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From: "dahmd" 
Newsgroups: alt.cancer.support, alt.support.diabetes, fidonet.diabetes,
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Subject: Re: Single Payer Universal Health Care
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Date: Wed, 26 May 2004 01:51:00 GMT
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"Jonathan Smith"  wrote in message
news:fbcaefd.0405251449.4cdb8d3b@posting.google.com...
> mike gray  wrote in message
news:...
> > matt weber wrote:
> >
> > > Because in the USA, someone other than the patient usually pays, and
> > > patient is almost entirely isolated from the cost issue, as is the
> > > physician, when a patient walks in and says my shoulder is bothering
> > > me, can you write me a prescription for Celebrex or Viox? The
> > > physician will happily do so.
>
> Why is this necessarily a bad thing?  Under the assumption that there
> is a doctor-patient relationship and the physician does an exam to
> look for something other than muscle or joint pain due to exertion or
> perhaps a touch of arthritis, thuis makes a lot of sense.  What would
> you do in this case?
>
> > That is, indeed, a major problem with the US system and I'll give you
> > another example. I sprained my wrist, went to the corner dugstore and
> > bought an Ace bandage. $3 and it was fine in five weeks. My Medicare
> > friend sprained his wrist, went to the ER, X-rays, orthopedic
> > specialist, and seven weeks of physical therapy even though it was fine
> > in five weeks.
>
> And Medicare would be that huge efficient single payer model that we
> all want and need?
>
> > But "rationing" has become a buzzword in the US roughly as evil as
> > "holocaust". An insured patient who goes to a doctor with a sprained
> > wrist and gets only an Ace bandage will certainly sue and just as
> > certainly win.
>
> If the sprain wasn't a sprain and the failure to diagnose results in a
> permanent disability - yes, that is what would happen.  Explain to me
> why it shouldn't.
>
> > This has created another problem: US doctors are scared to death of
> > their own patients. Very unhealthy situation.
>
> I don't believe they are - they may be a bit apprehensive over their
> patients lawyers - so lets fix that.
>
> js
>

I have enjoyed reading your comments.  It's much more pleasant debating
issues without vitriol.  Unfortunately, as on obstetrician I see dozens of
examples every day where physicians are so afraid of litigation that they
either refuse to see pregnant patients or, if they practice ob/gyn, refuse
to see "high risk" pregnant patients.  In the last 2 years the number of
ob/gyn physicians in our metropolitan area (Orlando; about 2 million in
surrounding communities) who are willing to see high risk pregnant patients
has dwindled dramatically.  Several of our top ob/gyns have left the area
rather than risk becoming part of the liability crisis, and many others have
given up obstetrics.  In Dade County (Miami) the median liability premium
for those practicing obstetrics is about $200,000 a year.  Physicians in
other specialties just don't want to be exposed to those kind of premiums.

I spoke with several physicians from various specialties in the OR lounge
today who made it clear that they will do anything rather than treat a
pregnant patient.  The statute of limitations for a newborn can be up to 21
years in Florida, and there are several hundred ads on TV and the radio in
our area each week advising locals to sue their physician.  One series of
ads suggested that ob/gyns don't perform c/sections in a timely manner,
leading to brain damage.  I would love to study the c/section rate before
and after that series of ads.  I am awaiting the results of a recent mail-in
survey to read hard data, but in the meantime, at least in Florida, fear of
litigation has had a negative impact on the availability of services and
quality of care for pregnant patients.  Pregnant patients can provide a
lottery win for trial lawyers.  It's to the stage where physicians feel
their careers are at risk when they care for pregnant women.  Best wishes,

Ashley