The babyjesuschristsuperstar on Board: filling the moral void of Clinton’s legacy

[Mmmm, Burger (C.J.)]

Originally posted by Replaced_Texan


And why weren't you watching one of the best college football games ever played?

For how long is Pete Carroll going to be second-guessed for not punting from the Texas 45. I just don't see how it makes sense to give Texas only 55 yards to go for the win. Not saying Texas didn't win it (that option pitch with the knee down in the first half not withstanding)--just saying.

[soup sandwich]

Originally posted by Mmmm, Burger (C.J.)
For how long is Pete Carroll going to be second-guessed for not punting from the Texas 45. I just don't see how it makes sense to give Texas only 55 yards to go for the win. Not saying Texas didn't win it (that option pitch with the knee down in the first half not withstanding)--just saying.

I had no problem with this decision. Both offenses moved the ball at will in the second half and USC was scared to death to punt and let VY have the ball again with 2 minutes to go. Carroll, with the best offense in the country at his disposal, needed to gain two yards to win the National Championship. I thought it was a good decision.

What drove me nuts was Carroll's decision to go for it on 4th and 1 from the Texas 17 in the first quarter. Kicking the damn field goal puts you up 10-0. How is this a bad thing? Jimmy Johnson made the same mistake in 1987 against Penn State. Take the early points! To go for it so early in the game is just plain arrogant.

But if I were a USC fan, I'd have to strangle the guy who called the timeout before the two-point conversion. Simply one of the stupidest decisions ever made in a game. The offense needed that time out so badly during that last desperate drive to get into field goal range. What a shame.

That being said, what a great game. I'm ambivalent toward both teams, but this was the best game I've seen in a while.

[sebastian_dangerfield]

Originally posted by Tyrone Slothrop
Future generations will have to pay either the principle or the interest, Spanky. You can argue that the debt won't be crippling -- I didn't say it would be, so I'm not sure whom you're arguing with -- but you can't say it won't exist. If you spend money today, and borrow to do so, you create a liability to be borne in the future. This administration is fine with this, because future generations are politically underrepresented just now.

Well, I agree that Bush should not be spending as he has. But the counter is that if we don't spend in the middle east now, we'll spend 10X more later, when we lose total control of the oil producers over there.

[Don't talk to me about developing new fuel sources. That's a solution for 100 years from now, utterly impractical to solve current energy dilemnas.]

But one point you seem to dodge is whether we should be shrinking the govt. Do you think that (1) we should stop borrowing and lower taxes at the same time; OR, (2) that we should fund a big govt with ample tax revenue?

If you think the latter, I say "fuck off, I'll take my money now and bet its returns over the next 100 years will more than cover the debt service you project will sadlle us."

I don't like guessing about super-long-term projections, since there are so many damned variables - particularly when we're talking about glabal economic events. Whatever puts the most cash in my pocket right now gets my vote. Call me a cynic. Call me a simpleton. Whatever. If you're as informed and armed with rock solid stats as you claim, you'd be retired with millions, not posting that info on a fucking chat board.

[sebastian_dangerfield]

Originally posted by ltl/fb
So, if you can't blame lack of tort reform in CA, what are you arguing now?

Doctors are, overall, whiny, cheating bastards. Just like lawyers. Always, ALWAYS getting involved in tax scams. It's fucking ridiculous.

2. I've only repped a few docs and med partnerships, and I've come away each time feeling like I need a really long shower. I think docs are generally decent people, but they always get roped into scams by their partners who are more business oriented and trying to figure out how to exploit their medical licenses for obscene profit (PI docs; self-referrers, etc...).

[Sidd Finch]

Originally posted by Spanky
Reregulate insurance companies, force the AMA to police its own, and mandate aggressive reductions in preventable errors in hospitals. Any or all of these will reduce malpractice awards - and the last two have the additional benefit of increasing the quality of health care."

On a recent plane ride, I sat with someone who had been involved in devising a self-policing program for one medical specialty. That specialty -- anesthesiology (sp?) -- has seen less growth in premiums and claims costs than have others, even though it is a high-risk practice and even though, prior to these initiatives, it had the same or greater problems with these issues as other specialties. There was also a significant improvement in patient care.

I relate this because I wonder, why is it necessary to "force" the AMA to police its own? And who would do that forcing -- government? Please.

I also wonder -- and in particular would like RT's thoughts -- on whether the benefits of what the ana-whatever docs did is actually as significant as I understood from my conversation (and later reading on the issue), and whether other specialties have considered similar measures.

[Sidd Finch]

Originally posted by Spanky
So why aren't lawyers malpractice rates really high? Why aren't the insurance companys trying to make up for their lost income from lawyers?

Lawyers malpractice rates rose considerably after the tech bubble burst (also after the insurers faced huge increases in reinsurance costs as a result, in part, of 9/11).

Why aren't car insurance rates climbing dramatically?

Rates for car insurance and other types of non-professional insurance are, I believe, subject to much greater regulation and state intrusion, so they can't just be jacked up.

That said, I've seen health insurance rates climb and climb over the few years I've been paying for it.

[Sidd Finch]

Originally posted by baltassoc
There are several explanations that do not involve the necessity of "tort reform" and which may actually be exacerbated by "tort reform."

The medical community imposes very daunting and unnecessarily stressful conditions on many of its doctors. There is simply no reason for the length of shifts doctors are expected to work. Fatigue increases errors, but the machisimo of the profession prevents reform.

Physicians (like lawyers) are remarkablely reluctant to discipline their own until way, way too late. Most claims come from a small minority of doctors. Medicine needs to recognize problems with practicioners sooner, intervene sooner, and yank licenses sooner.

Physicians are simply not paying enough attention. 25 years ago, anesthesiologists had some of the highest malprace insurance rates; now they have some of the lowest. The difference: anestesiologists collectively undertook to study why and how errors were being made and took steps to prevent them as a profession. Why haven't other doctors done the same? Because its easier to bitch about lawyers than to actually fix what's wrong and stop killing people.

Aargh!!!! STP!!!

I'll be quiet now, for awhile.

[Sidd Finch]

Originally posted by Spanky
What does this show: that Tort reform worked to reduce the growth rate. If a little Tort reform reduced the growth rate then more tort reform could stop the growth rate completely or even reverse it.

Brilliant! And if we just make doctors immune from all liability, then insurance costs will disappear!!!

[Sidd Finch]

Originally posted by Spanky
Listening to anything trial lawyers have to say about Tort reform is like taking Pat Robertsons advice about how to protect the integrity of science in the class room.

Good point. You can only get an honest assessment about the benefits and drawbacks of tort reform by listening to industry groups and insurance carriers.

[ltl/fb]

Originally posted by sebastian_dangerfield
2. I've only repped a few docs and med partnerships, and I've come away each time feeling like I need a really long shower. I think docs are generally decent people, but they always get roped into scams by their partners who are more business oriented and trying to figure out how to exploit their medical licenses for obscene profit (PI docs; self-referrers, etc...).

OK, but the partners are doctors too. . . .

[Hank Chinaski]

Originally posted by ltl/fb
OK, but the partners are doctors too. . . .

why would anyone become an ass doctor or a Gyn?

I wouldn't want to look up buttholes all day, and I don't know what they have to do once they find something, but it can't be fun. And while gyn might be interesting at first, I bet you get desensitized and make even jaded after awhile- like Gene simmons or Wilt C. but w/o the orgasms. Plus, seeing a diseased one probably hurts the libido for days.

[Oliver_Wendell_Ramone]

Originally posted by Hank Chinaski
why would anyone become an ass doctor or a Gyn?

I wouldn't want to look up buttholes all day, and I don't know what they have to do once they find something, but it can't be fun. And while gyn might be interesting at first, I bet you get desensitized and make even jaded after awhile- like Gene simmons or Wilt C. but w/o the orgasms. Plus, seeing a diseased one probably hurts the libido for days.

To make it interesting, you and your identical twin need to start creating really whacked out medical devices to use on your patients.

[Replaced_Texan]

Originally posted by Spanky

The other two articles you cited: One by a lawyers group and the other by Ralph Nader. When it comes to Ralph Nader, he is about as reliable on economics as Pamela Anderson is on astro-physics. Next you are going to cite an article by Noam Chomskey. Can't you cite any articles not put out by attorneys or far left organizations? If you are going to go that far why not be like Ty and cite some crazy left wing blogs why you are at it?

Texas Monthly is not a lawyer group or Ralph Nader.

One of the reasons that medical malpractice premiums are so high is that physicians, as a group, are much, much less willing to settle cases than other groups of insured. They (often rightly) see settlement as an admission of fault and worse, that they're bad doctors. They'll usually insist on going to trial unless it's glaringly, glaringly evident that they fucked up. And it's not a group that's really into admitting that they may, possibly be wrong about something. Also, settlement will end up on the NPDB, whereas taking a risk at trial may end up with a clear record as far as the rest of the world is concerned.

And the litigation is expensive. Experts need to be retained. Medical records need to be reviewed. Ever sat in on a deposition an expert going over 30 plus hours of a fetal monitoring strip? Experts costs money, the lawyers cost money, even the innocent law student who has to summarize the very boring deposition costs money.

Frankly, I'd rather focus on the 1999 IoM report which said that medical errors are the 8th leading cause of death in the United States, which I think is much, much more of an issue than medical malpractice insurance. The AAMC instituted the 80 hour rule for residents and fellows, which does help some. In June, after five years of debate, the Senate finally passed Jim Jeffords' Patient Safety and Quality Improvement Act, which hopefully will help in reducing medical errors, though I haven't seen any regs come out of DHHS yet on that bill. Additionally, the development of an electronic infrastructure for health information will help considerably in reducing medical errors. The National Health Information Infrastructure working group (with the help of the NCVHS) has been making vast steps towards this.

And I continue to point you in the direction of insurance companies if you really want to look at why malpractice premiums are increasing. And I'm not unsympathetic. I have an uncle who stoped his obstetrics practice because of the risk involved in running that sort of practice.

It appears that you and I are at an impasse. I suggest we stop the discussion while you ponder no-fault insurance.

[Tyrone Slothrop]

Originally posted by sebastian_dangerfield
Well, I agree that Bush should not be spending as he has. But the counter is that if we don't spend in the middle east now, we'll spend 10X more later, when we lose total control of the oil producers over there.

In my world, the price of oil is determined by things like supply and demand. What's your world like?

But one point you seem to dodge is whether we should be shrinking the govt. Do you think that (1) we should stop borrowing and lower taxes at the same time; OR, (2) that we should fund a big govt with ample tax revenue?

If you want to make the government significantly smaller, you need to cut Social Security, Medicare/Medicaid, and/or defense. The American people do not want this, and so the Republican Party is unwilling to do it. So easy talk about shrinking the government is exactly that.

If you think the latter, I say "fuck off, I'll take my money now and bet its returns over the next 100 years will more than cover the debt service you project will sadlle us."

What returns do you see from the programs above? Against what baseline?

If you're as informed and armed with rock solid stats as you claim, you'd be retired with millions, not posting that info on a fucking chat board.

Whoa, Sebby -- I wasn't the one posting all those numbers yesterday. That was Sidd. And I'm pretty sure he's retired with millions.

[Shape Shifter]

Originally posted by Sidd Finch
Brilliant! And if we just make doctors immune from all liability, then insurance costs will disappear!!!

Conversely, doctors could stop killing and maiming people through malpractice and their insurance rates would go down, too.