[Industrialblog,
April 28, 2004]
My Fellow Democrats, the time has come ...
I've recalled why I'm still a registered Democrat. Took yesterday's voting fiasco to jog my memory. Some of you may recall that I was a lifelong Democrat — and a committed one. I was a poll watcher for the Democrats in 1995. For a long time, I referred to myself as a conservative Democrat, probably since 1990. In 2000, I voted for my first Republican, Dubya.
Still, it was a difficult decision in the voting booth — surprisingly difficult considering I had every intention of voting for Bush for months beforehand. At the last minute, I had qualms. The GOP? I couldn't really go over to the dark side, could I?
Well, now I recall filling out my voter registration form prior to the election. I figured I was in Pennsylvania, and the Democratic Party in PA boasts the legacy of the great Bob Casey, the pro-life Democratic governor. That's closest to my position on things. So I figured the Dems were still friendly in the commonwealth to a conservative Democratic position.
Well, in the past four years, I'd have to say, no, the Dems aren't friendly to conservative ideas. I still hate the idea of going over to the GOP. I mean, when the woman at the polling place told me I was registered Democratic, it seemed right. To a certain extent, I'll always be a Reagan Democrat. I have no illusions that those who are very rich share my interests: The point is they're much less interested in damaging my interests than many Democrats, who in many cases don't share my interests.
Until the Dems stop demagoguing on various social issues and get serious about national security, crime, education and tort reform, I'll have to remain in exile in the GOP. Hell, maybe all the exiles will eventually take over the party, and drive the old mainline plutocrats somewhere else.
Still, it was a difficult decision in the voting booth — surprisingly difficult considering I had every intention of voting for Bush for months beforehand. At the last minute, I had qualms. The GOP? I couldn't really go over to the dark side, could I?
Well, now I recall filling out my voter registration form prior to the election. I figured I was in Pennsylvania, and the Democratic Party in PA boasts the legacy of the great Bob Casey, the pro-life Democratic governor. That's closest to my position on things. So I figured the Dems were still friendly in the commonwealth to a conservative Democratic position.
Well, in the past four years, I'd have to say, no, the Dems aren't friendly to conservative ideas. I still hate the idea of going over to the GOP. I mean, when the woman at the polling place told me I was registered Democratic, it seemed right. To a certain extent, I'll always be a Reagan Democrat. I have no illusions that those who are very rich share my interests: The point is they're much less interested in damaging my interests than many Democrats, who in many cases don't share my interests.
Until the Dems stop demagoguing on various social issues and get serious about national security, crime, education and tort reform, I'll have to remain in exile in the GOP. Hell, maybe all the exiles will eventually take over the party, and drive the old mainline plutocrats somewhere else.
What's odd is how many of them are the rich!
CTL - there you are with that hate thing again. First Bill gets angry and then its hate hate hate. I'm quite sure the vast majority of Democrats don't hate rich people. I can't say that I've ever met one Democrat that actually hated rich people. I've never heard anyone ever say, "I hate rich people." You're not projecting are you?
The idea was to create separate agency with judges and professional juries to decide on payments in malpractice cases. In addition, as part of the deal, payments to individuals and lawyers would be much more limited (capped on a yearly basis versus a ongoing basis). Insurance companies would be kept out of the loop and a fee based system would pay for the ongoing expenses. You'd still need some way to review MDs performance and weed out one's that truly weren't compentent. Institutions as well might need to monitored. However, patient selection (teaching hospitals get more difficult cases) and other factors would need to be considered.
The hope being that the medical health system and patients bear a more reasonable cost, MDs face a more reasonable risk for their services, but patients who truly are victims of malpractice are not simply left out in the cold.
In hindsight, the agency would probably grow out of control or potentially become ruled by over zealous people trying to over analyze physician performance.
In this particular case, I have a lot sympathy for MDs who generally are very hard working and highly committed that pay unreasonable prices for insurance. But it seems a little over the top for medical care to be at your own risk.
Then let the market weed out the bad doctors.
You have heard of the concept of hyperbole, right?
Yes, of course it's over the top for doctors not to be suable for malpractice. Doctors are people, like everyone else, and if they really screw up in a way that any normal person would be culpable (in a civil, legal sense), they should be culpable as well.
The problem is how to keep such a system from getting abused.
Any reasonable answer to that problem will end up looking fairly similar, though the names might be changed. If doctors end up paying fees to someone in exchange for immunity from the costs of reimbursing people deemed to have suffered because of said doctor's mistakes, this is malpractice insurance, whatever one might call it. Whether the malpractice insurance is sold by a private company or by the government under strict compulsion, it is still malpractice insurance. The government as much as any private company would need to minimize its payments since it has a limited amount of money to use to make said payments, and the people who want that money will always want more than is available.
Moreover, there will still be the problem of determining when a doctor has made a mistake for which he is culpable. (Incidentally, we already do this in a big government fashion, it's called a jury.) If you take this out of the hands of a jury and into the hands of a professional jury, it might be an improvement. There's always something a bit worrisome about putting all one's eggs in a basket, but professional jurors will have the advantage of some training which might make them better at telling culpable mistakes from simple misfortune.
Of course, this does assume that you don't want a nationalized health system where no matter what a person does, they can get unlimited medical treatment at the expense of the tax payer. Well, until this costs too much and treatment is scaled back, as is happening in many european countries today (as I understand it).
To tell the truth, I has expected that you were going to advocate not (what is in essence a professional jury system with nationalized malpractice insurance) but rather full nationalized health care where people don't get to sue the government, they just get free health care for everything and very generous unemployment checks if they can't work.
For my own part, I'm not sure what the right solution to medical malpractice is. It may be the case that it's too complicate for amateur juries to decide and we really do need to use a professional jury system. I would think, though, that it would be better to decouple the two sides from the jury and not nationalize malpractice insurance; this way there's a better chance of professional juries being neutral.
In general I agree with you're comments. Particularly, the issue of judges and jurists need to be independent in some way. Also, I agree that the current system is too full of abuse.
I'm against nationalized health system and insurance - it is the end of competition and that will ultimately lead to a dwindling level of innovation in medical research.