The Health Care Bill: A Doctor's Point of View

You almost had me.  Right up until you wrote "people deserve to be healthy".  And therein lies the rub with ObamaCare.  Define deserve to be healthy.  Do you mean don't smoke?  Exercise? Eat healthy food?  Or do you mean do none of the above and demand that their health concerns be covered by, and worst yet, paid for by others.  The is a gigantic difference.

I am particularly upset by the number of built-in and granted waivers.  McDonald's gets a waiver.  There have been somewhere around 1400 waivers granted so far, exempting countless numbers of people.  Who picks up those costs?  GM employees have the bulk of their health insurance premiums paid for by customers who buy GM cars, regardless of whether said customer also pays his or her own health insurance premiums.  They are not even taxed on those benefits, which no one could argue aren't real money.  It most certainly is, it just doesn't go through their bank account.

I certainly haven't read the entire bill, but from what have read there are no real cost savings.  Drug companies and hospitals in particular, and doctors too, will find (lobby for) ways to get around them.  Pills in hospitals will still cost $200, as someone else pointed out.

Tort reform may seem worthwhile, but it's a tiny fraction of health care costs...reportedly 1 to 1.5%, and this includes malpractice insurance premiums.

It's the wrong fix.  Try again.

I can understand the frustrations of the current HC system - it certainly leaves a lot to be desired. I can also understand the anxiety and worry of having to find coverage for those with pre-existing conditions, especially children. But do we, as a nation, really want the Federal Government to run healthcare? My problem with this is:

-$$$$$$ - anyone thinking that this bill will save money is living in fantasyland. The CBO estimate is nothing more than a wild guess. Remember Medicare? Medicare is 9x more costly than what was estimated (by the CBO). Companies such as AT&T, John Deere, Verizon (and the list goes on) estimate losses of 100's of millions with this bill. Do you think that the top wage earners will take the hit? Think again - they have many options including slashing HC coverage for their employees, layoffs, passing costs to the consumer, etc.

-physician support - the administration is not being forthright with its citizens. It has been estimated that as many as 40% of physicians would consider retiring early with Government HC. Also, many physicians are part of the baby-boomer generation and are close to retirement anyway. Lastly, I personally know physicians who will discourage their children from persuing a career in medicine. Add another 20-30 million patients that will supposedly receive coverage. The end result??!!!

-constitutionality - whether you believe this bill violates the constitution or not, since when has the FEDERAL Government had the authority to mandate its citizens/businesses to purchase ANY good or service? If you opt out of this system, you must pay a fine to the government. If you choose not pay this fine, it will be witheld from your tax refund (if you are lucky enough to receive one). If Government can mandate healthcare, what is next? The larger and more intrusive our government, the more (little by little) we start losing our liberty and freedom

-healthcare as a right - Our rights are life, liberty and the pursuit of happiness. If government can mandate healthcare as a right, where does it stop? The right to certain foods or even schools?

I agree there needs to be tort reform. It is interesting to me that Dr Rankin gives kudos to Obama for "taking a stab at" this problem yet completely ignores the fact that this administration intentionally left out meaningful tort reform. As the popular Howard Dean said when asked about tort reform at a town hall meeting, "we've upset so many people with this bill, we didn't want to upset the lawyers as well" Understandable, as the lawyers have contributed over $700,000,000 (yes, million) to the democratic party just in the last 10 years!

Dr Rankin is willing to intentionally sacrifice money to help secure her daughter's future? If you think people have a right to healthcare, thats your opinion - but at the sacrifice of your children? You have that much faith in your current administration?

How about we start with some straight-forward fixes instead of such a monstrous 2000+ page bill (filled with politician pet projects) that NOBODY understands.
The ability to purchase healthcare across state lines will increase competition and significantly reduce costs. Tort reform is crucial as well.

This bill is cost prohibitve with unintended consequences. The administration that promised <8.5% unemployment (now at 9.7%, 14% in Michigan) with the passing of a neccesary, rushed, pull-us-from-the-brink $700 billion plus stimulus package (of which less than 50% has been spent), a government that has let medicare, medicaid and social security teeter on the verge of bankruptcy, is going to be entrusted to take care of our healthcare?

We all have the freedom to access information - PLEASE be informed and vote your heart, mind and conscience in future elections because our freedom and liberties are at stake.

Thanks, Lissa, for being so open and honest. I think your views as a citizen are as valid as your views as a doctor.

I live in DC. I read the in's and out's of this debate in my daily paper. The whole thing is stupidly political and we just have to look at every other developed country in the world to know there are alternatives to better care at lower costs. The subject is maddening for all the reasons you (and others here on all sides) state.

All that said, a move in the right direction is a move in the right direction. This is not a problem that will go away and this bill provides mechanisms that didn't exist before to change the economics of the system to the benefit of the actual human beings who get sick. Every 'system' has inefficiencies, but this one is out of control and I support every effort to ensure that (1) people aren't left in the streets to die and (2) the cost burden is more closely and broadly managed. This bill does that, so I'm supportive.

I, too, hope we move closer to Universal Health Care. I'm a free market entrepreneur, but I also know that pure capitalism feeds the greed of people who lock their compassion away at the expense of the unfortunate. Health care of all things needs some regulatory checks and balances to make the economics capable of supporting basic and preventative care for everyone living in our prosperous and compassionate society.

Ok. I think I've said enough. Thanks for writing this and thanks to everyone else who added their views. The true discussion has just begun!

Love, Light and Blesssings

~Dana

I, like Amanda, am kind of embarassed to say I know next to nothing about any of this. I don't watch/listen to/read the news, and I rarely get sick. That asid, it's perfect that I would hear about it as said in the corageous, honest, heartful, and transparent way you say things. You're not taking a position ... you actually care. That's the kind of "news" I like to see. Thank you dear Lissa. xoxoox

Dear ones,

Thank you so much for your feedback, brilliance, truth, and authenticity. I was so afraid to post this on my blog, because my website is this very loving community of women and the few times I've brought up politics, it has divided us painfully.  So thank you so much for making BlogHer a sacred space to gather here together in safety, so that we might all speak our truth.

Bless you all!

Much love to you all, 

Lissa

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Two years ago, on my son's 1st birthday, I walked my Mother into the hospital to have a port surgically put in her chest so that the following week she could begin chemo for breast cancer. For the next year of my life I did two things, raise my son as a single parent and advocate for my Mom. Today she is cancer free and we are all very thankful for that. Everyday everyone in my family is grateful for the unique circumstances that allowed her to attack her cancer in a way that she and her doctor decided upon.

However during her treatment I had many encounters with people from all walks of life and positions all fighting for the same goal as my Mom was, to get the treatment that would cure them. Yet nearly every single person I came across was unable to get the treatment that truly would be the best course of action for them (as decided by themselves and the doctors) because the insurance company had their own ideas and if they were going to pay you had to play by their rules, period. The same types of rules and requirements applied with any type government funded route that a patient could explore as well. That is the simple nature of bureaucracy, love it or hate it that is the case. I have a great fear that those standardized rules will only grow in scope now and hinder the doctor patient relationship even more. Bureaucracy is not just a word, it is an element that can truly and immensely have life altering effects on if a person can make the choices that they what to make for themselves. Life and illness is not something that can be standardized because every single gene you have, every single breath you take, ever bite of food you ever eat makes your health unique to you alone. I learned this hard truth and it is something that is so often over looked.

Every week I would go down to the office at Texas Oncology to pay the bill and James in the financial office would pull up my Mom's chart and begin totaling up all of the discounts that we got on every service, each treatment and every drug. During the chemo phase of treatment the discounts were usually between 20%-40%. During radiation it was between 60%-70% for treatment. On top of that we would get a 20% discount on the straight doctors services. We incurred so many discounts that I truly lost track. How did we get all of these discounts and how was my Mom so unhindered in her decisions about her treatment and care and ultamently her life. She paid for all of her treatment in cash. No insurance company, no government, just us. I tell this story to point out what the price of bureaucracy and paper pushing really is. It's so far beyond what you think it is and it limits you far more then what many people understand. 

I know that the route that my family and my Mother were able to take financially is drastically unique and it is not a route that I would recommend to anyone. But I know that there are lessons to be learned from it. I got to really see what the cost of bureaucracy is on every level. Reguardless of what your opinions of what health care should be like in our country I hope that you will at least consider the limitations that we as a country are about to take on. If you disagree with me I respect that.  I hope that hearing what I and my family have been through will allow you to see that health care and bureaucracy do indeed make for bad bed fellows and that increasing it might not be the change that you want.

Melissa_B. 

I completely agree with your view on a universal healthcare system.  I may be young and but a sophmore to the workforce, but you perfectly summed up my opinion on this issue: "it’s worth it to me to give up some of my personal financial security in order to serve the world. People deserve to be healthy."

If people are on the fence regarding this topic, perhaps they should read a great book that highlights how many working Americans are unable to have health insurance: Nickel & Dimed ( http://www.barbaraehrenreich.com/nickelanddimed.htm ) (On (Not) Getting By in America). 

-Ashley-

http://honeysucklechic.com/

Jen @ ( http://twitter.com/ ) www.afterthealter.com ( http://www.afterthealter.com/ )

I appreciated reading about what you thought, and many of your points are valid, but I don't think that having the government tell me what I HAVE to do is the answer. Maybe the government shoudl tell insurance companies what they HAVE to do?

As for doctors, maybe more poeple could go to the ER if if wasn't $200 for a pill of asprin. My mom had a brain aneurysm and the bill from the hospital was $300,000.. That is INSANE! Luckily she had insurance but the funny thing is that the insurance company was able to negotiate the full amount down, and when it came time for my mom to pay her deductible they had to shell out $5000...no budging from the hospital!

People make choices in this world...and it's the middle class that's going to get screwed on this. I will agree that change is necessary, but I DO NOT think the needed change comes in the forms of the government running our healthcare...think of 1 government run program that is successful? Medicare?? ya right! social security? I won't see a dime! I hope I am wrong on this...but right now I don't see how. Right now I see the hard working Americans, that choose to live with in their means, and who work hard that are going to get hurt...let's how I"m wrong.

Joanne Tombrakos is a personal coach and novelist who blogs her observations as she reinvents life after Corporate America at Http://onewomanseye.blogspot.com ( http://onewomanseye.blogspot.com )

Thank you for your objectivity from all viewpoints. I agree this is not a perfect bill, but it is a step in direction we must go.

Thanks for sharing your viewpoints, I am still undecided as to whether it is a good thing or not, but I do see the good points.

I also agree about Malpractice suits, I think they are ridiculous! In some cases they are warranted, but some people are just money hungry and will sue for anything.

CrystalsCozyKitchen

http://crystalscozykitchen.blogspot.com

I just don't know how someone can say with a straight face that they live in this incredible country in the first world, but that they'd rather let the poor die without healthcare.

Jesus said, "What you do to the least of my brethren, you do to me"

How can they call themselves conservative CHRISTIANS? There's nothing Christian about denying people the right to be healthy.

And yes, the United Nations says (as well as Amnesty International) that healthcare is a BASIC HUMAN RIGHT.

I'm Canadian, and we've always done things this way. What is everyone crying for?

After all of the back and forth and political talk, it is refreshing to read how this will affect real people in real ways. Your perspective is very helpful and I appreciate how you broke it down. Thanks so much for writing this!

Caroline

http://www.morningsidemom.com/ ( http://morningsidemom.wordpress.com/ )

I know this is terrible, but I know almost nothing about the new healthcare bill. I rarely have time to watch the news, I'm always working and the only way I can concentrate is with the TV off. I'm always working because of bills. it's a vicious cycle. My husband's employer provides health insurance, but they don't pay anything toward, not even for the employee. We pay the full pop. So every week a deduction of $260 is taken out of his paycheck. I sometimes wonder if it's worth it, but I have 4 kids, all relatively healthy, but there are definitely hereditary issues in both sides of our family that worry me. And so we pay it, whether we can afford it or not. I have no idea if this bill will help us or not, I can only hope it's a step in the right direction.

Crafts by Amanda www.craftsbyamanda.com ( http://www.craftsbyamanda.com ) Amanda's Cookin' www.amandascookin.com ( http://www.amandascookin.com )

I've been curious to read/hear a well rounded opinion from someone who is affected by this bill both personally and professionally.

I myself have been involved in a lawsuit with an OB/GYN but my case was valid and I wasn't after anything except having my daughter's neurologist and physical therapy bills - things she'll need for the rest of her life due to her brachial plexus injury - covered. I'm no schizo, I swear!! Anyway, my point is that I got a little taste of how malpractice lawyers work back then and some of them are like pirahanas, so I agree that reform needs to be placed there as well.

Thank you for posting this!

- Maria Young

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My conservative friends feel that universal healthcare is welfare and this healthcare bill is a form of welfare. Of course their children do not have pre-existing conditions like my daughter does nor did their husband's lose jobs during the great recession like mine did. 

Until people truly understand how this bill and a public option would help them. They will only follow like mindless sheep, the nay sayers that are against good health for all. 

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