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I'm sure Texans are happy to allow the free market to sort this problem out.

jerf 13y ago
That doesn't sound like an unregulated system. That sounds like a system where the regulation didn't work. One of the reasons I'm much less gung-ho about regulation as the answer to everything is that I acknowledge that case exists, and must be considered carefully rather than unconsciously assumed away. Regrettably, this complicates things compared to a world in which we could just assume the problem away, but we don't live in that world. Those who could have stopped it had their ability to do so regulated away: The board’s mandate, spelled out in the Medical Practice Act, recognizes a doctor’s license as a hard-won, valuable credential. Doctors’ rights are to be protected at every step of the process. The board can’t revoke a license without overwhelming evidence, and investigations can take months, with months or years of costly hearings dragging on afterward. (Quote is trimmed a bit; a justification follows, but is a prime example of how regulation failed to consider an edge case and then made damned sure everybody else was obligated to fail to consider it as well.)
- masklinn 13y ago
  > That doesn't sound like an unregulated system. > That sounds like a system where the regulation didn't work. No, it's a system where all regulatory authority and ability has been willfully destroyed over the last decade. http://www.texasobserver.org/anatomy-tragedy/ http://www.texasobserver.org/anatomy-tragedy/ > But in the past 10 years, a series of conservative reforms have severely limited patients’ options for holding doctors and hospitals accountable for bad care. In 2003, the Republican-dominated Texas Legislature capped pain-and-suffering damages in medical malpractice lawsuits at $250,000. Even if a plaintiff wins the maximum award, after you pay your lawyer and your experts and go through, potentially, years of trial, not much is left. > The Legislature has also made suing hospitals difficult. Texas law states that hospitals are liable for damages caused by doctors in their facilities only if the plaintiff can prove that the hospital acted with “malice”—that is, the hospital knew of extreme risk and ignored it—in credentialing a doctor. But the Legislature hindered plaintiffs’ cases even more by allowing hospitals to, in most cases, keep credentialing information confidential. In effect, plaintiffs have to prove a very tough case without access to the necessary hospital records. This is an almost impossible standard to meet, and it has left hospitals immune to the actions of whatever doctors they bring on. Hospitals can get all of the benefit of an expensive surgeon practicing in their facility and little of the exposure. This has freed hospitals from the fear of litigation, but it’s also removed the financial motivation for policing their own physicians. > The medical malpractice cap and the near-immunity for hospitals snapped two threads from the regulatory web. What remained was the Texas Medical Board. > But the Medical Board wasn’t designed to be an aggressive enforcer. It was mostly designed to monitor doctors’ licenses and make sure the state’s medical practitioners are keeping up with professional standards. The board’s mandate, spelled out in the Medical Practice Act, recognizes a doctor’s license as a hard-won, valuable credential. Doctors’ rights are to be protected at every step of the process. The board can’t revoke a license without overwhelming evidence, and investigations can take months, with months or years of costly hearings dragging on afterward. The protections make some sense. The Legislature doesn’t want the Medical Board taking a doctor’s license—and livelihood—unnecessarily or based on flimsy or frivolous claims. But the result is that unless a doctor is caught dealing drugs or sexually assaulting patients—or is convicted of a felony—it is difficult to get his or her license revoked. > What all this means is that the Texas Legislature has committed the state to a policy of medical deregulation—a free-market system in which doctors can practice as they please with limited government interference. Only their consciences, and those of their fellow doctors, limit them.
  - dec0dedab0de 13y ago
    That sounds like regulation is working, just in favor of the doctors over the patients.
- anigbrowl 13y ago
  That doesn't sound like an unregulated system. [...] Those who could have stopped it had their ability to do so regulated away: It's the doctors & hospitals who are the regulated parties. The Medical Board are the regulators. Stripping them of their authority effectively leaves the medical practitioners unregulated. You're arguing that one group of meddling bureaucrats were hobbled by another group of meddling bureaucrats. Think through it again.
speeder 13y ago
This is actually a case of opposite of free market. Like the article said, if it was easier to people fire him when he was still a student for example, without fear of being sued, this would be averted. Also the licensing system is broken (ie: license is mandatory by law, law says hospitals can trust the license, licensing organization is broken and give broken licenses... what to do? Good hospitals will expend money to research the guy, but the average hospitals will trust the law, that says that if the guy has a license, he has right to be licensed...)
- masklinn 13y ago
  > This is actually a case of opposite of free market. > Like the article said, if it was easier to people fire him when he was still a student for example, without fear of being sued, this would be averted. That makes no sense. How would more free market yield less suits exactly? What would the mechanism for righting wrongs be, smashing people's heads in without court interference?
  - dragonwriter 13y ago
    > Free market proponents always claim righting wrongs is done by suing, how would more free market yield less suits exactly? While free market proponents tend to claim that lawsuits are the place to correct wrongs, the things they tend to favor abolishing are the laws that provide the basis for lawsuits against particular wrongs; fewer bases on which lawsuits can be sustained can reasonably be expected to lead to fewer lawsuits. > What would the mechanism for righting wrongs become, smashing people's heads in? For wide classes of things that are widely considered "wrong" now and for which self-styled "free market" proponents would abolish the legal remedies, yes, extra-legal remedies would be the only remedies available.
    - masklinn 13y ago
      > fewer bases on which lawsuits can be sustained can reasonably be expected to lead to fewer lawsuits. It might lead to fewer successful lawsuits, but I'm not sure why it would lead to fewer lawsuits.

jerf 13y ago

That doesn't sound like an unregulated system. That sounds like a system where the regulation didn't work. One of the reasons I'm much less gung-ho about regulation as the answer to everything is that I acknowledge that case exists, and must be considered carefully rather than unconsciously assumed away. Regrettably, this complicates things compared to a world in which we could just assume the problem away, but we don't live in that world. Those who could have stopped it had their ability to do so regulated away: The board’s mandate, spelled out in the Medical Practice Act, recognizes a doctor’s license as a hard-won, valuable credential. Doctors’ rights are to be protected at every step of the process. The board can’t revoke a license without overwhelming evidence, and investigations can take months, with months or years of costly hearings dragging on afterward. (Quote is trimmed a bit; a justification follows, but is a prime example of how regulation failed to consider an edge case and then made damned sure everybody else was obligated to fail to consider it as well.)

masklinn 13y ago
> That doesn't sound like an unregulated system. > That sounds like a system where the regulation didn't work. No, it's a system where all regulatory authority and ability has been willfully destroyed over the last decade. http://www.texasobserver.org/anatomy-tragedy/ http://www.texasobserver.org/anatomy-tragedy/ > But in the past 10 years, a series of conservative reforms have severely limited patients’ options for holding doctors and hospitals accountable for bad care. In 2003, the Republican-dominated Texas Legislature capped pain-and-suffering damages in medical malpractice lawsuits at $250,000. Even if a plaintiff wins the maximum award, after you pay your lawyer and your experts and go through, potentially, years of trial, not much is left. > The Legislature has also made suing hospitals difficult. Texas law states that hospitals are liable for damages caused by doctors in their facilities only if the plaintiff can prove that the hospital acted with “malice”—that is, the hospital knew of extreme risk and ignored it—in credentialing a doctor. But the Legislature hindered plaintiffs’ cases even more by allowing hospitals to, in most cases, keep credentialing information confidential. In effect, plaintiffs have to prove a very tough case without access to the necessary hospital records. This is an almost impossible standard to meet, and it has left hospitals immune to the actions of whatever doctors they bring on. Hospitals can get all of the benefit of an expensive surgeon practicing in their facility and little of the exposure. This has freed hospitals from the fear of litigation, but it’s also removed the financial motivation for policing their own physicians. > The medical malpractice cap and the near-immunity for hospitals snapped two threads from the regulatory web. What remained was the Texas Medical Board. > But the Medical Board wasn’t designed to be an aggressive enforcer. It was mostly designed to monitor doctors’ licenses and make sure the state’s medical practitioners are keeping up with professional standards. The board’s mandate, spelled out in the Medical Practice Act, recognizes a doctor’s license as a hard-won, valuable credential. Doctors’ rights are to be protected at every step of the process. The board can’t revoke a license without overwhelming evidence, and investigations can take months, with months or years of costly hearings dragging on afterward. The protections make some sense. The Legislature doesn’t want the Medical Board taking a doctor’s license—and livelihood—unnecessarily or based on flimsy or frivolous claims. But the result is that unless a doctor is caught dealing drugs or sexually assaulting patients—or is convicted of a felony—it is difficult to get his or her license revoked. > What all this means is that the Texas Legislature has committed the state to a policy of medical deregulation—a free-market system in which doctors can practice as they please with limited government interference. Only their consciences, and those of their fellow doctors, limit them.
- dec0dedab0de 13y ago
  That sounds like regulation is working, just in favor of the doctors over the patients.
anigbrowl 13y ago
That doesn't sound like an unregulated system. [...] Those who could have stopped it had their ability to do so regulated away: It's the doctors & hospitals who are the regulated parties. The Medical Board are the regulators. Stripping them of their authority effectively leaves the medical practitioners unregulated. You're arguing that one group of meddling bureaucrats were hobbled by another group of meddling bureaucrats. Think through it again.

speeder 13y ago

This is actually a case of opposite of free market. Like the article said, if it was easier to people fire him when he was still a student for example, without fear of being sued, this would be averted. Also the licensing system is broken (ie: license is mandatory by law, law says hospitals can trust the license, licensing organization is broken and give broken licenses... what to do? Good hospitals will expend money to research the guy, but the average hospitals will trust the law, that says that if the guy has a license, he has right to be licensed...)

masklinn 13y ago
> This is actually a case of opposite of free market. > Like the article said, if it was easier to people fire him when he was still a student for example, without fear of being sued, this would be averted. That makes no sense. How would more free market yield less suits exactly? What would the mechanism for righting wrongs be, smashing people's heads in without court interference?
- dragonwriter 13y ago
  > Free market proponents always claim righting wrongs is done by suing, how would more free market yield less suits exactly? While free market proponents tend to claim that lawsuits are the place to correct wrongs, the things they tend to favor abolishing are the laws that provide the basis for lawsuits against particular wrongs; fewer bases on which lawsuits can be sustained can reasonably be expected to lead to fewer lawsuits. > What would the mechanism for righting wrongs become, smashing people's heads in? For wide classes of things that are widely considered "wrong" now and for which self-styled "free market" proponents would abolish the legal remedies, yes, extra-legal remedies would be the only remedies available.
  - masklinn 13y ago
    > fewer bases on which lawsuits can be sustained can reasonably be expected to lead to fewer lawsuits. It might lead to fewer successful lawsuits, but I'm not sure why it would lead to fewer lawsuits.