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A Physician's View of Government Healthcare (It's Ugly)
American Thinker ^ | 08-18-09 | Dr. Zane Pollard

Posted on 08/18/2009 12:25:02 PM PDT by CWW

This letter is from Dr. Zane Pollard. His ophthalmology training was at Emory with my husband. He now operates at Children’s Health Care of Atlanta.

Friends:

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 and as your friend by explaining many of the problems from the aspect 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.Why is this. 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 tome which was mailed 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 on set 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 , 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 specifically what things the military personnel and their dependents could have and which things they could not have. While 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 goes 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 lowering of fees.

But there is more to the story that 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 can not 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 decreased 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 fundings. The average career of a woman in medicine 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.

Zane Pollard, MD


TOPICS: Business/Economy; Culture/Society; Government; Politics/Elections
KEYWORDS: bhohealthcare; government; healthcare; medicare; physicians
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Wonder Why We Don't Get To Hear From Other Doctors Like Dr. Pollard? Hmmm?
1 posted on 08/18/2009 12:25:03 PM PDT by CWW
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To: CWW

I asked my Doctor what he thought of Obamacare and he laughed and said it was a joke. He better stop laughing it is no joke.


2 posted on 08/18/2009 12:31:01 PM PDT by Venturer
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To: CWW
We had both doctors and nurses speaking out against HR 3200 in Santa Barbara in front of Lois Capps office. She called out America Works, PUEBLO, etc in an attempt to chant over any intelligent debate. Then Justin Tevis, a 26 year old inventory manager at a local clothing company jumped in the back of a V10 Dodge truck and let the Free-Loaders have it.

Justin Tevis stands up to ACORN Groups in front of Lois Capps office

3 posted on 08/18/2009 12:32:44 PM PDT by Zevonismymuse
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To: CWW

Minnesota Democrat Senators Al Franken, Amy Klobachar, and Rep Tim Walz will not get no where near the Mayo Clinic in Rochester, Mn, unless it’s a rigged meeting


4 posted on 08/18/2009 12:36:32 PM PDT by Son House (President Øbama Turns His Back On The Oppressed During Their Darkest Hours)
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To: CWW

mark


5 posted on 08/18/2009 12:41:33 PM PDT by griswold3
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To: CWW

And this story is EXACTLY why my dad the surgeon in the early 60s waas against Kerr-Mills as well as King Anderson. Both bills eventually led to the present medicare system of non health care. Your doctor is a servant of the government when this stuff passes


6 posted on 08/18/2009 12:49:03 PM PDT by the long march
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To: CWW

Have a couple of anesthesiologist friends who have provided me information I have posted before...the Medicare cut of 1991 reduced their reiimbursement by 50% and more by many ‘base point’ Medicare relative value reductions..some suffered 65% total Medicare reductions in reimbursement reductions....the reduction of 1991 has remained almost constant to the present..18 years...compared to todays average fees, the Medicare reimbursement allowed can be as much as 77% depending on region.

They say the Medicare reductions in the surgical subspecialties resulted in the difficulty of MDs to service malpractice premiums and resulted their shunning Medicare patients or RATIONED them in their practices. RETURN THE MD REIMBURSEMENT RATES TO 1990 LEVELS AND THE MALPRACTICE PREMIUM CRISIS AND THE MEDICARE PATIENT ESCHEWANCE DISAPPEARS!! GOVT HAS CAUSED IT ALL. Average MD has a greater than 50% of their practice in Medicare/Caid.


7 posted on 08/18/2009 12:49:35 PM PDT by givemELL (Does Taiwan Meet the Criteria to Qualify as an "Overseas Territory of the United States"? by Richar)
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To: CWW

Went to my eye doctor today for a usual checkup and wow she gave me the talking points that has been floating around the net blasting ObamaCare along with a list of our representatives and the blue dogs that need to be bombarded. She was wild, the more we talked the more heated she became. Told her I was going to my representatives town hall meeting on Thursday and she said, “see ya there.”


8 posted on 08/18/2009 12:53:45 PM PDT by engrpat (A village in Kenya is missing their idiot...lets send him back)
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To: Venturer
when are the AIDS 'victims' going to realize that they are about to become mulch under Obamacare?

.

9 posted on 08/18/2009 1:04:06 PM PDT by Elle Bee
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To: CWW

The link is bogus.


10 posted on 08/18/2009 1:05:47 PM PDT by browardchad
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To: CWW

Got a link?


11 posted on 08/18/2009 1:10:30 PM PDT by Admin Moderator
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To: Admin Moderator

http://www.americanthinker.com/2009/08/obamacare_and_me.html


12 posted on 08/18/2009 1:19:14 PM PDT by TruthFactor (The Death of Nations: Pornography, Homosexuality, Abortion)
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To: CWW

Informative


13 posted on 08/18/2009 1:26:51 PM PDT by mickidawn1969
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To: givemELL
The government's under-reimbursement means that the rest of us not on medicare & medicaid must pay for the shortfall in higher fees and/or premiums - it is, in essence, a hidden tax on the rest of us. By continuing to refuse to bring reimbursements in line with the actual costs for HC professionals to deliver care to the governments' patients, Congress gets to keep raising taxes on the rest of us indefinitely without ever actually having to vote for an increase on the floor, and the media can continue to sweep these hidden tax increases under the rug.

You're absolutely right that it's the part of medicine that government has already taken over & has so poorly managed thus far which has distorted the market & caused most of the problems that everybody must now endure - practitioners & consumers alike. Yet rather than fix it, or at least introduce some sanity (tort reform anyone?) now they want to grab what they haven't already screwed up completely just to bring that segment down to the same unsustainable level they've brought the medicare/medicaid system to.

I guess these career pols figure that when everyone's health care is under their control & there's no privately managed health care system for the public to be able to compare it to, the idjits in flyover country won't be able to realize anymore what an incompetent job they're doing. If you've nothing left to compare hell to, it should all look just like heaven, right?

But remember, Barack Obama is a genius. He knows all this but he will wave his magic wand & somehow the same bumbling crew who screwed up the Axelrod spam lists, and the same Prez who thinks the bankrupt US Postal Service monopoly is a fitting model for 'reform' will be able to pull out a miracle here. Just shut up, get in line & trust him.

That's the media's story, at least, and it looks like they'll be sticking to it for the duration.

14 posted on 08/18/2009 1:27:39 PM PDT by leilani
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To: CWW; ml/nj; firebrand; Yaelle; nikos1121; LucyT; ExTexasRedhead; Atom Smasher; Arizona Carolyn; ...
Wonder Why We Don't Get To Hear From Other Doctors Like Dr. Pollard? Hmmm?

Of course, part of the reason is that the MSM controls the message to a large extent. Another part of the reason is that most people in government mistakenly think that that the AMA speaks for the medical profession, when in fact, as Dr. Pollard points out, only 17% of practicing physicians are AMA members (and that percentage has been plummeting like a lead weight), and even many among that group don't like the direction in which the AMA is going.

Here is an interesting quote from Congressman (and Doctor) Tom Price (R-GA) regarding the nationalized healthcare debate:

"The AMA has sold out and let physicians and their patients down big time. The Board of Directors of the AMA barely represents the AMA members, let alone the vast majority of doctors who have trickled away from the leftist organization.

"Some doctors continue to try to re-direct this mammoth ill-fated group, but they are outnumbered by the socialist salaried sycophants who have now nailed the AMA's own coffin shut as well as the many patients who will soon prematurely meet their demise."

There is an alternative national physicians' organization that has opposed nationalization of medicine for 66 years: The Association of American Physicians and Surgeons (aka AAPS), 1601 N. Tucson Blvd. #9, Tucson, AZ 85716. The web site is aapsonline.org .

15 posted on 08/18/2009 1:57:52 PM PDT by justiceseeker93
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To: engrpat

Please see my post number 15. Urge your doctor to join and become active in the AAPS if she already hasn’t.


16 posted on 08/18/2009 2:00:38 PM PDT by justiceseeker93
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To: CWW; All
Everything that Dr. Pollard says in this piece is right on target. But even he confesses to “sitting on the sidelines” during this momentous national health care debate. Unfortunately, many doctors aren't heard from because they have too much on their plate as is, taking care of patients and running their practices. Plus, doctors as a group are not particularly politically astute, so their political enemies on the left tend to take advantage of their weaknesses. Fortunately, a lot of people like Dr. Pollard are waking up to the gravity of the threats posed to them and their profession and their patients by ObamaCare and are getting energized now.
17 posted on 08/18/2009 2:14:58 PM PDT by justiceseeker93
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To: Elle Bee

There will be an exemption in there somewhere for the Homosexuals. They vote Obama.


18 posted on 08/18/2009 2:48:49 PM PDT by Venturer
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To: CWW

Is public healthcare in the UK as sick as rightwing America claims?

The NHS has become the unexpected target of those opposed to Barack Obama’s healthcare reform proposals. Republicans and rightwing commentators in the US have made strong allegations about the failings of Britain’s health system. Denis Campbell and Girish Gupta put those claims to professionals in the health sector

*
Comments (118)
* Buzz up!
* Digg it

* Denis Campbell and Girish Gupta
* guardian.co.uk, Tuesday 11 August 2009 21.05 BST
* Article history

Growing numbers of patients aged 65 and over are having NHS heart surgery

Growing numbers of patients aged 65 and over are having NHS heart surgery. Photograph: Christopher Furlong/Getty Images

The claim

Ted Kennedy, 77, would not be treated for his brain tumour if he was in Britain because he is too old – Charles Grassley, Republican senator from Iowa.

The response

Untrue, says the Department of Health. “There is no ban on anyone of any age receiving any treatment, “ said a spokesman. “Whether to prescribe drugs or recommend surgery is rightly a clinical decision taken on a case by case basis.”

The claim

Government health officials in England have decided that $22,750 (£14,000) is what six months’ life is worth. Under their socialised system, if a medical treatment costs more, you’re out of luck - Club for Growth

The response

The National Institute of Health and Clinical Excellence (Nice) decides whether new drugs represent value for money for the NHS in England and Wales. It replied: “This is a gross misrepresentation of how Nice applies health economics to try and address the central issue: how to allocate healthcare rationally within the context of limited healthcare resources. Nice assesses the cost of a treatment in terms of a cost-utility analysis which takes account of the quality adjusted life year – the amount and quality of extended life it is hoped the patient will gain. The current ceiling is £30,000 but exceptions are made.”

The claim

In England, anyone over 59 years of age cannot receive heart repairs, stents or bypass because it is not covered as being too expensive and not needed – an anonymously authored, but widely circulated, email, largely sent to older voters

The response

Totally untrue. Growing numbers of patients over 65 with heart conditions are having surgery, including valve repairs and heart bypass surgery, says Professor Peter Weissberg, the British Heart Foundation’s (BHF) medical director. For example, the average age at which people have a bypass operation has risen from 58 in 1991 to 66 in 2008.

The claim

Breast cancer kills 46% of its targets in Britain, compared with 25% in the US; prostate cancer kills 57% of the Britons it strikes, compared with 25% of American victims; Britain’s heart attack fatality rate was 19.5% higher than America’s in 2005 – Pacific Research Institute, a San Francisco-based thinktank

The response

Breast cancer does claim more lives, proportionally, here than in the US. According to the 2002 Globocan database run by the World Health Organisation’s cancer advisers, 19.2 of every 100,000 Americans die of the disease, but 24.3 per 100,000 here die. On prostate cancer, a Lancet Oncology global study last year found that 91.9% of Americans with the disease were still alive after five years compared to just 51.1% in the UK. With heart attacks, 40% of Britons who suffer one die from it compared to 38% in the States – nowhere near the difference claimed.

The claim

In Britain, 40% of cancer patients are never able to see an oncologist; there is explicit rationing for services such as kidney dialysis, open heart surgery and care for the terminally ill – Conservatives for Patients’ Rights

The response

“The claim that 40% of cancer patients are never able to see an oncologist comes from a 15-year-old study which is completely out of date. Since then we have had the Nice Improving Outcomes Guidance series and the NHS Cancer Plan for England, which has increased the number of cancer consultants and established specialist multidisciplinary teams,” said Duleep Allirajah of Macmillan Cancer Support. However, “some people with serious kidney failure are unable to obtain dialysis on the NHS and die”, said Tim Statham, chief executive of the National Kidney Federation. “Some parts of the NHS can’t cope, because patient numbers are increasing by 6% a year, which is a huge burden. Of about 100 renal units in the UK, probably 20% are working at 100% capacity or above,” he added. The claim about open heart surgery is not true, said the BHF’s Weissberg. “There’s no explicit rationing. Some people don’t get treatment, but those decisions are made solely on the basis of clinical criteria and their risk of dying. We only operate on people who are likely to benefit and not die.” The three main political parties agree that Britain provides good quality end-of-life care but that access to it can be patchy, depending on location and the patient’s condition. The government is working to improve the situation.

The claim

In the UK, breast cancer survival rates are 11% lower than they are here in the United States – Sue Myrick, a Republican congresswoman from North Carolina

The response

If anything the gap is wider than Myrick says. Breakthrough Breast Cancer cite two recent studies from Lancet Oncology. One says that 83.9% of women in the US diagnosed with breast cancer between 1990-94 lived for at least five years compared to 69.7% in the UK – a 14.2% difference. The second showed that, among women diagnosed with the disease in 2000-02, 90.1% in the States survived for at least five years whereas in England it was 77.8% – a 12.3% gap.

The claim

The British healthcare system is infamous for denying state-of-the-art drugs to cancer patients – National Center for Policy Analysis

The response

Nice has recently reformed its procedures after a series of controversies over the unavailability of certain cancer treatments. “The vast majority of new cancer drugs are made available to patients with notable exceptions, such as the likely rejection of several new kidney cancer drugs,” said Allirajah of Macmillan Cancer Support. “However, the Nice process does need reforming to ensure decisions are made more quickly and patients’ quality of life is taken more into account.”

The claim

The British NHS “does not allow” women under 25 to receive screening for cervical cancer – Jim DeMint, Republican senator from South Carolina

The response

The NHS invites women in Wales, Scotland and Northern Ireland to attend for cervical cancer screening from 20 upwards. But in England screening for the disease starts at 25. That policy was recently reviewed and remains unchanged.

http://www.guardian.co.uk/society/2009/aug/11/nhs-sick-healthcare-reform


To be fair, I tried to find “the other side’s” view point. This is all I’ve found so far of any substance, but I think it needs to be addressed. It would be especially helpful if Dr. Zane would respond.

First problem with this “rebuttle” may be who is rubutting:

“Denis Campbell and Girish Gupta put those claims to professionals in the health sector.”

I’d like to hear from the patients!

Some of the rebuttles are valid, some are from gov’t reps or from those with a vested interest in defending the system.

ke


19 posted on 08/18/2009 5:09:28 PM PDT by kroy (Rebuttle to Dr. Zane Pollard)
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To: CWW

And one more...

I Answer A Thoughtful, if Wrong-headed Anti-Reform Letter (reformatted and revised)
by: lightseeker
Sun Aug 09, 2009 at 04:01:18 AM CDT

Photobucket
A friend of mine and I have exchanged URL’s on the issue of health care reform. I took the time to try and analyze the letter which her URL took me to and confront it with the facts. The author is a real , honest to God, hard working doctor. He seems to be a good man. All the more is the pity that he seems to get it , largely, wrong.

Here are his key points.

“ObamaCare and me” by Zane F. Pollard, Atlanta based M.D

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.

With respect, what conclusion can we draw from this??? At best, we can claim that we don’t know how the other 83% feel. Why would their feelings break different from the feelings of a 17% sample, if you will?
lightseeker :: I Answer A Thoughtful, if Wrong-headed Anti-Reform Letter (reformatted and revised)

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.

Who told him this? Given his confusion between Medicaid and Medicare, how much weight can be given to this unwarranted conclusion?

The doctor is talking about Medicaid. The better comparison is Medicare. This explains the difference:

MEDICARE

Health Insurance for seniors.
Need to have contributed to Medicare system to be eligible.
Pays for primary hospital care and related medically necessary services.
Generally individual must be over 65 to be eligible.
May have a co-pay provision depending on the services received.
Federally controlled, uniform application across the country.

MEDICAID

Needs based health program.
Pays for long term care.
Individual must meet income and asset test to be eligible.
Individual must be over 65, disabled or blind.
Requires mandatory contribution of ALL recipient’s income.
Individual state by state differences create a different program in each state. (Generally similar, but may be different in specific application.)

Medicare is a health insurance run by the government , Medicaid is needs based , run BY THE STATES

On this basis, not sure how relevant this doctor’s experiences are. Additionally, the poor have never had much political clout, thus the inadequacy of this and other such programs, especially in hard times.
I blogged on the situation in Texas here:

http://www.texaskaos.com/diary...

and here:

http://www.texaskaos.com/diary...

Back to the letter:

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 specifically what things the military personnel and their dependents could have and which things they could not have. While I was 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.

A valid point, since the Military System is government, single payer system.
Still,

Some 47 million Americans are uninsured and millions more have inadequate coverage or go without care because their out-of-pocket costs are too high. Most of them are working.

New research shows that medical bills are implicated in more than 60 percent of bankruptcies and that more than three-quarters of those families were insured

Even BAD care, beats NO care and BAD care can be improved!

Back to the letter:

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.

And, this is proven by????? Evidence proves the exact opposite!

In England anyone over 59 cannot receive heart repairs or stents or bypass because it is not covered as being too expensive and not needed.
We could find no documentation supporting the claim that Britain’s National Health Service (NHS) absolutely denies all coverage of “heart repairs or stents or bypass” to patients over the age of 59. An NHS representative told us, in response to our query, that:
There is no arbitrary cut off point where age is concerned. If a consultant decides that a heart bypass or the fitting of a stent is the required surgical intervention, then, providing the patient agrees to the procedure, the surgery will go ahead.
Additionally, many readers from the UK have related to us their personal experiences with such procedures being performed on persons over 59, including a paramedic who wrote to say:
I have personally transported many people to hospital for cardiac procedures, including stenting (the most common procedure). Virtually all of these patients are over 60, many are over 80, and none are treated any differently to younger patients. I have watched stenting operations performed on patients, the oldest I have seen was 85 and [he] made a full recovery.

We never treat older patients any differently from younger patients. The NHS may have its problems but it is a myth that old people are not given adequate or equal care to younger persons.
From: http://www.snopes.com/politics...

Back to the letter:

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.

Now he switches to Medicare discussion, without , apparently , being aware of the significance of this switch.

Fair point: argument for changing the fee structure. -Who among the uninsured could even afford the procedures in the first place?

Back to the letter:

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.

So, how do all those bad systems like France and England maintain sufficient levels of specialty doctors?

Here is a peek at the French situation:

Physicians in France make about $55,000 per year. Can that be realistically applied here?
France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don’t have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their American counterparts earn. Then again, the French government pays two-thirds of the social security tax for most French physicians””a tax that’s typically 40% of income . . .
. . . Many French doctors, in fact, earn more by increasing their patient load, or by prescribing more diagnostic tests and procedures””a technique, also popular in the U.S., that inflates health-care costs.

Presently, one of the biggest challenges is finding A DOCTOR in rural areas, forget specialists.

Back to the letter:

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.

Pure assertion that flies in the face of all the evidence. Here is where anecdotes fail miserably .
Consider the systemic evidence:

Facts on Health Insurance Coverage

How does being uninsured harm individuals and families?
Lack of insurance compromises the health of the uninsured because they receive less preventive care, are diagnosed at more advanced disease stages, and once diagnosed, tend to receive less therapeutic care and have higher mortality rates than insured individuals.11
Regardless of age, race, ethnicity, income or health status, uninsured children were much less likely to have received a well-child checkup within the past year. One study shows that nearly 50 percent of uninsured children did not receive a checkup in 2003, almost twice the rate (26 percent) for insured children.12
The uninsured are increasingly paying “up front” — before services will be rendered. When they are unable to pay the full medical bill in cash at the time of service, they can be turned away except in life-threatening circumstances.7
About 20 percent of the uninsured (vs. three percent of those with coverage) say their usual source of care is the emergency room.2
Studies estimate that the number of excess deaths among uninsured adults age 25-64 is in the range of 18,000 a year. This mortality figure is more than the number of deaths from diabetes (17,500) within the same age group.10
According to one study, over a third of the uninsured have problems paying medical bills. The unpaid bills were substantial enough that many had been turned over to collection agencies - and nearly a quarter of the uninsured adults said they had changed their way of life significantly to pay medical bills.13

What additional costs are created by the uninsured population?
The United States spends nearly $100 billion per year to provide uninsured residents with health services, often for preventable diseases or diseases that physicians could treat more efficiently with earlier diagnosis.14
Hospitals provide about $34 billion worth of uncompensated care a year.14
Another $37 billion is paid by private and public payers for health services for the uninsured and $26 billion is paid out-of-pocket by those who lack coverage.14
The uninsured are 30 to 50 percent more likely to be hospitalized for an avoidable condition, with the average cost of an avoidable hospital stayed estimated to be about $3,300.14
The increasing reliance of the uninsured on the emergency department has serious economic implications, since the cost of treating patients is higher in the emergency department than in other outpatient clinics and medical practices.11
A study found that 29 percent of people who had health insurance were “underinsured” with coverage so meager they often postponed medical care because of costs.15 Nearly 50 percent overall, and 43 percent of people with health coverage, said they were “somewhat” to “completely” unprepared to cope with a costly medical emergency over the coming year.

Back to the letter:

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 medicine 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.

Well consider this then:
Doctors per 1,000 population US figure is here...

US - 2.3
England - 2.2
France - 3.37
Canada - 2.1

And why, exactly, must we presume that we will have no doctors , or specialists? At best this is an argument to change our system of physician education and recruitment to a model, say to something similar to the French.

In summation, this Doctor seems well informed about his experiences , but not about the larger systemic issues.

Furthermore, he makes some of the same unfounded assumptions that other critics make. It turns out that being a doctor, does not guarantee any greater insight on the thorny issues of Healthcare reform than not being a doctor....

Finally, see the systemic outcomes for the key nations here:

http://thewastedyouths.com/dia...

and here:

http://www.openleft.com/diary/...

The outcomes for other developed, Western nations as the data points out , are equal to or superior to ours. Where is the advantage of keeping the status quo if it has all its present problems and no unique upside.

And oh, that America has a cancer survival meme that is being put out, it falls down when you ask one simple question. How many cancer victims simply can’t get treatment at all, or require more expensive treatments because they enter the system only when they are really, really bad off?

Health Care reform then, is too important to be decided by doctors or politicians or insurance companies alone. WE MUST MAKE OUR VOICES HEARD!

We must also fight the campaign of misinformaton and disinformation that the Repugs are pushing. Stay informed, stay positive, stay vocal!
Tags: letter, health care, doctor, half-truths, England, France, OECD, (All Tags)
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I Answer A Thoughtful, if Wrong-headed Anti-Reform Letter (reformatted and revised) | 0 comments

http://www.texaskaos.com/diary/6079/i-answer-a-thoughtful-if-wrongheaded-antireform-letter


20 posted on 08/18/2009 5:15:01 PM PDT by kroy (Rebuttle #2 to Dr. Zane Pollard)
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