Dr. Tim: Inside the White House Forum on Health Care

WOW! Makes me ill just reading it!

While the health forum is a good way to start the changes needed in health care, some health providers said they would not particapte. It is the health providers and the insurances companies that need to work with the consumer. They should STOP wasting funds on advertising and use those funds to eliminate (those with insurance) the out of pocket and deuctable expenses as well as office visit charges. This would result in more people using their facilites and more revnue

The Sate of Affairs on the American Health care Delivery System
The Health Care delivery crisis in America has many prongs. To start,
I know because I have been a ‘doctor’ at the patient’s end of medical treatment recently. Medicine has grown automatic, and with the introduction of surgical robotics, who knows if we’ll soon be treated via a flat screen by an online physician or worse, a talking computer. Don’t laugh; it’s here! Some might prefer this approach. It certainly saves time, possibly money, who knows?
But if Electronic Medical Records succeeds in automating medicine to where the Doctor is reduced to a “plug and play” ancillary member of the health care provision system, and patients’ privacy rights are foregone altogether, we [as doctors, and patients] have only ourselves to blame! We have allowed it, and further, have encouraged it. Like now, we are waiting around for the same special interest groups to write laws on our behalves. Undoubtedly, many forces have conspired against us to bring it on! But the government and a large number of physicians have ‘bargained with the Devil’ (HMOs, PSO’s,) and generally the ‘Organized Medical Industrial Complex’ who perpetrated the destruction of that sacred tenant of yore that was the doctor~patient relationship, which existed from the 18th through 20th century up until the triumph of managed care over conventional medicine.
The managed care industry continues to perpetuate the lie that cost-savings are necessary and inevitable, or medical costs will bankrupt our economy. Never mind that they perfected a system that channeled health care spending from patient care vertically upward toward executive compensation. Some making 1 one BILLION dollars in bonuses at end of the 2006 fiscal year!
The public, and the federal and states’ governments were sold a ‘cheaper alternative’ to traditional health care delivery which excluded keeping and choosing your own doctor. Usurping the individual’s power of decision and choice, brought on the restriction or elimination of participating doctors or “any willing provider” which, traditionally was the open and free-market system utilized by the indemnity style plans of yore. Which were mandated by statute to pay fairly and equitably for your covered health care. Free-market is the term so skillfully manipulated by politicians, attorneys, and corporate CEO’s when touting the fundamental benefits of our capitalist system. Defying these core democratic free-market values, the Managed Care Organizations created the “primary care physician’s gait-keeper and the specialist physician closed-panel with capitated specialty care, disease-specific treatment guidelines, and industry funded medical studies supporting the company’s treatment guideline, all of which translated into limitation of care. A term now touted for this is evidence-based medicine. Sounds great, but many of these are guided from industry-funded studies, which exclude contradicting data that is not considered in the final statistical ‘evidence’ for the basis of supporting a balanced successful outcome. The company touted such mantras in the sacred tenant of “prevention”, but the cost savings never truly materialized. The aging demographics of the American population, employer based health care coverage, globalization and exporting “good” jobs prevented it. Not to mention that the gait-keeper [primary care physician] system has sworn loyalty to the insurance carrier. Its cost saving structure relies on delaying or avoiding the expense of diagnostic tests, keeping patients from rapidly obtaining the test, scan, or specialty referral to quickly address their concern. In many cases, once performed, the diagnosis was found too late for the test to do any good.
The public fought back, but the government in protecting the corporate special interests’ bottom lines, instead of the people’s, outlawed individuals’ rights to litigation against the HMO. Instead, they were allowed to sue the doctors, hospitals other direct healthcare providers, and they did. What else could they do! So change came, and HMOs began to act more like conventional insurance carriers were before medicine became “managed”. The result is that instead of limiting care, they cut the reimbursement. The result is that CEOs make all the profits that the HMO organization saves by not paying fair fees to the doctors and providers. So what cost savings were achieved? None! Who made all the money the HMOs and CEOs! Who lost? The patients and their doctors. And your political representatives that we elected to congress to safeguard our rights, did so except the corporations’ rights were protected like individuals’ rights and, as such, they contribute more in campaign finances than we could ever contribute individually or as a conglomerate. Why? Because it’s intended to be a vicious circle and it will remain so for the foreseeable future.
Unless a leader with enough of a public mandate is able to stand firm in protecting the individuals he/she was elected to represent against the special interest lobby culture in Washington, the status quo will prevail. A new administration in the executive branch can do much to steer the political winds of change in favor of a more balanced approach to resolving the health care woes of our country. Critics and think tanks sponsored by the same special interest groups with hidden agendas, will accuse them of touting a populous socialist agenda. But even them will agree that a reimbursement system that channels profits from “delivery” narrowly toward upper executive management compensation is simply failing to recognize that management is only good at demonstrating share holder equity and corporate profit margins in-keeping with over-inflated stock prices which allow CEO’s to cash in preferred stock options. We all know how they have managed to blind the public and the Wall Street pundits during this financial meltdown with all the truculent trickery known to any forensic accountant: Cut labor costs, eliminate coverage for certain expensive treatments calling them “experimental”, establish pre-existing clauses that deny coverage when you need it [why even have insurance?], make the pre certification process a nightmare for physicians’ staffs when trying to get you a diagnostic test your doctor says you need, medicate you with drug panaceas until you can’t function or die from your illness! Ask the federal government to place all the Medicare eligible persons in an HMO advantage plan by making the traditional Medicare plan more expensive and less affordable to a population that funded it with their payroll taxes in the first place. Funny that the Congress spends the Medicare and Social Security trust funds by extracting the money for unappropriated spending and put IOU’s in its place. Then call the system unsustainable, when in truth, its one of the few government entitlement programs that is self-funding! I never understood why the public outrage never scorned higher. Are we really that naïve? I say ‘not’!
And I sincerely hope Mr. President, you hold steady in your sincerity, appoint cabinet members with same principles that can restore the balance you so proudly adhere to when discussing the injustices brought by special interest lobbying efforts and its undue access to government policy. Avoid the recommendation of a industry-filter health care ‘Czar’ who can be easily overwhelmed by the demands of special interests’ influence. Please remember that unlike what most believe, Physicians cannot be the sole segment attributable to rising health care costs, nor can the bear the full burden of cost-cutting schema, over-regulatory documentation requirements, and administrative blame-games pursuant to fraud, abuse and over utilization guidelines. Although everyone buys into the concept of eliminating excessive spending, most of the public is flabbergasted at Patients spending less ‘quality’ time with their physicians and more with ancillary staffs, because their doctor must comply with the whole gambit of documentations requirements mostly intended to delay or deny coverage for reimbursement of the same diseases people have suffered since medicine was invented. If the health care system is supposed to work as intended, we must remove the secret advantage built into the laws that allow insurance carriers to play these ‘coverage’ games which allow them to deny claim payments, exclude necessary treatment, reduce physician fees to bare-bones rates, and deny pre existing conditions. Change is needed now. COBRA is unaffordable, and ‘group plan’ policy clauses must be extended to help individual plan coverage limitations, which allow carriers to exclude a single family member from a new underwritten policy plan, or load the policy with pre existing coverage exclusions and riders.
Sincerely,
Alberto Abrebaya DPM, DABPS, FAPWCA.

I am tired of government sticking it to smokers.
I’m retired Navy and I can’t afford to buy cigarettes any more.
Why not raise taxes fast food its the biggest cause of Obesity in the United States.
Or raise the taxes on anybody earning more than 50,000.
I only get 1100 a mo. and cigarettes would cost me $250 you do the math.
I am going to try to grow my own tobacco this summer.
I hope the cigarette comp. go out of business so Government doesn’t get the taxes on cigarettes.
Anyone that voted on the Tax I will not vote for.
And I hope all smokers do the same.
There are so few pleasures in life and the Government has taken mine from me, by taxing it till I cant afford it.
Do you or the others in Government even care what you are doing to people.
How hard do you want to make on people?
You justify it by stating its bad for you.
So is the air around paper mills, so is Co2 from cars an Big trucks. I don’t see you taxing them to clean the air, you just tax so the state has some more money to spend.
One thing you do over any thing else is vote your self a raise.
Just once I would like to see you vote for a raise for the retired military or a tax break and not one for your self.
OR better yet instead of voting for a raise for Legislators ,
Vote on a special tax for being a Legislator. That’s what your doing to smokers.
Tax the war chest that you have or give it to the poor. Do something for the people that need it.
No thank you!!
Thomas Hopkins
teh770@charter.net