| Posted: 21 March 2010 at 6:01pm | IP Logged | 3
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Mike,
One of the big "culture shocks" when we got down here was that the number of c-sections at the two hospitals were about 1-in-4. It was just a very different way of doing business. Lynn does low-risk ob and her desire is always go vaginal unless there's weight issues or something is looking bad during labour.
That 1-in-3 number struck me as high, too, even though I pulled it from a reliable source. Pondering it for a bit, if you've had one child by section, all future deliveries are by section, so part of what's pushing that number up may be section mothers on their second and third child.
As for the importance (or lack of importance) of tort reform, there's a lot of moving pieces in the healthcare clock. The vote in congress today deals with fixes to the clock face. I'm talking about fixing gears hidden within the clock. Addressing both -- and other key parts -- is necessary to ensure the clock runs well.
Every time an ER doesn't receive payment for treatment, every time a hospital settles a lawsuit because it's cheaper than fighting it regardless of the merits, those costs get passed along to us. The bill being voted on today anticipates the reduction of about $300 billion in service payments over the next decade (one presumes predominantly by lowering fees for billings). My proposal addresses another significant cost driver. And the court system is exceptionally good at addressing the legal merit of a suit. What I'm suggesting is an impartial group that examines the medical merit, something pre-trial judges aren't very good at. Thus, we get away from defensive medicine and get back to best practices.
Of course, I realize my idea is a non-starter. Forget about any issues that the Republicans might raise. The Dems are in bed with the trial lawyers. They aren't going to bite that hand.
Speaking of best practices, one of the things that excites me about ERM is the possibility of outcome based diagnosis and treatment. Imagine your doctor being about to look at his tablet in the examine room and find out the outcome of various treatment courses from recent individuals that presented with your symptoms. (No HIPAA violation as the information is rolled up and non-patient specific.)
As for the Census... Last time I checked, there are significant fines and even possible imprisonment for failing to return your census form. The Republicans should be careful about advising people to engage in that particular form of civil disobedience. I think their efforts would be better spent winning as many statehouses as possible so they can gerrymander the electoral boundaries for the next presidential election. After all, Texas is likely to have another three seats in Congress -- and in the Electoral College -- at the expense of the northeast if population estimates are confirmed. (Assuming, of course, the Chicago Mafia in the White House doesn't cook the census books and they discover a massive unexpected population explosion in Minnesota, Illinois and New York...)
Edited by Matthew McCallum on 21 March 2010 at 6:04pm
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