Saturday, September 12, 2009

If Lawyers Are Going To Regulate Medicine...

I found this ironic, funny, and sadly true. In going back to school, I find the science people are generally more direct and precise in their words; wordy types who end up being lawyers twisters, using abject truth to fit their current need.

ObamaCare - a lawyer, twisting the words of truth to fit his own needs and encouraging this country to head down a destructive path.

In my own life, I was friends with a woman from a Canada who was battling her second round of breast cancer. Her only hope for life was to get to U.S. healthcare facilities stating that Canadian health care is deplorable at best, and deadly at its worst. She went on to say that it was not because the Canadian doctors were somehow worse than those educated in the U.S. but because the patient COULD NOT GET IN TO SEE ONE. She attributed it to the Canadian socialized medicine plan and hated it. Sadly, my friend with whom I volunteered, died. R.I.P. Shahna.

My uncle is married to a Canadian and loved living in the gorgeous province of British Columbia. Throughout his life, however, he came to the U.S. for healthcare. As his health began to fail in his mid-70s, he and his wife moved south. Again, not because the doctors themselves are somehow substandard - Canadian doctors are not - but because there simply are NOT ENOUGH doctors to treat all the patients who need help on a more immediate basis.

As President Obama moves toward socialism, I have to wonder where all these extra physicians are going to come from. Substandard undergraduate students? How about those licensed in other countries (ala Europe) who cannot pass the USMLE Step 1, 2 or 3?

And if we are going to socialize medicine, then let's socialize attorneys. Because in all honesty, the lawyers I've chosen to work with caused more stress and more mind numbing pain than any doctor visit I've ever had.

The article below was in the Wall Street Journal.

A Doctor's Plan for Legal Industry Reform
By RICHARD B. RAFAL
Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation.

At a town-hall meeting in Portsmouth, N.H., last month, our uninformed lawyer in chief suggested that we physicians would rather chop off a foot than manage diabetes since we would make more money doing surgery. Then President Obama compounded his attack by claiming a doctor's reimbursement is between "$30,000" and "$50,000" for such amputations! (Actually, such surgery costs only about $1,500.)

Physicians have never been so insulted. Because of these affronts, I will gladly volunteer for the important duty of controlling and regulating lawyers. Since most of what lawyers do is repetitive boilerplate or pushing paper, physicians would have no problem dictating what is appropriate for attorneys. We physicians know much more about legal practice than lawyers do about medicine.

Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:

• Contingency fees will be discouraged, and eventually outlawed, over a five-year period. This will put legal rewards back into the pockets of the deserving—the public and the aggrieved parties. Slick lawyers taking their "cut" smacks of a bookie operation. Attorneys will be permitted to keep up to 3% in contingency cases, the remainder going into a pool for poor people.

• Legal "DRGs." Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine's Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I'm surprised lawyers don't tack shipping and handling onto their bills.

• Legal "death panels." Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you're on your own.

• Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that' s tough: What do you want for "free"?

• Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. What a wonderful way for doctors to get even with the sharks attempting to eviscerate the practice of medicine.

• Discourage/eliminate specialization. Legal specialists with extra training and experience charge more money, contributing to increased costs of legal care, making it unaffordable for many. This reform will guarantee a selection of mediocre, unmotivated attorneys but should help slow rising legal costs. Big shot under indictment? Classified National Archives documents down your pants? Sitting president defending against impeachment? Have FBI agents found $90,000 in your freezer? Too bad. Under reform you too may have to go to the government legal shop for advice.

• Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily.

• Ban legal advertisements. Catchy phone numbers such as 1-800-LAWYERS would be seized by the government and repurposed for reporting unscrupulous attorneys.

• New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.

• Collect data about the supply of and demand for attorneys. Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.

• Lawyer Reduction Act (H.R. -3200). A self-explanatory bill that not only decreases the number of law students, but also arbitrarily removes 3,200 attorneys from practice each year. Textbook addition by subtraction.

Enthusiastically embracing the above legal changes can serve as a "teachable moment" and will go a long way toward giving the lawyers who run Congress a taste of their own medicine.

—Dr. Rafal is a radiologist in New York City.

1 comment:

Cecil said...

This does put things into perspective a bit doesn't it?

The concept of insurance in and of itself has been the biggest contributing factor in the public perception of medical care as a service to which they are entitled.

It is not that physicians are uncaring, but why can they not expect the same rewards for providing a service than any other business?

The argument, as I see it, is that everyone has a right to live; therefore, everyone has a right to healthcare regardless of their ability (or want) to pay.

This argument necessarily requires physicians to become slaves to the needs of the populace. I wonder if it will be possible to set up a private practice that does not accept insurance. I would base my fees on tangibles - overhead, cost of doing business, labor, etc. - and charge accordingly.

This model would provide incentives to the physicians to perform at their best and for patients to be conscientious about the services they request. After all, they are PAYING for it.

Their neighbors will not be obligated to subsidize their treatment via a group plan where the healthy are penalized for the cost of the sick.

Intermediate bureaucracy would be circumvented, thereby allowing the physicians to lower the cost of operations, and pass the savings on to the patient.

Now, I know that there will be those who will attempt to take advantage of the system, but how does that differ from what we already have? At minimum, there will be fewer sharks in the tank.