This Could Cost You An Arm and a Leg

The Washington Dispatch ^ | August 19, 2003 | Beverly B. Nuckols,MD

[hocndoc]

This Could Cost You an Arm and a Leg Exclusive commentary by Beverly B. Nuckols, MD

Aug 19, 2003

Once again, a very small minority is pushing universal health care, after the style of the Canadian Medicare System, as reported in The Journal of the American Medical Association (JAMA) in their August 13, 2003 issue. Everyone who does not want to receive the "benefits" of one size fits all medicine and healthcare must speak up, now.

We’d better, because the leaders of medical organizations other than the AMA and the small group mentioned above are also pushing for “universal access,” “universal insurance,” or “single payer” insurance. The American Academy of Family Practitioners, the AMA and 5 other groups joined to form the Physicians' Work Group on Universal Coverage back in 2000. The PWGUC works to ask politicians to promote policies to give healthcare to all in the US, using a centralized tax-funded system. The AAFP came out with its own proposal for a plan in March of 2001. The national Medicare plan boils down to government owned healthcare, paid for with taxes on individuals and businesses and with penalties for doctors and patients who would try to go outside the system for anything beyond the minimum definition of “medically necessary.”

In medical meetings, I constantly hear that health care is a "right," for all, from the first dollar. And then, the very same people who claim that I have a duty to all those entitled to free healthcare begin to plan the ways that right will be rationed.

I hear of standardized lists of medically necessary care. Then, I’m told that "one liver transplant will pay for the whole state's prenatal care."

I've also heard a Texas State public health official assert at the Texas Medical Association annual session that there comes a time, when the public is paying for healthcare, that "public rights" override "individual rights." (I explained to the man that there is never such a time and why.)

I’ve heard and read claims that doctors will get rich off any government paid medical insurance scheme. Maybe. But, I doubt it. We doctors are already under the constant threat of RICO and triple fines if we fail to follow rules that no one knows, and that no Government agency can interpret. It's been estimated that it would take over 2000 man hours to keep up with the *changes* in Medicare each year. (Even before the travesty that is called the “Health Insurance Portability and Privacy Act” - the name is Newspeak for the exact opposite.) In a survey of the advice given by Medicare help lines on Medicare rules, the Center for Medicare and Medicaid Services “helpers” were right only 15% of the time. Most of the time, their advice could have resulted in fines and/or jail time for the doctor. The last administration sent out the Attorney General of the United States and the head of the FBI to hold meetings with Senior Citizens where they offered to pay patients to report their doctors for Medicare "fraud and abuse.”

Because of the confusion and fear, most doctors are overly conservative in what they do at each visit and what they charge for those visits. We undercharge at best or fail to push preventive care at worst, because we don’t want to end up on some list of doctors to be audited. These audits are mandatory, the one audited must pay the costs incurred by the auditors which amount to thousands of dollars, and the audits are almost guaranteed to find that we are guilty of some sort of technical infraction of Medicare guidelines, since no one actually knows what the rules are. The fines and penalties are paid to the same agency which interprets the rules.

For example, a tetanus shot is “not medically necessary,” routinely or after a wound, according to Medicare. In order to give the shot and charge for it, the doctor must inform the patient that Medicare will not pay, get the patient to sign a piece of paper called an Advance Beneficiary Notice saying that he has been infomed, bill Medicare while noting that the patient has signed the Notice, have the fee denied by Medicare, and then bill the patient. Needless to say, the work costs much more than the fee charged, so the doctor loses money, risks being flagged as an “outlier” who charges for care that is not “medically necessary” according to Medicare, and irritates the patient. I wonder, how many doctors are interested in their patients’ tetanus shots knowing the risks?

Personally, I'm fed up with the bureaucracy, hassle and the lack of respect. I closed my private practice this spring, and only plan to work part time for other people in the future. I’m ashamed to say that I would rather someone else make the business decisions and take the big financial and legal risks. I’m not ashamed to say that I’d rather just practice medicine than the business of medicine. The business of medicine is not the culprit: the contamination by government regulation is.

Beverly B. Nuckols, MD is a Family Practitioner from New Braunfels, Texas. She is a member of the American Association of Physicians and Surgeons, not the AMA. She may be reached by writing to feedback@washingtondispatch.com.

[hocndoc]

I can't stress strongly enough that if you don't own your insurance, you don't own your healthcare. If the government owns your healthcare dollars, (they pretty much own the doctors, already) your life and health and your rights will become one more commodity to be traded for political advantage.

If you're interested in getting involved, the AAPS is a useful resource for information and activism http://www.aapsonline.org/

[EggsAckley]

Oh, thank God! I thought this was going to be yet another "Doctor Decapitated in Elevator" post!..........
</;o)

[Libertarianize the GOP]

http://www.freerepublic.com/perl/bump-list

[hocndoc]

let's try that link, again.

http://www.aapsonline.org/

Be sure and take a look at the Washington Dispatch site, too. Including our own Cathryn Crawford, there are many conservative, thoughtful columnists - "Exclusive" and syndicated - that you won't want to miss.

[hocndoc]

Thank you!
(And please put me on your list)

[.cnI redruM]

The truth that Dean ain't tellin':

1) His program tripled the cost Vermont's State Gov bore for purchasing health insurance.

2) There were 16 insurers hawking plans in Vermont before Dean care. 14 of them have been 'taken care of' by the Good Doctor. Only 2 private firms now sell health insurance in Vermont.

3) Vermont succeeded in insuring NO MORE people than the private sector.

[Libertarianize the GOP]

The Bump list "Socialized Medicine" is an index of related threads that you will have to check yourself, it won't ping you, but it can help find old articles and info.Follow the link and scroll down to Socialized Medicine.
http://www.freerepublic.com/perl/bump-list

[Glock22]

MEDICARE FOR LAWYERS

Public defenders in Massachusetts went on strike this week, refusing to accept assignment of new cases. Seems that the Bay State has a bad habit of falling behind in payments to the attorneys who accept assignment of public cases, and the lawyers have had enough. And you can't blame them: they are paid as little as $30 an hour for their services, a shocking sum in the legal world. It's a miracle they have any public defenders at all. Some of these lawyers are owed as much as $15,000. And it's not the first time things have been this bad; according to the news report, the state commonly lets payments to public defenders slide. So the lawyers got together and shut the system down.

This is the way Socialist republics like Massachusetts manage to provide "free" services: when they don't stiff the providers, they shortchange them. The only way a government can give away the services of its citizens is by not paying for them.

So to the Massachusetts lawyers, I have this to say: How do you like it, boys and girls?

We physicians have been getting stiffed by government for decades. The average Medicare doctor would love to have Medicare owe him as little as 15 grand; each of us is continually floating a no-interest loan to Uncle Sam to the tune of many tens of thousands of dollars.

When we get fed up, we can't do as the Massachusetts lawyers did, and organize. Thanks to our friend Fortney "Pete" Stark, that is considered racketeering. And for the privilege of continuing to receive late payment of pathetic fees for taking care of the sickest and most demanding class of patients, we must endure reams of paperwork and Byzantine, intrusive regulation. And the punishment for failure to dot every i and cross every t is draconian. Believe it or not, physician's offices have been raided at gunpoint at Medicare's behest.

So who gave us Medicare, with its shabby fees, dilatory payments, oppressive regulations, and complete lack of redress of grievance? Lawyers. It should come as no surprise that they won't tolerate what they impose on others. Look at Congress: a big gaggle of lawyers who have established a blue-ribbon health-care plan for themselves while demanding that the rest of us go to the back of the bus.

Here's my proposal: let's establish legal "Medicare". After all, a right to legal representation is far more firmly established in the Constitution than any right to medical care. Government should provide it to the citizens free of cost. Let's find out whether the lawyers like a taste of their own medicine. My bet is that if we ever established such a system, it would die a quiet and natural death before the next session of Congress.



Michael R. Bowen M.D.

Latest editorial for America's Voices
www.americasvoices.org

[hocndoc]

Thanks for pointing out the Socialized Medicine list.

This article, from 1971, is still very true
http://www2.misnet.com/~rick/pages/moral.html

"When a government ignores the progression of natural rights arising from the right to life, and agrees with a man, a group of men, or even a majority of its citizens, that every man has a right to a loaf of bread, it must protect that right by the passage of laws ensuring that everyone gets his loaf -- in the process depriving the baker of the freedom to dispose of his own product. If the baker disobeys the law, asserting the priority of his right to support himself by his own rational disposition of the fruits of his mental and physical labor, he will be taken to court by force or threat of force where he will have more property forcibly taken from him (by fine) or have his liberty taken away (by incarceration). Now the initiator of violence is the government itself. The degree to which a government exercises its monopoly on the retaliatory use of force by asserting a claim to the lives and property of its citizens is the degree to which it has eroded its own legitimacy.
****It is a frequently overlooked fact that behind every law is a policeman's gun or a soldier's bayonet."*****

[hocndoc]

This article (the one below, not mine) reminded me about your point that the agenda of the Communist Party has been slowly infiltration our nation.
Please take a look at this article from 1971, concerning "rights" and healthcare

http://www2.misnet.com/~rick/pages/moral.html

[hocndoc]

Here's the logical outcome of socialized medicine (I've already seen similar scenarios, when the "patient" believed that he/she owned me, because I owed him/her whatever was desired - a scooter, a tummy tuck, a special bed, narcotics - since I am a doctor):
http://www.galen.org/happenings/081503.html
“Heather Davies, 25, the office manager who handed out numbers, deli style, on the morning of registration, said she was still getting nasty phone calls from some of the 300 people she had to turn away.

“People hurled curses and rude gestures at her. One man threatened her, saying, 'I know what time you get off work,' Ms. Davies recounted. She felt compelled to telephone the police. In fact, the office now has a direct hot line to the police.

“'Because they are paying national insurance, people feel they are entitled to service,'" Ms. Davies said.”

How audacious!

So this is where it leads: Angry patients paying high taxes for universal access to health and dental care, only to be turned away after sleeping on sidewalks all night, with dentists calling the police to protect themselves from desperate patients.