The babyjesuschristsuperstar on Board: filling the moral void of Clinton’s legacy

[Hank Chinaski]

Originally posted by Tyrone Slothrop
Stop me if this gets too complicated.

If you spend money you don't have (a/k/a "deficit spending"), you have to pay for it later.

Therefore, future generations will have to pay not only for whatever spending they want for themselves, but also for the things Republicans have spent money on but chosen not to pay for. In this way, they are being taxed.

Even if they elect representatives who decide not to spend as much, they will still have to pay for the stuff today's Republicans are buying.

None of this has anything to do with social engineering.

are you familar with the Christian concept of Jubilee?
It's a debt forgiveness thing, if you had been reading FB you'd know Sebastian is a proponent- except not the Christian part. Oh, and as long as he's not owed.

[Replaced_Texan]

Grrrrrrr.

[ltl/fb]

Originally posted by Replaced_Texan
Grrrrrrr.

What's the point? I'm kinda drunk and even stupider than usual.

[Spanky]

Originally posted by Replaced_Texan
When I practiced law in the Bay Area, my only clients were physicians, and I represented them in every area of their practice except for medical malpractice claims. I worked very, very closely with CMA and I'm professional and personally sympathetic to the plight of the physician. (I'm typing this while two of them argue hospital politics during the Rose Bowl. BTW, Go horns!) My interest is in protecting physicians, and to focus solely on medical malpractice, especially in the state of California, is ridiculous.

MICRA rules and has since 1975 years in California. Further tort reform isn't really possible given MICRA. MICRA is the model for most other states' tort reform with regard to medical liability. I've represented physicians who got dinged with med mal insurance surcharges for "claims history" simply because of a notice to sue letter. *

The problem in your area is low reimbursement, a complete and total domination of a failed managed care system, and closed panels. I used to represent nephrologists that made less than $75K a year. Primary care physicians were even worse off, and this is mainly because managed care dominates the entire market.

Pissed off physicians in California are NOT bitching about medical malpractice. Pissed off physicians in California are bitching about capitation.

*This is what the CMA has to say about MICRA, and why your physician friends in the California Republican Party need to shut up and focus on the other stuff that the CMA advocates: I can see Republicans in other states bitching about these things, but not in California. The Texas Monthly rebuttal that I cited shows that medical malpractice premiums went up by as much as 10 percent after tort reform in Texas in 2004 for many insurance companies. Sort of tells you that the lawyers aren't the problem. And the doctors, as usual, are simplifying the issue by vilifying the lawyers. Which they always do, until they need me.

You seem to be contradicting yourself. First you agree with this:

"The Economist is probably the best news publication out there. That said, they sometimes come out with utter crap. This article might as well have been written by the AMA. Not a mention of the 1999 Institute of Medicine report that found between 44,000 and 98,000 preventable deaths every year in US hospitals, or the 2002 Public Citizen report that 5% of doctors are responsible for 50% of malpractice awards. A 2005 study by Dartmouth College researchers suggested that increases in doctors' insurance premiums are not due to jury awards and financial settlements for injured patients, but are more likely due to insurance companies having raised doctors' premiums to compensate for falling investment returns.

Reregulate insurance companies, force the AMA to police its own, and mandate aggressive reductions in preventable errors in hospitals. Any or all of these will reduce malpractice awards - and the last two have the additional benefit of increasing the quality of health care."

The you say: "MICRA is the model for most other states' tort reform with regard to medical liability." So are you saying most states have MICRA so the above article is wrong or are you saying that other states need MICRA (like Texas) so the article I was citing was correct for states without MICRA?

[baltassoc]

Originally posted by ltl/fb
What's the point? I'm kinda drunk and even stupider than usual.

I believe she's irritated that for some reason some delegate in Virginia thinks that unmarried women shouldn't be able to give birth to children without conceiving them naturally. God knows why. I think maybe Mr. (Ms.?) Marshall thinks it's somehow related to abortion.

ETA: Perhaps, however, it is useful remember that at least one Representative to the US House has introduced legislation within the past few years to abolish the Federal Reserve system. Perhaps this bill has about as high a chance of success.

[Spanky]

Originally posted by Replaced_Texan
When I practiced law in the Bay Area, my only clients were physicians, and I represented them in every area of their practice except for medical malpractice claims. I worked very, very closely with CMA and I'm professional and personally sympathetic to the plight of the physician. (I'm typing this while two of them argue hospital politics during the Rose Bowl. BTW, Go horns!) My interest is in protecting physicians, and to focus solely on medical malpractice, especially in the state of California, is ridiculous.

MICRA rules and has since 1975 years in California. Further tort reform isn't really possible given MICRA. MICRA is the model for most other states' tort reform with regard to medical liability. I've represented physicians who got dinged with med mal insurance surcharges for "claims history" simply because of a notice to sue letter. *

The problem in your area is low reimbursement, a complete and total domination of a failed managed care system, and closed panels. I used to represent nephrologists that made less than $75K a year. Primary care physicians were even worse off, and this is mainly because managed care dominates the entire market.

Pissed off physicians in California are NOT bitching about medical malpractice. Pissed off physicians in California are bitching about capitation.

*This is what the CMA has to say about MICRA, and why your physician friends in the California Republican Party need to shut up and focus on the other stuff that the CMA advocates: I can see Republicans in other states bitching about these things, but not in California. The Texas Monthly rebuttal that I cited shows that medical malpractice premiums went up by as much as 10 percent after tort reform in Texas in 2004 for many insurance companies. Sort of tells you that the lawyers aren't the problem. And the doctors, as usual, are simplifying the issue by vilifying the lawyers. Which they always do, until they need me.

I know that medical insurance rates in California are still really high. Generally much more that the physicians salaries. How could the tort system not be out of hand if the physicians are paying more for insurance than they are earning in salary? Why are insurance rates so high?

[Spanky]

Originally posted by Replaced_Texan
They're not gouging. They invested, like everyone else did, heavily in the tech boom, and then the bottom fell out of the market, and suddenly we're in a "medical malpractice crisis."

So why aren't lawyers malpractice rates really high? Why aren't the insurance companys trying to make up for their lost income from lawyers? Why aren't car insurance rates climbing dramatically? And why are most insurance companys ending medical malpractice coverage. If they were just trying to collect money all insurance companys would be staying in medical malpractice and all insurance rates would be climbing dramatically across the board? The argument is absurd on its face.

[Replaced_Texan]

Originally posted by Spanky
You seem to be contradicting yourself. First you agree with this:

"The Economist is probably the best news publication out there. That said, they sometimes come out with utter crap. This article might as well have been written by the AMA. Not a mention of the 1999 Institute of Medicine report that found between 44,000 and 98,000 preventable deaths every year in US hospitals, or the 2002 Public Citizen report that 5% of doctors are responsible for 50% of malpractice awards. A 2005 study by Dartmouth College researchers suggested that increases in doctors' insurance premiums are not due to jury awards and financial settlements for injured patients, but are more likely due to insurance companies having raised doctors' premiums to compensate for falling investment returns.

Reregulate insurance companies, force the AMA to police its own, and mandate aggressive reductions in preventable errors in hospitals. Any or all of these will reduce malpractice awards - and the last two have the additional benefit of increasing the quality of health care."

The you say: "MICRA is the model for most other states' tort reform with regard to medical liability." So are you saying most states have MICRA so the above article is wrong or are you saying that other states need MICRA (like Texas) so the article I was citing was correct for states without MICRA?

My comments about MICRA were directed to your comments about the grousing Republican Doctors in California. You were talking about the state of the practice of medicine in California, a subject I know a hell of a lot of about. I'm saying that if there's a problem with medical malpractice in this country, because of MICRA such a problem does not exist in California. The article you cited is irrelevant to California and your doctor buddies are just bitching about lawyers. Doctors have done that since the dawn of time.

I don't think that the article that you cited is correct for states without MICRA, but it's totally irrelevant to states like California that already have tort reform for the reasons that Panda laid out as well as looking at the two academic articles that I cited. (I can also give you a NYT editorial by the UT profs that did the first study.)

Did you read the Texas Monthly rebuttal that started this conversation, which sort of lays out the situation in Texas?

[Spanky]

Originally posted by Tyrone Slothrop
Future generations will have to pay either the principle or the interest, Spanky. You can argue that the debt won't be crippling -- I didn't say it would be, so I'm not sure whom you're arguing with -- but you can't say it won't exist. If you spend money today, and borrow to do so, you create a liability to be borne in the future. This administration is fine with this, because future generations are politically underrepresented just now.

Todays debt will not have to be paid back and the interest on todays debt will be insignificant forty years from now. Forty years from now the only deficits that will matter are the deficits that are incurred 33 years from now (if they are incurred).

That is why the comment of we are saddling future generations with debt is political hyperboly and the statement "future generations are politcally underrepresented is why Bush is doing this" is also politcal hyperbole that politicians spew but anyone who really understands the situation knows is just B.S. You just hear the mantra and you repeat it.

Bush creating deficits during a recession was the right thing to do. If the government continues deficit spending well into this recovery then that will be a mistake because it will hamper growth - in the short term. That is where we are screwing future generations, because slow growth now means a smaller pie in the future.

The best way to serve future generations is growth. Growth is like compounding interest so every little bit now makes a huge difference to future generations. Todays debt will diminish in importance as time goes forward (just the opposit of growth). Deficit management and debt management should be purely focused on growth. We screw future generations not by saddling them with debt, but by not maximising growth.

That is why all the liberals bitching about the deficit during the recession was pure stupidity (actually it was good politics for the Dems - but anyone who believed what the Dem leadership were spewing was an idiot).

[Replaced_Texan]

Originally posted by Spanky
I know that medical insurance rates in California are still really high. Generally much more that the physicians salaries. How could the tort system not be out of hand if the physicians are paying more for insurance than they are earning in salary? Why are insurance rates so high?

This is not true:

States without MICRA reforms are now experiencing their own version of California's mid-1970s medical liability crisis. Since 1975, California's premiums have risen 168 percent, while the average U.S. premium has increased 420 percent. Today the average annual liability premium for an ob/gyn doctor in California is $45,000. In New York City, that ob/gyn would pay $89,000 for the same coverage. In Miami, that doctor would pay $160,000. Neither New York nor Florida has a liability reform mechanism like MICRA.

See also: This.

[Spanky]

Originally posted by Replaced_Texan
My comments about MICRA were directed to your comments about the grousing Republican Doctors in California. You were talking about the state of the practice of medicine in California, a subject I know a hell of a lot of about. I'm saying that if there's a problem with medical malpractice in this country, because of MICRA such a problem does not exist in California. The article you cited is irrelevant to California and your doctor buddies are just bitching about lawyers. Doctors have done that since the dawn of time.

I don't think that the article that you cited is correct for states without MICRA, but it's totally irrelevant to states like California that already have tort reform for the reasons that Panda laid out as well as looking at the two academic articles that I cited. (I can also give you a NYT editorial by the UT profs that did the first study.)

Did you read the Texas Monthly rebuttal that started this conversation, which sort of lays out the situation in Texas?

So you are saying that states like Texas that don't have MICRA need it. So Sexual Harassment Panda arguments do not apply to non-MICRA states.

And you still didn't answer the question: if MICRA is doing such a good job of keeping litigation costs down why are malpratice rates so high in California and why have so many insurance companys in California disontinued providing medical insurance?

[Replaced_Texan]

Originally posted by Spanky
So you are saying that states like Texas that don't have MICRA need it. So Sexual Harassment Panda arguments do not apply to non-MICRA states.

And you still didn't answer the question: if MICRA is doing such a good job of keeping litigation costs down why are malpratice rates so high in California and why have so many insurance companys in California disontinued providing medical insurance?

The Texas legislature passed HB 4 and the voters in Texas voted for Proposition 12 in 2003. (YAY! TEXAS!!!! ARE YOU WATCHING THIS GAME???? HOLY SHIT!) We have tort reform. The non-profit insurance company dropped it's rates automatically by 11 percent. The for-profit insurance companies raised their rates in 2004.

I suspect that the shareholders are much more interested in making money than providing medical malpractice insurance that is affordable.

[Spanky]

Originally posted by Replaced_Texan
This is not true:

See also: This.

The interesting part of that article was this:

However, MICRA opponents are spreading false notions about this important reform, claiming that the insurance industry has created the rising premiums to make up losses due to troubled stock market investments. Both of these claims are myths and the facts speak for themselves.

The fact is that insurers cannot raise premiums to recover past loses - whether in the stock market or anywhere else.

So the article you cited explained why your claim, and SHP claim about raising rates to deal with Tech losses is complete B.S.

This article also explains that there is a medical malpratice crisis across this country where MICRA does not exist.

"States without MICRA reforms are now experiencing their own version of California's mid-1970s medical liability crisis."

In other words the Economist article was right. And you and SHP were wrong.

The article also stated the need for national Tort Reform and that many groups (Trial Lawyers) are fighting national tort reform, where tort reform has done so much good in California.

How does this article back up your and SHP's assertions?

My guess is that the Doctors here in Santa Clara County, like Dr. Burnett, who is the former head of the AMA, are pushing for national tort reform and are mad that the trial lawyers are blocking it. Your article supports their position that the trial lawyers are spending tons of money spreading disinformation (like this tech loss mantra that you and SHP so obediantly repeated) and are hurting the country by not letting it pass the type of tort reform California already has.

[baltassoc]

Originally posted by Spanky
I know that medical insurance rates in California are still really high. Generally much more that the physicians salaries. How could the tort system not be out of hand if the physicians are paying more for insurance than they are earning in salary? Why are insurance rates so high?

There are several explanations that do not involve the necessity of "tort reform" and which may actually be exacerbated by "tort reform."

The medical community imposes very daunting and unnecessarily stressful conditions on many of its doctors. There is simply no reason for the length of shifts doctors are expected to work. Fatigue increases errors, but the machisimo of the profession prevents reform.

Physicians (like lawyers) are remarkablely reluctant to discipline their own until way, way too late. Most claims come from a small minority of doctors. Medicine needs to recognize problems with practicioners sooner, intervene sooner, and yank licenses sooner.

Physicians are simply not paying enough attention. 25 years ago, anesthesiologists had some of the highest malprace insurance rates; now they have some of the lowest. The difference: anestesiologists collectively undertook to study why and how errors were being made and took steps to prevent them as a profession. Why haven't other doctors done the same? Because its easier to bitch about lawyers than to actually fix what's wrong and stop killing people.

[ltl/fb]

Originally posted by Replaced_Texan
YAY! TEXAS!!!! ARE YOU WATCHING THIS GAME???? HOLY SHIT!

Um, hook 'em?