From: andy@SAIL.Stanford.EDU (Andy Freeman)
Subject: Re: Sick to death
Organization: Computer Science Department,  Stanford University.
Date: Fri, 4 Sep 1992 17:07:26 GMT

In article <1992Sep4.142019.29627@aio.jsc.nasa.gov> lafave@ial4.jsc.nasa.gov (Dr. Norman J. LaFave) writes:
>In article <1992Sep3.235658.21773@CSD-NewsHost.Stanford.EDU>, andy@SAIL.Stanford.EDU (Andy Freeman) writes:
>> In article <1992Sep3.210155.5765@aio.jsc.nasa.gov> lafave@ial4.jsc.nasa.gov (Dr. Norman J. LaFave) writes:
>>>Example: A national health care plan will be a failure because of the
>>>government bureaucracy.
>>>
>>>a.) How will it be any worse than the huge, uncoordinated bureacracy we have
>>>already?  A bureaucracy being run by greed and corruption.
>> 
>> Wowsers!  Things can't get worse!  Wrong - they can get worse.
>
>So what is your point. They can also get better.

My point is that LaFave was making a specious "things can't get worse"
argument.  When I point out that bogosity, he backs off to "so?" and
repeats his unsupported "Clinton will change things for the better".
Since LaFave doesn't discuss the relevant details of those changes,
we know what he thinks is important....
>> If a moral person really believes that said insurance companies are
>> either wasteful or making too much money, said moral has an OBLIGATION
>> to start a malpractice insurance company that does things right and
>> charges less.  Not only will said moral person get rich (allowing
>> other good deeds), but health care costs will go down AND the evil
>> insurance companies will be driven out of biz.
>> 
>> Either there aren't any moral people who believe that the insurance
>> companies are "wrong" OR "moral" people aren't willing to risk their
>> money on their beliefs.
>
>OR it is so hard to get certification to start an insurance company (a
>system built by the large insurance companies to keep out people like
>you describe), it is not worth it.

Actually, it isn't.  The major obstacles happen to be those instituted
by "moral" people trying to rein in those evil insurance companies.

I like the "put up or shut up" because it's fun to watch the "moral"
people scramble for cover, much like roaches from the light.  They
always have an excuse....

>> >while ambulance-chasing lawyers bring ridiculous charges of
>> >malpractice to our already over-burdened legal system. How much is this
>> >costing us?
>> 
>> Everyone who's willing to give up/limit their right to sue an MD,
>> raise your hand.  What?  No one wants to?  Oops.
>
>Who said anything about giving up one's right to sue? I sure didn't.
>How about limitations on awards for various types of suits?
>How about the losing lawyer paying all court fees to keep flimsy cases out
>of our already-overburdened legal system.

Is LaFave suggesting that people are more willing to do those things?
If not, why bring them up?

What sorts of further limits is LaFave willing to accept on potential
awards for suits he might benefit from?  Will he agree to pay the
winning side when his case doesn't work out?  No?

>This issue is not as black-and-white as you suggest. Using some imagination,
>there are many things we could do to bring down the malpractice premiums to
>reasonable levels.

There are many things, but how many of them is LaFave willing to
agree to when he's a potential party?

>> An interesting experiment has been tried - access barriers (like cost)
>> to pre-natal care were removed.  Surprising result - infant mortality
>> rates didn't change much.  Explanation - the relevant population
>> didn't want the care.  What should we try next?  Forcing them to go?
>> Bribing them?  Both?
>
>Reference please. Details please. Time period of the experiment please. This
>is not at all convincing.

It's been discussed repeatedly.  The experiments were in inner cities; one
is currently being run in Oakland.

LaFave thinks he's the only smart guy, but there are lots of smart
people.  Things get tried.  Sometimes they work, sometimes they don't
and diletantes who don't bother to keep up rarely add anything useful
to the discussion.

>> Go for it - that doesn't require the federal govt (and is being done).
>> BTW - If it works in a given state, why expand it?  Why not just
>> DUPLICATE it in other states.  Less overhead that way and further
>> experiments can be tried.
>
>Wow, you just described the Canadian system. It is the provinces which
>administer the care. All the federal government does is coordinate care and
>dole out the funds. Billing, records, etc are all handled on the province
>and county level.

No, I just described the US system.  The experiment that LaFave wants to
try is being done, but one would have to keep up to know about it.

>> Interestingly enough, that's already happened, but there's one
>> additional factor.  The folks in the rich areas control the police in
>> the poor ones.  Said police are more interested in keeping the poor
>> out of the rich areas than in doing much else.  If the people in the
>> poor areas controlled their police, they wouldn't do that.
>
>I agree. So what is your point?

If LaFave both agreed with and understood what I wrote, he wouldn't
have proposed his solution.

>> Lockheed sure has strange policies.
>
>This is a computer glitch in my mail system and I have already stated my
>companies policies on my signature file on more than one occasion.

And as long as said policies make LaFave wear electronic bunny slippers,
people are going to point that out.

-andy
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