Tort reform. Little original content.

[jazzfish]

Scare tactics [by way of the incomparable Rivka ages ago] is probably the best of the articles I've found; it's got a decent chunk of linkery going on as well. One of those links goes to the Snopes page on tortuous torts, which itself contains a link to a description of the much-touted McDonalds coffee case.

On the medical side, rain_luong's got a Bob Herbert editorial from June, Sadly, No! pokes holes in Judson Cox, and Jesse "No Relation" Taylor of Pandagon does the same to today's Moonie Times article. And of course lots of doctors who have problems with malpractice insurance aren't the most reliable practitioners of medicine. To quote Kevin Drum again, "maybe ambulance chasing lawyers aren't the biggest cause of malpractice suits after all. Maybe malpractice is. Just sayin." Update: and, in a striking case of finding my own bloody links instead of scraping them from other people's blogs, the Charleston Gazette ran an interesting series of articles on malpractice back in early 2001.

Which isn't to say that there aren't frivolous lawsuits. I seem to recall Fox News launching one against Al Franken last summer. But, like the Fox News lawsuit, or the case of the kid who tried to get a Harrier jet out of Pepsi, most of these cases are dismissed quickly.

The first person to use the words jacuzzi cases will be treated in the same fashion as the first person to say first and fourth most liberal senators or voted against the $87 billion to fund troops in Iraq [follow the link, then do a find-in-page for 87 billion] in my presence. I'll even say "please" and "thank you."

Comments

[jazzfish]

Editorial [fixed link here for future reference]: 1 and 2 [changes in medical profession regulations] may have some potential; it's not something I know enough about to say. 3 [drug patents] I don't think is an issue. My understanding of drug patent law is that it's among the least broken of the patent laws. I know that there were Prozac knockoffs within ten years of the drug being released to market; I think there's some funky timing on the 17 years thing. And the basic argument for patents [preserving innovation: it costs way more to develop than to copy, so the developers have an incentive to develop by having an exclusive license to sell for several years] applies to drugs as well as to other things.

As 4, 5, and 6 deal with tort reform I of course consider them to be crapulent. :) 7 [no-sue clinics] scares me an awful lot, as I imagine they would attract doctors like the 40 from WVa.

8 [kill the FDA] I don't know about. 9 [kill the pharmacists who have to read labels to you] I disagree with, on the grounds that the elderly and illiterate probably find it to be a valuable service, and no one wants to have to ask to have something read to them.

10 [publicise medical prices] isn't a bad plan, and neither is 11 [more grants for medschool]. 12 [increase public awareness of free resources] sounds good as well but I don't know if it really belongs as part of "the solution to the health-care crisis." Maybe.

13 [nat'l health database] scares the bejeezus out of the privacy advocate in me. 14 [legal suicide], on the other hand, I wholeheartedly support.

And then 15 [lowered premiums, more out-of-pocket expenses]. Hoo boy. This is at the heart of this guy's reform plan, and is where it all falls apart for me. Sometimes you /do/ need the CAT scan when you've been having sudden headaches; not often, but sometimes. It could save your life. His comparison with housing is utterly bogus: basic housing services keep you alive at a more or less fixed cost, but medical gets more expensive depending on your problem. And his final argument "If people are forced to pay more out-of-pocket for all health care, they're more likely to exercise, eat right, and practice preventive medicine, all of which are vastly cheaper in the long run" obviously doesn't apply to the current legions of the uninsured, so why would it apply to everyone else?

Drug Patents

[jonny-law.livejournal.com]

I only understand the process from the technical side, not the legal side, but from what I understand the patent is filed as soon as the high-throughput screening identifies a compound that causes the desired effect. A few years are spent designing a synthesis, and hopefully one that is amenable to industrial-scale production. It then goes through years of safety and efficacy testing, all while under patent, and then finally emerges on the market for sale. Thus, the "17 years" are not from entering the market place, but from discovery of a target compound. The time put in figure out how to make the drug and then test it all count against the patent.

An analogy would be if a book's copyright lasted around 5-10 years, and was filed when the author started writing the book instead of being published. Thus, time at the editors, or time when the publisher sits on the book for a better release date counts against the time that the author will be collecting royalties. Or for films, 5 years from the time that someone has optioned a script.

If you wonder why drugs are so expensive, look at why books, music, and movies are so cheap.

[jonny-law.livejournal.com]

1. When you arrive at the emergency room with your bone poking through your skin, are you really going to stop to ask to see your doctor's credentials? Also, HMO phone banks with scripted people not disclosing they have no training beyond following a dialogue tree.

Simply put, it is a tax on people's time to do the necessary research to "shop around" for the best doctor. If you want to spend more time shopping around for the best doctor, if you can spend more time shopping around for the best doctor, you're probably already in a pretty secure position, health-care-wise and class-wise. Also, actually understanding that research undoubtedly favors the better educated, and we all know what education correlates with.

2. Hospitals have trouble maintaining enough specialists to staff an emergency room as it is. Do you want more specialists being paid to be on-call? Or maybe higher-paid multi-specialists. You know who will pay for that.

Also, back before doctors were graded on patients-per-minute, they could actually look up a patient's history to see if any patterns emerge beyond the symptoms of the day. Further dividing health into specialties will disincentivise that kind of overview, if deregulating education doesn't.

Finally, unless we create that scary liability-free medical care, the doctrine of defensive medicine means you will spend the whole day seeing 10 doctors for 5 minutes each to get a check-up.

8. Killing the FDA is already underway, just like killing the IRS. (Right now it's being increasingly funded by fees charged to drug makers.) Like any most attempts to reduce "waste," ie. regulation that protects Small Citizen, this will allow violators to get away with more and have little effect on the people already following the rule of law. See also, doctor certification.

Most drugs are produced by small pharm companies, where one unsuccessful drug will shut it down, say one that is promising up until it's injected into a human at the last phase of testing and is unexpectedly inactive. This will just delay their acquisition by GlaxoWellcome-SmithKlineBeecham-Pfizer until after the drug has proven safe.

Drug companies are run by investors who want to see a good rate of return. Xerox-, Enron-, and Worldcom-style events are rare, but when they happen they are Big. Wasn't one phthalidomide enough?

9. I can't shake the feeling that "waste" is any service that I don't need to use right at this moment.

10, also 1. Price =/= Quality.

12. Hypochondriacs rejoice. I just read this pamphlet about Conservatism, so let me lecture you about something you've been studying for years or decades. Also, let tell you what your deeply-held beliefs are.

13. One of my new mottos is "Social Conformity is a small price to pay for Universal Health Care." This is one point where I agree with Nixon.

Life without the FDA

[jonny-law.livejournal.com]

If you want to see like without the FDA, check out the current problems with "dietary supplements," such as ephedra-based drugs being manufactured by Herbalife. These are marketed like a drug without any of the "burdensome" regulations that require testing to ensure that it is safe and efficacious. Sure, the FDA will act once the product is proven unsafe, such as causing people to die or suffer from serious health complications. However, the only one possessing complete statistics on the safety of the product is Herbalife, and they have not been forthcoming with this information. Futhermore, there's no proof that the problems weren't caused by external factors, since there has been no FDA-approved testing of the drug; people taking the drug to self-medicate are probably prone to health complications from pre-existing conditions.