Tort Reform

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Jonathan
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Post by Jonathan »

Jason wrote:For instance, I would rather have doctors with a wide spectrum of skill levels rather than a homogenized mediocre skill level in a socialized system.
Finally, why is this an outcome of a single payer system? As I see it, the same people will practice the same specialities but bill the government instead of private insurance companies. It's not as if the government starts dictating who practices where.

Dave
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Post by Dave »

wow, long thread. Only thing I can add to this is that Harris is a defense contractor. The longer we're at war, the better biusness the company gets. I think most people after college realize that they will vote for whoever will best help them economically, whether through taxes or, say a fun war.

As for insurance. I like it. Medicare is my favorite tax to pay
It takes 43 muscles to frown and 17 to smile, but it doesn't take any to just sit there with a dumb look on your face.

Jason
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Post by Jason »

Dwindlehop wrote:Also, why should the cost to you rise simply because you're paying a tax instead of insurance?
Because with insurance you get to choose your level of insurance, esstentially, there are multiple levels of payment. With a tax you are forced to pay what the government tells you to pay.

Also, as I get closer and closer to how the government operates, I have to say I honestly don't believe the government can operate efficiently in any capacity. Don't get me wrong, it does a lot of good, but I would want something that covers my health to be semiefficient.

Jason
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Post by Jason »

Dwindlehop wrote:The current state of my and your health care is acceptable right now because of the private insurance we have through our jobs. If Intel were to embark on a major downsizing tomorrow and fire me, which they could because I am employed at will and have no contract or union, I would no longer have access to that insurance, nor would I be able to afford it because Intel subsidizes the majority of the cost of my health insurance as an employee benefit. The fact that I gain or lose access to doctors as a result of my access to my job is ridiculous. The two should not be correlated. I think it's a basic human right to have access to health care (the "Life" bit of "Life, Liberty, and the Pursuit of Happiness").

Most doctors, to the best of my knowledge, won't accept a patient that does not have health insurance. Some of the teachers who worked at the preschool where Amber worked could not afford the health insurance offered through their jobs, because the preschool did not subsidize the cost at all. These were people with fulltime jobs who paid for their own housing, and whose incomes were above the poverty line. If they had medical problems, they either hoped it went away or sought emergency room care.

You may not want to pay for the healthcare of 100 million obese Americans, but there's not any mechanism I'm aware of that ensures a minimum level of health care for everyone other than government. We can't leave this to market forces because the cost of human suffering cannot be accounted for.
I agree with you that there are a lot of people out there that need healthcare and are not receiving it, but a single payer health system is not the answer. I would agree to something along the lines of a healthcare welfare system. In pennsylvania, they have a healthcare welfare system for children and from what I've read about it, it seems like a viable solution. I have no idea how the solution would scale for the country however.

Jonathan
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Post by Jonathan »

Doesn't sound entirely different from Kerry's proposal to subsidize premiums and make insurance available for everyone at reduced cost.
http://www.johnkerry.com/issues/healthcare/
http://www.johnkerry.com/issues/healthc ... _Plan.html
I still think universal coverage should be the goal, but I'll settle for correcting the worst abuses.

Jason
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Post by Jason »

Dwindlehop wrote:
Jason wrote:For instance, I would rather have doctors with a wide spectrum of skill levels rather than a homogenized mediocre skill level in a socialized system.
Finally, why is this an outcome of a single payer system? As I see it, the same people will practice the same specialities but bill the government instead of private insurance companies. It's not as if the government starts dictating who practices where.
Because it makes healthcare like a factory. In this country, medicare reimburses cataract surgery a set amount. It used to be higher about 15 years ago, such that a doctor used to spend about 30-45 minutes with each patient. The medicare system slowly reduced the reimbursement amount over the last 15 years to the point where the doctors now stack patients back to back tightly. They on average spend 7 minutes in the room conducting the surgery and perform a surgery every 10 minutes. Now the orginal time seems high, but the current time is inadequately low.

I don't know many factory workers who really like what they're doing and really take the time to treat the product they're working on with great care since there are so many more coming along.

Jason
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Post by Jason »

Dave wrote:wow, long thread. Only thing I can add to this is that Harris is a defense contractor. The longer we're at war, the better biusness the company gets. I think most people after college realize that they will vote for whoever will best help them economically, whether through taxes or, say a fun war.

As for insurance. I like it. Medicare is my favorite tax to pay
You know, the majority of us work for a government dependent organization.

There have been some people at work saying that they don't like Bush, but they're going to vote for him anyway since we've never had so many contracts and growth. I've seen our financial forecast and it seems incredible really.

Actually speaking of Harris, I was working in the Harris building up in Maryland on friday. Had to work 11 hours to get something done by monday because of something someone in the government said to the media. They said something about possibly calling me on sunday to come in. It really opened my eyes to what the media thinks it knows.

George
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Post by George »

My biggest problem with punitive damages is that they're awarded to the victim and lawyers. Now, reimbursing someone for financial damages, medical expenses, lost wages, etc seems reasonable. That's what civil courts are for; recovering the costs of wrongdoing from the wrongdoer to whatever degree practical.

Punitive damages on the other hand make no sense. If a person has done something that the government/society believes they must be punished for beyond the financial damages incurred, they should be tried criminally and punished accordingly (fines payable to the GOVERNMENT, prison time, suspension of licensing, probation, community service, etc). I think medical malpractice, wrongful death, and most of the other common big money civil suit types should all be forced into criminal courts. Cap the civil court awards at quantifiable losses only, and watch the case volume drop like a rock. At the same time, the possibility of extracting punitive fees will excite all the local governments so that they are actually willing to put effort into prosecution. Look at how rabid they all got over the tobacco and now firearms suits (both grossly unjustified, but that's a different issue).

And of course, criminalizing malpractice brings me to another point. Malpractice insurance ought to be illegal. You can't buy murder insurance or rape insurance or even speeding insurance. You'd probably be thrown in jail if you tried to buy or sell anything like it. I realize that under the current legal system being accused (and even convicted) of malpractice is more a random act of God than a result of actually doing something wrong, but the idea of funneling money from every person (patient) in the country through good doctors through insurance companies through bad (or unlucky) doctors to a handful of dishonest "victims" and lawyers strikes me as the worst implementation of socialism yet. "From each according to their ability, to each according to their willingness to claim pain and suffering". The doctors who do commit real malpractice get off essentially unpunished, the medical industry as a whole is squeezed, and quality of life decreases for everyone.

Alternatively, I think that we should establish a policy of decimating the personal injury lawyers. When the deer populations get so high that they become a threat to themselves and the ecology around them, hunting season is declared to reduce the population to safe levels. Similarly, I think we ought to execute (or use for medical experimentation, hunt for sport, or put into a gladiator arena) every personal injury lawyer above some number. That way, the remaining lawyers can survive off of the legitimate malpractice claims and not have to create business by tricking the stupid and lazy.

George
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Post by George »

I would also point out that public hospitals in this country (and maybe private ones as well) are required by law to provide care without prejudice even when they know or suspect that the person can't pay. Actually, according to my uncle (a radiologist driven into retirement by the malpractice risks and insurance costs), one of the biggest problems facing many hospitals is that huge fractions (a third or more in some areas) of their patients don't pay. That results in reduced quality of care and increased costs for the rest of us who can pay. Worse, sometimes the deadbeats come back and sue the hospital because the hospital didn't choose the most expensive treatment available.

I do believe that we need a better "safety net" than this, but it has to be designed to minimize abuse and exploitation. And, as Jason said, there has to be a reward for doctor's who excel. I'd happily pay $120 for my annual exam (I currently pay $20) if I believed my doctor was actually interested in keeping me healthy. My current doctor is worthless, but there isn't any way to find a better one. Even if I could find a better one, he'd still only be getting $20 off of me and wouldn't have any reason to treat me any better than the current one.

Alan
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Post by Alan »

Yeah, all emergency rooms are required by law to treat patients with legitimate emergency conditions regardless of their ability to pay. Like George mentioned, uninsured patients often abuse the emergency room because they don't have primary care doctors (because they have no insurance). And emergency room staff often don't have the balls (or just don't care enough) to turn away the non-emergencies in case they turn out to be real emergencies, which would lead to a lawsuit sometime down the road. So they swallow the costs.

If these patients had insurance, they would (theoretically) make use of a primary care doctor, which lowers the emergency room costs in two ways - first, they don't visit it as much, and second, illnesses could be detected or prevented before they become emergencies.
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Post by Alan »

George wrote: Punitive damages on the other hand make no sense. If a person has done something that the government/society believes they must be punished for beyond the financial damages incurred, they should be tried criminally and punished accordingly (fines payable to the GOVERNMENT, prison time, suspension of licensing, probation, community service, etc).
Schwartzenegger has proposed a 75% tax on punitive damages:

http://www.cfo.com/article/1,5309,14432 ... yinfinance

It seems like several other states have this already in place.
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skanks
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Post by skanks »

George wrote:Punitive damages on the other hand make no sense. If a person has done something that the government/society believes they must be punished for beyond the financial damages incurred, they should be tried criminally and punished accordingly (fines payable to the GOVERNMENT, prison time, suspension of licensing, probation, community service, etc). I think medical malpractice, wrongful death, and most of the other common big money civil suit types should all be forced into criminal courts.
George, if the government actually went out and prosecuted major corporations for criminal offenses then we wouldn't need punitive damanges. Unfortunately that is never going to happen.

Consider the EPA (or the FCC or the SEC or the NNRC or the regulatory agency of your choice): they have some pretty serious regulatory power; they can levy some pretty serious fines. Now, there are some very blatant violators of environmental laws out there -- Why doesn't the EPA start getting tough with people who are obviously breaking the law and start investigating others who appear to breaking the law? Because the EPA is controlled by President Bush who is bed with energy and other major industries. Instead of enforcing the law, the EPA spends its time making loopholes and excuses for corporate misconduct. The EPA also enjoys harassing noncorporate entities like Carnegie Mellon University and Los Alamos National Laboratory and fines them thousands of dollars for unlabeled beakers of water.

So let's suppose your spouse or your children were fatal victims of corporate misconduct. Who are you going to want to call? Law enforcment? Hell No. You're going to want to go out and get the best goddamn legal team money can buy and sue the living shit of our of the perpetraitors.

Sometimes bureacracies work. Elliot Spitzer, attorney general of New York, seems to be doing a good job investigating many Wall Street violations that Bush's Securities and Exchange Commission won't touch. But -- call me a free-market zealot -- I think its clear that in most cases, private law firms are going to do a better job representing victims than a government bureacracy. Punitive damages are an essential element to making this mechanism work.

George
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Post by George »

The problem is that lawyers have no incentive to seek any solution that benefits society or that reduces the likelihood of future recurrences. Lawyers are happy to settle out of court with no admission of wrongdoing. The settlement fees aren't paid by the responsible parties; they're passed on the the customers, who were usually the victims to begin with. The actual wrongdoers aren't punished in any way.

I would hold up the CD price-fixing class action lawsuit as a great example of why private lawsuits don't work as a means of opposing criminal behavior. The court ruled that the big music companies were in fact colluding to hold CD prices steady. The result... a few consumers who actually knew about the lawsuit early on got checks for exactly $12 regardless of how many CDs they bought. School libraries received donations of all the surpluss CDs the companies couldn't sell (one school district received dozens of copies of an unpopular Whitney Houstin single). The lawyers pocketed tens (hundreds?) of millions. And most importantly of all, Best Buy still sells CDs for $15.00. The specialty stores still sell CDs for $18.00. Online stores still sell songs at $1.00 (approximately $10.00 a for a crap-quality, fair-use-crippled, no-production-or-distribution-cost album). No price fluctuations at all. No alternate pricing models tried. No one tried to boost sales by reducing price. The crime (price-fixing) is obviously continuing, consumers (society) continues to suffer, and the lawyers are slightly richer.

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Post by Peijen »

As much as I don't trust or like government I would have to agree with George on this one. The lawyers are benefitting greatly from these lawsuits while pretty much everyone else is getting screwed.

George
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Post by George »

The government is untrustworthy, politically motivated, and inefficient. Yet, they are the only organization capable of acting without a profit motive. The government does (in my opinion) an adequate job of enforcing the criminal justice code. Murderers, rapists, burglars, etc, are prosecuted and punished often enough that crime doesn't run rampant, even though noone makes any money through the prosecution.

Imagine for a moment that we tried to expand Neal's idea of private, commercial prosecution to the criminal justice system as a whole. Now, what happens if a beggar kills someone. Who's going to prosecute them? There's no profit. Besides, you can't inflict any financial punishment on them since they're already destitute. You can't sue for what they don't have. Similarly, if a gambler or day trader is unlucky, they could very easily be wiped out. Suddenly, there is no deterrent from them going on a killing spree in retaliation for their bad luck.

Deterrents only work when the wrongdoer believes that they personally will be affected. Punishments that hurt the wrongdoer's employees or customers won't deter the wrongdoer.

Jonathan
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Post by Jonathan »

Civil law is crazy. Here's another example:
Although Microsoft originally sued Lindows, it will pay the smaller company $20 million as part of the settlement, according to the settlement agreement filed with the Securities and Exchange Commission.
Bill: Hey, that's ours!
Michael: No way!
Bill: Lawyer!
Michael: You do realize that windows was a generic term before you named your operating system?
Bill: You do realize that you're a tiny company without enough cash to win through litigation?
Both: Um.
Bill: How about I give you $20 million and this all goes away?
Michael: Sounds good to me.
Both: Sucker.

I ought to start a Linux distribution called Jindows and collect my $20 million.

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Post by skanks »

George wrote:Imagine for a moment that we tried to expand Neal's idea of private, commercial prosecution to the criminal justice system as a whole.
I'm not suggesting we abandon the criminal justice system. I will even attest to the general effectiveness of criminal law.

What I am arguing is a class of crimes that require a great deal of research and a great level of expertise to prosecute. Exclusive reliance on the government to prosecute these crimes is not going to provide sufficient protections for people. Corporate crime is too complex, too diverse, and too widespread for government agencies alone to contain it.

Consider two cops on a typical Albuquerque homocide case:

Cop 1: "Young woman got murdered. Twenty-five years old."
Cop 2: "Hmmmm. Maybe the boyfriend did it."
Cop 1: "Where do you think he is?"
Cop 2: "Let's check the parents' house."

Suspect found covered in blood. Case closed

Point being that 95% of criminals are caught because they are stupid, impulsive, panicked, deluded, sloppy, or rushed and have almost no foresight or planning or money or friends. Another 4% are caught because of their stupid friends. Our law enforcement bureacratic apparatus is effective because the job is more-or-less straightforward. And when the job isn't straightfoward (eg: a sniper on the loose) then our law enforcement really isn't that effective.

Also consider the IRS. Experts estimate that we are only recieving about 2/3 (or something like that) of the tax revenue we should be recieving. The IRS should be auditing people left and right. Problem is, the IRS doesn't have the resources to do it. Modern accounting scams are so complex and involved that it takes an immense amount of work to prove anything. The IRS knows they are surrounded by crime (particularly by the wealthy and corporations), and they are unable to do much to contain it. I would hate to rely on an IRS-like organization to represent my complaints before court.

(There's an additional issue with the different standards of guilt for criminal and civil cases).

About the Recording Industry: I do believe that the recording industry is (legally) operating on at least an implicit level of collusion and price-fixing. That said, I think the lawsuit did provide an additional deterrant against explicit price-fixing. Futhermore, I never claimed that punitive damages were 100% effective, I just claimed that they were a necessary component of deterrance. Finally, I don't understand this idea that customer is the victim of the lawsuit. If your company needs to raise prices because they got sued, then switch companies. If you don't switch, then you have made yourself the victim. This is also true with the recording industry which a) doesn't produce a necessary commodity and b) is rife with competing small-time labels. Yes, most of the stuff on small-time labels is shitty, but so is most of the stuff on big-time labels. So find a small label you like, or buy your music from the bands directly, or have your friends burn you copies of their CDs, or start your own band, or just pirate your music off the internet.

George, you claim that personal consequences are necessary for a true deterrant against committing corporate crime. I disagree. Our economic understanding is that the behaviour of firms is driven by the maximization of profit. Consequently, only economic penalties can dramatically alter the behaviour of firms. Enforcing criminal penalties against corporate leaders may put a lot of people behind bars, but if it doesn't cut into shareholder returns, its not going to have a sustained effect.

Jonathan
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Post by Jonathan »

It is estimated that roughly 90% of Americans pay their federal income tax. I have not seen figures describing how much tax is collected versus the amount the IRS expects.

Here in Oregon, Multnomah County was expecting $128 million in tax revenue and came up short by $30 million, but that's an extreme case.

http://www.katu.com/news/story.asp?ID=66424

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