initial point. It has nothing to do with Health Care reform.

    34 states have in the last decade have enacted some form of Tort reform. If it had any value you would think that the argument in support of Tort reform would point out the positive results. That doesn’t happen because it hasn’t happened. In fact right now malpractice premiums are the lowest in over 30 years when adjusted for inflation. Whatever possible benefit Tort reform may have has been mostly already achieved.

    Oh by the way inflation adjusted claims are down 45% since 2000.

38. chile Says:
    August 31st, 2009 at 10:36 pm

    Jude, enough with the factoids unless you can provide unbiased sources to back them up.

    “In the discussion here about Malpractice and Tort reform no one has really addressed my initial point. It has nothing to do with Health Care reform.”

    To say Med-Mal has nothing to do with Health Reform, is like saying cost has nothing to do with health reform.

39. Jude Says:
    August 31st, 2009 at 11:34 pm

    Chile

    So Don’t bother you with any facts? Articles in JAMA are biased?

    Your answer is just because?

    Fine, you believe what you believe. What would you give me in exchange? Would you be willing to give me best practices medical boards?

40. chile Says:
    September 2nd, 2009 at 9:28 pm

    Sorry Moonbat Jude, but I’d rather read things for myself than take you word for it. Since JAMA is by paid subsription only, I don’t have access.

    “Dr. Judith Favor said tort reform is needed to cut health care costs. She said 40 percent of health care costs are associated with defensive medicine and malpractice insurance. Curtailing frivolous lawsuits and capping malpractice monetary awards would help physicians drive costs by eliminating many unnecessary or redundant procedures.”

    http://www.bizjournals.com/birmingham/stories/2009/08/31/daily21.html

    “And despite the CBO reluctance (dare I say courage) to score tort reform savings one irrefutable fact remains; between 1997 and 2007 medical tort costs (including insurance premiums) have risen from $15 billion to $30 billion a year. That fact alone should insure that yearly savings in the billions from medical tort reform would pass the credibility test.”

    http://www.realclearpolitics.com/articles/2009/08/18/dems_ace_in_the_hole_on_health_care_tort_reform_97919.html

41. chile Says:
    September 2nd, 2009 at 9:57 pm

    Moonbat Jude, let me say would see as problems with the best practices boards.

    The folks running it would be political appointees. Maybe some one like the pro-death Zeke Emmanuel would be included.

    Hospitals and clinics already have their own quality control standards, and follow managed care guidelines. There’s no need to throw a thick layer of federal beaurocracy over that.

    Every patient is different, and doctors are trained to evaluate each patient on an individual basis. A doctor may wish to go with treatment x or y, but instead go with z because that’s the the best practices manual says to do.

    The best practices manual might actually require defensived medical practices, such as lab tests, drugs, or x-rays that are unnecessary.

    Any best practices proposal, should have the approval of doctors and it should be governed by doctors. Let the AMA oversee it and tell Obama to keep his nose out of it.

42. Mn Gop Press Release: “Republican Party of Minnesota Announces … Says:
    October 23rd, 2009 at 1:25 am

    [...] Rochester- Former Representative Fran Bradley and Doctors Brian Davis, Fred Nobrega and Scott Wright today announced the formation of the Republican Party of Minnesota’s Health Care Coalition. The goals of the coalition are to help …Continue Reading [...]

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