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.

[GovernmentShrinker]

They already have a deal with the Obama crew. See the NYT article posted here today.

Trust me, the pharmaceutical companies aren’t going to get screwed by this. They’re partners in it. We will be taxed to pay them whatever the government wants them to get paid. When the government controls the list of approved medications (which is already explicitly the case in Medicare/Medicaid, and in European countries with socialist health care), the government can shovel any amount of money into the pharma companies pockets — government controls the prices, and we have to pay the taxes to foot the bill.

[uncbob]

Yeah the deal was to cut drug costs

I repeat SENIORS are the biggest users of drugs and they won’t be getting them

[verity]

“I repeat SENIORS are the biggest users of drugs and they won’t be getting them.”

I do not accept your hysterical opinion.

[uncbob]

And I dont accept yours

[verity]

Fair enough!

[uncbob]

Not really you called mine HYSTERICAL just like a lib would do

[verity]

Of course, you are hysterical.

[uncbob]

So are all those at the Townhall meetings protesting Obama care especially the seniors

[socialismisinsidious]

Socialized Medicine aka Universal Health Care PING LIST

FReepmail me if you want to be added to or removed from this ping list.

**This is a high volume ping list! (sign of the times)**

[neverdem]

Trust me, the pharmaceutical companies aren’t going to get screwed by this. They’re partners in it. We will be taxed to pay them whatever the government wants them to get paid. When the government controls the list of approved medications (which is already explicitly the case in Medicare/Medicaid, and in European countries with socialist health care), the government can shovel any amount of money into the pharma companies pockets — government controls the prices, and we have to pay the taxes to foot the bill.

House Tri-Committee Bill Would Hurt Patients and Kill Jobs

"PhRMA opposes the House Tri-Committee bill because it undercuts the main goal of health care reform which is to help all Americans access needed healthcare coverage and services. The bill would effectively act as a tax increase by raising premiums for seniors in the popular Medicare prescription drug program, severely restrict patient access and choice and hurt an innovative sector that currently employs hundreds of thousands of workers. The result could mean significant job losses in the middle of a recession. In addition, the legislation allows broad override of protections for Medicare and Medicaid beneficiaries by unelected officials, with no chance for review.

"Under the House bill, we're concerned that the federal government will wind up rationing health care and dictating what medicines doctors can prescribe to their patients. This may well prevent patients from gaining access to the critically important medicines they need to fight diseases such as cancer, diabetes and heart disease.

[Lorianne]

Do you have news articles or other things you can link us to about the French system? It would sure be helpful.

Even if it’s in French and not English, that’s fine, we can get it translated.

Merci.

[GovernmentShrinker]

Window dressing. You skipped the intro when you excerpted that:

“PhRMA remains committed to working with the Administration and Congress to help enact comprehensive health care reform this year. Our policy agreement with the White House and the Senate Finance Committee, which provides $80 billion in meaningful cost-savings over 10 years, clearly demonstrates that commitment. We share the same goal of helping ensure that all Americans have access to affordable, high-quality health care coverage and services.”

They are working WITH the administration to craft a plan that works for THEM. Further reality check here:
http://www.nytimes.com/2009/08/06/health/policy/06insure.html?ref=health

“Pressed by industry lobbyists, White House officials on Wednesday assured drug makers that the administration stood by a behind-the-scenes deal to block any Congressional effort to extract cost savings from them beyond an agreed-upon $80 billion. . . . But failing to publicly confirm Mr. Tauzin’s descriptions of the deal risked alienating a powerful industry ally currently helping to bankroll millions in television commercials in favor of Mr. Obama’s reforms.”

Trust me, the pharma industry lobbyists aren’t pouring millions into ads to sell the nation on Obamacare because they’re eager to be put out of business.

[Lorianne]

Oh for heaven’s sake, go join a mob!

/s

[uncbob]

They are like all lobbiests

They are trying to insure they get less screwed by government regs etc etc

They are being blackmailed into supporting t the plan

Again SENIORS are the biggest consumers of drugs

Unless the Pharms are hoping the GOV requires everybody to do statins etc

[verity]

I am over 70 and have no fear of losing drug coverage.

However, future competent medical care is entirely a different issue.

[uncbob]

I am over 70 and have no fear of losing drug coverage.

What causes you to be unafraid

How about if you need a bypass or pacemaker etc

[GovernmentShrinker]

Seniors already have extensive government coverage through the existing Medicare scheme. The new scheme being proposed is mainly about adding NON-seniors to a big new government program. Hundreds of thousands of under-65 deadbeats, drug addicts, alcoholics, etc. who are currently uninsured because they don’t work at jobs that provide coverage (and in many cases never did), and don’t have money to buy insurance (though nobody would be likely to sell them insurance anyway, nor would they willingly spend money on insurance when they’d rather spend it on booze or meth or whatever). THESE will be the primary new entrants into the government insurance plan, and THESE will be the primary source of new prescription medication sales for the pharma companies. The seniors are all already on the various Medicare schemes, and the pharma companies already have that captive market in their pockets.

Sure, Obama & Co. are painting a picture in which the main beneficiaries of the new scheme would be hard-working people who’ve recently lost insurance because they lost their jobs. But statistically, this doesn’t hold water when the scheme is to make *everybody* get insurance. There really aren’t that many people who are newly uninsured due to the economic downturn, but there are lots and lots of people who were never insured because they’re deadbeats. This scheme is about adding huge numbers of people to already bulging rolls of people who are “entitled” to have the government (i.e. taxpayers) buy them whatever drugs the government-regulated doctors say they “need” — in other words, artificially increasing the total market for prescription drugs. What’s there for a pharma company not to love? This is like bicycle manufacturers and a proposed “green” law to require everyone in the country to own a working bicycle, with the government to buy it for them if they “can’t afford” to buy it themselves.

[uncbob]

Aren’t deadbeats etc already getting any medical care they need throgh emergency rooms and or medicaid

[verity]

What causes you to be afraid?

[GoldwaterChick]

Bump for tomorrow.