ObamaCare and me (from the perspective of a pediatric ophthalmologist)

American Thinker ^ | August 06, 2009 | Zane F Pollard, MD

[neverdem]

I have been sitting quietly on the sidelines watching all of this national debate on healthcare. It is time for me to bring some clarity to the table by explaining many of the problems from the perspective of a doctor.

First off the government has  involved very few of us physicians in the  healthcare debate.While the American Medical Association has come out in favor of the plan, it is vital to remember that the AMA only represents 17% of the American physician workforce.

I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye.

Each time the request came back denied. All three times I personally provided the antibiotic for  each patient which was not on the Medicaid approved  list. Get the point -- rationing of care.

Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post  cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.

Again, extreme rationing. Solution: I have a foundation here in Atlanta supported  100% by private funds which supplies all of these contact lenses for  my Medicaid and illegal immigrants children for free. Again, waiting for the government would be disastrous.

Last week I  had a lady bring her child to me. They are Americans but live in Sweden, as the father has a job with a big corporation. The child had the onset of double vision 3 months ago and has been unable to function normally because of this. They are people of means but are waiting 8 months to see the ophthalmologist in Sweden. Then if the child needed surgery they would be put on a 6 month waiting list. She called me and I saw her that day. It turned out that  the child had  accommodative esotropia (crossing of the eyes treated with glasses that  correct for farsightedness) and  responded to glasses within  4 days, so no surgery was needed. Again, rationing of care.

Last month I operated on a 70 year old lady with double vision present for 3  years. She responded quite nicely to her surgery and now is symptom free. I also operated on a 69 year old  judge with vertical double vision. His surgery went very well and now he is happy as a lark.  I have  been told -- but of course  there is no healthcare bill that has been passed yet -- that these  2 people because of their age would have  been denied  surgery and just told to wear a patch over one eye to alleviate the symptoms of double vision. Obviously cheaper than surgery.

I spent  two year  in the  US Navy during the Viet Nam war and was well treated by the military.There was tremendous  rationing of care and we were told specificially what things the military personnel and their dependents could have and which things they could not have. While I was in in Viet Nam, my wife Nancy got sick  and got essentially no care at the Naval Hospital in Oakland, California. She went home and went to her family's  private internist in Beverly Hills. While it was expensive, she received an immediate work up. Again rationing of care.

For those of you who are  over 65, this  bill in its present form might be lethal for you. People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British  plan. For those of you younger, it will still mean restriction of the care that you and your children receive.

While 99% of physicians went into  medicine because of the love of  medicine and the  challenge of helping our fellow man, economics are still important. My rent goes up 2% each year and the salaries of my employees go up 2% each year. Twenty years ago, ophthalmologists were  paid $1800 for a cataract  surgery and today $500. This is a 73%  decrease in our  fees. I do not know of many jobs in America that have seen this sort of lowering of fees.

But there is more to the story than just the lower fees. When I came to Atlanta, there was a well known ophthalmologist that charged $2500 for a cataract surgery as he felt the was the best. He had a terrific reputation and in fact  I had my mother's bilateral cataracts  operated on by him with a wonderful  result. She is now 94 and has 20/20 vision in both eyes. People would pay his  $2500 fee.

However, then the government came in and said that any doctor that  does  medicare work cannot accept  more than the going rate ( now $500) or  he or she would be  severely fined. This put an end to his charging  $2500. The government said it was illegal to accept more than the government-allowed  rate. What  I am driving at is that those of you well off  will not  be able to go to the head of the line under this new  healthcare plan, just because you have money, as no physician will be  willing to go against the law to treat  you.

I am a pediatric ophthalmologist and trained for  10 years post-college to become a pediatric ophthalmologist (add  two years  of my service in the Navy and that comes  to 12 years).A neurosurgeon spends 14  years post -college, and if  he or she has to do the military that would be 16 years. I am not entitled to make what a neurosurgeon makes, but the new plan calls for all physicians to make the same amount of payment. I assure you that medical students will not go into neurosurgery and we will have a tremendous shortage of neurosurgeons. Already, the top neurosurgeon at my hospital who is in good health and only 52 years old has just quit because he can't stand working with the government anymore. Forty-nine percent  of children under the age  of 16 in the state of Georgia are on Medicaid, so he felt he just could not stand working with the bureaucracy anymore.

We are being lied to about the  uninsured. They are getting care. I operate  at least 2  illegal immigrants each month who pay me nothing, and the children's hospital at which I operate charges them nothing also.This is true not only on Atlanta, but of every community in America.

The bottom line is that I urge all of you to contact your congresswomen and congressmen and senators to defeat this bill. I promise you that you will not like rationing of your own health.

Furthermore, how can you trust a physician that works under these conditions knowing that he is controlled by the state. I certainly could not trust any doctor that  would work under these  draconian conditions.

One last thing: with this new healthcare plan there will be a tremendous shortage of physicians. It has been estimated that  approximately 5% of the current physician work force  will quit under this new  system. Also it is estimated that another 5% shortage will occur because of the decreased number of men and women wanting to go into medicine. At the present time the US government has  mandated gender equity in  admissions to medical schools .That means that  for the past  15 years  that  somewhere  between 49 and 51% of  each entering class are females. This is true of private schools also, because all private schools receive federal funding.

The average  career of a woman in medicne now is only 8-10 years and the average work week for a female in medicine is only 3-4 days. I have now trained 35  fellows in pediatric ophthalmology. Hands down the  best was  a female that I trained  4 years  ago -- she  was head and  heels above all  others I have trained. She now  practices  only 3 days a week.

[neverdem]

IMHO, five percent of docs taking early retirement with ObamaCare is wildly optimistic. Any doc who has enough money will probably do it. Most docs have big enough egos that they can only tolerate goobermint idiocy for so long.

[Soothesayer9]

A cardiologist in the UK told me he cant do any more surgeries for the rest of the year bc he filled his “quota” for Big Govt for the year.

[HiTech RedNeck]

Dr. Atlas will shrug and not participate in Medicare any more.

[HiTech RedNeck]

Can’t carry on a practice outside of his country either?

[SatinDoll]

Yes, I agree with you.

[MarMema]

Excellent!! Thank you for posting.

[GovernmentShrinker]

Most won’t retire — they’ll go to work as sales reps for pharmaceutical companies, helping drive up the cost of medical care.

[MarMema]

I hope you are planning to ping this. I know a lot of medical people who are planning to leave the field if this passes, and something will eventually be passed.

[Freedom56v2]

bttt

[1000 silverlings]

Or we’ll be reduced to going down back alleys in secret to obtain what will be illegal medical care and both the doctor and us will be subject to arrest

[Scotswife]

bookmark

[neverdem]

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Some noteworthy articles about politics, foreign or military affairs, IMHO, FReepmail me if you want on or off my list.

[Boucheau]

[Aria]

Frankly, I am petrified about this. Our government has never frightened me....until now. These people are ruthless.

One of zero’s czars preached that you should be able to “abort” a child up to the age of 2. Then Rham’s brother and his opinions on ending life that amount to murdering the sick. And of course the rationing of care and government interference such as the Dr. above describes. This legislation will kill people and destroy lives and people we elected are trying to force it on us while exempting themselves. How much worse can this get?

[NonValueAdded]

People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British plan.

I wonder what percentage of stent placement that would be in the US - 80% 90%? The only thing that might save the 60-65 year old crowd would be if they were still working and not collecting SocSec. And don't look for the grandkids to vote for your treatment, gramps. They will be desperate to get you off the SocSec and Medicaid roles so they can get their tax burden down to a comfortable 70%.

[1000 silverlings]

oh you are so reported mister

[1000 silverlings]

If Obama stays in office, no way am I collecting SS, and that’s probably what they want

[Ulysse]

Hello colleague

As a french physician i can tell that physicians and even health are not the matter in that kind of debate on a National Health Care since it’s firstable ideological...
It’s not a surprise for me if US physicians have not been involved in the debates by the current administration.
Guess they don’t want to hear your voice!

You will be supposed to be civil servants of the great Public National Health Care of the dear leader and then supposed to do and obey silently to what federal administration decide....

We have that in France since communists in De Gaulle’s government created our wonderfull Social Security after WW2.
And the system is about to explode. Physician surgeries are decreasing quickly,public hospitals are a real mess...

[Boucheau]

[Attention Surplus Disorder]

Terrific article, thanks for posting it.

I never stop being amazed at the sheer arrogance of our Congressites, who in most cases formulate their individual opinions based upon money incentives to keep themselves in office. They get rushed, 5-minute per witness testimonies about stuff they haven’t the slightest idea about, and feel empowered to make decisions Monday about who and how a giant car company will be taken over and run; Tuesday how a complex system of energy sources and transports and uses in the enormous economy that is the United States operates, Wednesday how a very complex medical system functions and Thursday about steroid use in baseball. They think from these scattered snippets they have enough info not only to make wise macro decisions; but to enact laws and regulations creating restrictions, priveleged classes, industrial ad/disadvantages, exceptions for themselves, and spawning massive bureaucracies of limitless size. The great majority of them have little more intelligence than a garden slug, but worse, there is no accountability on their part for the most egregious error or deliberate manipulation they can possibly concoct.