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uclayoda87 (30.66)

President Obama why stop at Health Care Reform?

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October 11, 2009 – Comments (13) | RELATED TICKERS: SCI , USA

Those who advocate President Obama's Health Care Reform should have no difficutly supporting Legal Industry Reform, since both health care and legal care are now considered a right without responsibility.  If President Obama is convinced that Health Care Reform is needed, then he should expand it to include Legal Industry Reform in the same bill, which would provide the template for reforms across multiple other industries such as Banking, Finance, Movie making, Professional sports, other entainment, etc.  It won't happen, but there is no logical or moral argument why the legal industry or any other profession should be exempt from the process of Reform that the President and Congress are proposing.  The article by Dr. Rafal sounds a little silly, especially to lawyers, but this is the world that the medical profession currently lives in.  If you think this is sane and reasonable, then encourage your President, Representatives and Senators to expand Reforms so that everyone could benefit from this enlightened state of being.  If you think that only the health care industry deserves this treatment, consider that the government thought it knew what was best when it helped out the auto industry or the mortgage industry (remember President's Bush's ownership society).  Our government has not been blessed with the wisdom of Solomon, instead they have to rely on the rants of Pelosi, Reid, Frank, and Obama.


WSJ OPINION


SEPTEMBER 3, 2009, 10:55 P.M. ET

A Doctor's Plan for Legal Industry Reform

My modest proposal to rearrange how lawyers do business.

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.

13 Comments – Post Your Own

#1) On October 11, 2009 at 2:35 PM, DarthMaul09 (98.56) wrote:

Cost savings would be dramatic with legal industry reform, but GDP would go down and unemployment would go up.  And what would we do with all those unemployed lawyers?  At least auto workers could go into other types of manufacturing, if we had any, what would lawyers do?

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#2) On October 11, 2009 at 2:44 PM, uclayoda87 (30.66) wrote:

DarthMaul09

The same thing that unemployed physicians, nurses, x-ray techs, other lab techs, medical assistants, billers and other people who will soon be unemployed from the medical field, collect unemployment.

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#3) On October 11, 2009 at 5:56 PM, kristm (99.75) wrote:

If we had as many doctor congressmen/women as we have lawyer congressmen/women health care reform would be as dead as Ted.

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#4) On October 11, 2009 at 6:59 PM, MichaelinWA (87.54) wrote:

We already have universal health care. It's called the emergency room, and we all pay for it.

Comparing health care, lack of which can lead to death, to legal representation (which a defendant already has) is sort of absurd.  

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#5) On October 11, 2009 at 10:14 PM, uclayoda87 (30.66) wrote:

MichaelinWA

In the extreme cases, lack of health care can lead to death or disability while a lack of legal representation may lead to a loss of freedom.  In your first sentence you point out correctly that we already have a universal health care safety net called the emergency room, like we have a legal safety net called public defenders.  Neither is ideal in all cases, but it does provide some level of protection.  The current health care reform is more about social engineering to fit a political ideology, which does not appear to consider the potential harm it may cause.  Just like President Bush's ownership society suggested that everyone could own a home, it didn't take into consideration that the risk of ownership was too great for some, who eventually saw what equity they had evaporate as they lost their homes.  We may be forced to live through another failed government plan, but the consequence of losing the access to care that we now have will not be tolerated well by the aging baby boomers who are nearing retirement.

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#6) On October 12, 2009 at 1:07 AM, ajm101 (38.70) wrote:

Here's the transcript of the Portsmouth town hall.  The President literally said nothing about physicians' preferences of treatment vs amputation, but he said that both should be reimbursed:

"All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be.  Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance.

But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed.  Well, why not make sure that we're also reimbursing the care that prevents the amputation, right?  That will save us money."

 http://latimesblogs.latimes.com/washington/2009/08/obama-healthcare-transcript-new-hampshire.html

I am curious about one thing - the issue on the table is reforming the health insurance industry.   Why is that being deliberately distorted to make it seem that the medical profession is being reformed?

 

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#7) On October 12, 2009 at 1:53 AM, AlexanderAkhavan (< 20) wrote:

With regard to MichaelinWA comment, there is a phrase I read once.  In spite of the best medical care, the death rate in the United States is still one per person.   Its a different way at looking at things, but spending money with a cost is no object mentality is going to bankrupt, and to a certain extent already has, this nation.  People need to get out of this death denial state that they are in.  We cant prevent death, but we can try to prolong peoples lives as much as possible with a good quality of life at a reasonable cost.  We need reform the system to avoid without bankrupting this nation and leaving unaffordable debt to our children.

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#8) On October 12, 2009 at 3:58 AM, ozzfan1317 (< 20) wrote:

To those opposing health care reform I will just assume you are wealthy. If you had ever been poor you would understand how it is nearly impossible to get medical care unless you are middle class or above.

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#9) On October 12, 2009 at 4:39 AM, kristm (99.75) wrote:

In 2004 I was involved in a very serious auto accident that resulted in a badly broken neck. Despite the fact that I was working in fast food, lived with my parents, and owned little more than a car (which was destroyed in the accident) I received top-quality care, including surgery that hadn't been available for many years performed by one of the few quality neurosurgeons in the area. I made a full recovery in less than four months, but the total bill ended up being north of $90,000. I had no insurance except for what was on my vehicle, a plan that included $10,000 of personal injury coverage.

I came out of the hospital expecting to go bankrupt, anticipating that I wouldn't have a penny to my name for years to come.

The hospital got the $10,000 from my auto insurance and then wrote off about $60,000 because of my low income. The rest I managed to pay off a bit at a time using my small savings and as I could. At this point, some 5 years and two months later, I owe only about $4,000 to the neurosurgeon, and I gladly write him a check each month for $75.

If I lived in Canada, the UK, Cuba, China, or anywhere in africa, south america, or the middle east I'd have been written off and would now be either dead or quite paralyzed from the chin down.

God has blessed America and all her citizens. I pray He will stop those intending to destroy what's left of Her. 

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#10) On October 12, 2009 at 10:50 AM, ChrisGraley (99.69) wrote:

He's not planning on stopping.

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#11) On October 12, 2009 at 2:19 PM, kristm (99.75) wrote:

No, he's not. But he isn't omnipotent. He doesn't know what the future holds. The congress could turn against him, he could have a 180 degree change of mind, or he could fall over dead from a stroke. The best laid plans of mice and men... I just pray he won't succeed, for whatever reason.

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#12) On October 12, 2009 at 2:39 PM, vrpirata (< 20) wrote:

Kristm. I went through a similar situation before I started living here in the USA. I know how you feel. However, because it happend in my previous country, I had to pay nothing. As a person that have experience other-country health care system, I can tell you that our health care system here in the US is really bad, we not only score really low when compare to other countries, we also do it by spending the most as % of GDP.

 We hear a lot of how bad waiting times are in Canada. Latest surveys have shown that yes, Canada ranks the worst in waiting times. However, we rank just before them. Every other western country (but Canada) had lower waiting times for surgeries and etc.

 People, wake up. Don't believe the lobbiest lies. Do your own research. We have a very expensive system with bad service, period.

 The answer to our problem is already being used in other countries. There are plenty of countries that have better health care systems for less as % GDP.

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#13) On October 13, 2009 at 4:27 AM, uclayoda87 (30.66) wrote:

  vrpirata

When quality doesn't matter getting something for a lower cost makes sense.  Can you guarantee that the changes being proposed by the Congress and the President will improve quality and access to care?  No.

I can guarantee that access to care will go down when there are more people waiting in line, lower reimbursements and draconian penalties for "over utilization of care".  These are clear incentives for physicians to adopt a European style of practice, 30 hour work weeks.  Physician can adapt to the new paradigm, but the expectation that fewer working hours for physicians will result in improved access to care for more people is unrealistic.

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