You ask me for a contribution

I have the greatest clients. I hope my whole career goes like this. Today I buttoned down the world’s longest escrow. The first lender was an absolute assclown. This dumbass would go 10 days and all we’d hear was crickets. I’d call and say “Excuse Mr. AssKlown, how are we doing?” And he’s say the same thing he said 10 days earlier. This went on for 70 days until he finally quit/left/might have been fired and someone else in the office took over the file. In two days they told us the loan was declined, not because of my stellar client but because of their ignorant underwriting practices. So here we are 108 days into a 30 day escrow and today he finally signed the loan docs provided by my loan guy who stepped in and saved the day. Suffice it to say, I’ve spent a lot of time with this particular client.

He’s a Doctor. Like a physician. He teaches at a teaching hospital I believe. Wicked smart man. He understands escrow and loan documents. And he likes me. We were having a cuppa today after the signing and he asks me what I think about the health care system. I had only ordered a grande, we were in trouble. I’ve had numerous discussions on the subject, some of the most interesting with the Brother. As an attorney he said that we needed to remove the health care system from the tort system, or something very similar. Personally, I’ve thought that the problem is the insurance companies. As exhausted as I was, once a real Doctor asked me that question, I was awash in clarity. We need to remove the tort system and the insurance companies from the equation before we are going to see any real reform in the health care system in this country. <—who said that? He laughed and said I was dreaming of Utopia. Then he asked “Fair enough, what do you do with bad Doctors?” I was worn out. Burn them at the stake was not the correct answer. It was just something I’d heard on the radio this morning in reference to the Salem witch trials. I probably would have mulled this over for a few weeks and really come up with not much of anything. But a funny thing happened on the way home. I’m going on a very tough ride tomorrow (map below) and before I do a really tough ride I like to have the same thing for breakfast. A whole wheat waffle made with egg whites and fat free cottage cheese (double your protein pleasure) with blackstrap molasses on it. Don’t ask. It just makes me happy. I was out of molasses so I stopped at Whole Wallet Foods in San Ramon on the way home. At the corner of Bollinger Canyon and Camino Whateverthatlittlestreetisnexttowholefoods there was a gaggle of protestors waving signs complaining about Obama’s perceived socialism and the proposed health care reforms. And of course American flags. Ass monkeys. Now I had a good Friday night traffic jam to sit in and stew about health care reform. Because no one in San Ramon has lost their health care because they lost their jobs. No one in San Ramon pays $1300 a month to insure their husband and small child because they’re the only family member working. No one in San Ramon is forced to pick between their medicine and food. San Ramon is full of insurance company employees and attorneys and folks that suck the current health care systems teet. Why would they give a damn about any one else on the planet? They carried signs that said we should call McInerney to complain. Unfortunately not one of them is smart enough to know that McInerney might be the smartest man in Congress. He’s a total geek. How would you like to be the smartest man in the room and the room is the Congress of the United States? Probably also the loneliest. And I’m thrilled that an intelligent man upset that grifter Pombo. Just a bunch of shit asses with signs.

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So you want real health care reform? Remove insurance companies from the equation. It’s that simple. Doctors no longer have to fill out forms. Patients no longer have to figure out if it’s covered or not. It’s not. Either you can afford it or you have to go see a government Doctor. It’s like anything else. Set your priorities. If you’re stone broke, not a problem, the State will provide you health care. If you can afford a private Doctor, great. Go hire one. If you want to join an HMO, great. If a Doctor commits malpractice a complaint is filed and they go before the Doctor Tribunal. Remove the wrong kidney? You’re voted off of the Doctor island. Your lantern is snuffed out and you leave your license with the concierge on your way outta there. Minor stuff equals revoked privileges for shorter periods of time. The board consists of intermittently either four or five attorneys and either four or five Doctors, for fairness. There’s a review panel that gets you to the infraction board. If you make it to the board, not good. All this is reported and available on a website. Doctor Feelgood gave the King of Pop too much happy juice. License revoked. It’s that simple.

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Insurance company profits topped $60 BILLION dollars in 2008. There are over 307 million people living in the U.S. That means that the insurance companies PROFITED $195 per person in 2008. So every American paid $195 more than they needed to for Auto, Life, Health Liability, Liability and Casualty insurance. More than they would have if they just paid for whatever went wrong. But take all the operating costs of the insurance industry and add that number into the figure. Roughly 13 cents of every insurance company dollar spent goes to operating costs. In my case $365 per year goes from my pocket to the insurance company’s cost of doing business. That’s $560 a year out of my pocket right into theirs. Add into that all the costs that aren’t covered, like in my case the first $2700 worth of bills and it’s a freaking racket. Seriously, do you really think that the government could make it any more FUBAR that it already is? Expand Medicare, outlaw the insurance companies, statutorily and be done with it.

Next week: The drug companies.


  • dolphyngyrl

    I’m totally not sure where to go with that. On the one hand, I completely see your point. On the other hand, as a broke ass state worker, I don’t even want to know what the next couple of months might cost me if I was paying out of pocket. Having been on MediCal (in a prior life, I think), I can tell you for sure I wouldn’t want to have to do that again. SweetPea has Medicare because of disability, but she’s also on my Blue Shield, so she doesn’t have to go to the back of the service bus.

    I think your idea might work, but there’d have to be some way of maintaining equity of service. If doctors make more serving cash patients, what’s their incentive to serve government insurance patients? Then, if all services are equal, what’s the incentive for people who CAN afford to pay to actually do so when they can just get the same thing for free?

    Also? We already have people that investigate and discipline for licensing violations of medical professionals. And not just those quacks out at Board of Registered Nursing.

  • Wine Dog

    They’re not going to be equal. And it doesn’t need to be equal. It’s kind of like owning a car. I don’t drive a Maserati. I’d like to but I can’t afford one. So I drive an eight year old BMW. It’s a safe car and it gets me where I need to go and sometimes I have to throw some money at it. And that’s life. I may have to take the bus, but it’s safe and it gets me where I need to go.

    If Doctors aren’t paying all sorts of insurance because the tort system is removed, their cost to you comes down. Way down. If they aren’t paying staff or services to deal with the insurance companies, their costs go down. If the cost for all kinds of insurance is removed from the equation everything becomes more affordable. My acupuncturist won’t play the insurance game. She’ll give you a bill with the right codes on it but she doesn’t jack up or discount for insurance companies. She has sliding scale for ability to pay. When things were bad, I paid the low end. Now I pay full pop. I run out of cash again, I pay what I can. That’s how she choses to run her business.

    Doctors can run their business how ever they see fit. Just like anything else there will be ones that want to help a certain community and they will charge accordingly. It’s a transaction between the consumer and the provider.

    And I’m talking about beefing up the State boards to review more like an appellate court. Taking juries out of the pictures. You have to eliminate the people sitting their going “God, I’d want $3 million if they did that to me”.

    It’s not like the VA hasn’t been providing medical services for years. It can be done.

  • dolphyngyrl

    How many people do you know have died because they didn’t get good health care? Not for lack of insurance, not for lack of going to the doctor, but because the medical professionals they were seeing didn’t do as good of a job as another doctor somewhere else might have done?

    Or the insurance company that dragged their feet for so long before approving an organ transplant that the approval finally came through four hours after the patient had died.

    How many people do you know that could afford to pay for an organ transplant out of pocket?

    And the VA? Are you kidding? Have you heard the stories about VA health care?

    Also, here’s a fun fact: some health care professionals, by virtue of working at VA, aren’t beholden to licensure at all. I have no idea how many professions that applies to, but because of the nature of VA, there are certain health care professionals who are not required to obtain state licensure in order to preform services while working for VA. So then what happens when there’s a problem?

    How many doctors, do you think, would be as noble as your acupuncturist?

  • The Brother

    M-kay, I’m not completely following the discussion above, but let me say I’m not for entirely obliterating the tort system, nor is that a reasonable option in the U.S. What I have said is that given that the reality of most PI cases is that an inordinate amount of time and money is spent shifting money between insurance companies, and the process of shifting that money is an extremely costly one. That process pays for Loki’s kibble, and let me tell you the attorneys aren’t the most expensive part of litigation. For example, doctors charge 500-1200 per hour to be deposed, and their lobbyists got them a special statute to allow that.

    Tort reform, as well as a system of universal coverage, should go hand in hand, although if there is universal coverage, one would think that tort reform would logically follow. If health care were covered for all, what benefit would there be in suing for medical damages or future meds (which are frequently speculative at best?) Likewise, if there were a REAL disability system, what benefit would there be in suing for future lost wages? I could tell you so many stories about cases that settled or were tried, where the plaintiff got a huge payout for futures and the day after settlement received a miracle cure (like the SFPD motorcycle cop who could never be a cop again because of chronic pain, and was seen 6 months later by the attorney who settled the case at Candlestick, RIDING A FRIGGIN’ HORSE IN THE MOUNTED POLICE UNIT.

    I’m in the mood to put my opinions in a full on rant, so stay tuned…. meanwhile, if you didn’t see Olberman last night google rep Wiener’s amendment seeking to kill medicare – the opportunity for Republicans to put up or shut up. I think I love that guy.

  • The Brother

    ok, that could have used a little editing. The “given that” clause was supposed to be followed by second paragraph, probably without a period. Whatever.

  • Wine Dog

    Ok, I could go for tort reform. And I forgot about the lobbyists last night. So that 13 cents probably just soared to 23 cents.

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