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Durbin calling out the R's who want the conflict of interest stripped out of the healthcare bill.

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flpoljunkie Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 03:01 PM
Original message
Durbin calling out the R's who want the conflict of interest stripped out of the healthcare bill.
You know the conflict that allows the doctor to send you for a cat scan, MRI's or other expensive tests, to a facility he or she has a vested interest in.

Republicans--protectors of those who are milking the health care system-while they whine about the profits lost by the insurance companies who have been administering the overpriced Medicare Advantage programs in the guise of 'protecting Medicare recipients.'

The Senate is debating hypocrite McCain's motion to recommit.
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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 03:09 PM
Response to Original message
1. I don't think I have a problem with a Dr. having a vested interest in
any of those facilities as long as that facility is part of the network my ins. co. has a contract with. Drs are humans and have a right to invest in whatever they want. I would have a problem if they passed up an in network facility to just push patients to the one they have the interest in. I always ask if it's part of my ins network, and I'm always told that they MUST check that first!
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flpoljunkie Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 03:20 PM
Response to Reply #1
2. How can you be sure the doctor is doing what's in your best interest and not his financial interest.
Edited on Tue Dec-01-09 03:21 PM by flpoljunkie
This drives up the cost for everyone--unnecessary tests, unnecessary operations, unnecessary prescription drugs.
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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 03:30 PM
Response to Reply #2
3. If the main concern is unnessary tests, you need to challenge
the ins. cos that provide malpractice ins. A very good friend of mine is the finance officer for the largest hosp system in Pgh. pa. I was complaining to her about knowing that my Dr. KNEW while I was in his office that I had pneumonia and should have prescribed the meds then and be done with it. Instead, he sent me to a facility that only did xrays, and his office called the next day to say "You have pneumonia and I will call in a 'script for you if you'll give me the # to the pharmacy you chose." My friend told me that the ins. cos demand the docs do that to CYA so there's no risk of a malpractice suit. I call BS on that kind of treatment! But that's the way it is now.
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flpoljunkie Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 03:39 PM
Response to Reply #3
4. Did the doctor perhaps have a vested interest in the facility who did your xrays?
There are problems with medical malpractice--not the least of which is those who are wrongfully injured who never file suit and those who have legitimate claims who do not receive compensation for their loss. We do need a more equitable system.

From The Medical Malpractice Myth:

The most impressive and comprehensive study is by the Harvard Medical Practice released in 1990. The Harvard researchers took a huge sample of 31,000 medical records, dating from the mid-1980s, and had them evaluated by practicing doctors and nurses, the professionals most likely to be sympathetic to the demands of the doctor's office and operating room. The records went through multiple rounds of evaluation, and a finding of negligence was made only if two doctors, working independently, separately reached that conclusion. Even with this conservative methodology, the study found that doctors were injuring one out of every 25 patients—and that only 4 percent of these injured patients sued.

The Harvard study stands for a large body of literature. On their own, however, the results don't disprove the Republicans' thesis that many medical malpractice suits are frivolous. Maybe badly injured patients don't sue, while the reflexively litigious clog up the legal system, making tort reform a viable solution. But a new study, released in May, demolishes that possibility. Dr. David Studdert led a team of eight researchers from Harvard School of Public Health, Brigham and Women's Hospital, and the Harvard Risk Management Foundation* who examined 1,452 medical malpractice lawsuits. They found that more than 90 percent of the claims showed evidence of medical injury, which means they weren't frivolous. In 60 percent of these cases, the injury resulted from physician wrongdoing. In a quarter of the claims, the patient died.

When baseless medical malpractice suits were brought, the study further found, the courts efficiently threw them out. Only six of the cases in which the researchers couldn't detect injury received even token compensation. Of those in which an injury resulted from treatment, but evidence of error was uncertain, 145 out of 515 received compensation. Indeed, a bigger problem was that 236* cases were thrown out of court despite evidence of injury and error to patients by physicians. The other approximately 1,050 cases, in the research team's opinion, were decided correctly, with damage awards going to the injured and dismissal foiling the frivolous suits.*

Nor is there evidence to show that the level of jury awards has shot up. A recent RAND study looked at the growth in malpractice awards between 1960 and 1999. "Our results are striking," the research team concluded. "Not only do we show that real average awards have grown by less than real income over the 40 years in our sample, we also find that essentially all of this growth can be explained by changes in observable case characteristics and claimed economic losses."

http://www.slate.com/id/2145400/fr/rss/

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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 04:36 PM
Response to Reply #4
7. I don't know. My objection is not that he somehow profited
from this xray, but that he ordered it at all! I'm 66 yo and I remember going to the GP for EVERYTHING! Neither my hisband nor I had ever been to a specialist until he was sent at age 55 to have a heart cath. Now no GP wants to make a dman decision on things they were trained in.

I agree there are probably too many frivilous law suits, but it also concerns me if we do reform, what happens to the obvious malpractice cases? In NC, a young girl was given a heart that didn't match her blood type. They tried another ransplant 2 days later but she died because her body was too week after the 1st surgery to withstand the 2nd one. I've read about drs amputating the wrong leg, leaving "things" inside the patient that cause infection, all kind of carelessness. How do you protect those victims but still eliminate the frivilous greedy ones?
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flpoljunkie Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 04:46 PM
Response to Reply #7
9. Perhaps through a disinterested board and mediation, both doctors and patients can benefit.
Edited on Tue Dec-01-09 04:48 PM by flpoljunkie
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elehhhhna Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 04:11 PM
Response to Reply #1
5. think about this , then --
a major oncology practice Doc told my hubs he "probably" had lymphoma in June. By August he'd run lots of tests but no marrow biopsy -- but he WAS fighting w/ our insurer to authorize a pet scan. (After 2 cat scans and no sign of cancer.) We fired him, got a different Doc, who immediately ordered the biopsy and said "you don't need a pet scan...they just want to pay for the machine".

Long story short, he doesn't have lymphoma, just a really big spleen, which has been removed w/ no complications.

The first doc ran up the bill, went outside normal diagnostic protocol to do it, AND let us worry about lymphoma for MONTHS. Why? Because we have "good" insurance and his practice made money on the side from the extra tests.
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napi21 Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 04:39 PM
Response to Reply #5
8. Geeze. How do you recognize the doc is pulling a scam?
I honestly don't think a 2nd opinion in every case should be the answer! All that does is run up costs too. I'm glad for your husb!!!!
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elehhhhna Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 05:02 PM
Response to Reply #8
10. in this case, google. the typical protocol for the diagnosis of various common diseases
is very easy to look up! Major deviations or tests done out of order are a sign.

R
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Cha Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-01-09 04:17 PM
Response to Original message
6. KR for the Health Care Debate.
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