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.

[wafflehouse]

First off the government has involved very few of us physicians in the healthcare debate

well no sh!t.. this isnt about health care, medicine, doctors, or the wellbeing of americans. this is about POWER, DEPENDENCE on the government and GOVERNMENT CONTROL over the LIFE and DEATH of its citizens

[rlmorel]

[rlmorel]

"...but the new plan calls for all physicians to make the same amount of payment...."

Can anyone help me with this? Buried in the legalese, I cannot find it. Does someone have the appropriate section handy?

I may try to go to a townhall meeting tonight, and I think this would be a great issue to address.

[Carley]

This doctor will find himself at the top of O’s enemies list before the day is out.

[paulycy]

[csvset]

Angry Bear is scary.

[paulycy]

Angry Bear is scary.

Seems appropriate...

[muggs]

I hope they don't ration dental care. The more I hear about this, the more I clench my jaw and grind my teeth.I have a mouth guard that I am supposed to wear at night but often I use it during the day now.

[uncbob]

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

Nope the Pharms will be going belly up also

Drugs will be rationed (the drugs that will still be manufactured that is )

[GOPJ]

First off the government has involved very few of us physicians in the healthcare debate.

Dems don't need no stinkin' facts - they got angry ACORNers who want their "piece of the pie"...

[Total Package]

I may shrug too T. Package RN.

[Total Package]

What pharmaceutical companies? Without the ability to make a profit there will be no new drugs to sell, because there will be no research done. You go to work for free and see how long you...... Who is going to go to school for 8 to 12 years to make minimum wage.

[Mrs.Z]

***I know a lot of medical people who are planning to leave the field if this passes, ***

Oh no.

The One will never allow that.

All medical retirees will be given a choice of going back to work or being sent to a reeducation camp.

[jch10]

My husband got a letter last week from his cardiologist, the best in town, saying he was no longer accepting Medicare payments.

[metmom]

Obama’s nightmare scenario.

[Paytriot]

Hey, thanks for posting this article. My liberal mother in law keeps holding up Sweden as some kind of single payer utopia. This will get her to think I hope, especially cuz she has really learned to depend on Doctors opinions.

[GovernmentShrinker]

Don’t be naive. The pharmaceutical companies have huge lobbying budgets and can generate huge amounts of money in campaign donations. Have you heard them howling against this vile Obamacare scheme? No, you haven’t — because they support it, because they know full well that they WILL be able to make plenty of money from it. It’s ordinary private citizens who are going to get screwed, not the pharmaceutical companies. The pharmaceutical companies will get cozy deals with the big government scheme.

[uncbob]

Nope there ain’t enough $$$$ around and when they can’t sell their drugs they are screwed —HINT Obama ain’t gonna let seniors have the drugs they need and THEY are the biggest consumers of drugs especially after 65

[Aria]

I just sent this article to 4 senators, 2 congressmen and the WH site.

Why do I think they don’t care what any of us think?

[MarMema]

WHat he means is that specialists like neurosurgeons, go to school beyond the MD to get the specialty, and then plan to make more money afterward. Under Obama, all docs will earn the same amount of money, apparently.