Friday, July 31, 2009

Attorneys' Laws 1-9

I have often heard that the fist law of Attorneys is that the attorney always gets paid. Well I saw today that Nancy Pelosi and Harry Reid are hiding in the health care bill provisions that allow attorneys to deduct all expenses in contingency cases as soon as they are incurred. Their idea is that this tax break will help improve access to trial lawyers and encourage attorneys to take cases that they would otherwise turndown. Not to mention that it would make the trial lawyers wealthier. Since the second through ninth laws of being an attorney are also, "attorneys always get paid," I guess the tenth is that they dont have to pay taxes.

Well I thought of our situation in medicine. We by law can not deduct from taxes our expenses for taking care of the indigent. For the most part neither can the hospitals or other health care providers. It seems that we are the only business that can not deduct bad debt. Would allowing medical providers to deduct their expenses help with access? Tax incentives seem to have worked in other areas, why not medicine? Right now, hospitals off set the cost of taking care of the indigent and the under insured by trying to get the most from the private insured. As a result, the private insured are paying more and more. Reducing the tax load reduces the hospital overhead, the lower the overhead, the less is needed from the private insured to make the hospital run. This lets the hospital negotiate lower contracts and thus more funds are available for care.

Oh, nevermind. I just saw that they want to add tax to private insurance and to increase the tax on hospitals. Just take what I said and reverse it.


Flarin' Karen said...

The sick employed people with "job lock" choose the most benefits with the highest premiums and will be the ones not only paying the most for premiums and deductibles, but also will get taxed on top of that to subsidize the care of the those healthy uninsured and unemployed 20 somethings. Now there is change I can believe in.

SeaSpray said...

Good points Throckmorton.

It doesn't seem fair. Physicians put so much effort into training and it never stops and you're working with human lives. It is such a noble profession. And through reading the med blogs... I have learned just how much time you put in that you are never compensated for. Being on call...having to take care of indigent ED patients and no guarantee of being paid. The office paperwork and phone calls, always being concerned about potential lawsuits, smaller payments from ins, etc., etc., and I just wonder why you aren't treated with more respect?

*** It seems to me they should be doing what they can to aid all providers so they can continue to maintain quality care. hospitals don't have to close for lack of funds.

And WHY would they encourage more lawsuits? It seems assbackwards!

Frankly...I am surprised they want to give ANYONE a tax break. Dems don't grasp the concept of over taxing, driving business out and thus people lose jobs etc.

It is surreal... the amount of things that are being taxed under this administration.

I was listening to Rush while driving today and he brought up the fact that sen Dodd has prostate CA and wanted to know if he would be having the surgery done in Canada or France..think he said France. But I was thinking... the politicians won't have to worry about their health care.

You know what is absolutely mind boggling to me? That these MAJOR bills can be passed without the politicians going over them line by line..actually reading and challenging questionable policies, etc. And something as important as health care being approved by Aug 7th? That was absurd.

Was watching Greta earlier and she had Drs/Senators Barrasso and Coburn on and they have a web show tues/thurs live 5pm. Can google it.

Flarin' Karen said...

And WHY would they encourage more lawsuits? It seems assbackwards!

Oh ye of little cynicism. Lawyers and law firms contributed $233 million dollars to congressional campaigns for 2008.

Supremacy Claus said...

What an elegant solution to the problem of the uninsured.

The uncollected fee is deducted at the full Medicare level. In the doctor's tax bracket, after state and local taxes, that is equivalent to getting half the fee. Most doctors would gladly fulfill their desire to treat if they could get half the fee.

This approach is far simpler and reliable than setting up the planned bureaucracy of 100,000 shiftless, lazy, moving as if at the bottom of a pool of molasses, worthless, government workers.

SeaSpray said...

I hate that political outcomes are influenced by the almighty dollar.
I've really had my eyes opened since perusing the med and occasional law blogs.

I erroneously, naively believed most politicians worked for the good of the country. I had know idea they (including the president) don't have to read what they are passing, regardless of the fact that it will impact all of us one way or the other and it's the other that worry's me. It truly is mind boggling. WHAT *are* we paying them for.
Not only is it disturbing and alarming...but it saddens me greatly. I guess my view of it all was too idealistic.

It's true Karen..I'm not the cynical type... but sadly..I am becoming Jaded.Still...can't wallow in it. I guess the only way to hopefully effect a cure is chipping away..a little at a time.
It's all so massive and even with cooperation..I feel like they don't know what they are doing. said "This approach is far simpler and reliable than setting up the planned bureaucracy of 100,000 shiftless, lazy, moving as if at the bottom of a pool of molasses, worthless, government workers." I feel the same way... particularly about the pool of molasses.

I truly do not get why they would RUSH this health care stuff through. There should be meetings with doctors, lawyers, patient advocates, insurance companies and government officials.

Maybe find a way to incorporate the best of socialized health care with ours as a compromise... without losing all choices.

perhaps the insurance companies that have unfairly been denying claims for both physicians and patients and pocketing the money (I know there are investors too) will become more reasonable if they think their companies will go bust. It seems there could be some leverage used against them if they want to keep their companies.

One thing that does sound appealing to me is that you wouldn't lose your insurance if you switched jobs or had a preexisting condition. There are unfair things that happen to people to. or lose your house over something catastrophic... God forbid. But the trade off of being denied appropriate care because one is deemed to old or a poor risk for the financial expenditure is frightening.

I love that elderly people are beginning to assert their opinions and protesting. They had to be removed from Sen Feinstein's office. :)Hopefully more and more people will protest. I don't understand what people thought they'd actually get as change. or how just because you are dissatisfied with one president... they allow the whole party to go down the tubes... thus enabling another with such drastically different views to take hold. can't anyone see the larger picture anymore?

We need balance. We need people on both sides to work for the *good of the country* and not for partisan gain. Wouldn't that be refreshing!

It seems these blogging docs have some really good ideas. I still say THEIR voices need to be heard in places beyond the medical blogosphere.

Yours is one of them..voice of reason Throckmorton.

SeaSpray said...

Hi Throckmorton -I left a couple of comments in your Buck Stops Here post.

I know you don't usually answer questions now.. but I did ask you a few I was curious about and wondering if you could explain.