Dr. Tom Price |
One of the signature issues of Donald Trump’s campaign was
the repeal of the Affordable Care Act or Obamacare. However, I noted in an
earlier post that Obamacare was actually repealing itself. Premiums are
increasing at double digit rates and already high deductibles are getting even
higher. Also, the number of insurance companies participating is getting
smaller and smaller.
Just this past week Connecticut announced that HealthyCT,
one of its most promising non-profit health insurance coops, would go out of
business on December 31. In the past couple of years the enrollment numbers had
not met expectations despite lower than average premiums, and claims had
skyrocketed. At the same time, the Federal funding that was designed to help
these coops get off the ground has now run out. The State announced that
existing claims would be paid out of an insurance industry fund designed to
rescue insolvent companies. HealthyCt’s remaining customers will have to find
new coverage.
I suspect that the fate of HealthyCT is being replicated all
over the country. Premiums are increasing all over and claims continue to rise.
Apparently, some states are now down to only one health insurance provider. A
recent article in the Wall St. Journal suggested that about 40 different
proposals to replace or change Obamacare have been proposed by Republicans in
Congress in the past four years but not one has been able to get past
President’s threat of a veto.
This week President-elect Donald Trump announced his
nomination of Representative Tom Price of Georgia to become head of the massive
Department of Health and Human Services (HHS). As a Congressmen, Price has
championed a replacement for Obamacare based on 20 years of experience as an orthopedic
surgeon and on his belief that the less government interferes in healthcare the
better.
What can the new administration do to rein in rising health
care costs? I’m sure that the will be many different suggestions and plans but
I would just like to mention one. If the government or Medicare can regulate
what hospitals, physicians, and drug companies receive for their services, I
don’t see why it can’t pass significant tort reform and limit the size and
extent of medical malpractice awards to attorneys who typically get 33% of the
claimant’s award. I also don’t see why enormous punitive damages that do not
benefit the actual claimant should be permitted.
Medical malpractice insurance makes up a huge part of the
expenses that hospitals and physicians must pass on to their patients. Why
should this be a political issue? Why have liberals and Democrats always
opposed tort reform? The doctors and hospitals that actually provide the
medical care must accept what Medicare and Medicaid allow but there is
practically no limit on what lawyers, who add nothing to medical care, can
charge.
Just recently I read that a commuter train conductor who
crashed his train into the landing platform in New York’s Grand Central station
was suing the rail line for $10 Million. He had fallen asleep on the job and
his train crashed after hurtling through the Grand Central tunnel at over 80
miles per hour. Nevertheless, his attorney claimed that the rail company should
have installed fool-proof braking devices in all trains to protect against
conductors like his client.
I am not saying that all medical malpractice claims are like
this one but even if they are not, what reasonable person would think a lawyer
should get over $3 Million for one case? Anyone on Medicare who looks at the
monthly claims report knows that the medical insurance company, following
Medicare guidelines, typically reduces the hospital or doctor bill substantially.
When I had radiation treatment for prostate cancer, the hospital billed my
insurance company over $120000. I have no idea how the hospital arrived at that
figure but it accepted the insurance company allowance of about $14000 of which
I had to pay 20%.
It will not surprise me to see tort reform in the medical
proposals emanating from the new Congress. The lawyers have a powerful lobby
and taking it on will be a test of the dedication of Donald Trump and the
Republicans to reforming health care.
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Cenzo from Fairfield comments:
ReplyDeleteIt's about time you wrote a concise and to the point blog. The lawyer issue goes without saying. Their bullshit is killing the country. The ACA does have a couple of good items, most notably the elimination of the pre-existing condition penalty and keeping junior on until age 26( you and I both realized years ago the pre-ex problem). They should retain the positive in the ACA and rewrite it from there.