2003 State of the Union Reaction and Discussion Thread.

"No offense, but that is the most ignorant statement I've read in this forum in a long time."


-Ha ha, DM, none taken. But if this was the real word...

No, kidding, but I stand by my statement. It's not that bad. I know lots of doctors and many of them have been sued once or twice, but all the claims were thrown out. Look, this is how it works, I explained the economics of it.

Many Doctors do indeed have god-complexes. And as for the rising cost of health care, don't forget how much cash doctors rake in and have always raked in. Doctors today are unhappy because they no longer control every facet of the medical process like they used to, and feel like rather than being lords of their own practice they feel more like medical technicians.

Now, I do feel bad that Docotors get sued, but come on, they have insurance, they have insurance company lawyers who get most frivilous claims dropped! Anyone of you medical professionals care to tell me about personal experiences of people you actually know (not some guy you heard) that got "screwed" by some lawyer and was wrongfully forced out of business? I doubt it. Even if it does happen in occasion, I have never heard of it, and I know plenty of doctors.

Yeah, V03, I'm sure in medical school they force you to take a medical-law class to fresh you up and prepare you for the onslaught of litigation, but it's not that bad. And contrary to what they taught you in medical ethics, many doctors do get older and many doctors are from the old school, who see themselves as infallable and whose arrogance cannot be questioned. Not most doctors, I'm sure most doctors are the humanitarians they claim to be, but there are enough sloppy doctors out there, and I kind of like how the legal profession checks the arrogance and awesome responsibility of the medical profession.

Doctors' just don't like answering to anyone, especially some snot-nosed lawyer punk.

 

Yeah, V03, I'm sure in medical school they force you to take a medical-law class to fresh you up and prepare you for the onslaught of litigation, but it's not that bad.

It seems that there's mounting evidence to the contrary.

 

Is this the case? I doubt that the majority of malpractice suits that are causing all of the worry are from cosmetic surgery.

Well, I said many, not all. All I know is some of the most grotesque examples of malpractice are coming from the cosmetic industry, IMO, primarily because doctors who are not certified are doing cosmetic procedures.


Last thing: You may have a point on the number of $250,000 -- it IS inherently arbitrary. States, in fact, are all over the map on what pain and suffering and punitive damages can be. I think the new proposals in Ohio will put a $400,000 limit on pain and suffering, and $300,000 limit on punitive (something like those numbers, anyway). It might be possible to have some sort of proportional damage limit -- the Supreme Court has held that a 4-to-1 ratio is probably appropriate on punitive-to-compensatory damages -- so this is debatable, but even an arbitrary limit is FAR better than no limit at all.

Why does there have to be a limit?

What if you were permanently disabled and required lifelong medical attention for the rest of your life? Is $700,000 going to cover those costs? Is $700,000 just compensation for losing your life, or having to wear a diaper and a drool cup? It seems to me that the people who lose the most in caps are the people who have lost the most healthwise.

Again, it doesn't settle with me that we want to limit the damages a person can recover for injuries, but ignore the other causes/problems of malpractice. If the medical industry could show us that ALL complaints were being investigated and that actions were being taken against doctors who are not doing their jobs, then maybe I would not have a problem with a sliding scale of awards where minor injuries do have a cap and major injuries do not.

 

chibiangi,

While I agree with you on the fact that they should not cap the limits, I do also thing that they have to stop the frivalous lawsuits, and unfortunately as I stated before, the number of frivalous lawsuits out there, are hurting people, and because of them, more people are going to be hurt. Like those who have legitmate lawsuits, because they are going to cap the lawsuits so as to discourage the frivalous ones, and in the bargain those with legitimate actions are going to be penalized. In this I agree with you, there needs to be something done that will do both things, stop the crap suits and still be able to award reasonable sums to people actually hurt.

Jaded

 

Yeah, V03, I'm sure in medical school they force you to take a medical-law class to fresh you up and prepare you for the onslaught of litigation, but it's not that bad.

I understand the point that you are trying to make, ObiWanMcCartney, but unless you have completed training at a medical school, I would respectfully ask you not to write posts based on assumptions. I took no such course in medical school; of the five medical schools in the philadelphia
area, none require a class such as the one you suggest. Offhand comments about the legal profession and malpractice woes are discouraged from physicians to students by deans' offices; it is seen as declasse (did I use that word right?) to taint students' perceptions of the problems of the profession before they have made selections for their residencies.

I'm not trying to insult you here, as you are one of the many members of this board that I greatly respect . But as I will point out below, the doctors' side of things is only now beginning to get any public play at all. Moving on, then....


And contrary to what they taught you in medical ethics, many doctors do get older and many doctors are from the old school, who see themselves as infallable and whose arrogance cannot be questioned.

This type of thinking, except at Ivy-League centers (and even there), is rarely ever tolerated anymore. The reason? The internet. What I was taught was not that doctors should be gods, or even the opposite, but that the "new" doctor-patient relationship was more along the lines of the "educated consumer". Nowadays, patients can (and often do) look up information regarding their illnesses and treatments over the internet, and come in with more questions and preconceptions than ever. It's only by assuming the role of negotiator that things oftentimes get done. The "infallable physician" model, so rampant in the 60s, has largely fallen by the wayside; doctors have been humbled by HMOs and lawyers. Again, more on this below.


Not most doctors, I'm sure most doctors are the humanitarians they claim to be, but there are enough sloppy doctors out there

But there really aren't, though (with the exception of HMOs, which breed mediocrity; that's a whole separate argument, though). "Sloppy doctors" kill their patients. They lose their practices as disgruntled patients leave. So many physicians rely on patient satisfaction and word-of-mouth to stay in business. Non-HMO docs can be fired by their patients with no trouble at all. That very fact keeps sloppy doctors to a minimum. The exceptions are physicians who are employees, such as of HMOs, and are "capitated", ie paid whether or not they see their patients and lose money for spending too many resources on them. In that environment, laziness is bred. And that does indeed lead to sloppy doctors. Most of the time, however, sloppy doctors can't stay in business. They either kill, or, if they are lucky, simply fade away.

and I kind of like how the legal profession checks the arrogance and awesome responsibility of the medical profession.

In two years of direct hands-on training as a junior and senior medical student, I have observed (both directly and indirectly), not a drop of arrogance to be found. Patients are treated with reverence and respect; part of this probably comes from fear of being sued. Arrogance is far more prevalent between physicians themselves than between physicians and patients. As I stated above, it is now more about "contracts", than "paternalism".

The legal profession may see itself as "checking arrogance and responsibility", but all it is really doing is breeding fear. Medicine is a service, not a job, and lawyers have, by mountainous suits and staggering awards, taken much of the joy out of its' practice. The very threat of lawsuits puts many physicians on constant edge, and it poisons the doctor-patient relationship. The degree of hostility that has entered into it is enormous-and a deep, deep shame. Because of a few bad apples,

 

I think your connection to the medical field taints your objectivity in this case, my friend.

 

I think your connection to the medical field taints your objectivity in this case, my friend

All too true, all too true . I can't help it, though . Especially since one of my very best friends, who is a lawyer, has said that if all else fails, he is going to make his living by suing me .

Peace,

V-03

 

I think your connection to the medical field taints your objectivity in this case, my friend

But does his bias change any of the facts surrounding this issue?

 

I'm an Englishman spending a year in the US for university, so that tells you where I come from:

The State of the Union Address was perhaps the biggest joke of the decade. Bush comes in (and some guy even whoops - control yourself, he's not a popstar!) and then proceeded to tell the 'Nation' exactly what they wanted to hear.

And the Senators lapped in up. Doesn't Bush have any opponents in the Senate? I can understand giving respect to a leader, but there's a difference between respect and a**-kissing.

 

You noticed that half the crowd -- the Democrats -- sat on their hands for much of the speech, right?

 

Really? No I didn't, I suppose I couldn't see them because the Republicans were constantly doing standing ovations!

In which, I apologise, I'm wrong about that.

EDIT - Got them the wrong way around.

 

You noticed that half the crowd -- the Democrats -- sat on their hands for much of the speech, right?

Which could be a good way to predict which bills might easily pass, and which will not.

Peace,

V-03

EDIT: KW, it all depends. I try to present facts, although my opinions are certainly subjective. Am I presenting all the facts? Probably not, since I have only listed the ones of which I am aware-and legal arguments that bad doctors are allowed to stay in practice certainly have merit. I just don't think that bad doctors are solely to blame here, or even the major responsible party for the crisis. It all comes down to that perspective thing, I guess.

 

You noticed that half the crowd -- the Democrats -- sat on their hands for much of the speech, right?

Just goes to show that not every politician blindly follows, and not every individual in these "United" States agrees with Dubya.

 

I personally was very angered to have seen it, as I am a firm ani-Bush person. I found some of my biggest problems with it were...

His War on Iraq. (which we won't discuss here cause there's another thread on it) and his money spending tactics.

On the money spending tactics. He is spending over 40 billion dollars. Thats a lot of cash. Yet he is also trying to cut the deficit. He is going to do this by spending more money? Oh yeah, and by cutting taxes as well. I can honestly say that this is one of the asinine ideas I have ever heard. And then the whole Iraqi War thing. War costs a lot of money and we are already spending lots of money domestically. I think that Bush is sending the US on a toilet runs down the hole.

Also I would like to state that Hitlerism is not a word. But hey GWB has coined lots of other words and new gramatics for te English language.

Peace and Unity

JMA

 

Risk-Taker

THE founding fathers invented the state-of-the-union address as a brief update for members of Congress. George Washington's first effort ran to 850 words, shorter than this article (those were the days).

George Bush's version was more ambitious and complicated. It was an address to the nation at a time when the economy is barely recovering, consumer confidence is at rock bottom and unemployment is up. It was an address to particular groups, such as pensioners worried about health care. It was an address to particular members of Congress in whose hands rests much of the president's domestic agenda.

Perhaps most of all it was a global event: an address to world opinion about Iraq, a statement of resolution to America's allies, even an appeal to Iraqi citizens that they should believe in America's good intentions. Not surprisingly, a speech with so many aims was rather patchy, hitting some targets and missing others.

For Mr Bush himself, mindful of his father's fate, the most important task was to reassure voters that he knows what he is doing on the economy. This is all the more important now that, for the first time, less than half the voters say they trust the president's economic management. In response, Mr Bush produced, in the first half of his speech, a dutiful laundry list.

First on that list was his ambitious $670 billion tax cut. Here, he had the task not only of convincing voters that it is the right stimulus now, but also of persuading Congress to pass it. Not easy. The Republicans who have to steer tax proposals into law (Bill Thomas in the House of Representatives, Chuck Grassley in the Senate) have said there must be compromise. Intriguingly, Mr Bush spent more time on the income-tax bits of his proposal?he would make cuts scheduled for 2004 and 2006 permanent this year?than on the plan to end taxation of dividends. That may mean he will compromise on the dividend bit.

The rest of his domestic agenda was a roster of spending plans: $400 billion for Medicare reform, $1.2 billion for new fuel-cell technology for non-polluting cars, $6 billion for domestic protection against bioterrorism, $10 billion extra for fighting HIV/AIDS. Many other projects were on the small-bore side. But, as Senator Everett Dirksen used to say, ?a billion here, a billion there and pretty soon you're talking about real money.?

Despite Mr Bush's insistence that spending restraint plus economic growth will balance the budget, there is little sign that the budget deficit is under control. This week, the Congressional Budget Office forecast that this year's deficit will be $199 billion and next year's $145 billion. As shares of gross domestic product, they look manageable (1.9% and 1.3% respectively). But those estimates do not take account of new tax cuts, new spending or war in Iraq. And Mr Bush had previously said deficits would be merely a passing phase, a claim that looks increasingly dubious. In his address, the words ?budget deficit? were notable for their absence. To judge by reactions afterwards, the address will not change public opinion about Mr Bush's economic record.

In other areas, it could be more successful. Last year's address was a broad definition of America's role in the world after September 11th, as leader of the struggle with ?the axis of evil?. This year's speech addressed more specific concerns.

Is America a reckless polluter? Then consider the clean-car initiative. Is it indifferent to the third world? Here is substantial money for AIDS. Bill Frist, the leader of the Senate, said he thought that, in ten years, people would look back on this initiative as the most important part of the address. Has Mr Bush forgotten ?compassionate conservatism?? Then here is federal money for volunteers who help children with parents in jail; here are vouchers to help drug addicts pick treatment programmes (which, incidentally, could raise worries about church-state separation, since many of the be