The ECONOMICS of Health Care (part 3)

Hey, this is really PART 4. Too many bong hits this morning. I could close the thread but nah... I know the folks who actually read this info are a cut above.

This is another part in a complete series which takes a hard look at the reality behind the political spin. \

==========================================================

Costs Of Malpractice Insurance Go Beyond Doctors' Premiums

Posted 10/30/2009 07:15 PM ET

This is the fourth installment of a nine-part series excerpting the chapter on medical care from the new edition of economist Thomas Sowell's "Applied Economics."
A major source of the high cost of American medical care is malpractice insurance for doctors and hospitals. The average cost of this insurance for individual doctors ranges from about $14,000 a year in California to nearly $40,000 a year in West Virginia. In particular specialties, such as obstetrics and neurosurgery, the cost of malpractice insurance can exceed $200,000 a year in some places.
These costs of course get passed on to patients, the government or whoever is paying for medical treatments. Even so, these are not the only financial costs created by medical malpractice lawsuits, nor are financial costs the only costs or necessarily the most important costs.
The threat of lawsuits can impose costs on obstetricians that raise their insurance premiums high enough to cause many of these doctors to stop delivering babies, or to stop delivering them in places where high jury awards on dubious evidence make it uneconomic to continue practicing obstetrics.
The net result of this can be that pregnant women in those places are at more risk than before because now there may be no doctor available in the vicinity to deliver their baby when the time comes.
Nor are obstetricians the only doctors who flee from places where it is easy to file lawsuits and win large damage awards. Pennsylvania, for example, lost one third of its surgeons between 1995 and 2002.
Ideally, juries would award malpractice damages only when the probability that malpractice had actually taken place was sufficiently clear, and the award only at a level sufficient to compensate real damages and deter such malpractice in the future.
In reality, an injured, deformed, or brain-damaged baby and an eloquent lawyer can lead to jury awards in the millions of dollars, even when it is by no means clear that the doctor who delivered that baby was in any way at fault.
A large study conducted jointly by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics — released in 2003 and reviewed and approved by leading medical authorities in and out of government, as well as from as far away as Australia and New Zealand — concluded that "the vast majority of brain damage and cerebral palsy among these infants originates in factors largely or completely outside the control of delivery room personnel."
According to The Economist, "few clinicians think that babies get cerebral palsy because the obstetrician failed to deliver them by caesarean section." Yet "fear of being sued prompts doctors to perform unnecessary C-sections — a risky and invasive procedure." Nevertheless, "a fivefold increase in C-sections in rich countries in the past three decades has brought no decrease in the incidence of cerebral palsy."
Seventy-six percent of American obstetricians have been sued at least once. The rationale for medical malpractice lawsuits is to force doctors to be more careful and thereby reduce risks to patients. The actual consequences, however, include unnecessary medical procedures, such as delivering babies by Caesarean section, as well as ordering medically unnecessary tests that doctors feel are financially necessary to protect themselves against lawsuits.
There may also be additional risks to patients when substantial numbers of doctors leave an area where malpractice lawsuits are easy to file and win.
Doctors usually win lawsuits that go to trial, but the pressure to settle out of court is substantial, since the average damage award in jury trials is $4.7 million.
Given the size of the damage awards and the resulting escalating costs of malpractice insurance, it is hardly surprising that defensive medicine has become widespread among obstetricians. A study of obstetricians in Pennsylvania found that "54% frequently called for tests, like sonograms, they felt were unnecessary and 38% often admitted to invasive procedures, like biopsies, that were not called for."
Such "defensive medicine" may not make patients any safer and in some cases, such as Caesarean sections and biopsies, can create additional risks. It is not merely the damages awarded in medical malpractice cases that add to the costs of medical care but also the greatly increased costs of defensive medical procedures.
It costs a jury nothing to "send a message" warning doctors to be more careful, and the particular doctor in the case at hand probably has insurance from a company that can pay a few million dollars easily out of its billions of dollars in assets.
Only if the jurors think beyond stage one will they take into account the increased cost of medical treatment brought on by their awards and future non-financial costs to pregnant women unable to find obstetricians at the time of delivery and the lifelong costs to babies who may incur more or worse injuries or disabilities as a result.
This is especially likely to be the end result in states where juries hand out multimillion-dollar awards readily, such as Nevada:
Kimberly Maugaotega of Las Vegas is 13 weeks pregnant and hasn't seen an obstetrician. When she learned she was expecting, the 33-year-old mother of two called the doctor who delivered her second child but was told he wasn't taking any new pregnant patients. Dr. Shelby Wilbourn plans to leave Nevada because of soaring medical-malpractice insurance rates there. Ms. Maugaotega says she called 28 obstetricians but couldn't find one who would take her.
While direct costs of malpractice lawsuits have been estimated as less than 1% of the total cost of medical care in the United States, the indirect costs include expensive tests and procedures, as well as the additional medical risks to patients that some of these tests and procedures pose.
Perhaps the biggest costs are those imposed on patients who cannot find a doctor available because the ease of filing malpractice lawsuits in particular places has led doctors to relocate. These costs are literally incalculable.
There is, of course, genuine malpractice, genuinely deserving of lawsuits and large damage awards. However, the ease of filing and winning lawsuits on the basis of shaky or speculative evidence, or on the testimony of "hired gun" experts who have financial incentives to back up what is said by the lawyer who hired them, has made the connection between malpractice lawsuits and genuine malpractice tenuous.
As in so many cases, political "solutions" to the malpractice problem can create new problems.
One popular political solution has been to put upper limits on the amount of awards for "pain and suffering." But if the carelessness or incompetence of some physician or surgeon has in fact caused someone to be in pain for the rest of his or her life, a quarter of a million dollar cap, as in California, is completely inadequate as compensation and inadequate as a deterrent.
The fundamental problem is not with the amounts of money awarded, as such, but with the fact that there may be no adequate basis for any award at all.
With laws and policies on medical malpractice, as with other laws and policies, what is most important from a political perspective may be the goals and rationales of those laws and policies. But from the standpoint of economic analysis, what is most important are the incentives and constraints created by laws and policies, and the consequences from those incentives and constraints — not only in stage one but beyond.

Excellent read once again CJ.

Where are you grabbing these articles from? I know who they're from, but what website is running this?

Excellent reading! Agreed and ditto!

Obama Santa said:

Excellent reading! Agreed and ditto!

Click to expand...

The message above was posted by the douchebag, Cloud City. The Real ObamaSanta does not endorse any statement made by this treasonous mutt.

I pull it from my subscription of the IBD. A newspaper for those who are economically inclined.

CrackerJax said:

I pull it from my subscription of the IBD. A newspaper for those who are economically inclined.

Click to expand...

Nice avatar by the way, CJ.

CrackerJax said:

Hey, this is really PART 4. Too many bong hits this morning. I could close the thread but nah... I know the folks who actually read this info are a cut above.

This is another part in a complete series which takes a hard look at the reality behind the political spin. \

==========================================================

Costs Of Malpractice Insurance Go Beyond Doctors' Premiums

Posted 10/30/2009 07:15 PM ET

This is the fourth installment of a nine-part series excerpting the chapter on medical care from the new edition of economist Thomas Sowell's "Applied Economics."
A major source of the high cost of American medical care is malpractice insurance for doctors and hospitals. The average cost of this insurance for individual doctors ranges from about $14,000 a year in California to nearly $40,000 a year in West Virginia. In particular specialties, such as obstetrics and neurosurgery, the cost of malpractice insurance can exceed $200,000 a year in some places.
These costs of course get passed on to patients, the government or whoever is paying for medical treatments. Even so, these are not the only financial costs created by medical malpractice lawsuits, nor are financial costs the only costs or necessarily the most important costs.
The threat of lawsuits can impose costs on obstetricians that raise their insurance premiums high enough to cause many of these doctors to stop delivering babies, or to stop delivering them in places where high jury awards on dubious evidence make it uneconomic to continue practicing obstetrics.
The net result of this can be that pregnant women in those places are at more risk than before because now there may be no doctor available in the vicinity to deliver their baby when the time comes.
Nor are obstetricians the only doctors who flee from places where it is easy to file lawsuits and win large damage awards. Pennsylvania, for example, lost one third of its surgeons between 1995 and 2002.
Ideally, juries would award malpractice damages only when the probability that malpractice had actually taken place was sufficiently clear, and the award only at a level sufficient to compensate real damages and deter such malpractice in the future.
In reality, an injured, deformed, or brain-damaged baby and an eloquent lawyer can lead to jury awards in the millions of dollars, even when it is by no means clear that the doctor who delivered that baby was in any way at fault.
A large study conducted jointly by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics — released in 2003 and reviewed and approved by leading medical authorities in and out of government, as well as from as far away as Australia and New Zealand — concluded that "the vast majority of brain damage and cerebral palsy among these infants originates in factors largely or completely outside the control of delivery room personnel."
According to The Economist, "few clinicians think that babies get cerebral palsy because the obstetrician failed to deliver them by caesarean section." Yet "fear of being sued prompts doctors to perform unnecessary C-sections — a risky and invasive procedure." Nevertheless, "a fivefold increase in C-sections in rich countries in the past three decades has brought no decrease in the incidence of cerebral palsy."
Seventy-six percent of American obstetricians have been sued at least once. The rationale for medical malpractice lawsuits is to force doctors to be more careful and thereby reduce risks to patients. The actual consequences, however, include unnecessary medical procedures, such as delivering babies by Caesarean section, as well as ordering medically unnecessary tests that doctors feel are financially necessary to protect themselves against lawsuits.
There may also be additional risks to patients when substantial numbers of doctors leave an area where malpractice lawsuits are easy to file and win.
Doctors usually win lawsuits that go to trial, but the pressure to settle out of court is substantial, since the average damage award in jury trials is $4.7 million.
Given the size of the damage awards and the resulting escalating costs of malpractice insurance, it is hardly surprising that defensive medicine has become widespread among obstetricians. A study of obstetricians in Pennsylvania found that "54% frequently called for tests, like sonograms, they felt were unnecessary and 38% often admitted to invasive procedures, like biopsies, that were not called for."
Such "defensive medicine" may not make patients any safer and in some cases, such as Caesarean sections and biopsies, can create additional risks. It is not merely the damages awarded in medical malpractice cases that add to the costs of medical care but also the greatly increased costs of defensive medical procedures.
It costs a jury nothing to "send a message" warning doctors to be more careful, and the particular doctor in the case at hand probably has insurance from a company that can pay a few million dollars easily out of its billions of dollars in assets.
Only if the jurors think beyond stage one will they take into account the increased cost of medical treatment brought on by their awards and future non-financial costs to pregnant women unable to find obstetricians at the time of delivery and the lifelong costs to babies who may incur more or worse injuries or disabilities as a result.
This is especially likely to be the end result in states where juries hand out multimillion-dollar awards readily, such as Nevada:
Kimberly Maugaotega of Las Vegas is 13 weeks pregnant and hasn't seen an obstetrician. When she learned she was expecting, the 33-year-old mother of two called the doctor who delivered her second child but was told he wasn't taking any new pregnant patients. Dr. Shelby Wilbourn plans to leave Nevada because of soaring medical-malpractice insurance rates there. Ms. Maugaotega says she called 28 obstetricians but couldn't find one who would take her.
While direct costs of malpractice lawsuits have been estimated as less than 1% of the total cost of medical care in the United States, the indirect costs include expensive tests and procedures, as well as the additional medical risks to patients that some of these tests and procedures pose.
Perhaps the biggest costs are those imposed on patients who cannot find a doctor available because the ease of filing malpractice lawsuits in particular places has led doctors to relocate. These costs are literally incalculable.
There is, of course, genuine malpractice, genuinely deserving of lawsuits and large damage awards. However, the ease of filing and winning lawsuits on the basis of shaky or speculative evidence, or on the testimony of "hired gun" experts who have financial incentives to back up what is said by the lawyer who hired them, has made the connection between malpractice lawsuits and genuine malpractice tenuous.
As in so many cases, political "solutions" to the malpractice problem can create new problems.
One popular political solution has been to put upper limits on the amount of awards for "pain and suffering." But if the carelessness or incompetence of some physician or surgeon has in fact caused someone to be in pain for the rest of his or her life, a quarter of a million dollar cap, as in California, is completely inadequate as compensation and inadequate as a deterrent.
The fundamental problem is not with the amounts of money awarded, as such, but with the fact that there may be no adequate basis for any award at all.
With laws and policies on medical malpractice, as with other laws and policies, what is most important from a political perspective may be the goals and rationales of those laws and policies. But from the standpoint of economic analysis, what is most important are the incentives and constraints created by laws and policies, and the consequences from those incentives and constraints — not only in stage one but beyond.

Click to expand...

Again, bogus accounting and costs evaluation. Actual costs of malpractice: About 2% of total health care cost. A synopsis of tort reform suggests that it would have little effect on health care costs.

Defenders of current tort law sometimes argue that restrictions on malpractice liability could undermine the deterrent effect of such liability and thus lead to higher rates of medical injuries. However, it is not obvious that the current tort system provides effective incentives to control such injuries. One reason for doubt is that health care providers are generally not exposed to the financial cost of their own malpractice risk because they carry liability insurance, and the premiums for that insurance do not reflect the records or practice styles of individual providers but more-general factors such as location and medical specialty.(1 Second, evidence suggests that very few medical injuries ever become the subject of a tort claim. The 1984 New York study estimated that 27,179 cases of medical negligence occurred in hospitals throughout the state that year, but only 415--or 1.5 percent--led to claims.(19) In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general. Read the entire article @
http://www.cbo.gov/doc.cfm?index=4968&type=0

medicineman said:

Again, bogus accounting and costs evaluation. Actual costs of malpractice: About 2% of total health care cost. A synopsis of tort reform suggests that it would have little effect on health care costs.

Defenders of current tort law sometimes argue that restrictions on malpractice liability could undermine the deterrent effect of such liability and thus lead to higher rates of medical injuries. However, it is not obvious that the current tort system provides effective incentives to control such injuries. One reason for doubt is that health care providers are generally not exposed to the financial cost of their own malpractice risk because they carry liability insurance, and the premiums for that insurance do not reflect the records or practice styles of individual providers but more-general factors such as location and medical specialty.(1 Second, evidence suggests that very few medical injuries ever become the subject of a tort claim. The 1984 New York study estimated that 27,179 cases of medical negligence occurred in hospitals throughout the state that year, but only 415--or 1.5 percent--led to claims.(19)In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general. Read the entire article @
http://www.cbo.gov/doc.cfm?index=4968&type=0

Click to expand...

hmmmm very interesting....have to know the whole story before you can understand the story... thanks

medicineman said:

Again, bogus accounting and costs evaluation. Actual costs of malpractice: About 2% of total health care cost. A synopsis of tort reform suggests that it would have little effect on health care costs.

Defenders of current tort law sometimes argue that restrictions on malpractice liability could undermine the deterrent effect of such liability and thus lead to higher rates of medical injuries. However, it is not obvious that the current tort system provides effective incentives to control such injuries. One reason for doubt is that health care providers are generally not exposed to the financial cost of their own malpractice risk because they carry liability insurance, and the premiums for that insurance do not reflect the records or practice styles of individual providers but more-general factors such as location and medical specialty.(1 Second, evidence suggests that very few medical injuries ever become the subject of a tort claim. The 1984 New York study estimated that 27,179 cases of medical negligence occurred in hospitals throughout the state that year, but only 415--or 1.5 percent--led to claims.(19)In short, the evidence available to date does not make a strong case that restricting malpractice liability would have a significant effect, either positive or negative, on economic efficiency. Thus, choices about specific proposals may hinge more on their implications for equity--in particular, on their effects on health care providers, patients injured through malpractice, and users of the health care system in general. Read the entire article @
http://www.cbo.gov/doc.cfm?index=4968&type=0

Click to expand...

Tell that to my GP and good friend who closed his practice last year due to excessive costs from malpractice liability insurance. Who do you think ends up paying for this insurance? Hmmmm, I wonder?

THE...ObamaStalin said:

Thanks, always looking for new sources of accurate information.

London, Medman, the problem with your assertion is that they're already putting tort reform into practice in TX and lo and behold, it's working.

You'll find that's true with most conservative ideas, while the libs can argue (poorly mind you) against them, when put into practice, they succeed. When Liberal policies are put into practice they fail miserably, require quadruple to 60 times their estimated costs and end up destroying jobs, segments of the economy and lives in the pursuit of their noble goals.

Click to expand...

OK I would like to take you serious and to see if you have a valid point, but it seems like you just change your name so my first question is who are you and why did you have to change your name to agree on a post ...Not enough people posting to it ???? Some one use your old name ????? Trying to confuse stoners???? just curious

THE...ObamaStalin said:

I've been reading the political forum for a while now and I just had to jump in. I don't feel qualified to make a firm judgement, however, after reading multiple posts, it appears Cloud City is a alias for another member just as Obama Santa (2) tried to jack Santas name and avatar and was really Libs R Scared who is most assuredly just another alias since they both just joined and jumped in like theyve been here all along. But like I said, I'm new here so what do I know.

Click to expand...

so you did the same...hmmmm...Fail to see the logic

Don't feed the troll!!!!! Some of you all are getting caught and hooked with your mouths wide open!

Sidewinder73 said:

Tell that to my GP and good friend who closed his practice last year due to excessive costs from malpractice liability insurance. Who do you think ends up paying for this insurance? Hmmmm, I wonder?

Click to expand...

doctors should not be afraid of malpractice insurance premiums. if they think it's too much $$, it's easy to re-structure the practice in a way that the business operation keeps itself profitable, while providing the doctor with the kind of lifestyle he deserves. i suggest your friend meets with a consultant that specializes in medical practices, to weigh his options, closing and setting up shop somewhere else is silly....


it's also another reflection of one of the MANY problems with the health care industry in the USA.

redivider said:

doctors should not be afraid of malpractice insurance premiums. if they think it's too much $$, it's easy to re-structure the practice in a way that the business operation keeps itself profitable, while providing the doctor with the kind of lifestyle he deserves. i suggest your friend meets with a consultant that specializes in medical practices, to weigh his options, closing and setting up shop somewhere else is silly....


it's also another reflection of one of the MANY problems with the health care industry in the USA.

Click to expand...

I guess you are suggesting we that he turn away high risk patients? What does that sound like???

Here is part of an article that may articulate my point a little better:
“In response to rising medical malpractice insurance rates, many physicians feel compelled to practice so-called defensive medicine, which may involve ordering extensive patient tests primarily to help defend their decisions in case the physician is later sued,” says Kenneth E. Thorpe, the Robert W. Woodruff professor and chair of health policy and management at Emory’s Rollins School of Public Health. “Concern over malpractice insurance costs are also driving more specialists like obstetricians and gynecologists, and neurosurgeons to restrict, sell or close their practices, leading to some question about whether or not there will be enough specialists available to meet the demand for their services.”
When the American College of Obstetricians and Gynecologists released its 2009 Survey on Professional Liability in September, the feedback was sobering.
More than 63 percent of respondents reported making changes to their practice “due to the risk or fear of liability claims or litigation,” while 60 percent said liability insurance “is either unavailable or unaffordable.”
OB/GYNs continue to “decrease their number of high-risk obstetric patients and decrease gynecologic surgical procedures,” warns the survey. In fact, it adds, about eight percent of the survey respondents reported that they had stopped practicing obstetrics altogether.
“It is imperative that any changes to our current health system include meaningful federal medical liability reform," according to Albert L. Strunk, deputy executive vice president of the American College of Obstetricians and Gynecologists. "The current medical liability legal system is out of control as evidenced by the fact that over half of all liability claims against OB/GYNs are dropped or settled without payment on behalf of the OB/GYN."
Theoretically, malpractice suits can be a good idea, because they can affect physicians’ behavior in a positive way, according to Ray Hill, an assistant professor in the practice of finance at Emory's Goizueta Business School.
“The problem is that research indicates that doctors practicing good medicine are just as likely to lose malpractice suits as are careless doctors,” he adds. “The result is that all doctors are penalized by high med-mal rates. In some states, physicians in certain high-risk practices are either cutting down or eliminating their practice, or are simply leaving the state for more attractive locations.”

You can find this article at:
http://knowledge.emory.edu/article.cfm?articleid=1278
Just my 2 cents, but I think these malpractice suits are a much larger problem than people realize. Calling a consultant is not always the answer especially when you can barely afford insurance. Restructing your practice to test someone to death or to decline high risk patients sounds like a problem that already exists.

And Yes, this is a large part of the problem of the current system, but aren't we all complaining about high health care costs? Let's start here before we put another program in the hands of the gov't who so often fail.

you did not understand what I meant with restructuring.

i meant changing the way the BUSINESS aspect of the practice works. there's a lot of word-play in different laws of different states. he should look into how this word-play affects him/her, and see if establishing a different business model can benefit his/her case.

jrh7912 said:

So basically what you are saying is that instead of tort reform, which is working quite well in several states. Better in fact than they dreamed it would, his friend should go pay lawyers to show him how to "beat" the current system.

Sounds like a winner for the lawyers either way, they continue to make crazy money off of the backs of physicians from lawsuits AND they can charge exorbitant rates to the doctors just trying to survive another day. Yes, that sounds MUCH better than tort reform. I was under the impression you slobbering Obama worshipping dolts were actually in favor of IMPROVING health care. My mistake.

Click to expand...

i was gonna keep civil, but since you have resorted to personal attacks my duty now will be to completely destroy you.

before you start connecting the dots in the inebriated fantasy you call your head, read well what I am saying.

that 'doctor' is nothing but a greedy piece of swine that is part of the reason this country is descending into a freefall. that doctor doesn't want to give up his lavish lifestyle, thus move elsewhere, because of the high insurance premiums. that's exactly the type of doctor, who cares most about his mercedez, not his patients, that make malpractice lawsuits necessary. you saying they have to survive another day makes them sound like a tribe in the congo basin, when in reality these people drink mimosas and enjoy seafood cocktails at 11am a couple of times a week...

as for the tort reform or what not, i am saying the system should be completely changed, ENTIRELY. period. no tort reform, we need a new system.

and for lawyers and doctors winning and what not, it is just a suggestion. will the poor doctor have to pay a CONSULTANT, yes, but it's all part of the game right now. if you forgot it takes work to make it, no matter if you're a janitor, astronaut, or a doctor, it takes work, and yes, you do have to know how to work the system to make it in this world buddy. if you don't know that, welcome to reality, time to lay off the weed my man.

when i was laid-off, along with 800 other employees 1 month after my first big purchase (a car), no bitching and moaning could help, i had to take that car, which I had put a 6,200 dollar down payment (basically all the money I saved during my last years in college) put it on the classified ads, and give away the account... the online posting was there for less than 20 mins and I had a guy who wanted the car. just gave it away cuz i couldn't pay it, it was either that or ruin my credit... guess what??? it's part of the game, it's called the REAL WORLD. WELCOME.

I'm fuckin' confused who are you people anyway?
JRH Ain't JRH
Its like wacky twilight zone world.
.....pod...people....?

redivider said:

i was gonna keep civil, but since you have resorted to personal attacks my duty now will be to completely destroy you.

before you start connecting the dots in the inebriated fantasy you call your head, read well what I am saying.

that 'doctor' is nothing but a greedy piece of swine that is part of the reason this country is descending into a freefall. that doctor doesn't want to give up his lavish lifestyle, thus move elsewhere, because of the high insurance premiums. that's exactly the type of doctor, who cares most about his mercedez, not his patients, that make malpractice lawsuits necessary. you saying they have to survive another day makes them sound like a tribe in the congo basin, when in reality these people drink mimosas and enjoy seafood cocktails at 11am a couple of times a week...

as for the tort reform or what not, i am saying the system should be completely changed, ENTIRELY. period. no tort reform, we need a new system.

and for lawyers and doctors winning and what not, it is just a suggestion. will the poor doctor have to pay a CONSULTANT, yes, but it's all part of the game right now. if you forgot it takes work to make it, no matter if you're a janitor, astronaut, or a doctor, it takes work, and yes, you do have to know how to work the system to make it in this world buddy. if you don't know that, welcome to reality, time to lay off the weed my man.

when i was laid-off, along with 800 other employees 1 month after my first big purchase (a car), no bitching and moaning could help, i had to take that car, which I had put a 6,200 dollar down payment (basically all the money I saved during my last years in college) put it on the classified ads, and give away the account... the online posting was there for less than 20 mins and I had a guy who wanted the car. just gave it away cuz i couldn't pay it, it was either that or ruin my credit... guess what??? it's part of the game, it's called the REAL WORLD. WELCOME.

Click to expand...

This is the most unamerican thing I have ever heard of. That doctor went through at least 8 years of school and many large tuition bills. Did you do that? He earned that lifestyle. Comeon people this is a country founded on people making their own way. Most of us have lost jobs before, but when I did, I thrived. I made a better living than before. It all comes down to the individual and the drive they have to do well. Let's take accountability for ourselves. Please do not depend on the gov't to take accountability for you. That is just crazy.

Red hasn't a clue......

OR... OR....OR the doctors could just quit. Britain hasn't enough doctors....know why?.... they quit.