The locals don’t come here just for the food, though.  They come here for Bubba.  Bubba has what you might call a “big” personality.  He’s a fixture behind the counter – a big burly guy with an anchor tattoo on each arm, wearing a dirty apron and always sporting a two-day beard.  He greets every customer by name, and if you are new he will surely have learned your name before you leave.  Bubba is always prepared with a joke or bit of gossip – and always ready to give his opinion on whatever the latest controversy might be.

Today I had a bit of trouble finding parking outside Bubba’s.  There were several county trucks parked right in front, with work crews getting ready to fill a big pothole that was taking up about half the sidewalk right in front of Bubba’s door.  I managed to slide through the door without falling into the hole, and grabbed the last stool at the counter.

Bubba was there right away, handing me what looked to be a brand new menu.

“Been a time Willie… how’s the road treatin’ ya?”

Bubba’s accent is thick and generally southern, but over the years he seems to have added pronunciations from all regions of the country.  One moment he might sound like a Tennessee Volunteer, and the next like a Maine lobster fisherman.

Now, my name isn’t Willie – but I am a salesman and Bubba read Death of a Salesman back in high school or something – so I am Willie.  In fact, I suspect every salesman who comes through here gets called Willie.  All the regulars get nicknames – even irregular regulars like me.

“Well, I knows who I’is votin’ for” Bubba announces to me.  In the mirror behind the counter I see some of the other patrons roll their eyes.  I would guess Bubba has said this to every customer that morning.

“I’is votin for that Randy Paul guy.  I don’ care what that dyke Madcow tricked ‘em inta sayin… I likes him anyway…. sides…. he was right about that civil rights stuff…”

Bubba gets a little quieter and comes a little closer.  Apparently he doesn’t want everyone in the diner to hear this next part.

“This here diner been in my family fo fo generations.  Ma granpappy start it back afta the war and those is my own boys cookin’ in the kitchen right now.  Thas ova sixty years now.  Back in mah grandpappy’s day if he din want coloreds in here he didn’t hafta have coloreds.  This heres a private family business and it was his right ta kick the coloreds out if thas wa’he wan ta do. “

Bubba pauses a second to catch his breath…

“Not that any’em wanted in here anyways.  Back then they wasn’t so uppity and they knew they’s place.”

I looked around the room.  As far as I could tell, not many of them wanted in here now, either.  The diner was packed, but there was only one dark face in the entire room.  Way in the back, sitting alone in a booth and reading a paper, sat a distinguished looking black gentleman.  I inclined my head in that direction, as if to ask “Who is he?”

Bubba quickly picked up on my silent question.  “Oh… thats Reggie Jefferson.  Real success story ‘round here, Reggie is.  Started out mowin’ lawns fo rich folk but he had a knack for fixin’ the mowers and jus ‘bout anythin’ mechanical and next you know he is openin’ his own auto shop an then he’s buyin’ a hardwars store and even an auto dealaship.  Boy must own five o’ six businesses here in town…. Lives in that real nice house ya see up on t’ hill on the way inta town.”

I opened my mouth to ask a question but Bubba cut me off.

“Oh… I know what you thinkin…. You thinkin I’d wanna kick Reggie outa my diner cuz’ he bein’ colored n’ all.  No… I ain’t doin that… that’d be stupid.  Reggie’s a good custmer and he tips good too…. But… I still think’d be ma right to toss em’ out ifn I wanned to.”

Bubba paused briefly.  I waited an extra second or two to be sure he was finished before asking my question.

“So, I bet with all those businesses Reggie owns he must pay a lot of taxes.”

I should have known better than to mention taxes to Bubba.

“Damn right he pays alotta taxes!  Him’n all the resta us business owners…. And ever’one else too.  See thas wha I likes ‘bout that Randy Paul.  He thinks we shud be payin’ a whole lot less taxes… he sez…”

At that moment I was rescued from Bubba’s rant by the unmistakable sound of a jackhammer on concrete.  The work crew had started repairing the pothole in the sidewalk.

Bubba was pleased.  “County boys getting’ on tha pothole real fast.  Good ta see…. I’se been worryin’ one a mah reg-a-lers was gonna fall an’ break an ankle.  Tha’d be bad fo business.”

It was getting hard to talk with all the noise, so I looked over the new menu.  It was pretty similar to the old menu.  Bubba’s Belly Buster Breakfast was still there, right at the top.  I did notice one new thing, though – a paragraph set inside a shield emblem, proclaiming “We only serve USDA Select Quality Beef.”

“What’s this?” I ask Bubba.

“USDA?  That?  Thas the U-ni-ted States ‘partment o’ Agiecultcha.  They grades meat n’ stuff and makes sho its safe.  People’ likes’ ta see tha USDA emblem these days…. Funny thing… select ain’t even da best grade but folks ‘round here they don’ know better..”

I ordered a steak and eggs (medium rare and over easy) with wheat toast and home fries, and coffee, of course.

“Hey… you seen’ one’a these?  Oh… prolly not… you ain’t from here…”

Bubba is holding up a post card, inviting the recipient to come on in and see the new menu.  It included a coupon allowing said recipient to buy one meal and get the second (of equal or lesser value) for half price.

“Best damn advertisin’  we can do, these cards.  Some folks likes usin’ the radio or the TV or tha newspaper…. But nobody reds tha newspaper and the radio n’ tha TV is expensive and ain’t got no coupon… so these is workin’ right well fo us.  Can’ beat th’old di-rect mailing!”

My meal arrives, and I begin eating.  I don’t know what Bubba does – the food here really should be awful – but it always manages to hit the spot.  As I eat, Reggie gets up from the back booth and ambles to the register to pay his check.  After some small talk I overhear Bubba say…

“Les’ see…  thas’ $5.95 for the foodn’ coffee, so with tax it comes to $6.31.”

Reggie hands over some bills, heads back to the booth and puts $5.00 bill on the table, then makes his way out of the diner, taking care to avoid the work crew.

As I watch Reggie leave, Bubba heads back my way.   “Tha’ Reggie always been a good tipper…. I thin’ he tryin’ ta tell me somethin’…”

“Bubba, how much tax was on Reggie’s bill?”   I ask.

“Oh… its six percent herebouts… wha’t he pay?  Forty cents’r so.  Yeah… ol Reggie may be a big business-man now but he pays taxes jus’ like tha rest oh us…”

It is time for me to hit the road again – I have a long day of sales calls ahead of me.  I make a bit more small talk and head out the door – assuring Bubba I will be back sometime soon.

When you do business in these parts it is best not to antagonize the locals – so I don’t point out the obvious to Bubba.  Reggie pays his taxes just like everyone else does.  The government uses some of those taxes to fix the sidewalk outside Bubba’s diner, to inspect the meat Bubba serves, and to deliver the post cards Bubba uses to advertise his business – and I am only scratching the surface.  I haven’t even mentioned the police and firefighters who protect Bubba’s place of business.  I could go on and on.

Bubba’s “private” business relies a lot on public infrastructure – infrastructure created with tax dollars.  Bubba’s business couldn’t exist without that infrastructure.

Reggie the successful black businessman pays his taxes and thus contributes to the infrastructure.

So, does Bubba’s “private” business have a right to exclude Reggie?  I think not.  I think not.

Next week I have a sales meeting out in Tempe AZ.  Now that should be interesting.

I never really felt comfortable calling myself a “Hoosier” though.  I had particular disdain for the practice of using “Hoosier” as a contraction for “Who is your”  – and here I go using that device myself in the title of this post.

So – who is your tort reformer?

It might just be Indiana – at least when it comes to medical torts.

The battle for health care reform has certainly been loud and divisive.  There has been more shouting and protesting and marching than actual discussion.  There has been a lot of misdirection and misinformation.  Some of the issues raised are downright silly and would be funny if people didn’t actually believe them (fear of death panels and involuntary euthanasia, for example).

Some criticisms are decidedly not silly.  For example, conservatives consistently raise “tort reform” as an issue.  Why don’t liberals include tort reform as a part of the package?

My answer?  Yeah – why not?   You might be surprised that I support tort reform.  After all, aren’t liberals supposed to be against it?

I think this comes down to a “baby and the bathwater” issue – and most liberals err on the side of protecting the baby while most conservatives really want that bathwater gone.

Let’s concentrate for now on medical malpractice.  There are certainly other areas ripe for reform – but with the ongoing health care battle it seems particularly appropriate to look at medical malpractice suits.

Besides – I have something to write about medical torts.

There are plenty of very real cases of medical malpractice.  Physicians operate drunk and kill patients… nurses misadminister drugs… drug companies improperly label drugs resulting in accidental overdose….  Surgeons somehow manage to remove the wrong kidney…. Pharmacists and physicians fail to recognize fatal drug interactions.

In my opinion victims of such malpractice – and their families – should receive substantial compensation from the courts.  If tort reform means limiting awards to victims of serious abuse – well, then I guess I am against it.

But for every example of true malpractice there are many more “fluff” malpractice suits – groundless suits submitted by personal injury lawyers in the interest of nothing more than making a quick buck.  The “fluff” class-action suits are the absolute worst because the lawyers are the only ones to profit from those.  Our current system is nothing more than a subsidy for PI attorneys.  The fluff lawsuits must be eliminated.

Therein lies the Gordian knot.

How do we separate the true cases of malpractice from the fluff lawsuits?

Our jury system is not well equipped to handle this issue.  A “jury of your peers” will generally not include anyone with enough medical expertise to distinguish true malpractice from the fluff.  In fact, you could be certain that any physician in the jury pool would be challenged and dismissed.

How is a jury of non-experts to decide?  Both sides will have passionate lawyers – lawyers who know how to talk a good game.  Both sides will hire “expert” witnesses – who really aren’t experts at all.  No – expert witnesses are just whores who sell their souls to tell the jury what their side wants the jury to hear.

In the end it does not come down to the facts – it comes down to which side has the most convincing lawyers and experts.

This practice has to stop.  Unfortunately, the typical suggestion – a cap on damage awards – hurts the true victim as much as it does the non-victim.  The baby goes out with the bathwater.

Is there a way out of this bind?  A way to untie the knot?

A physician friend recently told me of a system in Indiana that just might offer a solution.

In Indiana, individuals wanting to claim malpractice first submit their case to a three-member panel of physicians.  That panel reviews the facts of the case and determines if malpractice may have occurred or not.  If the panel finds malpractice is unlikely the case ends right there.  If the panel finds malpractice may have occurred, the case can more forward to trial.

The system has a number of advantages.  PI lawyers are far less likely to file “fluff” suits because they will generally be unable to fool a panel of experts.  True victims of malpractice, on the other hand, stand to receive just compensation.    Physicians in Indiana will be able to concentrate on providing good health care instead of “defensive medicine” designed merely to avoid lawsuits.  Finally, malpractice insurance will be less expensive because fewer lawsuits will be filed and even fewer will go to trial.  In the end, medical costs go down – and that is a major goal of all reform efforts.

It certainly isn’t a perfect system.  I can see several possible concerns:

– The review process is apparently quite lengthy – it can add up to a year to the process.   Does this delay put an undue burden on the true victim?

– There is a worry among lawyers – perhaps a real worry – that the panel will always err on the side of the physician.

– There is always the worry of corruption.  There is lots of money floating around in the medical world, so the temptation to buy off the panel is certainly there.

I have had quite a bit of trouble finding additional information about this program.  It looks like an interesting solution, despite the problems.  I would be particularly be interested in hearing from people who know more about the system.  Do you think it works?  What are its problems?

Then comes the bigger question:  Should something similar be enacted nationally?  Should this system, or something similar, become a part of health care reform?

To me, it does look promising.