[keepingitreal]

3. Actually, number three should have said $1000.00 dollar deductible (for the year) not co-pay. On top of that I think a reasonable copay (maybe five percent) up to a total out of pocket of maybe $2.000 per year would discourage over useage of medical rescources. Many health plans already feature something like this, but it would be even more powerful when combined with medical savings accounts.

[fergus51]

It wouldn't just discourage use, it would completely stop it for some people. That's just rationning dressed up as "discouraging waste".

[gwenith]

I had a patient pull the dying swan on me the other day about "just another 24 hours in hospital - you can't send me home now" I told her straight that there were no beds and that when the doctor said discharge that was what happened. Sorry but I see more waste in private hospitals where this attitude is pandered to than in public hospitals.

One example of us intelligently cutting costs. We used to do micro urines twice a week on all catheterised ICU patients to screen for infection - now we just test for leucocytes and if and only if they show leucs do we screen - we save $16 a test - not much unless it is multiplies by the number of patients and the frequency.

[Roland]

I think that I mentioned this before in a post in the "General" area. Has anyone looked at the Austrialian model where they have a "dual" public/private system? Have there been any studies since that system was implemented that examined the effects upon health care sector inflation (comparing the inflation rates in both public and private services since the system was implemented). Something is going to have to give in the United States. Medicare is set to go bankrupt in less than twenty years, and health care sector inflation is rising at double the rate of inflation in the overall economy. I think that a "dual" system would offer everyone basic coverage while allowing those with more money to access premium healthcare (just as the rich can afford nicer homes, safer vehicles, and healthier food&lifestyles). I don't think that the solutions that I referenced above are politically feasible, and the majority of Americans view healthcare as a basic human right (as evidenced by several Gallup and Roper/ Pew/ polls).

[user69]

I think that the right to sue is important, and if you are going to sue for punitive damages it need to be for an amount that will impact the ones at fault. But If the punitive judgment went into a fund for either the support of the government or for directed social programs you will eliminate so many of the frivolous suits. The legal system should not be used as a lottery for unscrupulous individuals. This should in no way impact the way actual damages are derived.

[Roland]

A veryation of this situation already exists with vaccinations. There is National, Vaccine Injury Compensation Trust Fund, created by Congress which requires that anyone injured by a vaccine to FIRST seek compensation through this program (I believe that it also offers limited liability protection for the manufacturers of vaccines). This was instituted because the profit margin is so low on vaccines (relative to the liability risk) that Congress was concerned that without such a program that there wouldn't be enough vaccines produced (the CDC also maintains the VAERS or Vaccine, Adverse, Event, Reporting, System which doctors are required to report to by law). I would argue that in certain medical subspecialties that a similar situation exists, and that they are in need of this type of protection.