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Linda Bergthold

Linda Bergthold

Posted: October 14, 2010 01:29 PM

Last week in the Coons-O'Donnell debate in Delaware, we heard the Republican candidate, Christine O'Donnell, lay out her answer to health reform -- or "Obamacare" as she and the Republicans so sarcastically call it. She cranked out two of the three talking points that Republicans have been spouting for over two decades: 1) Malpractice reform 2) Selling insurance across state lines and 3) Personal responsibility for care (translated means more of the "consumer driven" plans that have high deductibles up front.)

It's time to call them out. Since the Clinton health reform effort failed in the early 1990s, Republicans have been making these same points. They had eight years during the Bush Administration to show that these three talking points or "solutions" could make a difference. They did nothing about it. Why? Because these three talking points would make little to no impact on the real problems health reform is trying to solve. Here's why.

1) Take malpractice reform. Please. For years, studies have shown that malpractice reform, while desirable for a variety of reasons, would have almost no impact on the reduction of health care costs.

In fact a new study, published last week in Health Affairs suggests that costs associated with medical malpractice are far less than the $650 billion figure (26% of all money spent on health care) cited by some Republicans who have made tort reform a cornerstone of their vision for "bending the cost curve" in health care. The newly calculated figure, $55.6 billion, represents just 2.4% of health costs.

Reform the malpractice and medical liability system? Of course. But don't make it the centerpiece of a plan to reform health care. At best it's a byline.

2) Selling insurance across state lines? Republicans love this idea. Why? Because the very sleaziest of health insurance products and companies -- the ones that have such high deductibles you might as well not even have insurance ($5000, $10,000), what they call "catastrophic" plans, are just waiting for your state to allow them in, to sell you stuff that has almost no value. There has been legislation over the years to allow this sale of policies across state lines, but the conclusion is that it would little to no impact on the real problems we face.

As Ezra Klein pointed out in the Washington Post awhile back, this is a terrible idea.

As it happens, the Congressional Budget Office looked at a bill along these lines back in 2005. They found that the legislation wouldn't change the number of the uninsured and would save the federal government about $12 billion between 2007 and 2015. That is to say, it would do very little in the aggregate.


But those top-line numbers hid a more depressing story. The legislation "would reduce the price of individual health insurance coverage for people expected to have relatively low health care costs, while increasing the price of coverage for those expected to have relatively high health care costs," CBO said. "Therefore, CBO expects that there would be an increase in the number of relatively healthy individuals, and a decrease in the number of individuals expected to have relatively high cost, who buy individual coverage."

That is to say, the legislation would not change the number of insured Americans or save much money, but it would make insurance more expensive for the sick and cheaper for the healthy, and lead to more healthy people with insurance and fewer sick people with insurance. It's a great proposal if you don't ever plan to be sick, and if you don't mind finding out that your insurer doesn't cover your illness. And it's the Republican plan for health-care reform.

3) Taking personal responsibility for your health? Wolf Blitzer asked O'Donnell last night if she approved of a person refusing to buy health insurance and then having the rest of us pay when that person gets sick and goes to the hospital. This is her non-response.

BLITZER: All right. Well, here's the question. Let's say someone decides not to purchase health insurance, makes that conscientious decision, even though this person can afford to buy health insurance, but decided he doesn't want to. This person gets critically ill, is rushed to an emergency room.

Should we, people who pay for health insurance, provide him or her with that kind of treatment, or should we kick them out of the emergency room, said, you made a decision, you're not going to get this kind of treatment?

O'DONNELL: If we do the things that I've said that will help to address
-- that I'm proposing, that will help to address the issue of health care, then that person can afford to buy a catastrophic-only policy from across state lines. They'll be able...

BLITZER: Well, what if the person doesn't want to buy it?

O'DONNELL: Well, then we have to address that.

BLITZER: Who should take care of that person in an emergency?

O'DONNELL: We have to address it.

BLITZER: Would we, all of us tax-payers...

O'DONNELL: We have to -- no, we have to...

BLITZER: ... have to pay for that person?

O'DONNELL: Anything that they do when they have another bill that they can't pay, make them pay it. Hold them accountable for that.

KARIBJANIAN: Before or after they get care?

O'DONNELL: But right now, right now -- well, that's up to the hospital.
But right now we're forcing them to. We're forcing them that they have to give care to illegal aliens...

O'DONNELL: Well, nobody should be forced to pay for anyone else's health care, and that's what Obamacare is doing.

COONS: And that's what's happening today. Before the health care reform bill passed, all of us who have health insurance, who have health coverage have been bearing the costs, paying the freight for those who don't have insurance and don't have coverage. They're getting health care through emergency rooms now. That's partly why small businesses, employers like New Castle County have faced double digit increases in our insurance costs year after year and year because that's how we provide care now, it's inefficient, it's inhumane and it's not effective.

Note that Chris Coons nailed that answer and O'Donnell unwittingly agreed with him.

This is the Republican answer to "personal accountability." If O'Donnell knew more, she would know that hospitals have to write off the care of that type of person, and when they do, they shift those costs wherever they can -- mainly to those of us who are paying customers. Personal accountability is fine if you have an extra $100,000 around to pay for your health care if you are uninsured and get sick. But if you don't, you lean on the rest of us.

O'Donnell missed the third and main Republican talking point on personal responsibility -- and that is the sale of consumer-driven or consumer-directed health plans, where the high up front deductible is meant to discourage people from seeking unnecessary care. Not a bad idea if it's a choice for people. If they have enough money to pay those deductibles before they get the care, fine. But it has been shown that consumer-driven products tend to work better with higher income consumers, and consumers tend to delay care when they enroll in those plans. The American Academy of Family Physicians offers this analysis:

A December 2005 survey by the Employee Benefit Research Institute (PDF file: 12 pages / 163 KB. More about PDFs.) notes that patients with consumer-directed or high-deductible health plans "were significantly more likely to avoid, skip or delay health care because of costs than were those with comprehensive insurance, with this behavior particularly pronounced among those with health problems or incomes under $50,000."

So that's the Republican Plan for reforming health care and lowering costs. As you listen to the debates in the next few weeks, raise a glass every time you hear those talking points (but be careful to drink something non-alcoholic or you'll pass out). And remember -- as complicated as health reform is -- and it is too complicated for three talking points -- it is the Democrats who attempted to really solve these problems and will continue to work on this year after year until all the wrinkles are ironed out. (By the way, might I note that reform has NOT yet been implemented fully and won't until 2014, so could the candidates please stop blaming reform for everything that is happening now?)

Slogans are easy to spout. Real reform is a lot harder.

UPDATE: In the debate between Harry Reid and Sharron Angle in Nevada, Ms. Angle mentioned two of the three Republican talking points as her solution -- malpractice reform and selling insurance across state lines. Have a drink everyone!!

 
 
 
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07:24 PM on 10/31/2010
Tort reform, of course? Why? Is the 2.4% figure out of line with what it SHOULD cost when doctors or hospitals kill patients, maim them, or shorten their lives because they behave negligently? What percentage should be the right figure, and how do you arrive at that? Or do we make doctors, nurses, and hospitals immune from suit, hoping that they will just adhere to high standards without any effective deterrent for carelessness, inattention, or greed? Do you think bad surgeons will be weeded out by the profession that protects their own at virtually any cost?
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worker beenumbed
07:24 AM on 10/29/2010
Paying the penalty for non enrollment is just membership dues for living in the USA where every body gets emergency treatment,
04:45 PM on 10/19/2010
Oh goody, open enrollment starts for my company next week. I wonder how much Obamacare has jacked up my insurance rates for the coming year. Stand by................
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11:13 PM on 10/15/2010
I say, give them tort reform if they will shut up about the interstate insurance sales. I understand the Obama administration offered to negotiate on the malpractice insurance issue early on as a way to foster bipartisanship but the Republicans would not deal. True?
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
12:22 AM on 10/16/2010
Yes, that's true.
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tnkeating
Dyslexic agnostic insomniac
09:50 PM on 10/15/2010
It seems to me Health care reform is as big a con as global warming, medicare rates have sky rocketed, and it seems there really are panels that will dictate what drugs will be dispenced and what therapies will be used and of course the un-Constitutional practice of forcing people to buy health insurance. Since the insurance companies can no longer denie you because of pre-existing conditions, now they want 30% more than what they used to charge me, I simply can not afford 800. dollars a month, heck I can't even afford the fine if I refuse to purchace health insurance. I don't buy for a second that congress will improve what they haven't even read to begin with.
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HUFFPOST SUPER USER
Cananna
I like trees and bunnies.
11:37 PM on 10/15/2010
You Americans are getting shafted. I am a middle class Canadian lady of child bearing age, and what you pay for healthcare in a month is pretty close to my monthly income tax. Before you gasp, that includes my healthcare, which I cannot be denied.
From what I see, it's a tricky situation in the US. The common denominator is that US health insurance companies seem for lack of a nicer word: evil.
Option 1. Status quo
Option 2. Obamacare
Option 3. Dismantling the health insurance industry and creating a socialized health care.
Option 1 sucks. Option 2 definitely has its downside. Insurance companies need to be reigned in further. Option 3 is destroying a whole industry.
It's not an easy answer for my American friends.
It's easy for me, but that has been a legacy that was passed down to me.
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12:28 AM on 10/16/2010
http://www.huffingtonpost.com/caitlin-kraft-buchman/switzerlands-health-insur_b_291944.html
Caitlin Kraft Buchman: Switzerland's Health Insurance Providers are Non-Profit: That is the Only Reason Their System Works, Period.

"...So I won't get into the obvious. I did however want to remind you that the Swiss system of mandatory health insurance only works because health insurers are forbidden to make a profit on basic health insurance coverage!

But don't worry. Our insurance companies are in quite healthy (ha, ha) financial shape. Really.

Everyone in Switzerland carries two government mandated policies - 1. personal everyday medical health insurance ( with lots of choice regarding add ons and deductible), subsidized by the government for those in need, and - 2. accident medical insurance, half paid for by one's employer, half paid for by employee, or when necessary the state. (This is a relatively inexpensive subsidy for a country with unimaginably low unemployment).

That health insurance is competitive and non profit is built into this very capitalist and working Swiss system, a system that believes no one should go bankrupt and lose their home because of family medical bills, that no one should delay critical medical and preventive care, and lose even their health because they are uninsured, and that no one should lose their life because an insurer denied coverage due to any pre existing condition. This is a competitive capitalist system that says no one should go without health care if they need it...."
Bernique
Solar is clean, cheap and plentiful
07:48 PM on 10/15/2010
Thank you, Ms. Bergthold, for highlighting the talking points of the republicans on health care reform. I hear them again and again from republicans, as if they were "boilerplate" -- malpractice reform (it is well known that lawyers have a democratic bias, gotta hurt the lawyers) -- selling insurance across state lines (as if bad plans get better when they cross a state line!)-- and "personal responsibility" (to which I respond 'train yourself to do your own brain surgery?').

It's good of you to have confirmed what I thought was Fox-generated propaganda. I'm still, myself, for single-payer (medicare for all), and I can't wait until the day when this country comes to its senses, and adopts what the rest of the civilized world has had, successfully, for decades: universal, affordable (not for profit) primary health care.
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
08:11 PM on 10/15/2010
You are welcome, Bernique. I appreciate the thoughtfulness of many of the comments to this blog, and I am really glad that so many people took the time to respond.
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doctorkosan
PhD Chem E, HBS
05:40 PM on 10/15/2010
With annual income of $5600, someone should have asked her what she has for health insurance and who is paying the premiums.
03:13 PM on 10/15/2010
has the new health care plan have any protections put in to stop the insurance and pharmacy companiesd making the existing people who do have insurance cover everyone else by jacking the rates. so is that how you cover everyone just tell insurance they have to cover everyone but can just jack the rates to do it. so it's not taxes to pay it it's just taking more from those who do pay ordered by the government.
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02:06 PM on 10/15/2010
This wonderful nation of ours will never reach the potential we must to compete in this global economy until we have health isurance for all. The reality of life is all the Western Industrialized countries in the world have had health insurance for their citizens in place for decades. As a brief comparison, we spend 15.7% of our GDP on health care: the U.K. spends 8.4, Japan spends 8.1, Germany spends 10.4, and Canada spends 10.1. They all have a higher life expectancy than we, and a lower infant morality. This is a fact.

It is imperative we bring in those who are uninsured, and mandate health insurance for all. For our very survival in this conpetitive world of finance, any thinking person knows we must have a health insurance program at least as enveloping as other countries we trade with in order for us to thrive.

Those that are bound and determined to fight any reform, will bring this country down. Instead, they should be addressing the problem and working with this administration to improve what we have now. Yes, we must bring everyone into the pool; that is the only way to bring costs down and keep them down.

If the GOP really is on the side of doing what is vital for our recovery as a nation, our sustainability, and our very future as a leader nation, they must stop this partisenship and do the right thing. The health industry will survive, will we?
03:21 PM on 10/15/2010
The time for "America is always right" is over. Our methjod of providing healthcare is an example of how we've blinded ourselves. "Spreading the risk" over our entire society is where we'll eventually go, or we'll have more and more of our population without a way to pay their medical bills. That is, slipping to 3d world status. Although I sometimes it seems this would be OK with big business, they in fact would like nothing better than to have the government pick up their medical plans. It would make them more competitive. It would allow the externalization of a large cost.
03:23 PM on 10/15/2010
does each one of these countries have as diverse a population. will allow people to live on welfare for generations. have as large of an illegal imagration problem as the U.S. Do these countries also allow a case like as an example obama's auntie here illegaly, has public housing, gets a check each month. also she's someone who has never contributed to the economy but feels she is owed this because this is america. oh since you spoke of canada my neigbor who only lives in the house a month or two a year and travels between canada and florida. has a handy man who works for her in canada he needed surgery and got on the list in canada. my neighbor flew him to the US and had the surgery done here and paid for it because he might not of made it to his surgery date in canada. health care isn't the problem it's fat lazy slobs that cost health care.
03:43 PM on 10/15/2010
Red herrings. Places like Canada and Australia have quite diverse populations. But your point that diverse populations somehow effect medical care is baffling. Illegal or legal immigraqtion?
Europe, Canada and Australia have lots of both. But, less illegals because they're willing to enmforce it, particularly against companies who hire illegals ( a side benefit of their strong Unions). Even so, do you really believe "illegal immigration" causes helath insurance companies to raise premiums 30& a year? By the way, I simply don't believe your "real life example" is stating all the facts.
My wife's Canadian, her mom lives there, is 75 and needs periodic medical care. No problems, and she isn't worried that medical care will bankrupt her.
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02:04 PM on 10/16/2010
Actually, many of these countries have very diverse populations, but the governments believe in a socially democratic system where people have safety nets. Germany, for example, has one of the world's highest levels of education and technological development. They have a generous social welfare system which provides for universal medical care, unemployment compensation, and other social needs.

It is too bad many in our culture equate providing basic human needs to all Americans as somehow wrong. Instead of looking at it as something to abhor, it might behoove us to rethink how this country would move ahead if our nation stood up for all its people in the way of health care, education, with a sense of well-being. Americans have always been innovative and there is so much we have to contribute to this new world of alternate energy, and competition in our global society. How can we push forward, if many of us are always worried about our general welfare.

I'm using Germany as an example, because they have a large ethnic diversity compared to their size, they have ethnic Germans, as well as Muslim Turks who were brought in as guest workers and have stayed, and others. The literacy rate in Germany is 99%, according to one source I read.

We seem to be fighting a policy that would be good for America. We must get over this notion that everything that will benefit people is bad, and too European. We are being stubborn and pigheaded.
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sistermoon3
Common sense cant be bought
01:33 PM on 10/15/2010
6. Tax credits for insurance plans. Right now, you have to have spent 2,500 on medical probs to even get an inch of a tax break and that is with health insurance. There are many ways we could improve what we have which is the best in this world
02:34 PM on 10/15/2010
So the government should help artificially inflate the profits of health related companies? You do realize that if the government reimburses people, they will spend more. And health companies will raise their prices if they know people aren't looking at the cost of what they are spending.

Yes, this is actually a complicated topic.
03:15 PM on 10/15/2010
Well, employers already get a tax write off for their contributions. Its a business expense. One for the rest of us would be nice, but it would add to the deficit. More importantly, it would encourage the insurance carriers' current trend of 30%/year increases. Sure, it would remove bellyaching from us citizens for awhile, but how long before 30%/year increases cause our "tax credits" to eat up the entire Federal budget? Regulation of rates (like with utilities) might help if they could be implemented, but again, it simply is more expensive and more complex. You know my solution.
Thanks for adding to the "marketplace of ideas!"
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sistermoon3
Common sense cant be bought
01:31 PM on 10/15/2010
5. Why cant we buy drugs from Canada that are cheaper? Pharmas also advertise soooooo much on tv it is unbelievable even after they tell you of all the dangers, they still sell this crap. Hell, Im starting to think they want us addicted to their drugs.
02:27 PM on 10/15/2010
Why can't the US government negotiate prices directly with the drug companies so Americans can buy reasonably priced medications? Why are we relying on the Canadian government to do this? In addition, let's be honest about "generic" medications. While they are similar to their "brand name" counterpart, they are not the same. Excipients, binding agents, colors, and the quality of the ingredients are different. It is reprehensible that drug companies hold people hostage to their prices.
03:09 PM on 10/15/2010
Um, why can't the US negotiate prices like everybody else? (hint: other countries' legislatures aren't bought by our pharmaceutical industry). As far as advertising, remember when they did NOT advertise on TV? TV time, particularly prime time, is expensive. Never mind addicting us, it seems that pharmco needs more and more money so that they can feed their advertisement jones.
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sistermoon3
Common sense cant be bought
01:30 PM on 10/15/2010
4. Many car insurances are starting to lower people's insurance for each year they dont have an accident, why not lower the price of insurance plans for those people who year after year show
physical responsibility for taking care of themselves.
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Wizer
No more tiny coffins
01:52 PM on 10/15/2010
Explain "show physical responsibility for taking care of themselves". You are aware that people get heart disease and diabetes and cancer and have accidents and they didn't do anything except get born and live a life? How about the person with diabetes with a low A1C, who is at the proper weight? What then? How about the person w/heart disease or cancer who just got the disease.

You sound like another controlling republican who wants to tell other people what to do/how to live as you scream for smaller govt.
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Susanmg
09:16 PM on 10/17/2010
No, she doesn't want the GOVERNMENT deciding...it should be left up the the companies. You know that they will do right by us, and never deny coverage, or insist on a lower priced drug, or tell Grandma that at 80 she can't have cataract surgery. The free market would never do that.
03:04 PM on 10/15/2010
Some, but not that much. Why? Because if "safe/lucky" drivers didn't pay in, there wouldn't be enough to pay for the claims of"unsafe/unlucky" drivers. That's how insurance works. It's a "what if it happens to me" concept. Everyone pays "just in case". If premiums get pegged too closely to "risk", then people who need treatment won't be able to afford the premiums. Taken to its logical conclusion, it starts to look more and more like everybody should pay their own way, and forget insurance. Plus, would you be the first in the brave new world of paying more because your family has a cancer risk factor? Because you like hamburgers? Because you participate in sports (scuba, skiing, rock climbing, soccer, etc...). Its more of a slippery slope than most people realize. which brings us to the cheaper, simpler, less stressful idea of us a country simply taking care of each other while sick- single payer.
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sistermoon3
Common sense cant be bought
01:28 PM on 10/15/2010
3. Taking personal responsibiltiy. There should never be a mandate to make anyone buy anything. With that said, there should be levels of insurance plans the do actually go along with a families income and you at least get basics for a low cost. Yearly checkups, If it were affordable, people wouldnt have to be told they have to buy something they freaking cant afford. But Insurance companies should have alternative plans for people who fall between the medicaid cracks and and age cracks of Medicare.
02:20 PM on 10/15/2010
So you favor the government mandating private companies to provide money losing services?
02:56 PM on 10/15/2010
This is simply a "talking point". We, as citizens, are forced every day to "buy" things by the government. The most obvious is car insurance. See also smoke/Carbon monoxide alarms. Armies. Cops. Schools ( I know, through taxes- but for every person you find who would abolish public schools, I can find one who would eviscerate the defense budget). Affordability is she key issue. Problem with cheap plans is that they DIScourage checkups and testing. Those usually fall into the large deductibles, as the cheap plans are "catstrophic" coverage. And don't hold your breath about carriers having "alternative plans" for people "who fall through the cracks" unless they are required to by law.
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sistermoon3
Common sense cant be bought
01:24 PM on 10/15/2010
2. Selling and buying insurance across state lines, why not? Good grief, supply and demand. How the hell do all the cable networks make money, cellphones, technology sources, Ebay, jees, anyone can see it would make prices competitive.
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HUFFPOST BLOGGER
Linda Bergthold
Health policy consultant
01:34 PM on 10/15/2010
I supplied some links in the blog to good research studies and commentary about why these "solutions" do not solve our health care crisis. Please check them out, especially the one about why selling across state lines would only make things worse.
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Wizer
No more tiny coffins
04:27 PM on 10/15/2010
Linda: These guys don't want facts, they want sound bites. And if your fact collides with their opinion, you know which one is going to win. Good try, though. I try to post links with my postings and these b@ ggers will slam me on that, too. They don't care about facts. F&F'd
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04:43 PM on 10/15/2010
Thanks, Linda.

You probably already know about this:

http://www.manufacturingnews.com/news/10/0518/chinadrugs.html
You Don't Know Where Your Drugs Come From And Neither Does The FDA; U.S. Imports 90 Percent Of Its Antibiotics (And Vitamin A) From China
02:18 PM on 10/15/2010
Health insurance is not similar to cable, cellphones, etc. They do not function the same way in the market. Health insurers only want to sell to healthy people, and they want to discourage people from going to the doctor at all. Cellphone companies don't care who you are, because every customer is exactly the same. It doesn't matter if you are sick or poor, are a good user or bad user. There are set prices and no one is barred from purchasing their product as long as they can scrounge up the money. This is part of the reason why technology costs drop while insurance costs rise. Health insurance, car insurance, property insurance are different. If you are a risk, you are barred as a customer. So what should sick people do for coverage? There is no demand for them, so how do they fit into your theory???
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sistermoon3
Common sense cant be bought
01:22 PM on 10/15/2010
1. Malpractice Reform: Actually, Howard Dean cleared this one up, it would hurt the lawyer business.
Think about all the advertisements you see today on tv. Lawyer firms saying if you had this or you had that, please call us. They are making a killing and if it would save 2.6% of the cost on all of us forcing doctors to have to insure themselves to the max, so they could lower their rates, hell yes. That's just one part.
02:47 PM on 10/15/2010
This can be discussed. Only question is: what if it were you. your spouse, your child that was injured (killed) through malpractice? The question is: who bears the burden of the error? the victim or the doctor (and yes, through him, society at large).
03:31 PM on 10/15/2010
did you just say lawyers lower the percentage they get. why not just ask for a ride on a mermaid. that may be easier to get.