Ron Rosenbaum, Writer

January 27, 2010

Tort Reform Ignorance

Filed under: Uncategorized — ronrosenbaumwriter @ 6:22 am

Have any of you been reading the absolutely horrifying stories in the New York Times series on radiation treatment mutilations and medical murders?

(That’s what they are by the way, the hundreds of thousands who die from malpractice complications, usually after unbearable agony.)

Put yourself in the place of one of these patients who have been literally “cooked’ to death, had irreparable holes burned into their vital organs by incompetent, un-qualified, greedy, uncaring doctors, hospitals, technicians, and medical device profiteers. This isn’t medical malpractice; it’s savage, deadly butchery carried out to make a quick buck off the suffering and fears of (mainly) cancer patients, leaving them and their families physically devastated forever.

Reading the series (I’ve linked to today’s second part, but it’s easy to go back to the beginning) makes one’s disgust with human nature even more intense.

It is only sheer ignorance of the facts — of the millions of medical ” mistakes” with horrifically painful, debilitating, crippling and deadly results — that would cause anyone to take the blundering doctors’ side in this controversy. Sure there are great doctors, some of whom make inadvertent mistakes, but the vast majority of medical malpractice is committed by arrogant, incompetent greed-head MDs who treat patients like factory-farm chickens bound to be butchered sooner or later, so why listen to them squawk and spoil the noble image of godlike authority and benevolence so many doctors still arrogate to themselves?

It’s bad but the evidence is this: doctors don’t learn from their mistakes. They are multiple malefactors. Stopping one with a lawsuit is a blessing to the as-yet uninjured. They keep making damaging mistakes, ruining or ending the lives of patients through carelessness or ignorance or sheer lust to pack in as many paying customers as they can. Lawsuits at least allow citizens’ redress. Anyone who could say “tort reform” is a solution to the health care crisis is ignorant. And yes there are greedy and creepy medical malpractice lawyers, but there are also some who care about the ravages of the ruthless butchery they get to see in their office every day. And the steely unconcern of insurance companies in the face of emergencies or extensive life-saving procedures.

But that’s the way capitalism works. Shark eat shark, and I’d rather have the medical sharks looking over their shoulder at the malpractice sharks than not. Maybe they’ll pay attention when their super high-tech radiation machines are “cooking” and burning holes in people.

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47 Comments »

  1. You know, since my life was saved by a brilliant surgeon, one Dr. Fahey, and his remarkable team, at the New York Hospital, I have to put in a good word for doctors, BUT I also watched doctors really screw up the cases of other members of my family. What I do know is that there have been no common sense proposals enacted by anyone in this stupid health care fandango. (Personally, I long for a past full of house calls and hospitals run as charities treating everyone regardless of ability to pay…dream on.) So here’s health care reform, on the back of a napkin: 1) Catastrophic insurance for everyone with a $5,000 deductible 2) Ability to purchase insurance anywhere in the country 3) Creation of nonprofit insurance providers to compete with the for profits and eventually drive them out of business 4) hospitals must be non-profit entities only 5) a National Doctors Corps which would subsidize medical tuition costs in return for 5 years service at clinics for the poor and middle class and conduct a communit medical census…there are tens of millions of people in this country who are terrified of and cannot afford to deal with our medical bureaucracy 6) a tax on elective procedures, such as cosmetic surgery, to fund community clinics 7) insurance pools for each medical specialty that would fund malpractice payouts 8) no-fault tort judgments: special courts which would consider tort claims in a nonadversarial manner, eliminating the cynical use of courtroom experts by big institutions to defend malpractice Ron is absolutely right about the courage of attorneys to take on some of the most egregious cases of malpractice. I have a friend, a low rent attorney in Brooklyn, who makes his living on one case a year, usually a medical malpractice case involving infants, whose details are beyond horrifying. He has sometimes asked my advice on dealing with parents, etc. But the hardest part is cross-examining the experts brought in by powerful hospitals and doctors to deny the most brutal mutilations of children whose lives have been destroyed. Mercy, a key element in medicine, has been sucked out of the system, and compassion runs dry.

    Comment by charlie finch — January 27, 2010 @ 6:52 am | Reply

  2. Your case, and your dares, would be more convincing if you included links, or at least writer and title, to the articles you cite.

    Also if the situation is as bad as you lay out, then that’s an argument for tort reform. Since the status quo sounds unacceptable.

    It even sounds like something in the realm of criminal court as well.

    Comment by Jack — January 27, 2010 @ 7:31 am | Reply

  3. I vote with #2 on this. Why did you not provide links? Are you just too damn lazy?

    And WTF are you thinking using the NYTimes as a source?
    Do you honestly think that the NYT is a trustworthy source? My guess is that through a tear-jerk, emotion filled article they have tugged your heart strings.

    The legal filings are public. Why no links to them?

    Comment by Link — January 27, 2010 @ 8:05 am | Reply

  4. Who says tort reform is only about capping damages for the victims? What about holding lawyer compensation to billable hours? What about divulging the scut work done by paralegals on the bills? Funny how Tylenol has to be itemized on hospital bills, no? What about a “loser pays” system? (And no, I’m not objective on this one–after paying a lawyer $1000 to make a few phone calls with no viable results.)

    Comment by Lark — January 27, 2010 @ 8:35 am | Reply

  5. Please delete my little rant. Thanks.

    Comment by Lark — January 27, 2010 @ 8:36 am | Reply

  6. Dowd Obama Gay Watch: Maureen does it again in today’s column comparing Obama and Scott Brown as beefcake and ending her Times column with ubiquitous body man Reggie Love

    Comment by charlie finch — January 27, 2010 @ 9:23 am | Reply

  7. If there are really only egregious cases and honest lawyers, how come I see so many ads recruiting people who have ever taken a certain drug and subsequently had a headache?
    I have never seen a proposal for doing away with malpractice lawsuits. I have seen recommendations to set up a procedure for screening suits.

    Comment by vb — January 27, 2010 @ 10:44 am | Reply

  8. […] Read the rest of the story here. […]

    Pingback by Pajamas Media » Tort Reform Ignorance — January 27, 2010 @ 12:15 pm | Reply

  9. Tort reform will go nowhere until the American people understand what it means. The first problem is using the term “Tort Reform.” Those trying to sell the concept would do well to remember that people will respond better to the concept of “lawsuit reform,” a term that makes sense to them.

    Comment by ChuckL — January 27, 2010 @ 12:33 pm | Reply

  10. Did you hear about the writer who lied instead of doing research? He made wild crazy claims in an article without any references, names, actual examples, or statistics. In fact he never left his basement.

    Now its official – all writers are evil and should be forced out business by selfless courageous lawyers.

    Comment by Old Soldier — January 27, 2010 @ 12:46 pm | Reply

  11. Ron – Did you ever ask yourself if what you’re reading in the NYT is really what it seems to be? The NYT could have easily cherry picked the data to come up with the most egregious cases of radiation poisoning. Until very recently, the NYT was gung-ho on AGW and continues to do its best to bury Climategate. Also, before I stopped reading the NYT I observed that when it came to the issue of guns and the 2nd Amendment, the NYT not only cherry picked the data it misreprented those data.

    Then, too, don’t you think a bit strange that the NYT has chosen now to run the story? Again, ask yourself what may have motivated it to do so.

    Finally, amongst the many unsubstantiated comments you make is that: “It’s become clear to me that the medical and insurance lobbies have made fools of the pro “tort reform” citizens …” How so? Be much more specific.

    Comment by Jack in Silver Spring — January 27, 2010 @ 12:50 pm | Reply

  12. Link has been added. And that’s a good thing, but it’s ammusing to see it’s been done via “stealth edit”.

    No note of correction, no thanking readers for pointing it out. Just silently slipping in a change to the peice.

    Oh well, at least now the series being sourced can be read. I guess Ron was a bit silly assuming everyone read the New York Times.

    Comment by Jack — January 27, 2010 @ 12:57 pm | Reply

  13. I work in the court system, have for 21 years. I’ve seen all types of terrible malpractice, and also all types of fake plaintiffs. And the fake plaintiffs are terrible. The solution however is not to make it illegal to sue your doctor. I have seen women in labor given paralytic agents instead of local anesthetics, causing them and their child to become vegetables. Americans have a right to the courts. And that, is originalism.

    Eric. White Plains, NY

    Comment by ERIC — January 27, 2010 @ 1:01 pm | Reply

  14. “Sure there are great doctors, some of whom make inadvertent mistakes, but the vast majority of medical malpractice is committed by arrogant, incompetent greed-head MDs who treat patients like factory-farm chickens bound to be butchered sooner or later, so why listen to them squawk and spoil the noble image of godlike authority and benevolence so many doctors still arrogate to themselves?”

    The “vast majority”, eh? Statistics? Proof?

    There’s absolutely no doubt that some patients are harmed by careless doctors. I suspect you exaggerate both the extent and the nature of this problem however. I also suspect (and would look for proof to back it up if I was getting paid to say so) that the human cost of having health care priced out of reach of many people is higher than the suffering of these few wronged/hurt individuals.

    That isn’t to say people shouldn’t be able to sue bad doctors. I don’t think anyone’s saying that at all. But a ceiling on awards seems reasonable. A way of screening suits seems reasonable. The result of the status quo is exorbitant insurance prices, passed on to consumers (patients) as price increases.

    Comment by jvon — January 27, 2010 @ 1:14 pm | Reply

  15. In the course of my business over the past 30 years, I have YET to meet a single person who has been harmed by a doctor. I’ve met HUNDREDS, however, who’ve been harmed by arrogant, unfeeling and uncaring attorneys. If there have been “MILLIONS” of instances of malpractice, surely I’d have met just ONE of the alleged victims or their survivors. So far? Nada!

    Comment by Pappadave — January 27, 2010 @ 1:39 pm | Reply

  16. Mr. Rosenbaum is dead-on correct. Yes, the ability to sue on a contingency basis, no less, means that it costs money to defend frivolous claims. But the percentage of medical malpractice claims litigated that are frivolous is small, if not tiny.

    Moreover, there is simply no way to tease out frivolous claims without teasing out meritorious claims (at least until the point of a motion for summary judgment).

    Sorry, justice isn’t free. And I still haven’t seen a study that legitimately demonstrates that “tort reform” can save money, and not such the courthouse door to genuinely injured parties.

    Lets not use the climate change science standard for tort reform, ok?

    Comment by Steven Rosenberg — January 27, 2010 @ 1:46 pm | Reply

  17. It’s oftet not bad people but bad syustems. A lot of the error is caused by system problems that could be reduced/avoided by designing better protocols. High dollar lawsuits does not necessarily make this change.
    Here is a more reasoned discussion of the problem of medical error in radiation oncology.
    http://scienceblogs.com/insolence/2010/01/unforgivable_medical_errors.php

    Comment by Novathecat — January 27, 2010 @ 1:50 pm | Reply

  18. Tort reform is needed to deal with the serious abuses of legal process like the silicosis and asbestosis mass tort frauds that are still ongoing. Also the bogus malpractice scam based upon now discredited scientific evidence that made John Edwards millions comes to mind.

    Mr Rosenbaum uses a single example to slime everyone associated with health care delivery and malpractice insurers.

    Comment by Paddy — January 27, 2010 @ 1:52 pm | Reply

  19. What an extended appeal to emotion…

    Folks with fast growing tumors get huge radiation doses prescribed. The line between the dose prescribed and what burns a hole is not much.

    Better treatments are needed, not attacks on researchers. Take your hysterical rants to Daily Kos, and stop wasting our time.

    Comment by Attila — January 27, 2010 @ 2:19 pm | Reply

  20. This argument is absurd on its face. In the cases you cite as your basis of reasoning are criminal negligence and should carry severe criminal punishments, not expose good doctors to frivolous lawsuits for exorbitant amounts of money. The ceilings proposed are on suits regarding the incalculable subject of personal suffering and not on punitive amounts intended to compensate victims for life long medical and quality of life related expenses.

    Comment by Rob — January 27, 2010 @ 2:22 pm | Reply

  21. Ron – I’ve got to take issue with you on this. I recruit doctors. I talk to them at home after a long day of seeing patients and a longer day of EMR record keeping. The primary care docs work 5-6 days a week, are on call and are expected to see 5 patients an hour – one every 12 minutes. Why so many? Because that’s what they need to do to stay in business, paying their expenses, their malpractice, for their education, and trying to have something left for their families.
    Are there bad doctors? Sure. Just like there are bad commentators who write articles on Pajamas Media. Your diatribe is unfair & over the top.

    Comment by Mark Bielecki — January 27, 2010 @ 2:33 pm | Reply

  22. I am assuming than Ron was posting satire. I’ll throw out a few points just in case.

    Assuming this was true that doctors are carelessly hurting people in large numbers (they are not), then why bother licensing doctors at all? We can just say that everyone that graduates with a medical degree and passes a test is a doctor and then let the bottom feeder lawyers sue em if they screw up. Hopefully they sue em badly enough that they don’t practice any more – but that is not likely. They may get fired, but they will practice again more than likely.

    My point is that we license physicians for a reason. If doctors are hurting people, then they should have their license revoked by a medical board so they don’t get bailed out by an insurance company and hurt someone else.

    Having ambulance chasers siphon huge amounts of our medical dollars, and having doctors scared of these crooks to the point that they massively over prescribe and over-test is not the answer.

    Finally, John Edwards is a low life of the first order. He got rich by making medical treatment for woman more expensive and harder to find while doing very little to help anyone but himself.

    Comment by DaveT — January 27, 2010 @ 2:34 pm | Reply

  23. Tort reform is not intended to give bad doctors or other providers immunity. I’m not aware of any proposal for malpractice reform that would seek to deny an injured patient less than 100% of her or his actual damages, and some amount, from a quarter of a million to multiples of that, for pain and suffering, punitive damages, etc., depending on the circumstances. Assuming the stories in the Times are factual, the victims of these tragedies must be entitled to adequate remedies. But sound tort reform seeks to address the numerous examples of abusive suits and threats to squeeze out settlements based on the cynical (and accurate) calculation that medical professionals and their insurers would rather pay off nuisance claims than run the risk of undeserved damage to a reputation or paying a jackpot verdict. Real reform would address abuse of the system while retaining victims’ rights to redress. Much could be done without even addressing the amount or types of damages available. Merely adopting alternative dispute resolution procedures, imposing fees and costs on losers in frivolous cases, etc., would be worth huge sums in reduced costs and reduction of defensive medicine.

    To conclude from the Times’ examples of admittedly horrific stories that malpractice abuses should not be addressed is a bit like deciding not to change your oil because you had a flat tire.

    Comment by John Primmer — January 27, 2010 @ 2:37 pm | Reply

  24. Help me understand why incompetent, greedy money grubbing doctors, hospitals and medical professionals should even be allowed to practice… If these individuals exist go for them, eliminate the greedy non-productive HUGE pay for creepy lawyers… Go ahead, let law-suits go after the unprofessional medical persons, hospitals. then put them out of business.

    No ignorance on “tort reform”. It’s amazing you anti-tort-reformers are just hunky with allowing the HUGE lawyer salaries??? pathetic….

    Comment by oldmanfromblackforest — January 27, 2010 @ 3:01 pm | Reply

  25. I’ve read your article, and no, I didn’t read through to the article in the NYT. It’s in the NYT, after all, and I rarely take anything in that or any other newspaper seriously.

    One thing that’s odd here is your assertion that the individuals you mentioned are *criminals*. We have ways to deal with criminals; criminal trials are entirely appropriate when a doctor does something that’s criminally liable. I don’t know about you, but I find the prospect of surrendering on the issue of criminal trials, but allowing some private practice lawyer to make a bundle helping the victim *sue* the doctor, rather repulsive. What happens if the victim dies, and has no heirs or close relatives? Does that mean there’s no punishment for the person you describe as a criminal? Lawyers *love* the system the way it is: they make a bundle on the lawsuits, both filing them and defending against them.

    If you were to argue that we should also reform the procedure in which the authorities decide whether a medical professional is sanctioned for screwing up a medical procedure, you’d have me on board in a minute. Right now, the only way a doctor gets in trouble is if there’s a celebrity involved, or something extraordinary happens. We’re talking Michael Jackson and the Octomom here. Other doctors tend to benefit from the fact that they’re being judged by their colleagues, and so there’s a tendency to say “Well he’s probably a good doctor having a bad day”, or something to that effect, and give the defendant the benefit of the doubt. Then the only recourse the system has to redress the inadequacies of the system is civil court, and so people sue. It has always seemed inadequate to me.

    Tort reform is, and always has been, an issue in terms of the cost of doing business as a doctor, not so much because of the damages themselves but because of the expense incurred in the insurance. This in turn leads to the insurance company telling doctors what they can and can’t do, and sometimes making rules that aren’t in the best interests of the patients, just to avoid lawsuits. The legal community has even flirted with repealing the “Good Samaritan” protections, for doctors and others.

    One fascinating aspect of our current health care reform debate was a quip from a doctor, the last time when Hillary tried this. One doctor said (I can’t quote exactly, but I’ll get the gist correct): “For an encore, the government is going to let doctors redesign the legal system of our country.” The point, of course, is that if you put lawyers in charge of redesigning the medical system, the result will be something where everyone’s best option, in all cases, will be a lawsuit, with a lawyer getting 30%. The system won’t keep anyone healthier either; after all, what do lawyers know about health care, other than its vulnerabilities, and how to exploit them?

    Comment by DavidN — January 27, 2010 @ 3:27 pm | Reply

  26. Wow! Who knew that people really AREN’T living longer than ever? Or that cancer,heart disease, diabetes and every other major killer disease is more manageable than ever or that people suffering from these maladies live longer, better quality lives than ever in human history? All of this must be a crock! Because the New York Times (that fount of all truth) tells us so.

    No doubt there are irresponsible and/or incompetent doctors. The profession is, after all, staffed almost entirely by human beings. Just like the New York Times.

    Comment by Foont — January 27, 2010 @ 3:33 pm | Reply

  27. When you total the “medical care costs of malpractice suits”, though, you could not possibly be figuring the medical costs of the excessive, fear based medicine practiced by those tiptoeing through our litigious society.
    One word in particular comes to mind: obstetrics.
    I have first hand experience with this field, and can tell you that WAY too much of the practice is fear based, and not evidence based or even what’s best for a woman. Having a baby does NOT need to cost what it does in the vast majority of cases,with routine this and that, and a culture that sets women up for a whole domino chain of interventions that may be quite unnecessary in reality, up to and including cesarean section. Our section rate is excessive, and yet the whole approach has become ingrained. Countries with a midwifery model of care for a majority of women have better maternal/fetal outcomes, for goodness sake. And yet, people want a “perfect” baby, regardless of fate and genetics, so you’d better give the appearance of having done everything you could have…

    Comment by Mar — January 27, 2010 @ 3:43 pm | Reply

  28. Thank you, thank you, thank you.

    My God, light of reason comes on.

    Comment by Don — January 27, 2010 @ 4:07 pm | Reply

  29. (That’s what they are by the way, the hundreds of thousands who die from malpractice complications, usually after unbearable agony.)
    Please document. Over how many years?
    Should you get sued for journalistic malpractice for not documenting your statements?

    For some unknown reason you have previously blocked my postings, so this is probably a waste of time.

    Comment by Gringo — January 27, 2010 @ 4:30 pm | Reply

  30. Let’s say you’re right ( although I have some doubt ). I’ll propose a simple meaningful tort reform that won’t cause any of the problems that you see. In any lawsuit, undertaken on contingency basis, the total award to the attorney or attorneys shall not exceed 10% of the total. In any class action suit, the attorneys shall receive no more than the largest individual award or 10% of the total, whichever is less. And if any suit is settled out of court, the settlement shall be public.
    If the lawyers think these limits are unfair, they can undertake the suit for a set fee which won’t be limited except by their client. If they resist open settlements, then they’re out for the money and will protect bad doctors and their insurers for the big bucks.

    Comment by Ken Hahn — January 27, 2010 @ 4:48 pm | Reply

  31. Ron:

    1. Never quote the NYT, not smart.
    2. The medical staffs of hospitals are heavily regulated by both federal and state governments and their own administrative boards including a bevy of lawyers to ensure compliance to the rules, and quality control to monitor behaviors. Doctors also police themselves, ie; medical boards and commitees, wonder why? Lives are at stake. The stakes are high.
    3. All doctors are human: humans make mistakes and they are always going to. That is why they also carry heavy insuranse burdens.
    4. Are you saying there are no frivilous lawsuits? I dare say you will find as many as you find legit cases. Want to bet? Believe me it’s not that hard to figure out, it just takes a lot of time and money, for which we all pay increasingly more.

    Comment by Jeffrey — January 27, 2010 @ 11:49 pm | Reply

  32. My sister was butchered by a doc in Calif. Her treatment for cancer was delayed due to infections due to the butchery and she died. If I were to show a photo of her body from just below her neck to just above her thighs, you would not know what you were looking at…she looked like a damn alien, and I am not exaggerating one bit. She received the maximum allowed for pain and suffering…250,000. When her photos were shown to other women, not one thought a million dollars was worth it. We have to face it…although most drs are competent, there are some bad ones. Would you want your wife, daughter or sister to be butchered by one and then not receive just compensation? Surely there is a way to protect drs from the nuisance cases yet not take away the rights of those who are truly harmed. For the record, I used to favor these limitations…til it happened to my sis.

    Comment by bobbybb — January 28, 2010 @ 12:21 am | Reply

  33. If judges would have the guts to toss out suits with no merit, there would be no problem, but judges are so afraid of being censured or reversed by their colleagues that they act more as referees than judges per se.

    Comment by charlie finch — January 28, 2010 @ 5:14 am | Reply

  34. Stylistically, an excellent speech by the President. Substantively, there were a number of sops to the right, particularly on nuclear power (ugh, coal is the way to go, in spite of the global warming morons) and “pay as you go” (a very big lie). There is a very narrow range of thinking among both Dems and Repubs, that will just not get the job done. The political class is in love with the creeping incrementalism of bureaucracy, using the tax system to make small changes in policy, making health care more complicated, etc. Many Americans cry out for a streamlined simplicity, although, since many other Americans apparently get their kicks bureaucratizing the rest of us, we are a country caught between control and freedom. Especially alarming about Obama’s diction, is his parroting of Nixon, telling Diane Sawyer that “I would rather be a good one term President, than a mediocre two term President” (um, BO, the last good one term Prez was Polk), a direct, though apparently unconscious steal of one of Nixon’s more lurid expressions of self-pity, as well as Obama’s alarming statement last night that “America will not settle for second place” a borrowing of Nixon’s “pitiful, helpless giant meme” and other similar ropes from the Trickster. If you gotta protest second place, you probablyare not even going to be on the podium!!

    Comment by charlie finch — January 28, 2010 @ 5:35 am | Reply

  35. Barack Obama’s next State of the Union speech: My fellow Americans: for many years Presidents have told you that you have a bright future of growth and prosperity ahead of you. This promise has proved to be a lie. Ever since President Reagan’s administration created debt instruments and tax cuts which enriched the top one per cent of Americans in an obscene way, your government has exported manufacturing jobs, allowed corporations to chelter their profits abroad, created huge domestic debt through globalization and allowed entitlements to mortgage the future of our children to the point of infinity. As a result, despotic regimes in Russia, Mexico, China, Saudi Arabia and Iran have gained control of the very food on your tables and put our country under continued threat of terrorist attack. We have responded with the only power the United States has left, military power, the same advanced military power which has repeatedly saved the world from its own despotism for 100 years. Tonight, as I speak to you, the Army’s 82nd Airborne Division has landed in Saudi Arabia and seized the oil fields, which are now under United States sovereignty. At the same time, a joint command of US and Israeli fighter jets have destroyed half a dozen nuclear installations in Iran and we have dropped a series of bunker buster bombs along the Pakistan/Afghanistan border in an effort to destroy Al Qaeda and the Taliban forever. Furthermore, I have directed the secretary of the Treasury to cancel the US Treasury debt holdings of China, so that our economic relations with China now stand as debt neutral. This will allow the US government to issue new debt instruments within the United States only. Working with unions and corporations, this debt issuance will be devoted to a ten year plan to rebuild the manufacturing base of the United States in Detroit, Gary, Indiana, Flint, Cleveland, western Pennsylvanie, upstate New York and other areas of our country which have suffered real unemployment of over 30% for decades. United States citizens will be allowed to purchase our new bonds in one year, five year and ten year maturity issues completely tax free. In furtherance of the Obama administration’s goal to eliminate longterm debt and make the United States industrially self-sufficient again, all home mortgages in the USA are now forgiven. In the tradition of the Homestead Act, Americans have been granted perpetual title to their homes, debtfree, in order to allow our hardworking citizens the renewed opportunity to build real equity in their lives in order to strnegthen our country. In addition, I have directed the Secretary of Health and Human Services to charter all United States hospitals and health services as nonprofit entities. In addition, my fellow Americans, it is time to scale back our federal discretionary spending. We must begin with the Pentagon. We have 19 separate intellgence agencies in our government. By executive order I have abolished 17 of them, leaving only the CIA and the NSA, who will absorb the Department of Homeland Security, which is also abolished by executive order. The Education Department has been abolished and the responsibility for public education returned to the States. The Department of Energy has been eliminated. Its nuclear energy responsibilites will be assumed by the Pentagon. The National Security Council has been abolished. It responsibilities will be assumed, as they were in the past, by the State department. With this streamlined government, I plan to ask the Congress for sweeping changes in social legislation, including the introduction of a ten percent flat tax on all income, the elimination of payroll and withholding taxes by 2020, the folding in of SSI into the general income tax and a means test for Social Security. I shall also ask the Congress to create a national health insurance option to provide cheap catastrophic health insurance to all Americans combined with whole life insurance that will allow Americans, freed up from the withholding taxes in their paychecks, to use part of their income to protect against medical catastrophe and to build an annuity which will eventually allow us to eliminate the Social Security system all together. For too long, wealthy Americans have exploited cheap, illegal immigrant labor. It is time to bring these workers out of the shadows, I have directed the Census Bureau to hire contract workers to survey illegals at the jobsite, arrange for them to become citizens on the condition that they not be allowed to export their wages and must accept a five year period of government monitoring of their lives and incomes before they become fullfledged citizens. My fellow Americans, the economic irresponsibility of bipartisan Presidents and Congresses has necessitated an unprecedented assertion of the United States as the world’s only super power to eliminate our debts and start anew> I ask not just for your support, but for your innovations, investments and your fighting spirit. We have earned the right to stand astride the world again as a sentinel of liberty and prosperity. In the spirit of Rosie the Riveter, let us roll up our sleevs and get to work.

    Comment by charlie finch — January 28, 2010 @ 10:27 am | Reply

  36. Sounds like more self-serving propaganda to me.

    Although there are examples of things not working out the way people want them to, it should be realized that physicians and the health care system are taking on more and more difficult cases and no matter what physicians do they cannot cure everyone.

    Rule number One is that people die.
    Rule number Two is that Doctors cannot change rule number One.

    And if you don’t like that answer please realize that no matter how good doctors are we cannot do better than what God started people with. Everything physicians do is a compromise to overcome a deteriorating situation. Health care truly is an art, not a simple formula or equation. To sue physicians when the outcome is bad, or as is becoming increasing common to sue doctors as a possible lottery type of profitable outcome has made medicine extremely difficult to practice.

    As a doctor myself, even though I have never had a decision against me, I have to tell everyone I would no longer recommend anyone go into the profession. This is only because of the declining reimbursements, increased risk of litigation, and internal politics of the profession(which have become exacerbated by the first two reasons). I have decided that if the current Healthcare takeover bill passes I will be retiring.

    Comment by DoctorT — January 28, 2010 @ 1:24 pm | Reply

  37. That is not to say that there are not cases of truly gross criminal negligence. But the vast majority of cases are not the obvious mis-application of medicine, but rather simple mistakes or miscommunication, or unrealistic expectations. Something needs to be done that can filter out these trivial nuisance cases.

    And by the way, Physicians, as a consequence of Medicare, insurance companies keying their fees off of Medicare rates, and medicaid reimbursement rates, are now paid on the order of 30-35 cents on the dollar. Imagine how bad it will get if the government forces its new “cost cutting measures” on the system. Imagine only taking home 30 percent of your own paycheck every single week.

    Comment by DoctorT — January 28, 2010 @ 1:30 pm | Reply

  38. Health care reform without tort reform is like “Erin Brokovich” without the EPA. Wait, there was an EPA…

    Comment by Lark — January 28, 2010 @ 1:35 pm | Reply

  39. The only ignorance being displayed, Mr. Rosenbaum, is your own.

    New York, where the majority of these incidents occurred, does not labor under tort reform. Tort reform does not address verifiable economic damages, which are certainly significant in these cases, nor does it address public scrutiny being applied to any of the physicians or entities mentioned in the NYT articles. Tort reform does address non-economic damages, often with a cap on “pain and suffering” awards, and introduces procedural barriers that do not prohibit the filing of lawsuits when appropriate. Tort reform does raise the barrier for frivolous lawsuits, and none of your examples strike me as frivolous.

    The problem of limitation of access because of hotbeds of plaintiff lawyer activity is not insignificant. Pennsylvania and especially the Philadelphia area is suffering a drain of specialists because of this very thing, Texas and Florida were also suffering until they passed tort reform in the last several years. California and Indiana have had effective tort reform for years, neither is an epicenter for willful malpractice because the looming threat of devastating lawsuit has been lifted from physicians.

    Perhaps you would care to cross-reference this article with others detailing the risks of diagnostic medical imaging, which is a direct outgrowth of defensive medicine. We image because we can, and because we can document that we looked — not because we needed to know everything in every case. “Document, document, document” we are told by our insurance carriers, leading to an expensive and often invasive nth-degree pursuit of information that is rampant throughout American medicine. If you want to cut costs and share the medical financial pie with more of the population, a great way to do this is to reduce defensive medicine, and nothing you have discussed addresses that issue. You do not consider the downsides of defensive medicine at all in your polemic.

    I trust that your spleen has been sufficiently vented. A more careful, broadly-viewed and slightly less-impassioned response would be most welcome.

    Comment by Darren — January 28, 2010 @ 2:07 pm | Reply

  40. Mr. Rosenbaum,

    I have read many of your articles here on PJM. Sometimes I agree with your thesis. Other times I respectfully disagree, but appreciate your perspective. Today, I am disgusted. You should be ashamed at what you have written here.

    Over my life I have known dozens of doctors and medical professionals, some on a professional basis, but most on a personal level. I have been to their homes, been camping with them, played with their children. Some of them are family members. Without exception, these are people that I love and respect. More importantly, they love people and do their very best to care for them within a system that over-stresses efficiency. Not a single one of these people would ever intentionally harm a patient. The fact that you lambast these individuals and then cite as your only source a newspaper with an overt political agenda is dispicable.

    There are undoubtedly bad apples within the medical profession. These individuals should be stopped, punished and prevented from practicing medicine again. Likewise, victims of medical malpractice, both intentional and accidental, should be compensated for their additional medical expenses as well as pain and suffering. I don’t know of anyone who disputes this. However, the frivolous lawsuits, jackpot settlements and extremely defensive medical practices need to stop in order to bring down medical expenses and allow the vast majority of medical professionals, who are kind, compasssionate people, to practice in relative peace.

    Comment by JMD — January 28, 2010 @ 2:14 pm | Reply

  41. 16.

    But the percentage of medical malpractice claims litigated that are frivolous is small, if not tiny.

    Many frivolous lawsuits are settled. And yet, of the litigated claims physicians and hospitals win in 2/3 of cases suggesting that even those that are litigated are of questionable merit in many cases. Some of this is because juries are predisposed to give physicians and hospitals the benefit of the doubt, they are White Hats before they walk into the courtroom. Some of this is because defense attorneys can actually get juries to understand that medicine is far from an exact science in many cases.

    People do not sue because they were injured. They sue because they are angry.

    Comment by Darren — January 28, 2010 @ 2:39 pm | Reply

  42. Tort reform would not keep you from suing in Texas, where there is tort reform,’ on these cases. The Edwards counter example is instructive. Mr. Edwards made more than any practitioner of medicine by suing over cerebral palsy. Freud, when he was a neurologist, had the insight that the labored breathing at birth of someone who would later manifest cerebral palsy might have been due to a more remote cause than difficulties in labor which is what the doctors got sued for and Edwards was paid for. This remote cause would also be the cause of the cerebral palsy. Your argument would look a lot better if Mr. Edward’s career had taken the cause of those who had been injured in the kind of mistreatment you cite. So lawyers give us suits for nothing and possible malpractice goes without relief.

    Comment by Michael — January 28, 2010 @ 3:15 pm | Reply

  43. Tort reform does NOT mean preventing compensation for real damage. It means fixing a system that sends half of the money into the process, into the pockets of lawyers and into expenses on their invoices, a system that seems to give everyone a reason to stretch cases out for years and nobody a reason to come to a just settlement quickly. This isn’t–shouldn’t be–a competition between two opposite poles of injustice. This should be about justice, with all deliberate speed, with costs contained and with every incentive to get the facts out so that mistakes don’t happen again, whether those mistakes arise from clumsy paperwork, tired doctors, or negligent doctors.

    That is the true meaning of tort reform, and the person who can’t get behind it owes us an explanation as to why.

    Comment by njcommuter — January 28, 2010 @ 8:57 pm | Reply

  44. Bobbybb, I feel for the suffering and loss of your sister, however, how d you put a price on such a thing? By extension, can you justify the suffering of those unable to pay for care due to the rise in costs as a result of such suits? Would not her memory be best served and justice as well, by ensuring that such a physician were never able to inflict such harm on another patient? Monetary gain can never replace a human life or temper the suffering of such a loss, but without reform, it can and does lead to more suffering.

    Comment by Rob — January 29, 2010 @ 6:58 am | Reply

  45. @ Jack comment #12:

    “Link has been added. And that’s a good thing, but it’s ammusing to see it’s been done via “stealth edit”.
    No note of correction, no thanking readers for pointing it out. Just silently slipping in a change to the peice.”

    Jack, having published a couple of pieces here I can tell you that once submitted, the author doesn’t get to go back and make corrections. Likely, a PJM technician noted the omission and included it. It may have been omitted in the first place by accident. I disagree with Mr. Rosenbaum completely (and I’m a health care professional seeing docs at work all the time) but go easy on him. He doesn’t do the html in these articles.

    I have a piece being published sometime this weekend here and you are welcome to see if you like all of my links.

    Comment by GM Roper — January 29, 2010 @ 11:40 am | Reply

  46. 44. Rob:

    One thing you should know about the $250k cap in California is that it’s absolute, even if a person’s medical expenses as a result of malpractice far exceed that amount. Yes, the injured will be eligible for disability (although I’m not sure how much disability money one loses if one has a big cash award to cushion the blow) but why should taxpayers be the ones to foot the bill for a health care provider’s error? I know that’s not what you were arguing about, but as long as we’re on the $250k cap I thought I’d bring it up.

    As for the discussion here about Mr. Rosenbaum, two things:

    1 – The NY Times is not incapable of good investigative journalism. Check out Dr. Elizabeth Rosenthal’s reporting from Beijing as one example.

    2 – I’ve known at least one Yale- and UCLA-educated neurosurgeon who was frighteningly like Barack Obama. A narcissist to the core, but in reality barely competent at his work. Twenty years ago he was being slammed by his superiors during his internship. Now he’s in private practice, hopefully not turning too many people into vegetables. Such people exist in all professions.

    Comment by arhooley — January 29, 2010 @ 7:11 pm | Reply

  47. Ron … I appreciate your passion and your identification of a problem. However, that’s where you and I part company. The real reason for meaningful Tort Reform are multiple. The court system is arbitrary, capricious and often not evidence-base. The tort system does not remove “bad actors” from practice. Overhead costs of this ponderous system are such that over half of every dollar spent goes to administrative costs.

    Real reform is not about preventing injured parties from getting compensation. One example of real reform would be Health Courts, similar to Tax Courts, with specialist judges to deal with the complex issues. Real reform would have the court, not plaintiff or defense attorneys, appoint medical experts (chosen from a panel of experts provided by the various specialty societies.) These experts would review the case and submit an opinion based on medical evidence, not on who pays the check. Finally, this system would insure that the bulk of the compensation would go to the injured patient, not to administrative costs.

    Comment by Doc99 — January 30, 2010 @ 6:28 am | Reply


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