Sen. Durbin DESTROYS Republican Arguments on Malpractice Reform

[drkaje]

I used to work for an insurance company dealing with injured workers and I've seen first hand the abuses of insurance companies as well as billing by physicians.

Here's a tidbit for anybody out there who may not know.  It used to be in my state that if a physician performed a surgery on a person, let's say to correct a herniated disc and while performing the procedure the surgeon came across another problem, let's say another herniated disc, the doctor would fix the 2nd problem and instead of adding a fair mark-up for that extra effort, they would charge as though a WHOLE NEW SURGERY HAD BEEN PERFORMED!  It was called stacking.

And I don't even want to get started on the sheer volume of double billing that goes on.  Insurance companies actually have to pay an army of employees just to keep all of that in check.

My point remains the same.  Clean up your own profession if you want to endlessly cry about the malpractice reform.  I support malpractice reform and I think it's an aberration that people should be able to sue you for some of the nonsense.  And I want the best minds in the field, so I want you all well paid.  But, you're going to have to survive within what the market can bear, and right now healthcare is just crushing people.


But, I digress.  I'm sure you and Kaje are near the poverty level and his 3 children are surely close to starvation at this point.  Next month you'll both be down at the welfare clinic as Uncle Sam forecloses on your businesses.

Not being an ass here but..... you dorealize reopening a patient presents additional risk. "Stacking" for billing purposes is (or should be illegal) but an entire second surgery would put patients in harm's way. From an ethics perspective, many would say "Close the patient up and let them opt and give informed consent for the second surgery" so autonomy is kept intact but in a surgical scenario it hard to justify the additional risk.

[Skip8282]

Not being an ass here but..... you dorealize reopening a patient presents additional risk. "Stacking" for billing purposes is (or should be illegal) but an entire second surgery would put patients in harm's way. From an ethics perspective, many would say "Close the patient up and let them opt and give informed consent for the second surgery" so autonomy is kept intact but in a surgical scenario it hard to justify the additional risk.

So where do we disagree?  I understand reopening the patient is bad.  In fact I know from my dealing with worker comp injuries that physicians will go out of their way not to operate.  The stacking was the issue and it was abusive. 

As for the ethics, that was already determined by the surgeon.  He or she made that decision and I'm sure it was a tough one to make.  But, once made, it doesn't justify the stacking.

[drkaje]

So where do we disagree?  I understand reopening the patient is bad.  In fact I know from my dealing with worker comp injuries that physicians will go out of their way not to operate.  The stacking was the issue and it was abusive. 

As for the ethics, that was already determined by the surgeon.  He or she made that decision and I'm sure it was a tough one to make.  But, once made, it doesn't justify the stacking.

It doesn't justify "stacking" but someone shouldn't get a free surgical procedure because they're already open, LOL! I'm guessing you specifically mean people charging for two separate procedures in cases like that. They should get paid for the extra work/risk but not double bill. Money from insurance companies isn't free.

[Skip8282]

It doesn't justify "stacking" but someone shouldn't get a free surgical procedure because they're already open, LOL! I'm guessing you specifically mean people charging for two separate procedures in cases like that. They should get paid for the extra work/risk but not double bill. Money from insurance companies isn't free.

Who the hell said anything about free?

Here's a tidbit for anybody out there who may not know.  It used to be in my state that if a physician performed a surgery on a person, let's say to correct a herniated disc and while performing the procedure the surgeon came across another problem, let's say another herniated disc, the doctor would fix the 2nd problem and instead of adding a fair mark-up for that extra effort, they would charge as though a WHOLE NEW SURGERY HAD BEEN PERFORMED!  It was called stacking.

Read.

THINK.

Post.

Repeat.

"It's really that simple."
    -kaje, circa 2010

[shootfighter1]

Interesting. I am not in a surgical field so don't have any experience with that.  I speak specifically from a family practice perspective.  I'm sure there are lots of abuses, but I think many of those come from the hospital systems now and not the doctor.  As an example, the doctors at the cleveland clinic may assign a code for their visit but the extra charges tacked on come from the billing departments and/or auditors, particularly when procedures and surgeries are done.  It's a lot more difficult to overcharge in family practice, we basically take what we are given by regular E&M code reimbursements, it's not much.  I am reimbursed $55-59 for a typical (99213) follow up visit.

Kaje & I may not be in financial hardship now but we did more than our share of volunteer and non-paid work throughout training and in practice, that I can assure you.  We also basically waited 8-12 yrs later than our counterparts to make significant $ and paid debts back for years, so I feel absolutely no regret in being about to make a good wage now (still well under Obama's $200K/yr tax penalties).

Kaje, what kind of doc are you?  Good discussion!

[Skip8282]

Good, I think you should be well paid.  I don't want some flunky jackoff evaluating my family or I when we need help.  That's not the point, it was just Kaje attempting to deflect.

[drkaje]

Good, I think you should be well paid.  I don't want some flunky jackoff evaluating my family or I when we need help.  That's not the point, it was just Kaje attempting to deflect.

Skip, I'm a total geek and will probably end up working someplace for nothing. I love seeing patients and will still be happy as the proverbial pig in shit.