Cutting The Crap: Republicans at the Health Care Summit

I’m ba-a-a-a-ck…

It’s time to bury some of the bullshit the Republicans have
been throwing out there regarding health insurance reform.This will have to be done in several installments; there really is too much to cover in one article.

I watched the entire health care summit, and I was truly
impressed that President Obama could keep order in such obvious chaos. On the
one hand, you had the Democrats who were trying to make the case for various
aspects of their bills, and why the reforms were necessary. On the opposite side
were the Republicans, who seemed to have no idea why they were there, and could think of
doing nothing except trying to score political points with their brain-dead

Of course, some of those brain-dead followers seem to be in
the news media.Did anyone else see any of the grueling two-hour snoozefest on
MSNBC last night, in which mental midgets Chuck Todd and Savannah Guthrie
gushed over how “prepared” the Republicans were and how their bullshit probably
resonated with average folks. How the hell would they know? How many “average
folks” do you think those two talked to between the end of the health care
summit and the beginning of the extended edition of “Hardball” that began at
about 9:15? I wonder how often either one of them heads over to Southeast DC to
have a conversation with the uninsured and et their opinion on health insurance reform. Or
do you suspect, as I do, that they spend most of their lives working in the
halls of the White House and the Capitol building, and really don’t get around

But I digress; another column on media millionaires telling
us what we supposedly think about things is coming…

To those of us who live among these regular folks and live
in the world of the uninsured, the Republicans at that meeting looked like
buffoons, because that’s what they are. A few of the lower-profile Republicans
made a few decent points regarding cost containment that will have to be
addressed at some point, but on the whole, I got the sense that most of them were only there to score political points. And, as usual, the only ones
who scored political points yesterday were Democrats, particularly President
Obama. Unfortunately, only a few of us geeks got to see it, so we’ll have to
spread the word; the the Republican Party truly is “The Party of
No.” Based on Republican thinking, we can’t do anything right now, because they
put the economy in the shitter. Of course, since they put the economy in the
shitter, they think they’re the only ones capable of getting us out.

It was remarkable just how many times these idiots repeated
the talking point, “We can’t afford it!” Seriously; what part of this do they not get? We’re
already paying for everything; the main problem is that an
ever-shrinking assortment of people are paying the entire bill, because private
health insurance is by nature risk-averse.  

Let me repeat that for the benefit of any hardcore Republican
who might happen upon this little tome, and who probably think this ridiculous
“argument” makes sense on some level; our health care system already costs us
$2.5 trillion per year.  What part of “one-sixth
of the economy” do these folks not understand, despite the fact that they keep
repeating it ad nauseum, as part of their meme decrying what they envision as a
“government takeover” of health care? The number of people who don’t pay for
health insurance keeps growing, which means more people are going without care
until they need far more expensive, chronic treatment, more people are seeing
economic ruin, and those who continue to pay for insurance are paying an
increasing proportion of the bill.

Got it now? Paying the current cost of health care is a non-issue; it’s
already being paid for. This concept that we “can’t afford” to reform health
insurance is patently absurd; we already do pay for it. Those who are either
denied or can’t afford insurance stay away from the doctor until their
condition severe. But at some point, they will end up at an emergency room
somewhere, incur some huge bills and not pay for them.  Then, health care providers raise their prices
to make up for the money they don’t receive from those who can’t pay. Around a
half million people every year are forced into bankruptcy because they can’t
pay medical bills, and who knows how many others just skip on their bills and
never bother with bankruptcy? How many of those with huge bills simply die, and
their bills are uncollectible? Guess who ends up paying for them? No, the
private insurers don’t just increase premiums because they’re greedy corporate
whores; a part of their premium increases are somewhat justified, because their
costs go up every year.

Basically, fewer and fewer entities are paying
higher and higher bills to cover the costs of an ever-increasing number of folks who can’t or won’t
carry insurance, and who can’t afford to pay their medical bills when they come due. And as more
people lose their jobs, and more companies stop offering health insurance as a
benefit to their employees, and more people are denied coverage because of a
myriad of pre-existing conditions and other arbitrary determinants, the number
of unpaid bills will continue to skyrocket, which will continue the death
spiral for the health care financing system.

What these geniuses can’t get their head around is that the
mere act of covering everyone with insurance, thus making sure every health care bill is paid and having everyone pay their
fair share into the system will save money for those who already have insurance,
and most importantly, it will take a lot of pressure off the Medicare and
Medicaid programs, which will make them a hell of a lot more solvent, which
makes it less likely that taxes will have to increase. You see, Medicare sees
the same increases in costs that private insurers see, but they can’t just
raise premiums every year and lop people off the rolls. Therefore, Medicare and
Medicaid just cost us taxpayers more every year.

This is common sense, which is why Republicans don’t seem to
understand the concept.  If you are part
of the nearly 80% of the population who has health insurance, you simply can’t
afford to NOT reform the system. All of this crap about being able to “afford”
it is a red herring.  There is absolutely
no scenario under which covering those who are currently without coverage would
NOT result in lower costs for most people.  

Another constant Republican refrain from yesterday’s summit
was the constant mention of “tort reform.” I think President Obama missed a
major opportunity by not addressing this more forcefully, but there is no
redder a herring in this debate. Torts have nothing to nothing to do with the
issue of cutting overall health care costs.

See, these people get wood at the very concept of what they
call “tort reform,” which doesn’t actually reform a goddamn thing. What they
call tort reform would more rightly be called “limiting corporate responsibility,”
because all they ever talk about is capping awards. How much is a case of
medical malpractice worth, really? Are they all worth the same? Let’s clear
this up with a few statistics, shall we? These come from a paper Public Citizen
put out several years back, entitled “The Great
Malpractice Hoax.”
The statistics come from the National Practitioner
Data Bank Public Use File
, which is a
vailable to anyone
who wants to check the facts further

Between 1991 and 2005, the number of
malpractice verdicts actually declined by 15%, and when adjusted for inflation,
the average payment per malpractice verdict actually went down by 8%. Moreover,
contrary to what Republicans will tell you, payments of more than $1 million
constituted less than 3% of all payments in 2005, and verdicts of $5 million or
more constituted less than one-half of one percent of the total money awarded. Moreover,
64% of all awards were for significant injury and/or death, with only one-third
of one percent of awards being given for insignificant injuries.  Those who were deemed to have a “minor
permanent injury” received 55% less, on average, than those deemed to have a “significant
permanent injury.” Overall, 82.6% of the total amount paid to victims of
medical malpractice go to compensate those with the most severe injuries,
including those who die as a result.  

In other words, while malpractice insurance
PREMIUMS are skyrocketing, the problem doesn’t seem to be “frivolous lawsuits,”
given that almost all of the money paid out goes to people with serious
permanent injuries and the families of patients who die.  Contrary to popular Republican myth, people
are not getting a million dollars for a hangnail. In almost all cases, payments
are in line with the severity of the damages. Basically, this is another example of insurance companies screwing their customers. Who could ever imagine such a thing, right?

The median payment for a malpractice claim only climbed from
$125,000 in 1991 to $139,100 in 2005. Not only that, but the median verdict
(only those cases that go to trial and are heard by a jury) went from $284,896
in 1991 to $461,524 in 2005. That may sound like a huge increase, but adjusted
for inflation, it means the average verdict actually went down, to around $260,000 in 1991 dollars. See, while juries do sometimes award
ridiculous amounts in punitive damages, it is not uncommon for a judge to cut
that award by a significant amount.

Yes, that’s right; judges have the discretion
to cut an outrageous award. There also is no such thing as a “frivolous
lawsuit;” if a judge decides a lawsuit is frivolous on its face, he has the
discretion not only to dismiss it, but to order the complainant to pay court
costs and reasonable attorney’s fees for the defendant. Few attorneys will dare
to bring a frivolous lawsuit for many reasons; for one thing, it could cost
them money; discovery is a costly enterprise. Also, it makes judges mad, and
contrary to what some television shows would have you believe, attorneys value
their relationships with judges, and would never risk their income and
reputation bringing such suits.

By the way, the Republicans’ cry that
surgeons and obstetricians are being forced out of business because of high
malpractice awards is also a load of crap. Between 1991 and 2005, the
proportion of total malpractice awards paid out on behalf of surgeons and
obstetricians was basically unchanged. Therefore, the supposed threat of
litigation that Republicans cite as a major problem simply isn’t a problem at

Overall, the total amount of medical malpractice
awards was $30.7 billion in 2007. The total 
amount spent on health care that year was $2.1 trillion. Do the math,
Republicans; if you eliminated all medical malpractice altogether, you would
cut costs by less than one-half of one percent. If their constant invocation of
tort reform as a necessary element of health insurance reform isn’t a red
herring, nothing is.

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One comment

  1. The two big health “reform” proposals from the conservatives have this much in common. They’ve been tried and don’t work.
    Tort reform, caps on medical claims in the legal system, have been in place for years in Texas and other states. There has been NO reduction in costs for patients. There is also no evidence of fewer unnecessary tests and procedures. It is now impossible to get a lawyer to bring a legal claim against a doctor in Texas no matter how badly he screwed up or how drunk he was, even pro-bono, because of the limitations in damages awarded. There has been a slight reduction in insurance premiums for doctors, but that has just increased their income because there has been no reduction in costs to patients.
    What there has been is a big increase in insurance company profits, surprise, and an influx of bad doctors from other states fleeing malpractice suits to Texas major metropolitan areas.
    Insurance should be able to be purchased across state lines increasing competition and saving consumers money? The same arguments were made for credit card reform decades ago. Instead on increased competition you saw the opposite – rapid consolidation. Instead of more competitive rates and customer benefits all credit card companies consolidated in the states with the least oversight and fewest consumer protections. This will obviously also happen with medical insurance.
    Either no ideas or bad ideas for the typical taxpayers – conservatives are all about helping their big corporate donors.
    Gary D in Houston, TX

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