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.

[Attention Surplus Disorder]

THAT (the second image) is EXACTLY the kind of material I believe can have an impact.

[FormerACLUmember]

Thank you Dr. Pollard, for writing this and providing some genuine enlightenment.

You are are an Officer (retired) and a Gentleman. Not to mention, a Saint.

You are a man of ethics, the precise opposite of that shameful moral renegade Administration physician brother of Rahm Emanuel.

[Boucheau]

Well, use it!

I make this stuff for FR.

It’s all yours.

Let me know if you want some customization.

I’m delighted to help.

(What, was the first one too much? Be nice, I’m workin’ alone here.)

[Brad’s Gramma]

Whoops. I accidently emailed that link to a bunch of folk.

Sorry. /sarcasm

[Pajamajan]

EVERYONE-IN-AMERICA-NEEDS-TO-READ-THIS BUMP

[jwparkerjr]

The absolute hallmark of everything The One's team sets out to accomplish is that those selected to do the job have no experience or expertise in the field. They are political hacks and the positions are political payoffs. It's political patronage, a la Chicago, at its best. It's obvious, to me at least, that they have no interest in making the projects they take on work and work well. Rather, they are interested only in getting control of them and making them over in accord with their personal ideas of what they should be.

We are so screwed unless we find a way to activate the very effective term limits, called elections, provided for us by our Founding Fathers. They gave us everything we need to turn this around and put America back on track. But as long as the ruling class in DC can buy the votes of non-producers by taking at gun point the resources of the producers nothing will change.

Somehow we have got to get producers to the polls in 2010 and fire as many members of the House as we can.

[MarMema]

ping

[Database]

marker

[Brad’s Gramma]

Sad BTTT........

[dagogo redux]

Thanks for such a fine post. My specialty, psychiatry, is a bit different than most, but I and my patients will likely be among the hardest hit. I don’t see Medicaid, and will be curtailing Medicare soon I think. I specialize in more difficult cases in an area where there are few options for patients. If I retire, there will be a huge gap here. But I will likely retire as soon as possible from a specialty that can normally be practiced far into old age, and one which already attracts far fewer applicants than slots in residency programs.

Many of my elderly patients, without my saying anything, are bringing up their understanding that I may either retire soon (early) or stop seeing Medicare folks altogether. They understand the ship is going down. They understand there will not be a seat in the life boat for them. Many explain their embarrassment at having voted for Obama and the rest of the gang forcing this and other similar changes upon the country. It is poignant. Sad for them. Sad for us all.

Cicero and other Greco-Roman moral philosophers often wrote treatises arguing against fear of death. One of their arguments pointed out that an early but otherwise neutral death is preferable to a longer life that then ends in a death amidst great mental suffering. I think many of my patients, when the time comes, will look back and wish they had died before their lives and their country came to this. Perhaps we all will.

[CaliGirl-R]

“Whoops. I accidently emailed that link to a bunch of folk.”

OMG, me too. Were we not supposed to do that? :)

[Brad’s Gramma]

Hope no one reads them!

[Brad’s Gramma]

I was talking to my elderly Mom a couple days ago about this mess. No, SHE didn’t vote for the Zero...but she hurts for her kids, knowing what we’re about to go through....

[Boucheau]

You might think this extreme but I know a guy (79) who waited almost 30 minutes in an ER wait room, with severe head pain, while suffering what ended up being a minor stroke. That was just over a year ago--and he had a good private insurance plan.

What kind of care will you get from people who are essentially civil servants?

[neverdem]

What kind of care will you get from people who are essentially civil servants?

The ones who keep working will join a union and then strike for more pay. See what happens in a bureaucratic slowdown.

[Boucheau]

Here's that one with the typo fixed. I tol'ya I'm working alone here :0)

[Las Vegas Dave]

Worth printing out and making several copies for “when you need them”!

[wastoute]

I have been posting here about this for months. If Zero is successful back alleys is where those who can afford it will go. Abortion will be available on demand on Main Street but Lipitor will be pushed through car windows on street corners by "not so friendly" youngsters wearing their hats backwards. Like during prohibition LEOs will do nicely taking the bribes that allow the entire scheme to continue because "back alley" medicine will be illegal. Folks like pediatric ophthalmologists will be outa luck cause you won't be able to do what they do in a back alley. Of course many of them will emmigrate to India where those who can afford to go there will take their kids. If Zero and his minions get their way things will cahnge, fer sure, but there won't be much hope.

I suspect saner heads in the Senate will begin to prevail as Zero's poll numbers drop. It will be much easier for them to stand up to him as this happens. I expect the Senate to block every bit of his agenda because the consequences of his success would be so obviously disatrous. Cap and Tax, healthcare won't pass the Senate. Immigration reform damn well better not, if it does our only recourse is war. The Porkulus can be "undone" as most of it hasn't been spent yet. The libtards are guilty of over-reaching and will pay the price IMHO.

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[combat_boots]

bump

[Ulysse]

“FREE”(there is always someone who will pay the bill)National Health Care would create a huge drain for illegal immigrants ,create a huge tax burden for the next generations in US,weaken the US economy for a long long time,and “CHANGE” the US society...

It’s the corner stone of the OBAMAO’s untold plan...which is called “CHANGE” to fool people