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Post by joeking1978 on May 16, 2016 19:43:32 GMT -5
I wonder if not only did you cap Med mal settlements, made plaintiffs liable for the legal defense if the defense wins, and capped legal fees to hourly rates and no more than 40hrs per week per good ol fashion labor laws... How much Med mal you would still see.
Reduce liability, reduce Med mal insurance, reduce fraudulent claims... Reduce the cost of healthcare. Boom- JoKing for president. Making America Great again.
Instead, overtax medical manufacturers (the US's last real export since NAFTA), force even more jobs overseas, lay a heavier burden on those actually contributing to the system financially and cut down reimbursements forcing docs to see more patients then a puppy mill to keep ahead financially... Makes sense. Thanks O!
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Post by The Hoff on May 16, 2016 19:54:54 GMT -5
Of course the firm gets paid. They did all the work. Lazy Plaintiffs just want something for nothing. Ah yes, the patient who actually suffered and may have permanent adverse effects has no "sweat" equity in the game. You can't honestly tell me that the amount of time/work invested by the legal group definitely justifies getting an absurd amount? It's winning the lottery for a lawyer. They put maybe 6 months to a year of time into a case and make a few million? I have qualms with paying a very reasonable rate for hours billed... But getting such a large % of the settlement seems disproportional to how much the attorneys actually worked. Maybe in wrong... I'm not a lawyer, but I did stay at a holiday in express and posted on Sports Inferno... So I believe I'm qualified Um.... Sarcasm. How does it work?
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Post by joeking1978 on May 16, 2016 20:09:01 GMT -5
I'll be honest... I've gotten to be so cynical of lawyers over the years that my sarcasm meter broke.
So what's your honest thoughts on the system?
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Post by The Hoff on May 16, 2016 20:30:34 GMT -5
I'll be honest... I've gotten to be so cynical of lawyers over the years that my sarcasm meter broke. So what's your honest thoughts on the system? There are some legit cases that need to get filed. Some insurance carriers can be obstructionist and refuse to settle even when liability is clear. Many cases are straight up fradulant. On the med mal side, the doctor has the right to refuse/veto settlement. It is not unusual for their egos to get in the way of the facts. I tried a med mal case where our expert identified an error by my client in reading an ekg and the lady died. Plaintiff's doctor never caught it. My client refused to settle even after his error was pointed out. The only reason I won that case was the plaintiff whore expert was a worse doctor than my client. The system has become more political. Texas elects judges in partisan elections. The outcome of cases can turn on what judge is assigned to trial. Plaintiffs` lawyers get away with a lot of crap in some venues because they are politically aligned with the judge and contribute tobtheir campaigns.
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Post by AK on May 16, 2016 20:50:31 GMT -5
Joeking, I think you are vastly underestimating the amount of work that a plaintiffs firm puts into a file. And the risk involved there, especially a case that makes it to trial.
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Post by The Hoff on May 16, 2016 20:52:45 GMT -5
Joeking, I think you are vastly underestimating the amount of work that a plaintiffs firm puts into a file. And the risk involved there, especially a case that makes it to trial. And the costs. Costs alone can run mid 6 figures.
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Deleted
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Post by Deleted on May 16, 2016 21:14:56 GMT -5
I think Joe might have trumped his analysis on this one.
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Post by joeking1978 on May 17, 2016 8:28:00 GMT -5
I think there are a lot of parallels between the medical and legal industry. The biggest differentiator be that the legal industry sets the guidelines for themselves AND the medical industry.
That said, any surgeon could make a similar argument regarding the time invested towards honing their craft, continuing education and researching their patients symptoms, coupled with the cost of medical supply, implants, medications, staffing, EMR, etc., etc.
Now, regulatory bodies like CMS will come in along with commercial payers and dictate how much can be earned by using their algorithms to map out case costs. They will know that implant will be $1500. Anesthesia for an hour will be $1200. Nursing wages $400 an hour, Medications will be $600. Disposable, sharps, drape and downs and General supply will be another $300. So they know that case if done in an hour will cost $4000. They base that off of some data that shows that the average procedure takes one hour. So they will reimburse $5000 for that procedure.
If that procedure exhibits any complications or unexpected challenges and takes more than an hour... Or requires more supplies or any other additional cost, that surgeon or hospital or surgery center is now taking a loss. This forces some surgeons to rush through cases. Also it will force some doctors to do cases that they normally would or do cases they normally wouldn't because it is now a volume game versus A quality game. Yet ironically, their quality measurements are a part of their reimbursement as well. If there adverse event rates are outside a predetermined range, their reimbursement is penalized. Long story short, it has absolutely changed the face of medicine.
So based on this, would you still feel that the time and resources invested in law can't be regulated as well? I cannot believe, that there is not enough data out there to effectively predetermine what average hourly rates would be considered reasonable for a lawyer to defend or prosecute someone.
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Post by The Hoff on May 17, 2016 8:50:26 GMT -5
I think there are a lot of parallels between the medical and legal industry. The biggest differentiator be that the legal industry sets the guidelines for themselves AND the medical industry. That said, any surgeon could make a similar argument regarding the time invested towards honing their craft, continuing education and researching their patients symptoms, coupled with the cost of medical supply, implants, medications, staffing, EMR, etc., etc. Now, regulatory bodies like CMS will come in along with commercial payers and dictate how much can be earned by using their algorithms to map out case costs. They will know that implant will be $1500. Anesthesia for an hour will be $1200. Nursing wages $400 an hour, Medications will be $600. Disposable, sharps, drape and downs and General supply will be another $300. So they know that case if done in an hour will cost $4000. They base that off of some data that shows that the average procedure takes one hour. So they will reimburse $5000 for that procedure. If that procedure exhibits any complications or unexpected challenges and takes more than an hour... Or requires more supplies or any other additional cost, that surgeon or hospital or surgery center is now taking a loss. This forces some surgeons to rush through cases. Also it will force some doctors to do cases that they normally would or do cases they normally wouldn't because it is now a volume game versus A quality game. Yet ironically, their quality measurements are a part of their reimbursement as well. If there adverse event rates are outside a predetermined range, their reimbursement is penalized. Long story short, it has absolutely changed the face of medicine. So based on this, would you still feel that the time and resources invested in law can't be regulated as well? I cannot believe, that there is not enough data out there to effectively predetermine what average hourly rates would be considered reasonable for a lawyer to defend or prosecute someone. You do realize that doctors are not REQUIRED to charge pre-negotiated rates. They can (and some do) elect to forego any participation with Medicare and/or any insurance plans and are free to charge whatever they want. (Concierge Medicine, for example). We see that happening more and more frequently in bodily injury cases across the country. Attorneys send clients to their doctors, and fees are not submitted to the insurance carriers. This inflates the medical costs which are drivers for the evaluation of pain and suffering and other soft damages. But physicians operating outside the Medicare/Insurance system is a growing trend. www.businessinsider.com/private-doctors-stop-accepting-insurance-michael-ciampi-obamacare-2013-5The above link is an older article, but the trend is continuing, especially since the ACA has come into full force. Participation in the insurance system is voluntary on the part of the doctor. (For now-I expect the Gubmint will have to step in and mandate doctors accept ACA policies and Medicare at some point)
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Post by joeking1978 on May 17, 2016 10:13:04 GMT -5
Oh I absolutely understand the LOP market- it's probably the biggest driver of expansion and growth in my market right now. However, that's a loop hole that is getting more regulated and will change eventually. To say all docs can participate in this or concierge medicine is kind of a farce. This is a very niche segment of the market. Highly profitable, but not everyone is in a position to capitalize on it. It also has no bearing on general healthcare costs as these are payments are being covered by auto plans, workmans comp or similar groups via litigation.
Can a ticket clinic lawyer like AK just one day cover a Med mal case? No... That said, you won't see many pediatricians, or primary care or allergists, or GI docs, just to name a few, who have any angle to pursue this patient pop. Maybe Plastic surgeons, dermatologists, Orthopaedics, Neurospine docs, and general surgeons, but that's about it. For every one ACDF or one Total Hip they perform under LOP, they still have to service the other 98%'of their patient population that participate with commercial payers or medicated/Medicaid
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Post by The Hoff on May 17, 2016 10:16:36 GMT -5
Oh I absolutely understand the LOP market- it's probably the biggest driver of expansion and growth in my market right now. However, that's a loop hole that is getting more regulated and will change eventually. To say all docs can participate in this or concierge medicine is kind of a farce. This is a very niche segment of the market. Highly profitable, but not everyone is in a position to capitalize on it. It also has no bearing on general healthcare costs as these are payments are being covered by auto plans, workmans comp or similar groups via litigation. Can a ticket clinic lawyer like AK just one day cover a Med mal case? No... That said, you won't see many pediatricians, or primary care or allergists, or GI docs, just to name a few, who have any angle to pursue this patient pop. Maybe Plastic surgeons, dermatologists, Orthopaedics, Neurospine docs, and general surgeons, but that's about it. For every one ACDF or one Total Hip they perform under LOP, they still have to service the other 98%'of their patient population that participate with commercial payers or medicated/Medicaid LOPs are impossible to regulate. They are private contracts between the doctor, patient and the attorney. As to doctor's participation in the insurance system-they don't have to. They choose to. It's a business decision. Every doctor has a choice to participate or not participate in the insurance/Medicare system. If enough opt out, there will be a tipping point where the system will have to change. And it needs to change significantly.
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Post by joeking1978 on May 17, 2016 10:17:31 GMT -5
The PCP's going straight concierge now are still very niche in this space. Very few work in areas where their patients can afford to forgo Medicare or Medicaid. These docs are being mall kiosk owners more than docs as they are overloading their offices with profit centers- selling everything from skin creams to amniotics.
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Post by joeking1978 on May 17, 2016 10:18:08 GMT -5
No doubt it needs to change... Just like legal billing. ;) This was great redirecting by the way
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Post by The Hoff on May 17, 2016 10:23:23 GMT -5
No doubt it needs to change... Just like legal billing. ;) This was great redirecting by the way Who gets to regulate legal billing? It's a private contract between the lawyer and the client. Do you want the government regulating private contracts? If soi, what then prevents the government stepping in and regulating what you get paid? The problem with medical services is that people working in that industry are overpaid. If we can cap salaries, we can cap medical costs. Easy argument to make. Each according to his abilities, each according to his needs. Amiright?
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Post by joeking1978 on May 17, 2016 10:34:53 GMT -5
So, people in the legal industry are not overpaid? The giant amphitheater that hosts all the major concerts in Tampa used to be called the 1-800-ask-Gary amphitheater... Homie definitely got rich off his clients suffering and then rubbed in all their faces with his name on the biggest concert venue in the area.
Maybe the government does need regulate what contracts a lawyer can present to a client. It's an abuse of power in my opinion when the lawyer Who is in expert on contracts can take someone who is not even a layman at best and the coerce them into something that might not be in their best interest. In some industries a client is protected from this, except if the client is directly signing A contract with a lawyer. Many industries have regulatory safeguards in place to protect the uneducated in these situations.
The financial sectors and medical sectors are heavily regulated to protect patrons from being taken advantage of... But lawyers continue on relatively unchecked
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reggie
All-Pavel Datsyuk
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Post by reggie on May 17, 2016 10:52:40 GMT -5
worst. beef. ever.
this is boring as hell. where's gekko?
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Post by joeking1978 on May 17, 2016 11:00:00 GMT -5
This is a gentleman's beef good sir
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Post by AK on May 17, 2016 11:01:41 GMT -5
Ticket clinic, misdemeanor/felony defense, family law, commercial lit and referrer of all other issues...dick
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Post by AK on May 17, 2016 11:02:44 GMT -5
Speaking of, you want to really get your panties in a bunch consider the referral fee
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Post by The Hoff on May 17, 2016 11:23:22 GMT -5
So, people in the legal industry are not overpaid? The giant amphitheater that hosts all the major concerts in Tampa used to be called the 1-800-ask-Gary amphitheater... Homie definitely got rich off his clients suffering and then rubbed in all their faces with his name on the biggest concert venue in the area. Maybe the government does need regulate what contracts a lawyer can present to a client. It's an abuse of power in my opinion when the lawyer Who is in expert on contracts can take someone who is not even a layman at best and the coerce them into something that might not be in their best interest. In some industries a client is protected from this, except if the client is directly signing A contract with a lawyer. Many industries have regulatory safeguards in place to protect the uneducated in these situations. The financial sectors and medical sectors are heavily regulated to protect patrons from being taken advantage of... But lawyers continue on relatively unchecked Because one lawyer, or a handful of lawyers get wealthy, that opens the door to regulate all? Do your research. Not all lawyers are wealthy. Not even close. Again, intervention in to private contracts is a) constitutionally prohibited, and b) a very dangerous place to go. If you start regulating pay scales in one industry, there is no limit on regulating the authority to regulate income in ANY industry. You comfortable that some government flunky won't decide that medical device sales reps make too much money because the devices have become so expensive? Just a bad idea. You don't think the legal industry isn't regulated? Try hanging out a shingle and offer legal services. We have all kinds of regs and checks. Including a fee dispute board. The problem is, with all due respect, that you are arguing a point based on outliers, not the 99% of what happens within the legal profession.
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Post by Deleted on May 17, 2016 11:39:37 GMT -5
worst. beef. ever. this is boring as hell. where's gekko? I'm all beefed out.
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Post by joeking1978 on May 17, 2016 12:02:45 GMT -5
Ticket clinic, misdemeanor/felony defense, family law, commercial lit and referrer of all other issues...dick You don't wanna beef with me, pal
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Post by joeking1978 on May 17, 2016 12:15:07 GMT -5
So, people in the legal industry are not overpaid? The giant amphitheater that hosts all the major concerts in Tampa used to be called the 1-800-ask-Gary amphitheater... Homie definitely got rich off his clients suffering and then rubbed in all their faces with his name on the biggest concert venue in the area. Maybe the government does need regulate what contracts a lawyer can present to a client. It's an abuse of power in my opinion when the lawyer Who is in expert on contracts can take someone who is not even a layman at best and the coerce them into something that might not be in their best interest. In some industries a client is protected from this, except if the client is directly signing A contract with a lawyer. Many industries have regulatory safeguards in place to protect the uneducated in these situations. The financial sectors and medical sectors are heavily regulated to protect patrons from being taken advantage of... But lawyers continue on relatively unchecked Because one lawyer, or a handful of lawyers get wealthy, that opens the door to regulate all? Do your research. Not all lawyers are wealthy. Not even close. Again, intervention in to private contracts is a) constitutionally prohibited, and b) a very dangerous place to go. If you start regulating pay scales in one industry, there is no limit on regulating the authority to regulate income in ANY industry. You comfortable that some government flunky won't decide that medical device sales reps make too much money because the devices have become so expensive? Just a bad idea. You don't think the legal industry isn't regulated? Try hanging out a shingle and offer legal services. We have all kinds of regs and checks. Including a fee dispute board. The problem is, with all due respect, that you are arguing a point based on outliers, not the 99% of what happens within the legal profession. Fair enough... My point is it is a 2 way street. The assumption goes both ways regarding the idea that people in the medical industry are overpaid. Those that earn well do a great job of running businesses within the system, but are not direct products of the system. Sure, you could be an Ortho grad fresh out of fellowship and sign with St. Joes on a $220k year salary. However, because of how obnoxiously regulated the industry is... It took that guy approximately 8 more years of school and training to get that job than it did any of his counterparts in Europe. The average Orthopaedic surgeon will have 12-14 years of schooling... And we all know how inflated higher education costs are now. Most will come out of it with low 6 figures in educational debt... If they are lucky. Many hit the $200-300k range. So if you are going to make it that hard for them to become a doctor, their earnings once they get there should be proportional then... Otherwise, who the fuck would ever want to be a doctor again? A good or smart Ortho will eventually go on his own or in a partnership where he gets to keep more of what he earns (if he's good at selling his services of course), he will maybe invest in ownership of a surgery center, help design an implant, write a few journals, become a consultant or get on a companies speakers bureau, etc and could triple what the hospital would pay. However, he's not making this much just for being a surgeon- he's earning for being a business man. Regarding the 1%- your right, my biggest beef falls on the ambulance chasers, Med mal peeps and class action guys who really could give a fuck about their client, and only care about how many millions they will make on someone's suffering. There doesn't really seem to be a free market for lawyers to compete for your biz either... But I may be wrong on this. It's like a under the table collusional handshake that all lawyers will charge an industry standard 33% on settlements/awards. Nothing was more annoying when I had my lemon issues with my old BMW and won a $10k settlement and the lawyer kept $3k when I know all they did was file paperwork. There's no way they spent more than an hour on my case. Could I have gone elsewhere? Not really because everyone you called charged the same fee
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Post by AK on May 17, 2016 12:49:42 GMT -5
You can certainly take a lower percentage. Maybe you just don't have the same shrewd negotiating skills as gekko as evidenced by his low low payments on his new rover.
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Post by Juicy on May 17, 2016 16:35:55 GMT -5
Of course the firm gets paid. They did all the work. Lazy Plaintiffs just want something for nothing. Ah yes, the patient who actually suffered and may have permanent adverse effects has no "sweat" equity in the game. You can't honestly tell me that the amount of time/work invested by the legal group definitely justifies getting an absurd amount? It's winning the lottery for a lawyer. They put maybe 6 months to a year of time into a case and make a few million? I have no qualms with paying a very reasonable rate for hours billed... But getting such a large % of the settlement seems disproportional to how much the attorneys actually worked This may be the best joking post in the history.
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