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	<title>Comments on: Healthcare Update &#8211; 02/02/2010</title>
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	<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/</link>
	<description>A blog from inside the emergency department</description>
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	<item>
		<title>By: WhiteCoat</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16951</link>
		<dc:creator>WhiteCoat</dc:creator>
		<pubDate>Tue, 09 Feb 2010 05:38:19 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16951</guid>
		<description><![CDATA[Still waiting for the manifesto, Matt ....
*crickets*]]></description>
		<content:encoded><![CDATA[<p>Still waiting for the manifesto, Matt &#8230;.<br />
*crickets*</p>
]]></content:encoded>
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		<title>By: WhiteCoat</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16950</link>
		<dc:creator>WhiteCoat</dc:creator>
		<pubDate>Tue, 09 Feb 2010 05:35:49 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16950</guid>
		<description><![CDATA[Hey - some of us have jobs to work. And I still haven&#039;t received page 1 from your manifesto on proper prospective care about &lt;i&gt;anything&lt;/i&gt; there, Justice Roberts. 

You know how to use Google. Look the answers up yourself. Go to the National Practitioner Data Bank and you can find a ton of statistics. 

According to this NPDB Summary report, there were a total of 270,000 reports of medical malpractice between MDs and DOs between 1990 and 2010. Twenty billion divided by 270,000 is about 74,000. So malpractice reports are made in roughly 1 in 74,000 patient interactions. 
http://www.npdb-hipdb.hrsa.gov/pubs/stats/NPDB_Summary_Report.pdf

According to the 2006 report, the inflation adjusted mean payment was $332,000 and the inflation adjusted median payment was $107,000. 
http://www.npdb-hipdb.hrsa.gov/pubs/stats/2006_NPDB_Annual_Report.pdf

Of course there is malpractice and of course patients need to be compensated when malpractice occurs.  

What&#039;s your point? 

Because there aren&#039;t a lot of multimillion dollar judgments doctors shouldn&#039;t be afraid of them? I&#039;m not buying what you&#039;re trying to sell. Lawyers use the exact opposite when roasting medical malpractice defendants. &quot;This life threatening complication can occur 1 in 100,000 times and the negligent doctor should have known to look for it.&quot; 
By your logic, the state lottery system should go bankrupt, also. 

Your angle on the unreasonableness of fears doesn&#039;t take into account the adverse licensing and malpractice implications of a NPDB report, either. Do you even have an inkling of what&#039;s involved with those? An iota? A quark?

I&#039;m sure many patients suffer damages in the multimillions. And I&#039;m all for compensating patients fairly. If there are multimillion dollar damages, then the patients should have periodic payments for their economic expenses. Right now the families and their attorneys get a windfall. If the patient dies two days after payment of damages, how much long term economic damages are there? Does the family have to return the unused economic damage money? After all, lawsuits are about *fairly* compensating patients, aren&#039;t they, Matt?]]></description>
		<content:encoded><![CDATA[<p>Hey &#8211; some of us have jobs to work. And I still haven&#8217;t received page 1 from your manifesto on proper prospective care about <i>anything</i> there, Justice Roberts. </p>
<p>You know how to use Google. Look the answers up yourself. Go to the National Practitioner Data Bank and you can find a ton of statistics. </p>
<p>According to this NPDB Summary report, there were a total of 270,000 reports of medical malpractice between MDs and DOs between 1990 and 2010. Twenty billion divided by 270,000 is about 74,000. So malpractice reports are made in roughly 1 in 74,000 patient interactions.<br />
<a href="http://www.npdb-hipdb.hrsa.gov/pubs/stats/NPDB_Summary_Report.pdf" rel="nofollow">http://www.npdb-hipdb.hrsa.gov/pubs/stats/NPDB_Summary_Report.pdf</a></p>
<p>According to the 2006 report, the inflation adjusted mean payment was $332,000 and the inflation adjusted median payment was $107,000.<br />
<a href="http://www.npdb-hipdb.hrsa.gov/pubs/stats/2006_NPDB_Annual_Report.pdf" rel="nofollow">http://www.npdb-hipdb.hrsa.gov/pubs/stats/2006_NPDB_Annual_Report.pdf</a></p>
<p>Of course there is malpractice and of course patients need to be compensated when malpractice occurs.  </p>
<p>What&#8217;s your point? </p>
<p>Because there aren&#8217;t a lot of multimillion dollar judgments doctors shouldn&#8217;t be afraid of them? I&#8217;m not buying what you&#8217;re trying to sell. Lawyers use the exact opposite when roasting medical malpractice defendants. &#8220;This life threatening complication can occur 1 in 100,000 times and the negligent doctor should have known to look for it.&#8221;<br />
By your logic, the state lottery system should go bankrupt, also. </p>
<p>Your angle on the unreasonableness of fears doesn&#8217;t take into account the adverse licensing and malpractice implications of a NPDB report, either. Do you even have an inkling of what&#8217;s involved with those? An iota? A quark?</p>
<p>I&#8217;m sure many patients suffer damages in the multimillions. And I&#8217;m all for compensating patients fairly. If there are multimillion dollar damages, then the patients should have periodic payments for their economic expenses. Right now the families and their attorneys get a windfall. If the patient dies two days after payment of damages, how much long term economic damages are there? Does the family have to return the unused economic damage money? After all, lawsuits are about *fairly* compensating patients, aren&#8217;t they, Matt?</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16914</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Sun, 07 Feb 2010 17:32:36 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16914</guid>
		<description><![CDATA[*crickets*]]></description>
		<content:encoded><![CDATA[<p>*crickets*</p>
]]></content:encoded>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16890</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Sat, 06 Feb 2010 07:58:47 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16890</guid>
		<description><![CDATA[Hi Matt - 1. My friend did know she could sue and that is what is special ..imo. Her family was upset ..but she sat down and explained to her adult children why she would not sue and they understood.

2.I don&#039;t think any physicians would just hand over money. But I think they&#039;d understand if you were in a catastrophic situation and they knew they were at fault.

The thing about being a doc (from what I can tell) tho is that their patient encounters/work can be fraught with potential landmines when they are genuinely doing their best in such a noble profession as facilitating healing in their fellow man. It doesn&#039;t seem fair.

3.I understand the need for the ability to file suit in catastrophic cases if it was the fault of the doc.  But ..there are so many variables.. and so should be clear cut.

I am 100% against the MacDonald (coffee was too hot&quot; kind of law suit ..the unfair..frivolous ones. I also think if a case is frivolous and tossed out ..the person trying to do that should be responsible for the doc&#039;s legal expenses ..matter of fact ALL suits should be that way.]]></description>
		<content:encoded><![CDATA[<p>Hi Matt &#8211; 1. My friend did know she could sue and that is what is special ..imo. Her family was upset ..but she sat down and explained to her adult children why she would not sue and they understood.</p>
<p>2.I don&#8217;t think any physicians would just hand over money. But I think they&#8217;d understand if you were in a catastrophic situation and they knew they were at fault.</p>
<p>The thing about being a doc (from what I can tell) tho is that their patient encounters/work can be fraught with potential landmines when they are genuinely doing their best in such a noble profession as facilitating healing in their fellow man. It doesn&#8217;t seem fair.</p>
<p>3.I understand the need for the ability to file suit in catastrophic cases if it was the fault of the doc.  But ..there are so many variables.. and so should be clear cut.</p>
<p>I am 100% against the MacDonald (coffee was too hot&#8221; kind of law suit ..the unfair..frivolous ones. I also think if a case is frivolous and tossed out ..the person trying to do that should be responsible for the doc&#8217;s legal expenses ..matter of fact ALL suits should be that way.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16828</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 05 Feb 2010 07:10:28 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16828</guid>
		<description><![CDATA[SeaSpray, I understand your friend&#039;s rationale.  But a couple of thoughts:

1.  On your friend&#039;s case, I don&#039;t think that&#039;s as unique as you think.  The number of medical errors is far, far higher than there are claims.  Most people don&#039;t sue for med mal, either because they don&#039;t know about it or because their claim isn&#039;t large enough to be worth the trouble, or a large set because they fully recovered and it&#039;s not worth the headache.

2.  You say some people want more money, but often those people want money to pay bills.  If you don&#039;t sue, the physician and their insurer aren&#039;t just going to hand you all you need. 

3.  Your physicians aren&#039;t going to understand if they don&#039;t agree with you that their mistake caused your debilitating injury.  They&#039;re going to be very angry, and their insurance company, who is actually paying those damages, isn&#039;t going to have all these warm and fuzzy understanding feelings either.  They&#039;re going to expect the lawyers that represent your doctor to do all they can to reduce what you get paid to the absolute minimum they can.

I appreciate your good feelings, and it would be nice if all our interactions can be like that.  But at the end of the day your physician isn&#039;t and probably can&#039;t write a check for millions in future care.  And their insurer doesn&#039;t give a damn about your warm feelings for their insured doctor.  They don&#039;t make money by PAYING claims.]]></description>
		<content:encoded><![CDATA[<p>SeaSpray, I understand your friend&#8217;s rationale.  But a couple of thoughts:</p>
<p>1.  On your friend&#8217;s case, I don&#8217;t think that&#8217;s as unique as you think.  The number of medical errors is far, far higher than there are claims.  Most people don&#8217;t sue for med mal, either because they don&#8217;t know about it or because their claim isn&#8217;t large enough to be worth the trouble, or a large set because they fully recovered and it&#8217;s not worth the headache.</p>
<p>2.  You say some people want more money, but often those people want money to pay bills.  If you don&#8217;t sue, the physician and their insurer aren&#8217;t just going to hand you all you need. </p>
<p>3.  Your physicians aren&#8217;t going to understand if they don&#8217;t agree with you that their mistake caused your debilitating injury.  They&#8217;re going to be very angry, and their insurance company, who is actually paying those damages, isn&#8217;t going to have all these warm and fuzzy understanding feelings either.  They&#8217;re going to expect the lawyers that represent your doctor to do all they can to reduce what you get paid to the absolute minimum they can.</p>
<p>I appreciate your good feelings, and it would be nice if all our interactions can be like that.  But at the end of the day your physician isn&#8217;t and probably can&#8217;t write a check for millions in future care.  And their insurer doesn&#8217;t give a damn about your warm feelings for their insured doctor.  They don&#8217;t make money by PAYING claims.</p>
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		<title>By: SeaSpray</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16827</link>
		<dc:creator>SeaSpray</dc:creator>
		<pubDate>Fri, 05 Feb 2010 06:55:20 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16827</guid>
		<description><![CDATA[Matt - I understand in that case.  Then you are forced into it. Those are legitimate reasons to help and protect the patients in a bad situation.

I just could not hurt my doctors. I could not. It would have to be for a situation so bad that one wouldn&#039;t recover and then I would think even docs understand. I don&#039;t think anyone negates that.

But if a doc has done everything they can, you know they&#039;ve worked hard on your behalf ..they&#039;ve been a great doctor, supportive, skilled and there for you... you know they did their best ..then how do you turn on someone? Things don&#039;t always work out the way we want in life.

I have a question for the doctors that read this?

If you as a practicing physician were harmed by your doctor..unintentionally ..but as a patient was left as Matt describes... would you sue? 

I just thought of that question and I have never seen a doctor address that.  What would doctors do if they suffered harm from their doc?  WC ..what would you do?

I think I&#039;ve said this here before, but Matt you may not have read it.

I have a friend who has severe asthma and after years of working had to go on disability. She had been going to her doc for years and had a great rapport with him and the staff.

She was about to get her monthly injection..when a pediatric emergency came in and the nurse had to leave.  When she came back in ..she injected my friend with 10 x the dose and she went into an immediate anaphylactic reaction and woke up 3 days later in ICU. Her doc had told the husband to get family together because it wasn&#039;t good. But she rallied back. She had a heart problem which was caused by that and they put her on meds.

She said when she woke up her doc was standing next to her husband by her bed and he looked ashen. She told him she wouldn&#039;t sue and not to fire the nurse because it was a mistake. She said he looked like he didn&#039;t believe her. They allowed her to go on vacation,but she had to stay in the beach house. She sent them a post card, telling them she was alright and for them not to worry. When she went back to the office they all hugged and cried. Her heart condition cleared and she has been fine for years now.

*I admire her so much for that.* I&#039;d like to think I am that patient/person too.  She could&#039;ve won a suit ..but she did not want to harm them and she recognized it for what it was. An honest mistake.  She actually told them &quot;if her kids bake a cake, make a mistake and leave something out the cake doesn&#039;t turn out right. But if a DR or nurse makes a mistake ..they could kill someone. Everyone makes mistakes.&quot;

That was her rationale.

MORE people should be like that.  What&#039;s most important is she lived and is well. But some people would want money anyway.

Regarding suing my mother&#039;s nursing home (assuming there is actually just cause).. it would be like blood money or I don&#039;t know ..whatever I bought..I&#039;d remember why I had it. It would just feel very wrong.  I do feel I will have to do something if something is wrong and I don&#039;t know ..like I said ..maybe a meeting to air my feelings.. maybe like WC said ..report them.  Or maybe I should try to bury it all.

I also hope I am not disrespecting Mom by not looking into it. It&#039;s very painful to think about. Honestly I have extremely mixed feelings about it, it was a tough year ..that I was feeling I was beginning to get past and I don&#039;t want to get dragged back into the worst feelings.]]></description>
		<content:encoded><![CDATA[<p>Matt &#8211; I understand in that case.  Then you are forced into it. Those are legitimate reasons to help and protect the patients in a bad situation.</p>
<p>I just could not hurt my doctors. I could not. It would have to be for a situation so bad that one wouldn&#8217;t recover and then I would think even docs understand. I don&#8217;t think anyone negates that.</p>
<p>But if a doc has done everything they can, you know they&#8217;ve worked hard on your behalf ..they&#8217;ve been a great doctor, supportive, skilled and there for you&#8230; you know they did their best ..then how do you turn on someone? Things don&#8217;t always work out the way we want in life.</p>
<p>I have a question for the doctors that read this?</p>
<p>If you as a practicing physician were harmed by your doctor..unintentionally ..but as a patient was left as Matt describes&#8230; would you sue? </p>
<p>I just thought of that question and I have never seen a doctor address that.  What would doctors do if they suffered harm from their doc?  WC ..what would you do?</p>
<p>I think I&#8217;ve said this here before, but Matt you may not have read it.</p>
<p>I have a friend who has severe asthma and after years of working had to go on disability. She had been going to her doc for years and had a great rapport with him and the staff.</p>
<p>She was about to get her monthly injection..when a pediatric emergency came in and the nurse had to leave.  When she came back in ..she injected my friend with 10 x the dose and she went into an immediate anaphylactic reaction and woke up 3 days later in ICU. Her doc had told the husband to get family together because it wasn&#8217;t good. But she rallied back. She had a heart problem which was caused by that and they put her on meds.</p>
<p>She said when she woke up her doc was standing next to her husband by her bed and he looked ashen. She told him she wouldn&#8217;t sue and not to fire the nurse because it was a mistake. She said he looked like he didn&#8217;t believe her. They allowed her to go on vacation,but she had to stay in the beach house. She sent them a post card, telling them she was alright and for them not to worry. When she went back to the office they all hugged and cried. Her heart condition cleared and she has been fine for years now.</p>
<p>*I admire her so much for that.* I&#8217;d like to think I am that patient/person too.  She could&#8217;ve won a suit ..but she did not want to harm them and she recognized it for what it was. An honest mistake.  She actually told them &#8220;if her kids bake a cake, make a mistake and leave something out the cake doesn&#8217;t turn out right. But if a DR or nurse makes a mistake ..they could kill someone. Everyone makes mistakes.&#8221;</p>
<p>That was her rationale.</p>
<p>MORE people should be like that.  What&#8217;s most important is she lived and is well. But some people would want money anyway.</p>
<p>Regarding suing my mother&#8217;s nursing home (assuming there is actually just cause).. it would be like blood money or I don&#8217;t know ..whatever I bought..I&#8217;d remember why I had it. It would just feel very wrong.  I do feel I will have to do something if something is wrong and I don&#8217;t know ..like I said ..maybe a meeting to air my feelings.. maybe like WC said ..report them.  Or maybe I should try to bury it all.</p>
<p>I also hope I am not disrespecting Mom by not looking into it. It&#8217;s very painful to think about. Honestly I have extremely mixed feelings about it, it was a tough year ..that I was feeling I was beginning to get past and I don&#8217;t want to get dragged back into the worst feelings.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16822</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 05 Feb 2010 05:09:33 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16822</guid>
		<description><![CDATA[&quot; I’m asking you to look prospectively – how do we prevent all these “mistakes”?
You won’t even venture an answer because by doing so it cuts off your ability to earn money with your retrospectoscope. “If only the negligent doctor has done this differently, my poor client would never have suffered these grave injuries ….”&quot;

WC, was that the question you wanted me to answer?  I can&#039;t.  I have no idea how to improve the way you deliver your services.  Like you in practicing law, I don&#039;t have the background to suggest that.  That&#039;s on you. 

I do know that at least one group of providers, anesthesiologists, did in fact look very hard at what they were doing and have significantly reduced their premiums:

http://www.medicalnewstoday.com/articles/26452.php

Whether that can translates to what you do I don&#039;t know.  

I am certain, though, that it will require you looking into the past, something you don&#039;t like doing, apparently.

And like I said, I don&#039;t really earn any money off med mal.  Of the two cases in over a decade of practicing that I have handled, one settled very low five figures pre-suit with the hospital as it was a nurse&#039;s actions, and one settled high six figures but involved what was an intentional act followed by falsifying the medical records.  Also resolved pre-suit.  So your constant insinuations and accusations that I&#039;m somehow horrible because you think I earn a living doing this type of law don&#039;t really make sense.  

And really, even if I did make my living handling those cases, it wouldn&#039;t necessarily bolster your arguments any by calling me greedy.  I realize that demonization is part of today&#039;s political discourse, but for some inexplicable reason I expect more of you.]]></description>
		<content:encoded><![CDATA[<p>&#8221; I’m asking you to look prospectively – how do we prevent all these “mistakes”?<br />
You won’t even venture an answer because by doing so it cuts off your ability to earn money with your retrospectoscope. “If only the negligent doctor has done this differently, my poor client would never have suffered these grave injuries ….”&#8221;</p>
<p>WC, was that the question you wanted me to answer?  I can&#8217;t.  I have no idea how to improve the way you deliver your services.  Like you in practicing law, I don&#8217;t have the background to suggest that.  That&#8217;s on you. </p>
<p>I do know that at least one group of providers, anesthesiologists, did in fact look very hard at what they were doing and have significantly reduced their premiums:</p>
<p><a href="http://www.medicalnewstoday.com/articles/26452.php" rel="nofollow">http://www.medicalnewstoday.com/articles/26452.php</a></p>
<p>Whether that can translates to what you do I don&#8217;t know.  </p>
<p>I am certain, though, that it will require you looking into the past, something you don&#8217;t like doing, apparently.</p>
<p>And like I said, I don&#8217;t really earn any money off med mal.  Of the two cases in over a decade of practicing that I have handled, one settled very low five figures pre-suit with the hospital as it was a nurse&#8217;s actions, and one settled high six figures but involved what was an intentional act followed by falsifying the medical records.  Also resolved pre-suit.  So your constant insinuations and accusations that I&#8217;m somehow horrible because you think I earn a living doing this type of law don&#8217;t really make sense.  </p>
<p>And really, even if I did make my living handling those cases, it wouldn&#8217;t necessarily bolster your arguments any by calling me greedy.  I realize that demonization is part of today&#8217;s political discourse, but for some inexplicable reason I expect more of you.</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16804</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 05 Feb 2010 01:04:54 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16804</guid>
		<description><![CDATA[WC you said people don&#039;t worry about fender benders and for the most part you&#039;re right- IF they have insurance. If you don&#039;t then you probably care very much because if you don&#039;t have a few hundred for insurance you probably don&#039;t have q few thousand to pay out of pocket for a new fender. 

Those of us with insurance know it&#039;s remote we will ever pay any of an excess judgment. So you, for one, don&#039;t worry about a fender bender. Do you know how likely it is you&#039;ll ever pay out of your pocket in a malpractice case?  More or less likely than the fender bender in excess of your car liability coverage?]]></description>
		<content:encoded><![CDATA[<p>WC you said people don&#8217;t worry about fender benders and for the most part you&#8217;re right- IF they have insurance. If you don&#8217;t then you probably care very much because if you don&#8217;t have a few hundred for insurance you probably don&#8217;t have q few thousand to pay out of pocket for a new fender. </p>
<p>Those of us with insurance know it&#8217;s remote we will ever pay any of an excess judgment. So you, for one, don&#8217;t worry about a fender bender. Do you know how likely it is you&#8217;ll ever pay out of your pocket in a malpractice case?  More or less likely than the fender bender in excess of your car liability coverage?</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16803</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 05 Feb 2010 00:58:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16803</guid>
		<description><![CDATA[SeaSpray, you said you&#039;d be glad to waive a claim for simple negligence and I understand.  But if you were injured by that negligence and had significant long term injuries rendering you uninsurable, who would pay for your care?  Especially if you couldn&#039;t work?]]></description>
		<content:encoded><![CDATA[<p>SeaSpray, you said you&#8217;d be glad to waive a claim for simple negligence and I understand.  But if you were injured by that negligence and had significant long term injuries rendering you uninsurable, who would pay for your care?  Especially if you couldn&#8217;t work?</p>
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		<title>By: Matt</title>
		<link>http://www.epmonthly.com/whitecoat/2010/02/healthcare-update-02022010/#comment-16802</link>
		<dc:creator>Matt</dc:creator>
		<pubDate>Fri, 05 Feb 2010 00:55:17 +0000</pubDate>
		<guid isPermaLink="false">http://www.epmonthly.com/whitecoat/?p=4302#comment-16802</guid>
		<description><![CDATA[I&#039;m typing on an iPhone killing time in an airport. Hard to keep track of all your questions on a small screen.  Which ones specifically?

Although I posed four rather straightforward ones to you that remain unanswered so your scorn seems a bit premature.]]></description>
		<content:encoded><![CDATA[<p>I&#8217;m typing on an iPhone killing time in an airport. Hard to keep track of all your questions on a small screen.  Which ones specifically?</p>
<p>Although I posed four rather straightforward ones to you that remain unanswered so your scorn seems a bit premature.</p>
]]></content:encoded>
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