WhiteCoat

Another Gash In The California Safety Net

broken-netAn article in yesterday’s California Daily Journal (subscription only) by Evan George titled “ER Patients Use Court Ruling to Push for Billing Refunds” shows why Californians are going to soon have a lot more difficulty obtaining emergency care.

A man named Ariel Sabban is suing Scripps Memorial Hospital and its emergency physician group for $57.83 as a refund for a medical bill he paid more than a year ago after bringing his kid to the hospital and having the emergency physician sew up his kid’s head. In essence, since balance billing is now “illegal” in California, Sabban is stating that the hospital and emergency physicians shouldn’t have billed him for what his insurance didn’t cover. He is being represented by Vincent Slavens, a partner at Krause Kalfayan Benink and Slavens in San Diego.

The Daily Journal expects that if a wave of class action suits over the case occurs, “hospitals and ER doctors could be on the hook for hundreds of millions of dollars in collective refunds to patients.”

I “Googled” the terms “Ariel Sabban” and “San Diego” and the first thing that popped up was this link to the California Bar Association.

Is Ariel Sabban’s full name “Ariel Joseph Sabban” and is he a San Diego attorney with the firm Murray, Hayes & Sabban?

If Krause Kalfayan Benink and Slavens is able to obtain class action status in their law suit, they have the potential to get a large settlement on behalf of the “class” who will each likely end up with a pittance in “reimbursement”. You have to know that a class action is what the firm is shooting for – why else would they file a lawsuit over $57?
If Ariel Sabban is an attorney, he just might have a “referral fee” arrangement with the law firm representing him, which could mean that a class action settlement becomes a windfall for him — all over his $57 “overpayment.”

Whomever Ariel Sabban is, he can revel in the fact that his frivolous lawsuit will likely be the straw that breaks the back of the California emergency medical system.

Everyone in California should realize just how bad their emergency medical care is about to get. I already posted about the difficulties with emergency medical care in California HERE and HERE. According to the Daily Journal article, 70 hospital emergency departments in California have closed in the past 13 years. It’s not going to get better.

When your dad is dripping with sweat, can’t breathe and is clutching his chest with a heart attack and seconds count, the next hospital emergency department that closes because of lack of funding just may be the one down the street from you. When your child stops breathing and you have to drive an hour or more in traffic and hope that you get to the hospital before your child dies, think of the California Supreme Court’s ruling about balance billing and ask yourself whether the lives of your family were worth $57.

My advice to California emergency physicians: Leave.
My advice to California emergency physician groups: Give notice to each and every hospital that you work at that you will not renew your contract and send the notice to the editors of the newspapers. Then leave.
My advice to other groups that might want to do business in California: Avoid California like the plague.
My advice to Californians: Put some law firm phone numbers on your speed dials for when you have a medical emergency. After all, everyone knows that lawyers are more important than doctors, anyway.

I said that cases like this would create a public health crisis … here it comes.

Boy am I glad I’m a doctor.

49 Responses to “Another Gash In The California Safety Net”

  1. hashmd says:

    This is an indictment of the legal system as well. Since when can a class action lawsuit proceed for an incident that was not labelled “illegal” until AFTER the event occurred?

    • Matt says:

      “Illegal” applies to criminal acts. A class action is a civil matter. It’s hard to tell from this post whether it was actually made a criminal offense, but I doubt it. Also, if it is prohibited, there is nothing “frivolous” about this suit, unless the term “frivolous” means simply “something White Coat disagrees with”.

      If balance billing is prohibited, then the hospital shouldn’t be allowed to keep the funds. Can you think of another method for the people who were wrongly billed to recover? Hundreds of thousands of individual suits in small claims courts around California? Is that a more desirable result? If your credit card billed you an extra $10 in interest every month for a year, would it be “frivolous” for you to sue to get that $120 back?

      But hey, why would the California docs leave? They’ve got some brutal tort “reform”, which according to so many of these docs, including White Coat, is the key to getting more doctors in your state. Screw the elderly and kids, and your state is physician nirvana, they claim. Did they lie to us?

      • scalpel says:

        That is a strawman argument; nobody made any such claim. Yes tort reform is important, and when properly implemented can improve the practice climate in a state and therefore, all else being equal, entice more physicians to work there, as has happened in Texas. But getting paid for one’s services is the sine qua non of any job, and if we can get paid more with less hassle elsewhere, then it shouldn’t be surprising when the inevitable occurs.

  2. ERP says:

    This case is just truly shocking. Who knows what ripple effect will occur.

  3. J says:

    This is complete lunacy. The lawyers in CA will certainly stay busy. I guess this is their own economic stimulus package.

  4. Amy says:

    Is it bad that as a medical student I’m sort of glad for the s— to hit the fan like this? I feel like that makes me a terrible, unempathetic person on some level, but if they’re going to push us and push us and push us (like bullies on a schoolyard) then it’s time for us to finally walk away entirely. I’m tired of watching physicians have the life squeezed out of them while the good ones (which are most of them) just keep trying to stay afloat and take care of patients.

    I’m ready for the shit to hit the fan. I’m just glad it’s not starting near home.

  5. Matt says:

    “My advice to California emergency physicians: Leave.
    My advice to California emergency physician groups: Give notice to each and every hospital that you work at that you will not renew your contract and send the notice to the editors of the newspapers. Then leave.
    My advice to other groups that might want to do business in California: Avoid California like the plague.”

    If this is the advice physicians readers are getting, I hope they’re smart enough not to follow it, unless you WANT universal healthcare. You choose this route and you’ll all be members of the federal employee’s union so fast you won’t know what happened. Do you really think a Democratic president who believes in universal healthcare, as this one does, is going to lose California’s electoral votes because he can’t deliver Californians healthcare?

    Or do you think that California the state or Californians are going to magically pay you more in the midst of a budget crisis and recession? Particularly after they gave you tort reform during your last “crisis”.

    You better get your lobbying in order before you start issuing threats like that. Average salary of an ED Physician in CA – around $120K. Wonder what the average California salary overall is? You better figure it out before your walkout starts.

    • scalpel says:

      Do you really believe that physicians can be forced to practice in a particular state? If your numbers are correct, ER docs can easily make two or three times as much money in other states already, some with no state income tax and equally protective tort reforms.

      • Matt says:

        2-3x? Show me areas with comparable demographics that pay that much more – on AVERAGE. I doubt rural Texas allows the average to get any higher.

        It’s not that you will be “forced” to practice, it’s just that California’s population is too big to ignore, and you’re all going to be government employees making essentially the same, with adjustments for costs of living in particular areas, of course.

      • Amy says:

        You may doubt that rural Texas averages any higher, but you are wrong. Salaries in Texas are some of the highest in the country (with the best medicolegal climate to boot). I’m having trouble finding the numbers, but even academic jobs in Texas are paying over 200k. Fee for service jobs are probably closer to 250-300k.

    • Kim says:

      @Matt: Do you feel all educated professionals should make no more than the state’s average salary, or just emergency medicine doctors?

  6. Matt says:

    “If Ariel Sabban is an attorney, he just might have a “referral fee” arrangement with the law firm representing him, which could mean that a class action settlement becomes a windfall for him — all over his $57 “overpayment.””

    One more thing – you can’t get a referral fee when you’re the named class member in a class action. Trying to do things that way brought down Milberg Weiss.

  7. Matt says:

    “That is a strawman argument; nobody made any such claim.”

    Nobody made that claim? Really? No one has held up Texas as flooded with physicians because of their “reform”(putting aside the fact it doesn’t actually show that)? Have you read any of these sites?

    You’ve yet to show you can make more in Texas, so perhaps you might want to confirm that before you go granting it most favored state status. Kind of like the claim that Texas is all the sudden flooded with physicians, even though they lag behind the population growth, you’re light on facts, long on assumptions.

  8. scalpel says:

    Texas is indeed flooded with physicians because of our successful tort reform, but they would just as quickly leave if we made the same idiotic billing restrictions as California. Nobody said that tort reform was ALL that was required for “physician nirvana.”

    And ER docs here generally make $100-$200+/hour. I don’t know what they make in Cali, but I suspect your numbers are wrong.

  9. Matt` says:

    If by “flooded” you mean trailing population growth, then you’ve radically redefined the term. But hey, this is politics, so I guess you can do that.

    You’re right, no one said that was “all” it took, but strangely no one mentions in their press releases and their tort reform lobbying efforts all the other things. And you still haven’t shown that Texas has anything else. You’ve made lots of assumptions though, so I guess Texas has those.

    According to the same site that gave me the Cali number, http://www.indeed.com/salary?q1=emergency+medicine+physician&l1=Texas, Texas is about the same. What are your numbers based on? Do they include the salaries down in Orange, or up in Borger, places like that?

  10. scalpel says:

    I live in Texas, I practice emergency medicine in Texas, and I have actually been employed by several different emergency departments in Texas including one in a town that is half the population of Orange and just down the road from that hellhole.

    I don’t know where that website gets its information, but I suspect it’s from the same place that you get your expert witnesses. GIGO.

  11. paul says:

    this is good news, as far as i’m concerned. true reform will not happen in this country until the system collapses or is on the brink of collapse. people who would risk decimating emergency care in cali so they can get their 50 dollars should help that process right along.

  12. Matt` says:

    “I don’t know where that website gets its information, but I suspect it’s from the same place that you get your expert witnesses. GIGO.”

    Yeah, I’m sure your anecdotal evidence is a much better basis for an average. You should call the Dept. of Labor, too. Save them the trouble of surveys when they can just call and ask you about the “several” places you’ve been employed.

  13. DensityDuck says:

    Ah yes, the classic refuge of the loser; “oh well that’s just ANECDOTAL EVIDENCE”.

  14. Matt says:

    Actually, the comparison was to a review of three (“several”) v. a survey of the state. But perhaps you have better figures? I keep hearing assumptions, but no citations to actual statistics one can examine objectively. Is that too much to ask? Or do you guys really believe Texas pays that much more than Cali based on your “gut feelings”?

  15. Jill says:

    I think that after considering all of the attorney fees, court fees, time, etc., the amount would surpass the $57.83 he is suing for.

  16. stephen h says:

    I think Matt is just a troll. he seems to love making the opposite argument in order to attract more comments. on a previous post, I asked him why lawyers, mainly who sue mal[practice, didnt make the system more just by charging a per hourly, instead of percentage,a nd he never answered.

    Not to be biased, but I cannot imagine him saying anything that would go against his big lawsuit, big judgement, jackpot jury system of thinking. I wonder if he works for more than 100 an hour,a nd if so how he justifies his paper pushing as equivalent, and of equal worth, to somebody who saves lives on a daily basis.

    the fact is, california is going down for the count in more ways than one. this is just one more thing that will add pressure to a system that already is close to the breaking point. when, not if, it breaks, then people like matt will be the ones that then blame physicians for the lack of care being available.

    • paul says:

      oh for sure a lawyer troll. there’s another one i’ve seen prowling this site. neither one can be argued with so i stopped wasting my time.

      maybe white coat can allow their continued participation on the condition that they change their screen name to “i am part of the problem”

    • WhiteCoat says:

      I agree that Matt’s comments can be frustrating and note that, through all his posts, he has only given one link to back up any of his assertions. When he makes an assertion and is shown to be wrong, he typically abandons the thread.
      Paul has the right idea.
      That being said, Matt’s posts remain civil and he does raise valid points to consider. For example, I wasn’t aware that class action participants couldn’t obtain referral fees until Matt posted it.
      If you can substantively answer Matt’s posts, just imagine how well-prepared you’ll be to argue the issues with others. :-)
      One of the purposes of this blog is to encourage discussions about the topics, so I won’t censor anyone just because I don’t agree with his/her thought processes.

    • Matt says:

      ” I asked him why lawyers, mainly who sue mal[practice, didnt make the system more just by charging a per hourly, instead of percentage,a nd he never answered.”

      I apologize, I missed the question. The short answer is that the victims of malpractice typically can’t afford to pay hourly, particularly if they have the kind of injury that leads to a large verdict. They typically can’t work, so they’re not making their normal household bills. If you believe the insurers that trying a med mal case costs at least $100K, where is that money supposed to come from for the average joe?

      I do work for over $100/hr. You can too, you have just chosen a different payment model. Of course, according to the Dept. of Labor, the physician payment model results in an average salary nearly 50% higher than the average lawyer. You may not find it particularly valuable, but people need help in more areas than just having their lives saved.

      As for Cali going down healthcare wise, it won’t happen. It will more likely be the straw that breaks the camel’s back with regard to universal healthcare. You mentioned it in passing above, but do you realize you are more focused on disliking my profession (incidentally, I’ve only handled 3 med mal cases in 10 years) than you are on reforming the payment model in your own? That’s your real problem, not the outside chance your insurer one day pays a judgment due to your malpractice, or the likely statistically insignificant chance any money ever comes out of your pocket for your malpractice. I’ve looked and only found reports of 3 or 4 doctors who ever were bankrupted, and they all had many, many judgments, and had been suspended for misconduct by their medical boards.

      • Matt: Do you or do you not support ending the privity obstacle to legal malpractice cases by adverse third parties? As you know, 80% of medmal claims are weak, and fail. The filing of a weak case is legal malpractice. No other type of party has had a privity obstacle to a negligence claim for the past 100 years.

        [Remainder of comment redacted. Please do not engage in ad hominem attacks]

  17. tyro says:

    Matt is distracting from the real argument. If people are allowed to sue retrospectively for all of the billing that is now ‘illegal’, that 120K is now substantially reduced.

    The real issue is that the ED safety net which sees all as an unfunded mandate just got a lot harder in california and the state will undoubtedly have trouble because of it. The idea of a lawyer to class action sue is terrible with regards to keeping services alive. Keep in mind that when the malpractice costs got too high in Las Vegas, the trauma center closed in protest.

    As if I can be scared of government healthcare as a california EP when I apparently only make 120K before malpractice and now can be sued for the majority of my already recovered billing for the past few years. This looks bad to me.

  18. Julie says:

    Problem seems to be that if ER Docs in California leave there will be some other group in some other state who think that they can do better and in spite of the system, they can make it work. It will take them about 5-10 years to figure out they can’t and then they will leave and some other group will follow suit. The bottom line is ER Docs just want to take care of patients and it is convienient to take jobs that are close, you don’t have to move and disrupt your wife or husband and their job or your joint life style. Moving is traumatic for all and in this economy even more so.

    We are all like sheep, each one of us thinks we are better than the other guy and that we could not possibly fall victim to the lawyers. No one pays attention to the trends, or what is going on in their state and realises that it could and probably will happen to them. As Amy so aptly says, “I am glad it is not happening near my home” I rest my case.

    We as a group of Doc’s are very slow to recognise that yes the attorneys are going to pursue this, it is their own stimulus, job security, package and yes we as a group will suffer and continue until we band together and do something about it.

    Problem comes back to the sheep, we just keep doing things to stay a float and meantime the lawyers are having a field day and will always find other ER Doc’s who will, go to court, testify against us. I am not saying that clear cases of malpractice shouldn’t be dealt with, however there will always be people to pontificate about the ideal situation, when each and everyone of us knows that in most non teaching situations, there are no ideal situations.

    Like any group, we should learn from history and our mistakes and moves of the past, I agree with Matt, Get out of California, there will be others to take our place but at the rate the lawyers are going that might not last as long as one thinks.

  19. Matt says:

    “through all his posts, he has only given one link to back up any of his assertions.”

    Is there an assertion I’ve made that you think I can’t back up? I can provide links, usually government links, to any claim I make.

    ” If people are allowed to sue retrospectively for all of the billing that is now ‘illegal’, that 120K is now substantially reduced.”

    Maybe, maybe not. Are you arguing that hospitals are budgeting for funds they know they aren’t legally entitled to recover?

    “Keep in mind that when the malpractice costs got too high in Las Vegas, the trauma center closed in protest.”

    So is your solution to allow balance billing? I mean, I see the complaint – but I’ve yet to see the solution you’re advocating? Continue allowing hospitals to violate the law?

    As usual, you guys are turning on lawyers, when your real problem here is how healthcare is funded. You’re missing the boat.

  20. [...] Another Gash In The California Safety Net [...]

  21. [...] fallout from California’s balance billing ban is about to get much, much [...]

  22. The scenario above may take place, and people may die trying to reach ER’s because the nearby one is closed.

    In my state, that happened for a few days. The ER could not pay its insurance and closed. People in car crashes were flown to another ER in the adjoining state an hour away. Within days, the Governor sent a check to the insurance carrier, and it reopened. I anticipate such a remedy, except Cali has no money for checks to ER’s.

    That leaves holding the cult criminals on the Cali Supreme Court accountable. They should be forced to resign, impeached, or driven out of town by street justice meted out by bereaved family members. To deter. There is full moral and intellectual self-defense justification for a remedy against lawyers who kill.

  23. 4Q2 says:

    Matt,
    you are a [redacted] lawyer. Your mental masturbation is so typical of a lawyer. You do not provide services of any significant value. You just [redacted] all the people who are actually trying to help real live patients live and survive sometimes terrible illnesses. You sit back and watch the carnage and with your all knowing retrospectoscope analyze and judge the care you couldn’t provide even if I held your hand and mind every step of the way, because you have never actually taken care of a live, breathing, anxious, scared human being in real time.
    There is a role for lawyers, but most of you have never had to do anything of life saving importance (note I did not say of savings account importance) in your lifetime. So walk a mile in my shoes [redacted], feel the lifeblood bleed out of a real live person seeking your help and then come to me with your legalistic arguments and I will listen. Until then, [redacted] leave the decent doctors out there just trying to save people from the various vagaries of life and their bad habits. Rant off.
    Just another pissed off M.D.

    It is perfectly acceptable to take issue with someone’s arguments. Please no ad hominem attacks.

  24. Matt says:

    I sit back and watch the carnage? Actually, I am the one who is there when you send them back out into the world because they’ve reached maximum medical improvement. Sure, you’re the hero in the confines of your workspace, and deserve to be applauded – but life doesn’t stop once they leave the hospital.

    I’m the one who helps them navigate the maze of insurance when the drunk driver who hit them’s insurance company won’t pay and the bills they owe you are piling up, your collection companies are calling every night, and you are sending process servers.

    I’m the one who helps them get the protective order, and find a shelter to hide them when the bastard who knocked them around makes bail. You want to talk real time? Feel a woman in a chair in the courtroom sitting next to you shake with fear at the mere sight of her POS boyfriend despite cops and bailiffs everywhere around. That’s real.

    I’m the one who when one of your colleagues operating drunk or high mangles them to where they can’t work, makes the SOB’s insurer pay for the care (money that goes back in your hands) they need, make the mortgage, make the car payment, buy groceries, get on disability. Where are you then? Tut-tutting about jackpots?

    Don’t be so arrogant. There’s more to life than what you do.

    • Whoa says:

      Matt, sometimes frustration gets in the way of good people’s thought processes. Thanks for bringing us back to reality.
      I needed the help from a lawyer just like you not too long ago and I’m glad that there was someone on my side.
      For once I agree with you and I appreciate the examples of what you do to help others.

  25. Matt refuses to answer a simple question of equal treatment, and the left wing blogger protects him from ad hominem comments. Yet, when Matt calls people names, and issues personal attacks calling doctors sons of bitches, drunk and arrogant, there is no redaction of Matt’s misleading comments. The left wing ideologue loves the rent seeking lawyer.

    I invite Matt to come to Pennsylvania where we know how to deal his ilk. No plaintiff lawyer should file a weak claim without facing personal destruction for years. Always countersue, and file a monthly ethics charge, parsing every utterance for a violation. Do so for a decade.

    If the lawyer is more than 5 minutes late, file a complaint with the judge of the case. Every bullying remark, file a complaint with the judge demanding the disqualification of the plaintiff lawyer. Parse every word of the plaintiff expert for a false fact, and demand a mistrial and all legal costs from the judge of the case from the assets of the expert. Once this has been done, demand total ediscovery of the personal computers of the plaintiff, of the plaintiff lawyer, and the plaintiff expert. The insurance defense attorney will refuse to do that. One must hire a personal attorney to terrorize the insurance attorney into doing its job.

    So far the intimidation has been only in one direction. It is high time to strike the lawyer bullies and predators in the nose. As they give no quarter, so only their personal destruction, and their leaving the state will suffice. Suicide of the lawyer would suffice as well.

  26. If the person is a slimeball, please, explain why he cannot be accurately labeled. Let the slimeball rebut the characterization with facts if inaccurate.

  27. 4Q2 says:

    Matt,
    You think doctors don’t see the patients once they leave the Hospital or rehab? Your kidding right? Some of these poor souls become ” frequent flyers” if they survive the acute illness/injury. You think lawyers are the only professionals that get to experience the anger/frustration/grief/depression/name your emotion related to medical illness and the loss of income/status/divorce/disability/bankruptcy/etc? Your absolutely right there is far more to life than what I do, and for that matter what you do as well. I applaud all you do to help these poor souls and bad doctors deserve to be punished. A bad outcome does not mean that the patient received poor care. Try doing your job with a lawyer looking over your shoulder and breathing down your neck every day ( of course reviewed months or years later, in a nice conference room, with little bottles of water on the table, in a quiet, contemplative atmosphere,not obviously in real time with hysterical family members pleading ” save my husband/wife/mother/father/son/etc.). Again, walk a mile in my shoes, make real time decisions, not retrospective ones.
    Supremacy Claus,
    I couldn’t agree more with your comments.

  28. Matt says:

    I didn’t say you never saw them again. I said that what you do is not the complete picture of their lives.

    “Try doing your job with a lawyer looking over your shoulder”

    Your perception is not reality. It is a tiny, tiny percentage of the people you see that will ever go see a lawyer about your care, and an even smaller number where the lawyer will even take the case on an exploratory basis, and a smaller number yet where the patient will have a claim the attorney is willing to pursue. So what lawyer is breathing down your neck every day? Because you might, maybe, someday have a claim you’ve got a lawyer breathing down your neck? That makes no sense. Do you feel like that every time you speed when you’re driving? That because you might possibly get in a wreck because of your driving there’s a lawyer breathing down your neck in the car?

    You want everyone to walk in your shoes before they comment, but you feel quite comfortable criticizing others, namely lawyers, who you know little about. Or are you trying cases on the side? Do you realize the hypocrisy of this position?

    And really, back to an earlier point, do you realize how much time you waste getting incensed at lawyers when your profession is about to become a wholly owned subsidiary of the federal govt? You spend so much money, time, and energy damning lawyers on behalf of your liability carriers, while Daschle and his ilk are working to add you to the federal employees’ union. If you should be worried about anything, it’s that.

  29. Matt says:

    “That leaves holding the cult criminals on the Cali Supreme Court accountable. They should be forced to resign, impeached, or driven out of town by street justice meted out by bereaved family members. To deter. There is full moral and intellectual self-defense justification for a remedy against lawyers who kill.”

    And these are the comments you couldn’t agree more with? They’re not even sane.

  30. The government is a wholly owned subsidiary of the criminal cult enterprise that is the lawyer profession. The elected and other high officials are figurehead puppets. About 99% of policy decisions are made by lawyers indoctrinated into its supernatural doctrines and loyal only to enterprise rent seeking. this is true of lawyers of all political affiliation and of all beliefs. The lawyer enterprise wants to control and plunder the health care budget, as a mob takeover of a business would. The criminal element of criminal cult enterprise fully justifies public self-help. The legal system is rigged airtight, and there is no other recourse. It is almost a public duty to kill the Mafia when they come around to take over and plunder a neighborhood.

    The lawyer called me insane in an inappropriate ad hominem attack. The blogger did not remove that attack. He only censors dissent from left wing extremists.

    • WhiteCoat says:

      First, Matt said that your “comments” were not even sane, not that you were insane.
      I don’t get into the left wing/right wing stuff and I’m not going to engage in playground politics.
      I try to keep the discussions on point. Using foul language and/or calling names doesn’t further that goal.
      Sorry if that upsets you.

  31. Matt refuses to answer this question. Will he support ending the privity obstacle to a legal malpractice claim by an adverse third party?

    This is a neutral question and not anti-plaintiff. If a plaintiff is the victim of a frivolous defense, he should be able to sue the defense attorney, since the filing of a frivolous defense is legal malpractice.

    Why won’t Matt support ending a privilege no other party has had as a defense for over 100 years? What justifies this unique lawyer, self-dealt immunity?

  32. WC: I think you would enjoy part time law school. You would do well, since parsing word for word is what they teach. I say that as a compliment, not as the insult it may appear.

    Matt can defend himself. There is nothing wrong with summary characterizations as a short hand theory to explain the anomalous arguments of the lawyer. If someone is a “slimeball,” their low morals explain their views. “Slimeball” is a short hand category for the many elements of lawyer rent seeking.

    The Rent Seeking Theory best explains all anomalous lawyer behavior, especially appellate decisions. It actually helps to predict 70% of Supreme Court decisions, and trumps all political affiliations and religious beliefs of the Justices.

    http://en.wikipedia.org/wiki/Rent-seeking

    It is a fancy name for literal not metaphorical armed robbery, i.e. “Slimeball.” Someone with a gun collects your taxes, and the public gets nothing in return.

  33. anon says:

    physicians will never be made government employees because that will restrict access to civil remedies under malpractice torts. It is very very difficult to sue a government employee in the performance or their duty, VA doctors for example.

    If, however, the economic benefit of practicing medicine is reduced and the risk is not, well the doctors remaining will either be fewer in numbers or lower in quality, If you don’t understand that, you are not a serious person.

  34. sj says:

    The ER doc who saw my wife for a max of 15 minutes including charting time & research (and offered no solutions, only excluded one significant thing it wasn’t) still received a few hundred bucks from our insurance company. Isn’t that enough? He was a decent fellow, but his group’s president has lied through his teeth to the local newspaper about how they would not do balance billing even if it were legal. Why then do they threaten to take my wife to collections even now that it IS ILLEGAL in the state of California? Screw the attorneys and bureaucrats, they are mostly parasites. But you better start policing your own, because dear doctors, some of your kind are indeed greedy and unethical and they are giving you all a bad name. Come to think of it, I know no other profession where the customer has effectively no choice but to pay a month later for whatever costs they were never told about up front much less asked permission for regardless whether the attempts to help did help or not or were even in the ballpark. Pass the buck to yet another specialist- “no we have no answers but we will be happy to take your money anyway…” My mechanic would be in jail, lose his BAR & business license, and be liable for civil damages if he tried doing to our cars what has been done to my wife!

  35. DocD says:

    The doctors get cheated and the attorneys and patients reap the full rewards with this legal ruling – here is why- Lets pretend an ER doc and hospital bill is $3000 and the rate they have to accept is $1200 this leaves an open unpaid balance of $1800 which THEY are NOT ALLOWED to COLLECT and have to WRITE OFF. So this injured person leaves the ER with his $3000 bill which his insurance only paid $1200 on he takes the FULL bill of $3000 to the attorney. It is common practice for personal injury attorneys to use a multiple of 2x-3x the medical bills as a rule when they are seeking a settlement for an injured client. So the attorney will multiple the $3000 bill by 3 and demands a settlement of $9000. The insurance company may settle for say 70% of that ($6300) the attorney will be paid 33% (the going rate for attorney fees) $2079 and the patient gets the rest $4221.
    Doctor and Hospital (who did ALL the WORK and pays taxes): $1200
    Attorney (who does virtually nothing): $2079
    Patient (hits a huge TAX FREE pay day): $4221
    The attorneys love this new law as they can now spread the wealth with the client keeping they money that should rightfully go to the doctors and they walk away like bandits for doing virtually zero work to get the money. I should have gone to law school. Lawyers have a license to steal!

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