February 16, 2005 - 00:31 [z-05:00]

       I want to say something about tort reform. In order to do that, I have to say something about the state of medicine in South Carolina.

       The only good thing I have to say about medicine in the Palmetto State is that the quality of doctors is as good or better here than any place else you can find. MUSC and USC-Med turn out excellent, caring physicians in every field. That's the good news.

       The bad news is manifold and omnipresent.

Hospitals: The more they take on, the more dangerous they become. The bigger they become the more dangerous they become. These are not laws of nature. It doesn't have to be this way. But big institutions, by their nature, have to rely on one-size-fits-all regulations. A nurse should not have to learn more than one set of rules. But the nature of healing demands individualization. Modern, large hospitals cannot do this without trying very, very hard. Baptist Hospital in Columbia has worked hard to be this sort of hospital. Frankly, I don't know how they do it. Certainly Greenville Memorial doesn't know how to. I do know, from personal knowledge, that they don't.

       The big ones are also dangerous because they are ridiculously expensive. But this is not always their fault. They have to treat anybody who comes in, regardless of ability to pay. It's both South Carolina law and Federal law. And that does add to the expense. But they also dangle pretty, modern toys in front of Doctors. Those toys cost immoderate amounts of money. Then there are the buildings and buildings and buildings. Hospitals have no business EMPLOYING doctors, but they do - high class very expensive ones. That costs you money too.

       But Big Hospitals are not the only health care cost problem.

Medicine costs have risen almost 300% in the past 15 years.

Ancillary medical costs like crutches and ambulance rides have also risen three times. It took them 20 years to do it, but it still happened.

       Then there is the cost of Medical Insurance.

       When I started my first business in Charleston back in 1975, I could make $3,000 a week and live like a king on two-thousand a month, including a house payment! My medical insurance did not exist except for the catastrophe medical and life insurance which everybody in company enjoyed. A trip to the best doctor in Charleston (who wasn't kidding himself) was $25. Most were $15. Mood altering drugs were expensive and penicillin was cheap - 3 bucks for 30.

       Lawyers only sued doctors who really screwed up.

       Government-mandated health insurance was non-existent.

Then came Nixon and Ford and Carter. Medicare, Medicaid, Health insurance, and Social Security as a retirement instrument. People discovered a new civil right - to sue for displeasure, suspicion, and inferred effrontery. Everybody became a victim.

       Everybody wanted to get rich - And, Right Now.

So what's the answer?

       Restraining greedy lawyers is fine, but it's not the answer by itself. Price-fixing drugs will only work for a while and then it becomes a bigger monster as suppliers dwindle and the market sees too much money chasing too few items. Suing big hospitals is inevitable, but it's not the answer, either. All big hospitals (and that includes Greenville Memorial, Charleston County, Mary Black and others) should be forced to study Baptist Hospital in Columbia to find out how they manage to be big and stay a caring, loving, medical wonder.

       No, the answer is getting rid of health insurance, except for catastrophic circumstances. Insurance for Cancer, Kidney Machines, Paraplegia, that sort of thing.

       If you remove health insurance, doctors become competitive for what money there is. Hospitals do the same. Inventors still get their royalties, but they won't be as big because the market won't stand it. You have a MRI to sell us? OK. Let's make that $60,000 rather than $3,000,000. After all, the parts and labor only cost you $600.00.

       SO.. you feel like hell. Your doctor, who just persuaded you to use his services, drops by your house and looks at and writes you a prescription for a Z-pak. You pony up $45 and ten bucks for the z-pak. You're back at work in three to five days without breaking you buttocks in twain. there's no paperwork. You did break out in a rash the first four hours, but you trust your doctor, there was no harm, and the board of arbitration is frowning on "discomfort" lawsuits these days.

       Two weeks later, your son gets run over by a drunk Bubba Truck Company driver. He needs major surgery, a CAT-scan and lab work. He's in the hospital for five weeks and, by the grace of God, he survives, but is a paraplegic. For this, you have been paying 100 bucks a month to Zowie Catastrophic Insurance. They pay for the entire medical stay, no questions asked. The Bubba Truck Company is sued by your best friend, Amilio the Lizard Zepharelli, an extremely competent attorney, and your son is awarded the equivalent of a salary that would be made by any college graduate for a lifetime plus physical retraining costs - $8,000,000. The Lizard bills you for $4,000,000, but the Lawyers board says he can only get 20%, or a mil-six. "And all is well in the garden," as Chance, the Gardener, would say.

       Nothing is perfect. There will always be those who can't or won't work with the system and fall through the cracks. But if you want to stop the spiraling costs of medicine, kill health insurance. It can be done in drips and drabs with definitive time limits and ear-muffs (to block out the sounds of the liberals) so as to not be traumatic to the pocketbook of companies who feed off the living bodies of the sick. But we must reform the insurance system and the legal system together.

       If we don't, expect nothing but rising prices, more government control, and, eventually financial chaos.

       And that's what I wanted to say about tort reform.