Health Care Reform: A Dangerous Prescription, ACT NOW!!

from a friend

The following was forwarded to all employees of the Travis County, TX, Blood and Tissue Center, by the Medical Director. This is something that everyone should read and take to heart. Share it with all you know.

Many Americans are stunned by what our President and Congress wants to deliver for health care for our country. The lack of physician voices, and reticence to contact our Representatives results in our silence as tacit approval.

Obama and Pelosi recently called doctors “greedy”. This is a new tactic imposed to silence dissenting voices. Health-policy Adviser at the Office of Management and Budget, Dr. Ezikel Emanuel, has claimed that we take the Hippocratic Oath too seriously, “as an imperative to do everything for the patient regardless of the cost or effects on others” (JAMA, June 18, 2008). As our patient’s advocate, we are on higher moral grounds than anyone sitting in Washington. Many of us have given sacrifices and trained for many years to be able to practice our craft. It is time that we speak up for our patients and stop living in a vacuum. We should not underestimate our position in the society and impact of our opinion on all Americans.

Many of us run busy practices, and have family obligations that reduce our opportunity to read this 1000+ page plan. I would like to shed some light on important facts for you to address with your congressional representatives. The August congressional recess will be your last opportunity to be in front of your elected representatives and put them on notice. SO PLEASE ACT NOW BEFORE IT WILL BE TOO LATE.

Patient Care Issues:

1. The Plan exempts our representatives and our President: My first and foremost question to our Congress is, if this plan is so good for all Americans, why has Congress exempted themselves from the public option plan? I wish that every American citizen will ask their elected representatives during their August recess this question. (House plan page 114)

2. The Plan forces seniors who are on social security to meet with counselors every 5 years regarding end of life options, more often if they contract a disease such as cancer. In other words, they will encourage your patients to not20have care. This stifles the incentive of companies to invest in innovations to improve care for these diseases. Is this what American people want? Do you want your parents to die as soon as possible because government thinks that it is better for society? These decisions should be made by the Physician and the patient, not a bureaucrat. (House plan pg 425-430)

The Plan forces all Americans to eventually go under a universal plan. As soon as there is a change in the current insurance contract, for example, a change in co-pay, or a change in jobs, you or your patient will be forced to move into a qualified government plan. Ending any competition in the Medical Insurance business will breed complaisance. No business without competition has ever generated a good product. Innovation and improvement will have no meaning and no reward. (House bill, page 16-17 and page 341)

The Plan has a committee to decide what treatments your patients will receive. Again, my concern is for our patients. Who should decide what treatment your patients receive- a skilled, trained physician that knows them personally or a committee? Enacting one size fits all restrictions, don’t respect variation in preferences or disease, which will make costly products suitable for some even if they are wasteful when prescribed to everyone. (House plan page 29)

3. Half of the plan will be financed by limiting care for our poor seniors. This is achieved by cutting $177 billion dollars from the current Medicare Advantage plan. That means less care for poor seniors. (House plan page 331)

Physician Issues:

1. On Page 909, the House bill states: "In awarding grants or contracts under this section, the (HHS) secretary shall give preference to entities that have a demonstrated record of the following: . . . training individuals who are from underrepresented minority groups or disadvantaged backgrounds." In other words, the entry into the medical school will now not only be decided by merits but by race, color, sex etc. We will be forced to train candidates who have not been chosen based on their ability, but by meeting a pre-determined quota. Is this who we want taking care of our future generations?

2. The Government will now decide how much Physicians are reimbursed. (Page 127)

3. Doctors will now be compensated exactly the same. They are planning to reduce compensation from specialists reimbursement to entice more Doctors into the primary care field. (Page 241)

4. This bill covers all people in the United States, legal or not. As a Legal Immigrant who is now proudly an American citizen, I take huge exception with this, especially since we will have to limit care at the expense of our elderly citizens. (Page 50) Further, non-resident aliens will be exempt from taxation. (Page 170)

5. The government, not us, will decide what is appropriate for end of life care. (Page 429-430)

What are changes that would impact the cost of medicine and improve care?

1. Allowing insurers to sell across state lines would increase competition, and therefore reduce the cost of health insurance plans.

2. Cap malpractice awards. The Department of Health and Human Services has said that reasonable limit placed on noneconomic damages in malpractice cases would save an estimated $60-108 billion a year.

3. Placing a cap on malpractice will reduce defensive medicine. Physicians spent $6.3 billion last year on malpractice coverage. If reasonable limits were set on noneconomic damages to reduce defensive medicine, it would reduce the amount of taxpayers’ money to the federal government by $25.3 billion a year”. Department of Health and Human Services, 2002 report “Confronting the New Health Care Crisis”.

4. Placing a cap will also lower the cost of health care services. PricewaterhouseCoopers has estimated that 10% of the cost of health services is attributable to medical malpractice lawsuits.

Finally, I want to point out some other facts that you should be aware of.

Let us look at the statistics of the “uninsured”:

· 46 million Americans are uninsured (according to Income Poverty and Health Insurance coverage in the United States, a census bureau report published last August).

· 9.7 million are not American citizens. 39% of the uninsured live in 5 states- Florida, Texas, California, New Mexico, Arizona, all of which are entry points for illegal aliens.

· 20 million working Americans change jobs every year. Many of them are briefly uninsured between jobs.

· 14 million are eligible for existing government programs, but have not enrolled, such as Medicare, Medicaid, SCHIP, Veterans Benefits, etc.

· 10 million are in households with annual income that exceeds $50,000- they are voluntarily uninsured.

· 7 million are in households with annual income that exceeds $75,000-they are voluntarily uninsured.

I ask you, is punishing the many of Americans who take care of themselves to reward a few at worth the absurdly high cost, when it fails to address the fundamental issues that will still prevail? So, ACT NOW. I know you are busy, but if you do not ACT NOW you will lose this great profession once and for all. Please call, meet and attend town hall meetings of your elected representat ives.

Warmest regards,

Raj Dave, MD, FACC, FSCAI