trrenter_IHB
New member
no_vaseline said:
You are joking right? You have now proven you do not read what you yourself post.
I am citing your cite by the way!!!!
Classic. I would be embarassed if I were you.
Govt. to REQUIRE adults to carry Health care insurance
- Thread starter trrenter_IHB
- Start date
NEW -> Contingent Buyer Assistance Program
You are joking right? You have now proven you do not read what you yourself post.
I am citing your cite by the way!!!!
Classic. I would be embarassed if I were you.
You are misstating my cite, and as a result, showing false cause: assumes that two events juxtaposed in time or space, have a cause and effect relationship.
My site claims income interruption - not unreimbursed/uncovered expenses - as a factor in Canadian BKs. No where in my cite does it claim unpayed medical bills are a cause - because in Canada, you don't have that problem.
Error in logic: Begging the Question: a logic lapse committed when, instead of offering proof for its conclusion, an argument simply reasserts the conclusion in another form.
I think if put in the proper perspective. Even you can be sold on "Universal Health Care".
Personally. I can see panic on the faces of some of my friends that sell Health Insurance.
They were all big GOP supporters. They all laughed when I supported Obama. Now they are going to need to find REAL JOBS that produce monetary value rather than just suck people dry.
That is untrue I copy and pasted from your site to here. Unless my copy and paste funtion has an unknown error.
HMM interesting we are impressed now by that comment.
So you define medical bankruptcy I get it now!! And depending on where you are posting the criteria change.
I call that situatonal dependency.
So when citing Himmelstein everything is included even income interruption and many other factors including gambling that count toward a medical bankruptcy. But you refuse to include that as a medical bankruptcy in Canada. HUH?
Your definition is very strict compared to your Cite which is Himmelstein. Which is correct yours or Himmelsteins?
Lookie here right on this Fancy Chart from your site as included in Medical Bankruptcies. It includes income interruptions as a reason. I don't want to mis state your postion but it seems like you are saying those don't count in Canada but they do in the US
Wait your study doesn't say that? HMMM.
Hey Rocky watch me pull a rabbit out of my Hat.
So if we go by your NEW statement of what counts
If only unpaid medical bills count because of unreimbursed/uncovered expenses you just proved what I have been saying all along. The cite you used to prove your point was erroneous for including everything but unpayed medical bills becuase of unreimbursed/uncovered expenses.
If you are correct you just proved my point that Himmelsteins is a Joke. If it is Himmelsteins you proved your error logic.
So why don't we peel off everything but the 27% that is stated as Uncovered medical bills exceeding $1,000 over a 2 year period.
I would say that a higher threashhold would yeild different results.
Oh who cares you just double talked your way into agreeing with me.
Can't have it both ways. One of you is right and one of you is wrong.
Juxtapose that logic lapse!
Of that group, I wonder what percentage is the medical event just the excuse that allows the filer to swallow their pride and end the long descent into debt?
It seems like a large percentage is only a couple paychecks from missing their mortgage or rent, any disruption would basically push them over the edge.
I guess that's where I got lost. I've been looking and looking and I haven't seen any actual reporting indicating that the possible plan is more like Canada's than say, Germany's or France's, and yet that seems to be the underlying assumption. Or maybe I just read too quickly?
Maggie could certainly turn a phrase, but those Scandinavian countries seem to be doing ok, and by all accounts their people are happier than those in other countries. Yes, I know, it all depends on how you measure things.
In this thread I started off with the question is it constitutional to require healthcare. Three Sheets answered the question for me.
No Vas threadjacked very early on stating that nobody goes bankrupt in the Canadian system due to medical coverate. It was actually the fifth post on this thread.
Then I wanted to know if a challenge to the supreme court would delay getting this through congress and Three Sheets answered that.
The we went off topic again and when we came back around No Vas brought up Canada again using a study that is questionable but widely cited.
When I challenged his number he posted the US VS Canada bankruptcy statistics and asked me to explain why our numbers are higher if the study was wrong.
This is the same "Logic Error" he accused me of which is false cause. In other words he linked the first study to the BK numbers as proof that the study was right.
To be fancy I will quote No Vas "assumes that two events juxtaposed in time or space, have a cause and effect relationship".
Since his argument was based on false cause it is difficult to debate the point because only he can determine if your point is good enough to overturn his conclusion.
Then if you continue on through the thread after he has told me to STFU and challenged everything I said he is so intent on proving his point at the time he forgot what his orginal point was.
So here it is for you.
I thought the report citing the large amount of personal bankruptcies may have been biased. The Authors are advocates for a Universal Health Care system and I believed they used a too broad a definition and two low a threashold when it came to what a medical bankruptcy was.
No Vas continued to challenge me to find cites to prove my point. I think I did using studies from economists even one that testified in front of congress. Nobody came close to the numbers in the Himmelstein study. Some even said it was inexcusable that he set the threashold at $1,000 of medical bills over a two year period and included that in a medical bankruptcy.
Finally when I stated that there were bankruptcies in Canada No Vas asked me for Cite and Proof. I went back to his study and showed him that I was indeed correct that medical bankruptcies do occur in Canada.
No Vas threw that out saying they were due to loss of work not unpaid, uncovered/unreimbursed medical bills.
The problem with that arguement was that the cite I pulled that from was the Himmelstein paper that claimed that medical expenses in the US were the cause of over 50% of bankruptcies. That paper included more then just the unpaid, uncovered/unreimbursed medical bills. It included gambling as a medical cause for bankruptcy.
So in the US study it is fair to say that a medical bankruptcy can be caused by gambling or loss of work due to injury, BUT it is not fair to say a medical bankruptcy even occurs in Canada due to loss of work caused by injury.
I am at a loss as to how that point could be argued.
My idea here is to stimulate thinking regarding Universal Healtcare. Lets not be sheeple and run toward a system that is broken. Lets not use false logic and say anything is better then what we have here. Lets do some research and say hey this report may have an underlying agenda.
When I saw that a Dr. that was an Advocate for Universal health care wrote that report I wanted outside validation. Just like if I saw a report written by someone from the NRA showed owning a gun made you 100% safer I would want some outside validation.
I didn't find the outside validation I was looking for. I found people slamming the report.
Lets look at the source and if we conclude it may be biased lets look for more information.
Lastly what is curios is that the Himmelstein DID NOT run the study in Canada using the same criteria. He cited somebody that used a stricter criteria for Medical BK in Canada.
Not all procedures in Canada are free there are out of pocket expenses. That is why they have Supplemental Insurance to cover what the government doesn't cover. In many case prescriptions are NOT covered again you need suplemental insurance for that or pay out of pocket.
I am not worried about the attacks that is No Vas MO agree or beware.
negligence? or poor outcome?
I would disagree with the former, and agree with the latter.
Oh, three sheets, you are making my head hurt.
Not all premium increases are due to lawsuit awards. Here is another discussion of same.
Of course, in California we have MICRA, which caps pain and suffering damages at $250K, and the limit has not been increased since MICRA was passed in 1975. And while in some instances that cap seems sufficient, imagine an instance where a surgeon amputates the wrong leg or screws up back surgery, especially on someone fairly young. In such an instance, $250K for a lifetime of ongoing pain isn't nearly enough. Yet, despite the cap, and the cap not being increased over the years, malpractice premiums in California have continued to climb. Fancy that.
Further, in med mal cases, it's not "mere negligence." The plaintiff must prove that the doctor (or nurse, or other medical professional) failed to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful doctor would use in the same or similar circumstances - and often in the same community, such that docs in Bakersfield cannot be compared with docs in La Jolla. That the doctor's acts which fell below the standard of care caused plaintiff's harm must be established with a degree of medical certainty. Both the standard of care and causation can only be proven by experts, which are usually expensive to hire.
Moreover, a doc is not considered negligent simply on the basis that the doc's efforts are unsuccessful or the doc makes an error that was reasonable under the circumstances, or because the doc chose one medically accepted treatment over another.
Here are the jury instructions. (Start at #500 - "Medical Negligence.")
I'll get to R&D later, and how patients in other countries are paying lower prices because patients, or rather, insurance companies in the US are basically footing the R&D bill.
You are joking right? You have now proven you do not read what you yourself post.
I am citing your cite by the way!!!!
Classic. I would be embarassed if I were you.
trrenter_IHB
New member
BLT,
That video was hilarious. Now if I could get paid in tall blonds and get that swedish massage I would probably sign up. See that is a compelling argument for Universal health care.
That video was hilarious. Now if I could get paid in tall blonds and get that swedish massage I would probably sign up. See that is a compelling argument for Universal health care.
no_vaseline_IHB
New member
trrenter said:
You are misstating my cite, and as a result, showing false cause: assumes that two events juxtaposed in time or space, have a cause and effect relationship.
My site claims income interruption - not unreimbursed/uncovered expenses - as a factor in Canadian BKs. No where in my cite does it claim unpayed medical bills are a cause - because in Canada, you don't have that problem.
Error in logic: Begging the Question: a logic lapse committed when, instead of offering proof for its conclusion, an argument simply reasserts the conclusion in another form.
bltserv_IHB
New member
trrenter said:
I think if put in the proper perspective. Even you can be sold on "Universal Health Care".
Personally. I can see panic on the faces of some of my friends that sell Health Insurance.
They were all big GOP supporters. They all laughed when I supported Obama. Now they are going to need to find REAL JOBS that produce monetary value rather than just suck people dry.
trrenter_IHB
New member
That is untrue I copy and pasted from your site to here. Unless my copy and paste funtion has an unknown error.
HMM interesting we are impressed now by that comment.
So you define medical bankruptcy I get it now!! And depending on where you are posting the criteria change.
I call that situatonal dependency.
So when citing Himmelstein everything is included even income interruption and many other factors including gambling that count toward a medical bankruptcy. But you refuse to include that as a medical bankruptcy in Canada. HUH?
Your definition is very strict compared to your Cite which is Himmelstein. Which is correct yours or Himmelsteins?
Lookie here right on this Fancy Chart from your site as included in Medical Bankruptcies. It includes income interruptions as a reason. I don't want to mis state your postion but it seems like you are saying those don't count in Canada but they do in the US
Wait your study doesn't say that? HMMM.
Hey Rocky watch me pull a rabbit out of my Hat.
So if we go by your NEW statement of what counts
If only unpaid medical bills count because of unreimbursed/uncovered expenses you just proved what I have been saying all along. The cite you used to prove your point was erroneous for including everything but unpayed medical bills becuase of unreimbursed/uncovered expenses.
If you are correct you just proved my point that Himmelsteins is a Joke. If it is Himmelsteins you proved your error logic.
So why don't we peel off everything but the 27% that is stated as Uncovered medical bills exceeding $1,000 over a 2 year period.
I would say that a higher threashhold would yeild different results.
Oh who cares you just double talked your way into agreeing with me.
Can't have it both ways. One of you is right and one of you is wrong.
Juxtapose that logic lapse!
awgee_IHB
New member
Funny, this quote was just posted on Coto Housing Blog today.
Margaret Thatcher – former Prime Minister of England
“The problem with socialism is that you eventually run out
of other people’s money.”
Margaret Thatcher – former Prime Minister of England
“The problem with socialism is that you eventually run out
of other people’s money.”
stepping_up_IHB
New member
I don't understand why TR is getting so beat up here. He's already said that he isn't against universal healthcare, only that he doesn't think we should throw a ton of money at a model similar to a country that isn't rated so highly. And, I don't think he's really said medical bk's are non existant. He is correct that bk laws do influence entrepeneurship. I studied a lot of development economics and this is one of many things that they said developing countries need to implement if they want to stimulate ecnomic growth.
However, I have heard and read too many articles with reputible sources saying that medical bills are the biggest cause of bk among individuals to think that it's not significant. I remember one particular case that broke my heart.... the husband insisted that his wife of 30 years divorce him because the medical bills were going to force them into bk and he didn't want her to be left with nothing. She refused. It was really really really sad. I'm not sure if he's with us on the notion that medical bills are the biggest driver of bk or not.
But either way, he plays a heck of lot nicer than some of the other conservatives we have had here and actually has a sense of humor. Am I the only one who doesn't miss WINEX?
However, I have heard and read too many articles with reputible sources saying that medical bills are the biggest cause of bk among individuals to think that it's not significant. I remember one particular case that broke my heart.... the husband insisted that his wife of 30 years divorce him because the medical bills were going to force them into bk and he didn't want her to be left with nothing. She refused. It was really really really sad. I'm not sure if he's with us on the notion that medical bills are the biggest driver of bk or not.
But either way, he plays a heck of lot nicer than some of the other conservatives we have had here and actually has a sense of humor. Am I the only one who doesn't miss WINEX?
freedomCM_IHB
New member
I've read pretty recent study that said right around 50% of 2006 BKs (after the reform law, iirc) were medical.
No_Such_Reality_IHB
New member
freedomCM said:
Of that group, I wonder what percentage is the medical event just the excuse that allows the filer to swallow their pride and end the long descent into debt?
It seems like a large percentage is only a couple paychecks from missing their mortgage or rent, any disruption would basically push them over the edge.
EvaLSeraphim_IHB
New member
stepping_up said:
I guess that's where I got lost. I've been looking and looking and I haven't seen any actual reporting indicating that the possible plan is more like Canada's than say, Germany's or France's, and yet that seems to be the underlying assumption. Or maybe I just read too quickly?
EvaLSeraphim_IHB
New member
awgee said:
Maggie could certainly turn a phrase, but those Scandinavian countries seem to be doing ok, and by all accounts their people are happier than those in other countries. Yes, I know, it all depends on how you measure things.
trrenter_IHB
New member
EvaLSeraphim said:
In this thread I started off with the question is it constitutional to require healthcare. Three Sheets answered the question for me.
No Vas threadjacked very early on stating that nobody goes bankrupt in the Canadian system due to medical coverate. It was actually the fifth post on this thread.
Then I wanted to know if a challenge to the supreme court would delay getting this through congress and Three Sheets answered that.
The we went off topic again and when we came back around No Vas brought up Canada again using a study that is questionable but widely cited.
When I challenged his number he posted the US VS Canada bankruptcy statistics and asked me to explain why our numbers are higher if the study was wrong.
This is the same "Logic Error" he accused me of which is false cause. In other words he linked the first study to the BK numbers as proof that the study was right.
To be fancy I will quote No Vas "assumes that two events juxtaposed in time or space, have a cause and effect relationship".
Since his argument was based on false cause it is difficult to debate the point because only he can determine if your point is good enough to overturn his conclusion.
Then if you continue on through the thread after he has told me to STFU and challenged everything I said he is so intent on proving his point at the time he forgot what his orginal point was.
So here it is for you.
I thought the report citing the large amount of personal bankruptcies may have been biased. The Authors are advocates for a Universal Health Care system and I believed they used a too broad a definition and two low a threashold when it came to what a medical bankruptcy was.
No Vas continued to challenge me to find cites to prove my point. I think I did using studies from economists even one that testified in front of congress. Nobody came close to the numbers in the Himmelstein study. Some even said it was inexcusable that he set the threashold at $1,000 of medical bills over a two year period and included that in a medical bankruptcy.
Finally when I stated that there were bankruptcies in Canada No Vas asked me for Cite and Proof. I went back to his study and showed him that I was indeed correct that medical bankruptcies do occur in Canada.
No Vas threw that out saying they were due to loss of work not unpaid, uncovered/unreimbursed medical bills.
The problem with that arguement was that the cite I pulled that from was the Himmelstein paper that claimed that medical expenses in the US were the cause of over 50% of bankruptcies. That paper included more then just the unpaid, uncovered/unreimbursed medical bills. It included gambling as a medical cause for bankruptcy.
So in the US study it is fair to say that a medical bankruptcy can be caused by gambling or loss of work due to injury, BUT it is not fair to say a medical bankruptcy even occurs in Canada due to loss of work caused by injury.
I am at a loss as to how that point could be argued.
My idea here is to stimulate thinking regarding Universal Healtcare. Lets not be sheeple and run toward a system that is broken. Lets not use false logic and say anything is better then what we have here. Lets do some research and say hey this report may have an underlying agenda.
When I saw that a Dr. that was an Advocate for Universal health care wrote that report I wanted outside validation. Just like if I saw a report written by someone from the NRA showed owning a gun made you 100% safer I would want some outside validation.
I didn't find the outside validation I was looking for. I found people slamming the report.
Lets look at the source and if we conclude it may be biased lets look for more information.
Lastly what is curios is that the Himmelstein DID NOT run the study in Canada using the same criteria. He cited somebody that used a stricter criteria for Medical BK in Canada.
Not all procedures in Canada are free there are out of pocket expenses. That is why they have Supplemental Insurance to cover what the government doesn't cover. In many case prescriptions are NOT covered again you need suplemental insurance for that or pay out of pocket.
I am not worried about the attacks that is No Vas MO agree or beware.
EvaLSeraphim_IHB
New member
Wow...
Thanks for the detailed overview. I think I would like to gift you my old avatar that an IHB friend-yet-adversary made for me. I'll be PM'ing it to you shortly.
Thanks for the detailed overview. I think I would like to gift you my old avatar that an IHB friend-yet-adversary made for me. I'll be PM'ing it to you shortly.
bltserv_IHB
New member
Interesting Bill Moyer Interview with Cigna Manager.
Seems he agrees we should have a Canadian type Program after working at Cigna for 15 Years.
Very interesting indeed.
(embedded video no longer available)
Seems he agrees we should have a Canadian type Program after working at Cigna for 15 Years.
Very interesting indeed.
(embedded video no longer available)
trrenter_IHB
New member
That situation sucks.
I will veer off of medical for a moment and delve into the legal side of the health care arguement. I am sure three sheets can back me up!!!
I cannot prove it becauase I am sure details aren't available but I would almost bet that anyone treated at that outdoor clinic in the video had to sign a waiver of rights to sue for malpractice.
It is my humble opinion that before we can overhaul the healthcare system we need to overhaul the legal system in the US as it pertains to the healthcare system.
We cannot reasonably expect to drive down the cost of healthcare here until we drive down the cost of lawsuits and malpractice insurance.
Malpractice: Do other countries hold the key?
How Other Countries Judge Malpractice
As much as people malign doctors what was missed in that video is the Doctors that donated their time to help these people. Those were some great Doctors out there helping out their neighbors and that should have been driven home as well.
I doubt they would have been out there though if they had to be worried about being sued for malpractice. (again a personal opinion, I have no proof)
I will veer off of medical for a moment and delve into the legal side of the health care arguement. I am sure three sheets can back me up!!!
I cannot prove it becauase I am sure details aren't available but I would almost bet that anyone treated at that outdoor clinic in the video had to sign a waiver of rights to sue for malpractice.
It is my humble opinion that before we can overhaul the healthcare system we need to overhaul the legal system in the US as it pertains to the healthcare system.
We cannot reasonably expect to drive down the cost of healthcare here until we drive down the cost of lawsuits and malpractice insurance.
Malpractice: Do other countries hold the key?
How Other Countries Judge Malpractice
As much as people malign doctors what was missed in that video is the Doctors that donated their time to help these people. Those were some great Doctors out there helping out their neighbors and that should have been driven home as well.
I doubt they would have been out there though if they had to be worried about being sued for malpractice. (again a personal opinion, I have no proof)
kevin_IHB
New member
There is no doubt that malpractice risk mitigation is a significant cost affecting health care costs. I agree that it is a serious problem.
Another huge cost is R&D. I think someone already posted the outrageous cost and time associated with bringing a drug to the US market. I've read that 1 in 250 drugs actually make it to market. US drug prices are higher than any other country and US based private research companies are by far the largest innovators. It makes sense. The US has fostered the greatest incentive to invent new drugs (specifically because of our health care system and IP protections), therefore more drugs will be produced here.
I think if we have national health care, then we must acknowledge that every person cannot be afforded the most innovative technology. If we want the Cadillac of health care, then we can't complain about paying the Cadillac price. I envision low cost health insurance (or government provided health care) which buys lower grade health care. If you get sick and there is a new drug on the market that can cure you, you shouldn't get the benefit of the drug without paying for it. If you get sick and there is a specialist that demands a high price for his services, he shouldn't be compelled to perform without being paid what he wants.
If we want low cost health care, then we must be willing to accept that we can't sue a doctor for mere negligence.
Another huge cost is R&D. I think someone already posted the outrageous cost and time associated with bringing a drug to the US market. I've read that 1 in 250 drugs actually make it to market. US drug prices are higher than any other country and US based private research companies are by far the largest innovators. It makes sense. The US has fostered the greatest incentive to invent new drugs (specifically because of our health care system and IP protections), therefore more drugs will be produced here.
I think if we have national health care, then we must acknowledge that every person cannot be afforded the most innovative technology. If we want the Cadillac of health care, then we can't complain about paying the Cadillac price. I envision low cost health insurance (or government provided health care) which buys lower grade health care. If you get sick and there is a new drug on the market that can cure you, you shouldn't get the benefit of the drug without paying for it. If you get sick and there is a specialist that demands a high price for his services, he shouldn't be compelled to perform without being paid what he wants.
If we want low cost health care, then we must be willing to accept that we can't sue a doctor for mere negligence.
freedomCM_IHB
New member
three sheets said:
negligence? or poor outcome?
I would disagree with the former, and agree with the latter.
no_vaseline_IHB
New member
I’m going to take TR’s comments out of order because it will make it easier to answer.
"What we've got here is failure to communicate."
I think you're going to find that either way, because anyone who has enough budget to do a study or analyze a study on a topic like this likely had an axe to grind before they got into the study.
Because we are arguing two different points maybe (your definition of a ‘medical bankrupcy’ vs mine)? In fairness, I attempted to draw a distinction between:
- a “medical bankruptcy” where somebody got drunk and fell off their motorcycle, couldn’t work and discharged all of their debts via bankruptcy vs
- a “medical bankruptcy” where somebody had an migraine on Christmas eve that turned out to be more than a headache, and was subsequently denied coverage for the resulting life flight and Christmas morning brain surgery because they didn’t get a preapproval.
The first guy is going to file no matter what. It’s the second guy I’m sticking up for. The surveys don’t break them out because the second guy doesn’t exist in Canada. The first guy exists everywhere (irresponsible and stupid people are everywhere) and can’t be helped. This is why I was pounding the point so hard. The distinction needs to be made.
And I couldn’t agree more. But here’s the thing (and I don’t think these guys are trying to grind an agenda):
Per capita bankruptcies in 2004 (a year unskewed by 2006 BK legislation)
Bankrupcy Cite
US – 7.7 per 1000
Canada – 2.2 per 1000
Percent of GDP (it’s 2009)
GDP % cite
US – 16%
Canada – 10.1%
And what’s worse is Canada has everyone covered (ex supplemental) and we leave a significant portion of the public out, making our per capita spending for users who actually have insurance (and lets not kid ourselves, they are the ones footing the bill) way higher.
So……….I guess my point is what can we learn from Canada to reduce our BK’s and how do we get our costs under control? They don’t have malpractice in Canada like they do here but malpractice is NOT a third of expenses……..
trrenter said:
"What we've got here is failure to communicate."
trrenter said:
I think you're going to find that either way, because anyone who has enough budget to do a study or analyze a study on a topic like this likely had an axe to grind before they got into the study.
trrenter said:
Because we are arguing two different points maybe (your definition of a ‘medical bankrupcy’ vs mine)? In fairness, I attempted to draw a distinction between:
- a “medical bankruptcy” where somebody got drunk and fell off their motorcycle, couldn’t work and discharged all of their debts via bankruptcy vs
- a “medical bankruptcy” where somebody had an migraine on Christmas eve that turned out to be more than a headache, and was subsequently denied coverage for the resulting life flight and Christmas morning brain surgery because they didn’t get a preapproval.
The first guy is going to file no matter what. It’s the second guy I’m sticking up for. The surveys don’t break them out because the second guy doesn’t exist in Canada. The first guy exists everywhere (irresponsible and stupid people are everywhere) and can’t be helped. This is why I was pounding the point so hard. The distinction needs to be made.
trrenter said:
And I couldn’t agree more. But here’s the thing (and I don’t think these guys are trying to grind an agenda):
Per capita bankruptcies in 2004 (a year unskewed by 2006 BK legislation)
Bankrupcy Cite
US – 7.7 per 1000
Canada – 2.2 per 1000
Percent of GDP (it’s 2009)
GDP % cite
US – 16%
Canada – 10.1%
And what’s worse is Canada has everyone covered (ex supplemental) and we leave a significant portion of the public out, making our per capita spending for users who actually have insurance (and lets not kid ourselves, they are the ones footing the bill) way higher.
So……….I guess my point is what can we learn from Canada to reduce our BK’s and how do we get our costs under control? They don’t have malpractice in Canada like they do here but malpractice is NOT a third of expenses……..
Sunshine_IHB
New member
I'm so jealous of trrenter's new avatar; I'm serious. :down:
EvaLSeraphim_IHB
New member
three sheets said:
Oh, three sheets, you are making my head hurt.
Not all premium increases are due to lawsuit awards. Here is another discussion of same.
Of course, in California we have MICRA, which caps pain and suffering damages at $250K, and the limit has not been increased since MICRA was passed in 1975. And while in some instances that cap seems sufficient, imagine an instance where a surgeon amputates the wrong leg or screws up back surgery, especially on someone fairly young. In such an instance, $250K for a lifetime of ongoing pain isn't nearly enough. Yet, despite the cap, and the cap not being increased over the years, malpractice premiums in California have continued to climb. Fancy that.
Further, in med mal cases, it's not "mere negligence." The plaintiff must prove that the doctor (or nurse, or other medical professional) failed to use the level of skill, knowledge, and care in diagnosis and treatment that other reasonably careful doctor would use in the same or similar circumstances - and often in the same community, such that docs in Bakersfield cannot be compared with docs in La Jolla. That the doctor's acts which fell below the standard of care caused plaintiff's harm must be established with a degree of medical certainty. Both the standard of care and causation can only be proven by experts, which are usually expensive to hire.
Moreover, a doc is not considered negligent simply on the basis that the doc's efforts are unsuccessful or the doc makes an error that was reasonable under the circumstances, or because the doc chose one medically accepted treatment over another.
Here are the jury instructions. (Start at #500 - "Medical Negligence.")
I'll get to R&D later, and how patients in other countries are paying lower prices because patients, or rather, insurance companies in the US are basically footing the R&D bill.