Today is pain doc day and I'm writing about yesterday's meltdown. That's already a bad sign to an epic degree. Pain doc day tends to be what sets me off and causes me to have times like last night. It was a full symptom explosion from full body pain through debilatating twitches to some relatively minor aphasia. It all started when I reached the point of not sleeping when I started to feel good.
My in-laws are in town and they are among my favorite people in existence. The problem is that my symptoms could fool you very easily. My sister-in-law is as opinionated as I am about most things. Part of being as opinionated as I am is believing that no one else ever considers their positions carefully enough when they don't agree with me. It's worse than rooting for the wrong sports team when that person says or does something that violates my strongest held values. It's also worse when my temper has been triggered already.
In this case, the trigger ties right into a subject of this blog: "frivolous" lawsuits. There is a belief in this nation that we are plagued by hordes of people filing useless lawsuits and taking money from honest businesses. Like most big lies, there is a small bit of truth in it to attract the belief of honest people like my sister-in-law. The classic "frivolous lawsuit" story tends to involve the case of a woman who spilled hot fast food coffee on herself. She sued the company and won big bucks in the jury trial. Factually, that's correct as far as it goes.
What really happened is that she asked the company to cover her medical bills which included surgery. When they refused, she hired a lawyer and learned that the company kept its coffee unreasonably hot. (The cup may also have been defective but I can't trust my memory there.) They kept refusing to settle out of court despite the disabling injury until a jury of her peers imposed punitive damages in the millions. Then the company appealed and villified the woman in the far less open world of appeals. Her award was reduced to the point of not even covering her medical bills but she's known as the woman who made millions by being stupid enough to spill coffee on herself.
Stories like that are misused to protect the wrong doctors. Once again, there is the factual story that says most doctors pay way too much for malpractice insurance. That is true and it is doubly the fault of the insurance companies. First of all, they blame these so called frivolous lawsuits for the high cost of insuring doctors against malpractice. They claim that these few high awards are to blame for the high costs by using the "Donald Trump fallacy." Whenever Donald Trump enters a room, the average income of everyone else in it rises considerably. Replace Trump with Bill Gates if you prefer but it's still the same point.
The high cost of insurance premiums is due to two factors both controlled by the companies, themselves. First of all, they had a premium war in the early 90s during the Clintom boom. In order to attract the least risky doctors, they lowered rates to below cost for those risk categories. (John, that doesn't make any sense! Tell me about it.) They turned a profit by investing the premiums in the ever rising stock market. When the market bubble crashed, those profits went poof and the companies had to replace the funds needed to cover potential losses with massive rate hikes.
That factor may be stupid but I'd agree with you that it isn't malicious. The second factor is malicious. It is well known that a few bad doctors generate most of the big awards that survive appeals. Instead of doing the public a favor and refusing to insure a few doctors who are killing and maiming people, they try to spread the costs around by raising the rates on everyone. Worse, they have managed to succeed in passing laws limiting damages through "tort reform" making it more difficult to protect yourself. I do not know if I would have filed a lawsuit against my first surgeon under any legal circumstances. What bothers me is that I cannot list him by name and warn other Chiarians not to trust his opinion. He could have killed me without the intervention of the real Chiari expert and I cannot even tell people that "Doctor A" is not a Chiari expert so trusting him could lead to decades of suffering.
My PCP, who is wonderfully caring and careful, has to pay increased rates because insurance companies realized they could make more money that way. Remember, they have to collect the increased rates from as many doctors as possible while shielding themselves from paying out damages in order to maximize profits. When you hear about the "stupid woman" who maimed herself because she didn't know that coffee is hot, think of the motives behind the creation of such a story.
I'm going to post this now despite the fact that I haven't gotten to the meltdown part. This is what used up the emotional energy that left me so defenseless later on.
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