Health Care Reform – Seen through the eyes of the typical American Citizen

When suits like this are initiated the insurance companies have to hire or pay their lawyers to defend the doctors in these law suits, and the never ending circle of legal chicanery continues in perpituity. The lawyers have us all caught in a no win situation. They sue doctors and file frivolous suits, then they demand that people have rights to file these suits in order to protect themselves. Certainly no one would argue that people have such rights, in fact they do and should, but only in real cases. Not cases initiated simply to acquire money, and argued with a paid expert, paid witnesses, paid examining physicians, and sometimes plaintiffs who are simply lying.

Filing so many frivolous suits and so frequently, the legal profession has become a major contributing factor to the exceptionally high malpractice insurance fees that doctors have to pay. Thirty years ago if I wanted to see my doctor, he would show up at my home and charge me a fair price to see me. Now I cannot see him or her without first having insurance. I is absurd.

So we say, let’s start this medical cost reform with a healthy dose of tort reform. Let’s have recourse on attorneys who file frivolous suits, let’s have tort reform where doctors can sue attorneys for any lawsuit they file which the attorney loses and where the doctor was found to have committed no wrongdoing or malpractice. Certainly if the initiated suit discredits the doctor or puts them through unnecessary legal action, then the initiating attorney should be held accountable. Let’s start there and see how dramatically these frivolous suits drop off.

As for the next aspect of rising health care costs, the problem comes when the public and/or certain organizations that assist the public, abuse the system. You may ask; How does this happen? Let’s take a look at real life example of this. Sleep Apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal (a 3-second or greater shift in EEG frequency), a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a “sleep study”. This condition can lead to high blood pressure, heart problems and conditions, and in extreme cases even death.

Treatments include wearing a mask conencted to a machine (Called a CPAP machine) which blows air through the nose or nose and mouth thereby maintaining an open airway and eliminating the apnea’s. The CPAP machine, mask, and accessories can cost from a few hundred dollars to a couple thousand dollars. When one is diagnosed with sleep apnea and a CPAP prescribed, one’s insurance may cover the cost of the machine and accessories. However, in many instances the insurance companies are forced to significanlty overpay for these devices for their insured individuals. The reason is that many of the suppliers also sell this equipment to medicare or medicaid patients. In doing so, they charge them the maximum allowed for a machine by those programs. Still, the program rules are that if they sell to medicare or medicaid patients at a specific price, then they are not allowed to sell at a lower price to others, else they risk losing their ability to provide to medicare or medicaid patients.