Wednesday, May 07, 2008

Southern Arizona's Health Care Crisis

I'll leave it to the Citizen reporter to provide the full story on Trent Humphries' health care forum. KGUN-9 made it their lead story on the 5 o'clock news. For those who missed it, it was quite enlightening. Here are a few memorable quotes from doctor-panelists at the forum:

"Orthopedics is required in every emergency room, but we don't have coverage for the whole month."

"You're living in a dream if you think the public health department can take care of you in an epidemic. Just look at the measles problem."

"We couldn't staff another trauma center even if we had one."

"Arizona is short over 2200 doctors."

"The national average is 293 doctors per 1000 patients. Arizona has 211 per thousand."

"Malpractice insurance in other states costs half of what it does in Arizona."

"We have only one neurosurgeon trying to cover all of the emergency rooms in Tucson."

"There are only five ears, nose, and throat specialists in all of Southern Arizona."

"The Bishop died because of the twelve hours it took to get him to Phoenix as a result of not having a neursurgeon to treat him here."

"The Border Patrol drops them off to be treated. The time that the illegals are being treated, they are in the custody of the hospital, and the feds don't pay for any of the treatment they get."

"When the Border Patrol doesn't come back to pick them up after we treat them, we have to pay to transport them to wherever they need to go."

"We don't have the sub-specialists we need in emergency. It takes six hours to locate a specialist and complete all the paperwork. It takes 8 to 12 hours to transport the patient to another facility. Sometimes we transport them to Phoenix, Texas, or New Mexico. Some patients won't make it."

34 comments:

GOP Boomer Gal said...

Just got notified in my hospital TODAY 5/7 that we have until 5/9 to get immunized for measles to continue to work; orders of Pima County Health Department.

People were being bussed to the clinic, and the workers (from the Health Department) were shocked that there were so many people after THEY gave the directive.

We have an incompetent health department in Pima County. The doctor who said we were unprepared for major epidemics was right on.

Anonymous said...

Did the Citzen ever publish an article on the forum?? I thought they covered it. If there's an article, could someone post a link?

Anonymous said...

Healthcare in America--isn't it great?

No more phetoric from the right--the problems need to be addressed like the amount of time a doctor has to fight with an insurance company to get paid and the outrageous costs of malpractice insurance.

Enough is enough.

roger said...

Whew..at least this wasn't the tired and unsubstantiated attack on tort law and lawyers that I usually hear out of some of ya. This is an evolution. Now we are only blaming illegals.

Anonymous said...

Did the Forum address potential solutions or only identify the problems?

AZAce said...

Roger,
If all you got out of this is something about illegals, you need to break out of your fixation. This is a serious problem. You can bury your head in the sand and say everything is okay, but it doesn't change the fact that we have a serious shortage of care in Southern Arizona and people are dying because of it when they can't get the help they need locally.

AZAce said...

Yes, solutions were discussed and there is some very practical legislation that can help that most commonsense people, regardless of party, will support.

roger said...

Hey Ace,

I think the federal government should subsidize it. It would be frankly cheaper than the effort we are placing now to stop people from coming.

AZAce said...

Heidi Rowley from the Citizen covered the event and stayed afterward to ask more questions. I asked when she would write a story and got no response. If it doesn't happen Sunday, I doubt it will.

AZAce said...

If taxpayers subsidize healthcare, that takes more money out of an already shrinking economy. Probably not supported by economists at this point.

An alternative is to support laws to reduce the number of frivolous lawsuits that would take malpractice insurance rates down, and use the state to circumvent federal anti-trust laws that prevent large, competitive association pools from forming. Together, these would have a substantially positive effect on competitive forces and reduce consumer costs.

t isn't the whole answer, but it's a meaningful start.

roger said...

"An alternative is to support laws to reduce the number of frivolous lawsuits that would take malpractice insurance rates down, and use the state to circumvent federal anti-trust laws that prevent large, competitive association pools from forming. Together, these would have a substantially positive effect on competitive forces and reduce consumer costs."

So what you are saying is that you support government regulation of a market based system? In this case it is the legal over the medical?

As for what I said about healthcare, the big border problem is a drain on our healthcare system...noted. Subsidize it. The feds should be paying these hospitals and doctors to make up for the externality caused by the border. As I said before, it would be far less expensive in this case to put this bandaid on, rather then to spend endless numbers of dollars fighting to send every single person here illegally home.

My overarching point here is that GOPers talk markets and anti-regulation, but you do spend endless tax dollars on the border and regulate when it suits you.

It is why Gifford's press conference this past week was so damned brilliant.

roger said...

The big problem with penalties for frivolous suits is that we already have them and that it didn't do a thing for rates. Judges have long been able to dismiss frivolous suits and now we have the ability to make the person bring them pay.

What the insurance companies, doctors, and hospitals don't like is that this is the only way left, truly, to really regulate their failures. Doctors DO have malpractice, patients and families do suffer, and their damages should not be limited by the government (tort reform) arbitrarily when our system of law is already based on the market.

The insurance companies, doctors, and hospitals...and the rest of us...get tort law in leiu of agencies that regulate the healthcare industry strickly.

The very theory of tort law is that people who are hurt should be made whole again and that making people pay for their mistakes and errors will make them more careful.

What the GOP has been selling is to gut this market based system of regulation, because they know that it will increase profits. Without a strong tort law system, we would desperately need a strong regulatory agency to pry into the workings of the healthcare system. We really don't have that now.

Anonymous said...

Assuming there is one person at the Tucson Citizen who can read, that may be a big assumption, congratulations on killing a great story. Medical professionals discussing specific problems with the heath care system here in Tucson. Great job guys.

AZAce said...

Roger, You completely ignore my point in favor of the rhetoric rut from which politicians seem to struggle to fee themselves. Anti-trust laws have prevented free market competition in health care giving total control to insurance companies and preventing consumers from having choices to exercise. When you have 3 insurance options and they're all HMOs, and the government doesn't let you get insurance anywhere else or join with others to increase your buying power, that is anything but a free market.

Also, it doesn't matter that doctors win 80-90% of lawsuits filed against them. The malpractice insurance companies pay to defend the doctors and pass along the costs through rate increases, regardless. Nobody believes (and I bet including you) that it makes sense for an emergency room doctor who sees a patient—one that he or she has never seen before, for which he has no history, and about whom it can't possibly be known he is an illegal drug user—to be held to the same standard as the family physician who knows the patient's history, etc. when it comes to malpractice. If the doctor did everything according to accepted practice and the outcome wasn't positive, any family lawsuit in this situation can only be frivilous and further drive doctors out of the state.

If you think that not having doctors to treat our elder and child populations is okay, you're probably fine with this. From the reactions of both Democrats and Republicans at the forum, however, I think you're in the minority.

GOP Boomer Gal said...

Furthermore, choice is regulated out of the insurance copanies by state and federal legislation.

This also increases cost.

roger said...

"Anti-trust laws have prevented free market competition in health care giving total control to insurance companies and preventing consumers from having choices to exercise. When you have 3 insurance options and they're all HMOs, and the government doesn't let you get insurance anywhere else or join with others to increase your buying power, that is anything but a free market."

Ace,

This is just plain not true. You can't blame anti-trust law...there is host and hosts of healthcare companies, hospitals, and the like providing service. Are you arguing that allowing mergers to the point of monopoly (which antitrust law prevents) would be MORE competition? It would actually be LESS. I also don't see many hospitals and healthcare units getting broken up or busted by antitrust law.

As for insurance options...we don't have just three...are you kidding, there is TONS of competition and legislation has far more favored this industry than harmed or regulated it. The problem is that a market doesn't work so well with respect to healthcare. You either get employer provided or you shop on your own. Some argue that employer provision has left any without that provision left to a smaller risk pool and a more expensive set of private insurance.

I don't think that further deregulation is going to get it, or help one bit.

Last, on the litigation stuff. I was told by a family member that is quite quite high up in the insurance industry that the litigation thing is essentially a scam. When insurance companies are sued for real reason...bad faith and the like...or to simply have them pay what consumers have paid for in premiums for years, the solution is to delay the litigation and delay it and delay it and delay it. Why you might ask? Because the longer it is delay the less the pay out and the longer the money built up in the company can be invested and "ridden" by the finance team to profit.

This is not because of regulation...it is because of a lack of it.

AZAce said...

Roger,

Sorry about the confusion. We seem to have passed each other in this conversation. When I wrote about anti-trust laws, I was referring to their use in preventing individuals and employer groups from combining to increase their purchasing power. We could get a better deal if the feds would let us buy insurance as a group.

Regarding competition, if you buy auto insurance, you can buy it from anywhere and get pooled with a huge number of drivers. If you buy health insurance, you buy it from an Arizona company for the most part. You don't have the broad competition like you do for other insurance. And you get pooled with a small number of people that can't spread the risk very far. Employers have a handful of options only. Consequently, they have very low bargaining power in Arizona.

The litigation you talk about applies to insurance companies. I am talking about lawsuits against doctors. That's where the problem exists.

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