# What (if any) health care/insurance reform can we all agree on? **URL:** \ **Category:** Great Debates\ **Created:** [March 20, 2010, 9:16am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120 "2010-03-20T09:16:01Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [March 21, 2010, 1:00am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/21 "2010-03-21T01:00:40Z")
> [@Kearsen](#): > > Speech like this is delusional if not outright lunacy. > [@Grumman](#): > > Feel free to stop lying about my goals any time, **Der Trihs**. > [@Der\_Trihs](#): > > Pretending that these people are decent, well meaning human beings won’t make it so. Pretty good for 20 posts. Accusing posters of lying is not allowed in this forum, and pointless vitriol is also not encouraged. So this kind of rhetoric is not going to continue in this thread. Otherwise warnings will follow. ---
**Author:** ![Cheshire\_Human](https://avatars.discourse-cdn.com/v4/letter/c/5f8ce5/32.png) [@Cheshire\_Human](https://boards.straightdope.com/u/Cheshire_Human)\ **Post date:** [March 21, 2010, 1:09am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/22 "2010-03-21T01:09:37Z")
> [@magellan01](#): > > I was thinking that the company would have to comply with state regulations. If you are an insurance company in WI and want to sell insurance in CA, you’d have to comply with all CA laws. If you find it to troublesome, you don’t do it. That’s the situation we have now. It doesn’t matter where your company is based, any policy you sell in CA has to meet CA’s minimum coverage requirements. What is meant by “buying across state lines” is that if CA requires that the policy cover viagra, but I’m willing to risk having to pay for that out of pocket if I ever need it, and WI doesn’t require viagra coverage, I can buy it from the WI company and save whatever premium increase is required to pay for the viagra coverage. Otherwise, there would be no point. ---
**Author:** ![Cheshire\_Human](https://avatars.discourse-cdn.com/v4/letter/c/5f8ce5/32.png) [@Cheshire\_Human](https://boards.straightdope.com/u/Cheshire_Human)\ **Post date:** [March 21, 2010, 1:18am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/23 "2010-03-21T01:18:38Z")
> [@Grumman](#): > > … create _reasonable_ standard templates for a few forms of health insurance, identified by specific, protected titles, and publish a layman’s guide to these specific contracts, making both freely available for use by industry. I _ **like** _ that idea. Count me in. ---
**Author:** ![Cheshire\_Human](https://avatars.discourse-cdn.com/v4/letter/c/5f8ce5/32.png) [@Cheshire\_Human](https://boards.straightdope.com/u/Cheshire_Human)\ **Post date:** [March 21, 2010, 1:24am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/24 "2010-03-21T01:24:19Z")
> [@Der\_Trihs](#): > > Oh, please. The Republicans quite clearly would oppose anything Obama wants, just because he’s Obama. Bull. I’m a republican and I can say that he has pleasantly surprised me on a number of occaisions. Where he has, I support him. Where I disagreed with him from the start, insofar as he hasn’t changed his policy, I disagree still. If he changes course to something I like, I will support it. I’m quite sure a large percentage of the congressclowns feel the same way. They have supported him so far when they thought he was right. They did that when Clinton was president. Why should it be any different with Obama? ---
**Author:** ![Cheshire\_Human](https://avatars.discourse-cdn.com/v4/letter/c/5f8ce5/32.png) [@Cheshire\_Human](https://boards.straightdope.com/u/Cheshire_Human)\ **Post date:** [March 21, 2010, 1:25am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/25 "2010-03-21T01:25:59Z")
> [@Der\_Trihs](#): > > Pretending that these people are decent, well meaning human beings won’t make it so. And pretending that they are your evil stereotype doesn’t make it so, either. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [March 21, 2010, 2:25am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/26 "2010-03-21T02:25:21Z")
Well, golly, Obama must be up to some serious, world class evil to have such a reasonable and unbiased bunch of people so adamantly set against him! I don’t recall Republicans being in such solid opposition to…well, several proposals that proved to be, ah, not so good. Not very good at all, actually. So this must be a calamity, a catastrophe, and an avalanche of anarchy and debauch to merit such unyielding opposition! Of course, some scurrilous lefties will try to float the notion that what this is really about is who is making money off the status quo, and who would like to keep it so. I confess, I can see as how they might have a point. We have the insurance companies swearing mighty oaths, that they just scrimp by with their modest profits in service to the American people. And yet, oddly, they have about 45 Godzillabucks to spend trying to sway public opinion on the matter. By the by, who’s money is that? Is that money from premiums, paid by us, spent by them, to change our minds in their favor? What a fine bit of post-modernist irony that would be, don’t you think? To take a guys money, fuck him over into the poor house, and spend his money convincing Congress not to help him. Now that’s droll. American humor at its most unique. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 21, 2010, 5:07am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/27 "2010-03-21T05:07:28Z")
> [@Kearsen](#): > > Speech like this is delusional if not outright lunacy. Of course **most** libertarians and republicans both agree that reform is a necessary. The reasons for and the methods to obtain are where they differ. I don’t agree at all. Under Bush and the GOP congress you did get medicare part D. But by and large the contemporary GOP comes across as having no real interest in solving the issue of our unsustainable health care system. All their solutions seem to revolve around 3 principals Tax cuts Reducing consumer protections Reducing government aka, they seem to be pursuing a shock doctrine technique of getting Friedman style economics implemented in health care rather than trying to address the serious issues health care poses to our public debt and private economy. So no, I don’t agree. I don’t see republicans out with great ideas, ideas designed to improve health care (and not implement a shock doctrine of achieving the 3 things listed above) with any seriousness. If they are I haven’t seen them. Supposedly in 1993 (I wasn’t paying attention back then) they were promoting working solutions. And they were doing so under Nixon. But not the current GOP. FTR the republicans and libertarians who post here tend to be far less ideological and radical than the ones elected in national politics. But that doesn’t change the fact that Cantor and McConnell seem to have no real interest in pursuing valid solutions to serious problems with our health system. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 21, 2010, 5:19am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/28 "2010-03-21T05:19:03Z")
> [@RingsOfPylon](#): > > Hi. > > Someone who leans Libertarian, but with a practical bent. 🙂 > > I’d suggest the parameters that are already in effect in my state: > > 1. No exclusions for pre-existing conditions. However, just like with the current health care bill, you may have to wait up to 90 days after purchasing insurance to have the pre-existing condition covered. [In my state some insurance companies make you wait anywhere from 30 to 90 days for pre-existing conditions; some have no wait period.] > > 2. No lifetime caps. > > 3. No rescissions or cancellations except in the case of fraud (identity theft, intentionally lying about pre-existing conditions and treatments). > > 4. Community rating. Everyone pays the same amount for the same level of coverage. The current health care bill allows older folks to be charged 3 times the premium of younger folks, for example. In principle, I’m okay with charging higher risk groups a higher premiums. However, if you’re only penalizing a few high risk groups and not penalizing others, it’s rather arbitrary. > > 5. Establish minimum coverage requirements; allow people to purchase coverage above and beyond minimum standards without tax penalty. [I know of no one who has coverage for cosmetic procedures, for example.] > > 6. No one is compelled to buy health insurance. > > 7. High deductible and catastrophic policies are allowed. > > The state also runs an insurance fund for lower income people who don’t qualify for Medicaid. Of course, the state doesn’t abide by its own minimum mandates for those who offer and buy private insurance. > > For example, the state requires that private and employee-sponsored insurance cover chiropractors. However, their own plans for lower income folks do not offer that coverage (surprise!). Nor does it cover ambulance services (which private insurers must). > > Anyhow, does all this make health insurance affordable? That depends on your definition of “affordable”. For individuals it’s really pretty affordable. For families, the scaled-down state plan can cost up to $918 per month with a prescription program. But there are several levels you can choose from. > > Beyond that: > > - Keep the current rules that allow FSA/HSA holders to buy OTC drugs with their own FSA/HSA funds. The current bill would eliminate this provision so that no one can use their funds to buy NSAIDS, OTC eyedrops, Claritin, etc. > > - Keep the deduction for health care expenses at 7.5% of AGI. The current bill raises it to 10%, except for those age 65 or older. If you have a bad year healthwise, this can make a difference in your disposable income. > > - At least some states tax all health care, from insurance to services. In my state, that tax hovers around 10%, which also drives up the cost of health care. Really? – if the goal is to make health care affordable then why are you adding 10% to the costs right off the bat, except that it’s an easy money grab. > > - Some sort of tort reform should be included. I suspect that most folks just look at awards or the cost of malpractice insurance and figure that those are the total costs of malpractice. There are additional burdens that I had never considered until I came to know an ob/gyn nurse. > > For example, the principals involved in any suit are often deposed multiple times. This means that the provider must pay the person who is being deposed AND pay someone else to cover their duties at work. The process can go on over the course of months, which is probably one of the reasons why most providers settle out of court, regardless of culpability or lack thereof. > > Either way, it can be a cost driver. Overall, it may not be a huge driver, but it’s probably larger than most people claim when you factor in stuff like this. > > - Encourage providers to publish fees for services. If the provider is going to send out for tests, inform the patient which tests are being performed and a rough estimate of the cost [assuming the patient is capable of informed consent]. > > If the tests are not critical, allow the patient to opt out. Ask me how I know about unnecessary tests and their surprising costs, plus taxes. 🙂 Those are pretty interventionist policies for a libertarian. Not that I’m complaining. I remember reading about the proposal of a libertarian in Idaho. “Shoot a deer, sell the meat and buy health insurance”. Either way, a problem is that points 1 & 4 tends to contradict 6. If you mandate that health insurance cover pre-existing conditions, and charge everyone the same then healthy people see their rates skyrocket. So they drop coverage, leaving only those who ‘need’ coverage staying on the plan. This causes another rate hike which makes more people leave. So supposedly you can’t do health insurance reform that covers pre-existing conditions w/o a mandate. Supposedly that is why rates are spiraling out of control for the individual market, and are going up 20-40% a year. People drop coverage leaving only the sick, which causes a rate hike which causes more healthy people to leave. What about comparative effectiveness research? Is that something both sides can agree on? ---
**Author:** ![AboutAsWeirdAsYouCanGet](https://avatars.discourse-cdn.com/v4/letter/a/22d042/32.png) [@AboutAsWeirdAsYouCanGet](https://boards.straightdope.com/u/AboutAsWeirdAsYouCanGet)\ **Post date:** [March 21, 2010, 7:57am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/29 "2010-03-21T07:57:50Z")
> [@](#): > > If you mandate that health insurance cover pre-existing conditions, and charge everyone the same then healthy people see their rates skyrocket. Yes, but there’s a GIANT difference between someone who’s hard of hearing and just needs hearing aids, and someone with about ten billion different medical problems. Besides define “healthy” It just seems like a lot of the “preexisting conditions” are totally and completly arbitary. Yes, there’s stuff out there that costs a hell of a lot of money…but there are also a lot of conditions that ARE not all that big of a deal but insurance companies act like they’ll bankrupt them. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [March 21, 2010, 8:33am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/30 "2010-03-21T08:33:53Z")
> [@Cheshire\_Human](#): > > That isn’t actually the case. Even if a company were to go where the regulations were weakest, they would sell what people want to buy and are willing to pay for. The people at the lowest end would buy the least, but if it didn’t give them something they considered worth the cost, they wouldn’t bother buying, and it would avail the company nothing to have offered it. At higher price levels, they wouldn’t buy from that company if they felt there were too many strings attached. Only if **every** company offered trash would the consumer suffer, but then all it would take is **one** company offering better to suck up all the market share from the skinflint companies. What you aren’t seeing is that insurance companies don’t want anyone they won’t turn a profit on. They are more than fine making it impossible for someone who has a pre-existing condition to buy coverage. Widgets you want to sell as many of as you can. Health Insurance you want to sell to as few people as you can. Anyone who costs more than they pay can just fuck off. ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [March 21, 2010, 11:18am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/31 "2010-03-21T11:18:54Z")
> [@RingsOfPylon](#): > > 1. No exclusions for pre-existing conditions. However, just like with the current health care bill, you may have to wait up to 90 days after purchasing insurance to have the pre-existing condition covered. [In my state some insurance companies make you wait anywhere from 30 to 90 days for pre-existing conditions; some have no wait period.] Yeah, I’ll just go 90 days without the painkillers and anti-inflammatories that allow me to work to pay for the insurance to begin with. That’ll work. Maybe 90 days without insulin won’t kill a diabetic. Think your asthmatic kid can go 90 days without their inhaler? Let’s take the risk. That aggressive cancer won’t grow too much in 3 months, right? A full trimester without prenatal care won’t kill the kid, will it? The idea of making people who are already in need of care, by definition (for true pre-existing conditions and not insurance industry garbage like acne or being a victim of rape or domestic violence qualifying as a condition worthy of denying coverage over) wait for coverage is repulsive. > [@Cheshire\_Human](#): > > That isn’t actually the case. Even if a company were to go where the regulations were weakest, they would sell what people want to buy and are willing to pay for. That, however, puts the onus on consumers to be able to crawl through the legalese of the insurance regulations of their state to know just what insurers can and cannot do in their state, and can and cannot cover. The full body of regulations is bigger than the bill that’s going to be voted on today (in each state) and written in some arcane language; if this burden is going to be put onto the public, then that information is going to have to be openly available at a level that is accessible to the average consumer. That would be a lot of work. ---
**Author:** ![RingsOfPylon](https://avatars.discourse-cdn.com/v4/letter/r/3da27b/32.png) [@RingsOfPylon](https://boards.straightdope.com/u/RingsOfPylon)\ **Post date:** [March 21, 2010, 12:40pm UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/32 "2010-03-21T12:40:13Z")
> [@Wesley\_Clark](#): > > Those are pretty interventionist policies for a libertarian. Not that I’m complaining. I remember reading about the proposal of a libertarian in Idaho. “Shoot a deer, sell the meat and buy health insurance”. Good morning. These are the rules I’ve lived under for more than a decade, so maybe I’m just used to them. Or, maybe it’s some form of Stockholm Syndrome. 🙂 If we’re bound & determined to have even more government intervention in this sector of the economy – and it seems inevitable – there are various models that have been implemented in some states, and they’ve been around a while. > [@Wesley\_Clark](#): > > Either way, a problem is that points 1 & 4 tends to contradict 6. If you mandate that health insurance cover pre-existing conditions, and charge everyone the same then healthy people see their rates skyrocket. So they drop coverage, leaving only those who ‘need’ coverage staying on the plan. This causes another rate hike which makes more people leave. So supposedly you can’t do health insurance reform that covers pre-existing conditions w/o a mandate. Supposedly that is why rates are spiraling out of control for the individual market, and are going up 20-40% a year. People drop coverage leaving only the sick, which causes a rate hike which causes more healthy people to leave. Currently, NYS does not mandate that anyone be forced to partake in that part of the economy. There are no penalties for not purchasing health insurance, and it’s been that way since the 1990s. Premiums are somewhat burdensome, but not any worse than someone in their fifties buying insurance in other states. Based on my own imperfect data mining, the premiums here are cheaper than the premiums that folks in Massachusetts pay, although I haven’t finished the detailed comparison with Massachusetts yet, so that’s just a superficial conclusion right now. As someone who leans toward Libertarianism, this is the part of the current bill that I object to the most. No one should be compelled to buy a product that they don’t want or don’t need, especially when the government demands that you buy said product from a private industry. Most rates are NOT going up 20-40% per year. I have a sneaking suspicion that insurance companies, who are about to get millions of new customers and tens or hundreds of billions of new dollars, are escalating the drama so that this bill passes. It is rather miraculous that, after the election of Scott Brown, when the HCR noises died down a bit out of sheer shock, various insurance companies started announcing that certain pockets of the population would experience hefty increases. Quite the coincidence, don’t you think? Many states actively “manage” their insurance markets. State Boards of Insurance review proposals each year and either approve or deny various plans, based on coverages and costs. Plans have to justify their premiums to the state BOI. If they don’t meet state standards they are not approved. I’m sure the level of involvement varies from state to state, but an insurer can be disallowed from offering their plans in a state if they fail the review process. > [@Wesley\_Clark](#): > > What about comparative effectiveness research? Is that something both sides can agree on? I’m not sure I understand what you mean by effectiveness research, so I don’t know if we can agree there. 🙂 ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [March 21, 2010, 6:30pm UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/33 "2010-03-21T18:30:57Z")
> [@Richard\_Parker](#): > > (1) Recission Window: All rescission of health insurance contracts must be made within 6 months of signing the contract. Health insurance companies are not allowed to investigate whether you crossed all your t’s and dotted all your i’s only after you get sick and they’ve taken years of your premiums. > > (2) Targeted Tort Reform: The kind of lawsuit that supposedly causes defensive medicine is a claim that a doctor failed to diagnose some condition. There is no need to amend tort rules for when a doctor cuts off the wrong leg, or gives you the wrong medicine – even the reform advocates don’t think those kinds of torts are driving health care costs in any significant way. So just amend the rules regarding claims that a doctor failed to find some condition. That way, there’s a lower incentive to do unnecessary tests. Additionally, this is a kind of malpractice people can defend themselves against (by getting a second opinion), unlike the kind where the doctor removes the wrong arm. I think both mandatory arbitration and a cap on the award would be appropriate. Yeah, I can agree with both of these, & I’m not generally one to like “tort reform” proposals. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [March 21, 2010, 6:54pm UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/34 "2010-03-21T18:54:12Z")
> [@RingsOfPylon](#): > > I’m not sure I understand what you mean by effectiveness research, so I don’t know if we can agree there. 🙂 Unbiased research into medical interventions to find the interventions with the highest rates of success, lowest costs and lowest side effects. And making that information transparent so doctors and patients can access it. ---
**Author:** ![RingsOfPylon](https://avatars.discourse-cdn.com/v4/letter/r/3da27b/32.png) [@RingsOfPylon](https://boards.straightdope.com/u/RingsOfPylon)\ **Post date:** [March 21, 2010, 11:29pm UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/35 "2010-03-21T23:29:53Z")
> [@Wesley\_Clark](#): > > Unbiased research into medical interventions to find the interventions with the highest rates of success, lowest costs and lowest side effects. And making that information transparent so doctors and patients can access it. I thought so, but wasn’t sure and didn’t want to speak out of turn. Perhaps for common things like sinus infections, UTIs, etc, cookbook treatments are called for, and probably already in use. For rare or very serious diseases, you may have to think outside of the box and try something new or different if the patient is not responding. One thing I don’t want is for bureaucracy to trump innovation, especially when the stakes are high. There are already varying degrees of obstacles attached to some treatments and they can range from inconvenient to downright difficult. None of the ones I’m thinking about are due to financial issues; they’re entirely bureaucratic. ---
**Author:** ![Qin\_Shi\_Huangdi](https://avatars.discourse-cdn.com/v4/letter/q/f04885/32.png) [@Qin\_Shi\_Huangdi](https://boards.straightdope.com/u/Qin_Shi_Huangdi)\ **Post date:** [March 21, 2010, 11:34pm UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/36 "2010-03-21T23:34:11Z")
Tort reform certainly. Putting up false or frivolous lawsuits should be a crime possibly a felony. ---
**Author:** ![yorick73](https://avatars.discourse-cdn.com/v4/letter/y/b5a626/32.png) [@yorick73](https://boards.straightdope.com/u/yorick73)\ **Post date:** [March 22, 2010, 4:53am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/37 "2010-03-22T04:53:25Z")
> [@RingsOfPylon](#): > > 1. No exclusions for pre-existing conditions. However, just like with the current health care bill, you may have to wait up to 90 days after purchasing insurance to have the pre-existing condition covered. [In my state some insurance companies make you wait anywhere from 30 to 90 days for pre-existing conditions; some have no wait period. I think most people agree with this in theory. The problem is that many people have diagnoses that CAN wait 90 days or more for treatment. True, this would take care of the accident victims that did not carry insurance or those who need an immediate operation, but what about people diagnosed with some slowly progessing illness. Find out you are getting ill and sign up with a policy that will take care of all those future meds. This just does not seem sustainable to me without a mandate on coverage. Unless, of course, the point is to drive premiums through the roof or put private insurance companies out of business. ---
**Author:** ![Piker](https://avatars.discourse-cdn.com/v4/letter/p/ba9def/32.png) [@Piker](https://boards.straightdope.com/u/Piker)\ **Post date:** [March 22, 2010, 5:14am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/38 "2010-03-22T05:14:43Z")
> [@Curtis LeMay](#): > > Tort reform certainly. Putting up false or frivolous lawsuits should be a crime possibly a felony. The prospect of being jailed for over a year should they fail would probably keep a lot of legitimate possible plaintiffs from bringing their claim. There is such a thing called “overdetterence”. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 22, 2010, 5:18am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/39 "2010-03-22T05:18:31Z")
> [@Curtis LeMay](#): > > Tort reform certainly. Putting up false or frivolous lawsuits should be a crime possibly a felony. Tort reform is a lot harder than it sounds, and nobody (even the Republicans who have been harping on the topic for years) have produced a workable means of actually reforming the tort system. Capping awards sounds like a good idea in principle, but it actually has a negligible impact. Compensatory awards are based on actual loss - medical bills, lost wages, and so on- so obviously capping them is silly. Punitive damages are based on what the jury feels like awarding, and occasionally there are outrageous awards, but 99% of the time the award is in line with the compensatory damages (if punitive damages are awarded at all). Capping attorney’s fees raises constitutional implications - state and federal courts have often ruled that legislation capping attorney’s fees limits plaintiffs’ access to counsel. Is it a good idea to cap punitive damages? Probably, but the difference in actual litigation costs will be negligible. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [March 22, 2010, 5:29am UTC](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120/40 "2010-03-22T05:29:17Z")
[QUOTE=Curtis LeMay] Putting up false or frivolous lawsuits should be a crime possibly a felony. [/QUOTE] [QUOTE=Piker] The prospect of being jailed for over a year should they fail would probably keep a lot of legitimate possible plaintiffs from bringing their claim. There is such a thing called “overdetterence”. [/QUOTE] That apart, proving health-related insurance fraud is damn near impossible. “Do you have a pre-existing low back injury?” “No.” “We have an MRI from 2003 showing that you had a herniated disc at L4-5. Your Honor, the defendant clearly misrepresented his medical history.” In comes the defense attorney. “John, do you know where the L4-5 vertebra is?” “In my back?” “Where in your back?” “I have no idea.” “Your honor, my client is not a physician. He cannot be blamed for his failure to properly identify his prior injury.” Guess who the judge will agree with? Hint: it’s not the prosecutor. People don’t file frivolous claims for injuries that are easy to disprove. There’s probably somebody out there who sued for accidental amputation of a finger and showed up at his deposition with all ten digits intact, but for the most part we’re talking about complaints of inexplicable pain or loss of range of motion, or of complaints which are greater than what could reasonably be expected from a given actual injury. I work in a related field- workers’ compensation. Over the last five years, we’ve uncovered hundreds of cases of blatant fraud - injured workers who claim to have no feeling in their legs running marathons while under surveillance, and the like. The state attorney’s office has agreed to prosecute exactly _one_ of the cases we submitted. [Previous page](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120.md?page=1) [Next page](https://boards.straightdope.com/t/what-if-any-health-care-insurance-reform-can-we-all-agree-on/533120.md?page=3)