How we're getting robbed by health care providers

[Menelvir]

For a cancer patient, or patient with a similar ailment, I think it's about a little more than mere living. It's about maintaining a certain quality of whatever life you do have.

Also, a terminally ill patient should always have the choice to "opt out" if they so desire. It seems more often than not that the choice is not even in the hands of the patient, which is where it belongs, save perhaps in cases of mental illness.

I guess I'm just very strange. In various ruminations I've had about being incurably sick, or mortally wounded, I've thought more about mercy than care. That is, even if someone wouldn't take me to a hospital or find a cure for my ailment, I'd hope that some stranger would be so kind as to grease the tracks for me, to speed along the passage.

[Maeya]

Speaking as a nurse within a not-for-profit healthcare system, this:

5) Enact tort reform to cut down the amount of frivolous malpractice suits, so that doctors don't feel compelled to order multiple unnecessary tests, just because they're panicked about liability. (CT scans, just because someone says the word "head" in the emergency room, etc.)

Hospitals have to jack up prices to help cover the cost of miscellaneous bullshit lawsuits from every sue-happy jackass who thinks they just won the lottery every time they go to a hospital. They look for things to sue about.

Additionally, Medicare reimbursements are being jacked. They're withholding 1% of reimbursements (for us that translates to 6 million dollars annually) based on perceived customer service. Is customer service important? Sure. Is it as important as saving your life? Not in my opinion. I'm sorry if the doctor is a little brusque with you when you are non-compliant with your medications for the zillionth time ending you up in the hospital for the same damn thing.

Furthermore, we treat a lot of people without health insurance knowing full well we won't see a cent for all the man power, diagnostics, and medications we pour into your ass. (Those are usually the people who treat me like shit, too). Services don't come free, so unfortunately the cost has to be recuperated somewhere, and it will come in the form of jacking up prices.

It is definitely an imperfect system, but I personally think tort reform is the SINGLE BIGGEST step we can take in the right direction.

[brinstar]

^ or people can just not be assholes ;\

our dad's mom was in the hospital for something non-life-threatening that nevertheless required abdominal surgery (i was like 11, don't remember exactly what)

during the routine operation the doc accidentally nicked a bowel and no one caught it - a week later she was gone

there was some discussion but we decided not to file a malpractice suit because we are not assholes and we know that doctors are human too

[Arlos]

I had a couple with a local hospital myself, though nothing fatal, obviously.

1) I had a bad reaction to a IV antibiotic (Daptomycin if anyone cares) I was getting, where I had to make daily trips to the emergency room to get it. Told the staff when I arrived that day I was showing symptoms I had been told to look out for as a bad sign, they hooked me up and gave me that day's dose anyway, then turned around and had to immediately admit me, because I swelled up like a ball park frank, got a lovely case of rhabdomyolysis which caused compartment syndrome, (CK levels were wildly inflated, etc). So, I got to spend a week in the hospital in rather significant pain, getting continual massive doses of IV fluids to stave off my kidneys from shutting down, with only partially functional limbs. I know for a fact there was official action taken at the hospital over it too.

2) I had what's called a PICC line, which is a semi-permanent IV port installed in your arm, with the end of the line from it going to the big vein by your heart, so that I could get a long-term home antibiotic IV treatment. (Vancomycin in this case) (I had a bad 2011, can you tell?) Now, since that thing is a direct pathway from the outside of your body into your bloodstream, it needs a ton of oversight, and it's supposed to be taken out as soon as the antibiotic cycle is done. Well, the hospital inexplicably cancelled the removal appointment, and delayed it a week. Then cancelled the nurse appointment later that week to make sure the dressing and site is protected. Well, the day after it was supposed to come out, I get sick, go into the hospital, and get to spend 10 days that time admitted, since I got a lovely case of MRSA that got onto the line and into my bloodstream and started attacking my heart (among other organs), because apparently the dressing loosened and got unsealed, because, you know, no nurse visit to fix it. So, could easily have died, did get very sick, because the hospital fucked up with proper care.

Still debating suing over one of those, since both were entirely avoidable, but meh. I'm not the suing type.

-Arlos

[Lyion]

Speaking as a nurse within a not-for-profit healthcare system, this:

5) Enact tort reform to cut down the amount of frivolous malpractice suits, so that doctors don't feel compelled to order multiple unnecessary tests, just because they're panicked about liability. (CT scans, just because someone says the word "head" in the emergency room, etc.)

It is definitely an imperfect system, but I personally think tort reform is the SINGLE BIGGEST step we can take in the right direction.

I agree and some states already have done fairly large tort reform. The problem is it's a nationwide issue and a single state fixing things is a drop in the bucket. What we need are reforms similar to what the UK has in place, where the loser pays court costs, and far lesser caps on awards to Lawyers.

Tort reform is a very tough sell on the federal level, since Lawyers pretty much own the DNC, and are also deeply embedded in the RNC.

On the flip side, lawsuits are needed to keep our medical systems in check, especially since despite making a ton of coin they use antiquated equipment, cheap IT solutions, and often times understaff their hospitals. The ease with which people check into hospitals with one issue, and end up contracting multiple others is a huge cause for concern.

[Maeya]

Yeah I'm not arguing that some lawsuits aren't absolutely justified. I'm talking about the McDonalds-my-coffee-was-too-hot-when-I-spilled-it-on-myself style of lawsuits, which happen far, far too often. Healthcare workers are humans, humans make mistakes. There are many checks and balances in place to try to minimize mistakes, but they still happen. Arlos's experience sounds like a nightmare. However, to this comment:

The ease with which people check into hospitals with one issue, and end up contracting multiple others is a huge cause for concern.

Frequently people "end up contracting multiple other" health issues because they were running around with undiagnosed problems. I work on an orthopedic wing, and we primarily deal with elective total joint replacements. I've had MORE THAN ONE patient who comes in with "no medical history - they're a healthy person" because they have not been to routine preventative appointments to discover they're actually diabetic, have high blood pressure, high cholesterol, etc. So when they come into the hospital and their body is put under stress, the other problems manifest and compound and suddenly your "healthy" person is having a stroke. Their family freaks out because they feel like we somehow caused it when really their cholesterol levels were out of control and no one knew it.

Now in situations where you contract an infection - yes, that can happen. Hospitals are rife with opportunity for that. We have all sorts of policies in place to try to minimize that, and that's why I wash my hands so frequently they are dry to the point of cracking. Sometimes, it still happens, though. In situations like Arlos's, that's where lawsuits become justified, and as I mentioned, some lawsuits are justified and necessary.

Overall, though, I feel obligated to defend the healthcare system because of the sheer quantity of crazy lawsuits people try to pull, and also a general misunderstanding of the population in general how healthcare works. It's largely a mystery to most people, so when "healthy grandpa" does come in and has a heart attack after an elective surgery, tenancy is to blame the healthcare industry or workers for it somehow. So we have to raise prices to compensate for costly litigation procedures.

Additionally, may I point out no one pitches a fit when other industries make a profit? Maslow's hierarchy of needs states that our most basic human needs are food, water, shelter and warmth. Where's all the people up in arms about restaurants, grocery stores, realtors and utility companies marking up their product? How much markup do you think there'd be if hey had to deal with the shitstorm of litigation and unpaying customers that healthcare sees? How much do you think your bread would cost if they had to give away a quarter of it for free?

As I've said, it's an imperfect system and definitely room for improvement, but we are not the bad guys.

[brinstar]

Additionally, may I point out no one pitches a fit when other industries make a profit?

have you READ my posts? hehe

[Arlos]

As I've said, it's an imperfect system and definitely room for improvement, but we are not the bad guys.

Oh, I know the nurses and doctors CERTAINLY aren't the bad guys here. Its the people owning and running the hospitals that are being problematic.

You have to admit, the whole Chargemaster system with levying fees that have no relation whatsoever to what things actually cost is insane. So is the kind of stuff Ganzo described, with the Pacemakers and the forced using of less efficient and more harmful surgical procedures, just because the profit margin is higher.

When you go to a restaurant, they base the cost of your meal on the cost it takes them to get the ingredients, plus costs for overhead and salaries, with enough leftover for a reasonable profit. (at least, well-run restaurants do this.) Plus, if you go to a restaurant and look at the menu, and they list Cheeseburger at $8,725, you can simply decide not to buy the cheeseburger. You break a leg, have a heart attack, etc., you can't exactly shop around between emergency rooms to see if one is having a special on transfusions this week, or one is having a President's Day Sale on bypass surgery or something. Effectively, you're trapped. If you want to keep living, you HAVE to participate in the market. Therefore, it si not in any way a free market, and as such, needs to be better regulated.

I still say again, going to a single-payer system will fix all these problems. If EVERYONE is covered, then everyone can get preventative care, which is orders of magnitude less expensive than emergency care. People won't be going bankrupt because of medical bills. Business won't have to offer insurance benefits, saving them the costs they spend subsidizing the premiums, AND saving them the costs it takes to manage the program in the first place.

-Arlos

[Tikker]

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[Drem]

i think it's BS and if the coffee was spilled by a younger person that didn't have fragile 74 yo skin that none of that would've happened. you have to brew coffee at 200 degrees F or it doesn't taste right. you kinda take a risk of burning yourself if that's what you want to drink. whether you're just burning your tongue or your crotch

and i've been burned (read cooked my hand) for a good 4 or 5 seconds with 350 degree oil on my fingers floating desserts and garnishes in deep fryers and it was a nasty 2nd degree burn that healed up 100% and looks absolutely fine. i just think the circumstances of that lawsuit were perfect for them to extort money from a company that made someone a cup of coffee served well below the temperature actually required to brew it correctly

not to mention holding scalding liquid right next to your vagina in a flimsy cardboard cup is classic darwinism

[Ganzo]

Yeah I'm not arguing that some lawsuits aren't absolutely justified. I'm talking about the McDonalds-my-coffee-was-too-hot-when-I-spilled-it-on-myself style of lawsuits

You should actually read this lawsuit


everyone points it out as the definition of frivolous lawsuits, but it's really not

I think there's even a documentary about that case because of how often it gets brought up but most people use it as an example of frivolous lawsuits when it should be used as an example of corporate carelessness and the pursuit of profits over a customer's safety.

[Drem]

then why isn't there a documentary about all the exact same cases from other companies (starbucks, burger king, blah blah) that have just been straight dismissed by the courts? this case was a fluke. people bring it up all the time because it's a load of shit

[Arlos]

Because those other companies may brew it at 190-200F, but don't give it to the customer (especially at a drive-thru) at that temperature, thus lessening the risks involved?

-Arlos

[Ganzo]

i think it's BS and if the coffee was spilled by a younger person that didn't have fragile 74 yo skin that none of that would've happened. you have to brew coffee at 200 degrees F or it doesn't taste right. you kinda take a risk of burning yourself if that's what you want to drink. whether you're just burning your tongue or your crotch

and i've been burned (read cooked my hand) for a good 4 or 5 seconds with 350 degree oil on my fingers floating desserts and garnishes in deep fryers and it was a nasty 2nd degree burn that healed up 100% and looks absolutely fine. i just think the circumstances of that lawsuit were perfect for them to extort money from a company that made someone a cup of coffee served well below the temperature actually required to brew it correctly

not to mention holding scalding liquid right next to your vagina in a flimsy cardboard cup is classic darwinism

There is a bit of a difference between burning your finger and spilling 200 degree coffee on your crotch. The money was not awarded for the burns, but for the neglect of customer safety in order to maximize profits as was proven in court.

[Drem]

Because those other companies may brew it at 190-200F, but don't give it to the customer (especially at a drive-thru) at that temperature, thus lessening the risks involved?

-Arlos

It was a difference of 3 degrees celsius between mcdonalds and all the other ones. Science has proven that difference to be negligible. Thus the rhetoric about frivilous lawsuits, because the case is bullshit and the lady was an idiot. If you need a larger printed disclaimer to avoid spilling shit on yourself then that's your fault. Operator error

And yea, submerging your hand in liquid fat at 350' is worse than 200' water in your.... nevermind, you all obviously know fucking everything about everything, even shit you have obviously zero experience with. Oil burns are infinitely worse than coffee

Another aspect of the trial that no one's commentig on is that she only asked for money to cover medical expenses. Mcdonalds said no. Thats when they actually fucked up. If you think a larger printed disclaimer is gonna solve the problem then you're stupid. They served coffee that way for decades. I can tell you right fucking now that no restaurant or coffee serving facility in the world checks the temp of their coffee, because you serve it as hot as you can and expect your customers to be competent human beings. I'm sure fast food bullshit temps it now be ause of this awful lawsuit, but i guarantee you no one else does

So because some lady with fragile skin burned herself because she foolishly put a cup of scalding liquid next to her vagina, the whole industry has to change?

Absurd

[Drem]

Honestly cant believe you guys are blaming mcdonalds for serving hot coffee. No wonder brits say we dont know how to make a good cup of tea or coffee

[Drem]

I just asked everyone in the room at work what they thought. General consensus: why the fuck you gonna put hot liquid between your legs while you're in a vehicle? You got no business doin that/it's some seriously dumb shit

[Arlos]

She was a passenger, not the driver, and the vehicle was parked.

Still think it's as retarded she had it there?

-Arlos


PS. I still think it was a silly award, but McD's could have done more to make the shit safer. They've already done several things SINCE then. (Bigger labels, better cups that don't spill as much, etc.)

[Tikker]

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[Harrison]

Suing because you burned yourself with your own coffee...

The epitome of fucking retarded.

[Drem]

P much. Took someone centuries to make money off being a dumbass but now it's finally happened. Congrats humanity. Idiocracy inc

[brinstar]

just read http://mentalfloss.com/article/26862/re ... ee-lawsuit

yeah she spilled the coffee, but yeah mcdonald's was total dickcheeses about it. ultimately i think i would still rule in favor of the old lady, though by a slim margin

what i will say though is why the fuck wasn't the grandson all like "here gram, that's real hot, let me get that for you"

what a shit grandson, shame on him

[Gaazy]

If you could cure aids in your garage would you ? It takes funding like say a university but people try to do good shit all the time.

I understand what you're saying


the funding tends to flow towards profitable stuff though

it sucks, but it's the reality of how it works


but really tho, $5000 bucks is enough to cure Aids



right Gaazy?

Wow, has it really been a month since ive been on this board?

/sigh as i was reading this thread, I knew that was coming

[araby]

The first step should be to deny doctors the right to refuse Medicare/Medicaid as many of them do now

this would be a horrible mistake. the sole reason most of them deny Medicare/Medicaid is because those services do not provide for the standard of care. if I were a practitioner of any kind, I would quit before I were told to lower my standards to get paid.

of course, I do think that there is great confusion over which went up first, the insurance premium or the doctor's salaries...hm....

I still believe to this day that the free market simply means being able to charge whatever you want as a practitioner. Insurance companies still pay what is "reasonable and customary" and both are getting paid, getting paid. getting paid. cha ching.