Healthcare Reform – Tell Me Why Not

health_care_reform

… Rep. Roy Blunt (R-Mo.), said his party may not even need to put forward a plan.

Why are my friends so vehemently against Obama’s Health Plan without offering any alternatives of their own?  I suppose it’s because they have jobs that provide health insurance for a nominal fee and if they go to the doctor or, heaven forbid, something catastrophic happens they know that they will be covered.

At most companies for which my friends work the withholding for their plans doesn’t amount to much and they feel justified in making a lot of noise ranting and raving for nothing to be done.

Nothing.

But every day more and more people – hard-working people – cannot afford health insurance so they drop their coverage and hope for the best. I am one of those people.  Sometime you have to make a decision between rent and health insurance.  You know what wins?

American history is peppered with beautiful stories of people standing up for beliefs and fighting for their rights – for real change.  But the present protests are against any change.  They are for nothing more than the status quo.

Recently a friend of mine told me his story:  His employer didn’t offer health insurance and he couldn’t afford to purchase a private plan.  He happened to get in an accident on his bike and dislocated his shoulder and had a gash that required stitches on his chin.  Everyone was yelling to call an ambulance, but my friend came to in time to stop them and say, “take me home” because he didn’t have insurance.  He had to “consider his options” before getting treatment.  Eventually he did go to the emergency room and had a physician’s assistant reset his shoulder. (He recently paid off the $3000 bill — this wasn’t even a doctor!)

Everybody’s against “rationing,” but isn’t rationing happening now? Care is rationed to those who can afford it and withheld from those who can’t.

The Declaration of Independence proclaims that we are given (by God) unalterable rights to life, liberty, and the pursuit of happiness.  How can you have life without basic healthcare?  By denying healthcare to people in America, for whatever reason, are we not revoking one of those guaranteed rights?

So, please, speak out against ideals you don’t believe in.  But, so much more importantly, put forth ideas of your own.  We need them.  I need them.

25 Replies to “Healthcare Reform – Tell Me Why Not”

  1. Well, as your physician friend, I feel I should at least throw in my 2 cents. In fact, I may throw in 10 cents.

    First, there is no argument from my standpoint that some form of health care reform would be beneficial. There is also no argument that top-tier health insurance is fairly expensive for someone not covered by their employer plan. Your friends who have health care for a “nominal fee” only do so because their employer pays the cost of the plan behind the scenes. I am a physician, but I am also a small business owner who pays for his employees to have health care insurance. Each one of your friends probably makes a smaller salary because a portion of their value to the company goes to pay for their health insurance coverage. This is *not* a small amount of money. Your friends likely just don’t miss the money because they never saw it in the first place.

    Second, your worry over not being covered for a catastrophe is misplaced with your desire to have comprehensive health insurance. A catastrophic health care insurance plan would likely cost you far less than comprehensive. This would allow you to rest easy and not fret over a major illness. I would encourage you to check this out.

    You mention:

    “American history is peppered with beautiful stories of people standing up for beliefs and fighting for their rights…”

    I would argue that comprehensive, top-tier health care is not a God-given, human, or Constitutional right. In my opinion *basic* health care is. Point of fact: no person is denied basic emergency health care in this country. You, your friend without health insurance, the homeless guy off the street, or any multi-millionaire can walk into any emergency room in this great nation and have your needs met. Yes, he may receive a bill for the services. Some people choose to pay in full. Others negotiate a better rate with the hospital or physician. Still others pay nothing. Regardless of the economics, no one is left without emergency health care.

    If someone has no insurance or no ability to pay, he should not be surprised to be triaged to an appropriate level health care provider. You don’t work for free. Neither do the hospitals or physicians. Our emergency rooms are overrun with people who walk in off the street with the sniffles or a urinary tract infection, expect immediate personal attention, generate a large bill, and expect to pay nothing.

    Your statement that care is rationed only to those who can afford it is absolutely wrong. In fact, it is offensive. Not a single person is denied emergency care. The only care that is denied is *elective* care. If you want to see a dermatologist about a rash–get in line and get ready to pay the bill. If you want your infected appendix taken out at 2:30AM on a Sunday morning, you get a surgeon, anesthesiologist, at least three operating room personnel, and at least one recovery room nurse at your service. The physicians and hospital involved may send a bill, but often receive no compensation for their time and efforts to care for you. Somebody else has to pay enough to compensate for the free care that the health care system gives out to those truly in need.

    Here is where Obama’s health care reform comes in: As part of this pork-laden 1000+ page health care reform bill, it is discussed that the country to should provide universal health care. (Although I’ve already stated that universal health care is already in place and enforced by law.) The idea that the government should start its own private health care insurance plan is ludicrous. Here’s why:

    1. The government is designed for governing. NOT competing with private businesses in any market. No private corporation can compete with a taxpayer funded, low cost, subsidized health care insurance plan. The government oversteps its bounds. Your taxes and mine would go to pay for the government to compete with private industry.

    2. One of the possibilities discussed is the tie of the “public option” to Medicare reimbursement rates to physicians and hospitals. Currently, medicare payments to many physicians are already so low, that if a larger portion of patients were to shift into this category, many of us could not keep our doors open. It has also been discussed that physicians should be legally bound to accept the government insurance. This would be a disaster.

    3. The “public option” is designed to force private insurance out of business. Pure and simple. As above, insurance companies can’t compete with the government if the government gives out cheap health care insurance. Many small business owners would opt to provide the less expensive Obamacare plan to their employees, instead of paying for the more expensive Blue Cross coverage. Slowly, we would reach the tipping point after which companies such as Blue Cross cannot afford to operate. As they die, more and more people shift to the government health care plan. *This* is how socialized medicine is accomplished.

    The Declaration of Independence does proclaim that man has the right to life, liberty, and pursuit of happiness. Basic health care is already in place in the US. Don’t confuse basic health care for Cadillac care.

    True health care reform should focus more on encouraging intelligent, motivated physicians into primary care; pay them enough to make it worth the effort; and allow them enough time to sit down and have a reasonable discussion with their patients.

    True health care reform would help those people who cannot afford top-tier insurance to procure solid comprehensive care insurance. Not everyone can afford steak and lobster, but everybody should be able to buy enough peanut butter and jelly to live.

    True health care reform would address tort reform. Physicians wouldn’t be forced to order expensive tests to rule out blue polka dotted zebras when a stampede of horses is staring them in the face.

    True health care reform would encourage good health practices by making insurance more affordable for those who don’t abuse their bodies. If you decide to drink, smoke, and weigh 350 pounds, you should expect to pay more in insurance than a 27 year old marathon runner.

    True health care reform would set in place a system to help people look at their finances and learn how to manage. Encourage people to trim back the $80/month cell phone bill + $40 internet + $70 cable TV + living in a city where the cost of living is twice that of suburban areas. Encourage people to take an active interest in providing a safety net for their family.

    I love what I do. I can’t think of another profession I would love more. But if Obamacare takes over and punishes me for the 12 years of work I’ve put into my career (including the last 10 years of 70-80 hour work weeks), I’ll never encourage a single intelligent student to pursue a career in medicine.

    Ben, I’d encourage you to reconsider your financial ability to provide your family some form of health insurance. I’d also encourage you not to confuse the wonder that is modern day advanced medical care with basic health care. Never forget that basic health care is already provided by law in this country.

  2. Part 2:

    In my fervor to discuss a topic obviously so near to my heart and my profession, I probably have come across harsh. Sorry… I didn’t mean it that way.

    The point of my diatribe is that yes, some form of health care reform is necessary. The current system of government subsidized health care (i.e. Medicare) is unsustainable in its current form.

    People do have the right to basic health care. I say that basic health care already exists for anyone who needs it. Advanced or elective health care is often costly.

    Basic health care is not currently rationed to anyone. Stand by and let this current administration have its way, and everyone will see both basic and advanced health care rationed.

    Two short videos regarding Obama’s intended “public health plan” option:

    Stay informed. Think hard. Remember that health care providers put their patients’ best interests at the center of their care. Sometimes the hardest thing to remember is that God has blessed this country with the most advanced system of health care the world has ever seen.

  3. Well boys….we need a ladies perspective and badly. It’s funny as I read the two posts I just laughed out loud. Really. I know these issues are hot points and it is very hard not get personal, but it seems like everyone else is…..so I am jumping in the pool. BUT I am going to break it down my way.

    To be extremely honest I disagree with both of you. I think socialized medicine would be a HUGE mistake for our country…..why do you think people flock to the states for the highest quality medical care…..AND THEN DON’T PAY. They do this because people in countries that have socialized medicine die waiting to see Oncologists because they have been on a two year waiting list. It just waters down the healthcare system and produces doctors that are not up to the highest standards which is what this country has worked so hard to build. Yes, it is within everyones right to receive medical care…..I don’t think anyone would argue that, but if you are a responsible working class patient and you receive emergent medical care you will have to pay. Yes, the hospital, physicians, PA’s, nurses, nurse practitioners, radiologists, anesthesiologists, and all the way down to the lowly receptionist have provided you with a service and should be paid. This is where I have a major problem. If I go to the emergency room because my appendix has ruptured at 2am and my bill is 10,000+ dollars when it is all said and done……I am going to spend the rest of my life paying that debt off, for two reasons…..1. I pay my bills in full and on time……I have been working since I was 14 and paid my way through college and grad school and I don’t intend to stop now…..2. I don’t want to have to file Chapter 13 and ruin the good credit I have spent my entire adult life building. So, I can’t just NOT PAY the bill like Mr. Joe Homeless or Mr. Crap Credit because it matters to my integrity and my future. So, what am I to do you ask. Well many would just choose not to seek medical care. The best part of this scenario has to be the $10,000 bill you are sent….and I am not saying it is not worth every penny, because they obviously saved your life. It is funny how this works…..so, with no health insurance you pay the entire bill…..sometimes, you can work out a lower pay schedule with the hospital, but in this economy it is extremely hard to get them to work with you. What kills me is that let’s say I went in to have the same procedure with my UHC health insurance and the surgeon/hospital sends UHC the bill…..if you think that United Healthcare is going to pay the hospital/surgeon $10,000 for that procedure you are CRAZY. The insurance companies follow the pay schedule for CPT/ICD-9 based on medicare’s government regulated fee schedule. If the doctor even sees a couple thousand for that same procedure through insurance he/she will be extremely lucky. BUT, Mr. No Insurance (who doesn’t want to ruin his credit) has to pay in full. That my friends is a big pile of you know what. And just FYI to anyone who reads this…..I work my butt off at a 9 to 5 job in a SURGEONS office and I do have health insurance. No, I am not a doctor or a healthcare expert, but I have been working in Doctor’s and Specialists offices as an insurance coordinator/coding/billing for the last 8 years and I have seen quite a bit. My biggest issue is with the Insurance companies….who don’t pay anything and continue to place the burden on the people that can’t afford the premiums. If you don’t have insurance there is no basic health care. Is it the most responsible way to live?? No, and I don’t think anyone would volunteer to go without health insurance, but for some it is just how it is.

    Lastly, I take great issue with the idea that if you only live in the suburbs your life will be peachy and cheap. This is a very southern small minded generality. It is amazing how many experts are out there that have zero life experience to back these ideas up. Yes, I do live in a very expensive city, but I live in an apartment that is cheaper than a mortgage on a small home (in the south). I take public transportation…..I do not drive a luxury car with a huge payment or a gas guzzling vehicle….which means I also don’t pay for car insurance. I eat and cook primarily in my home with groceries I buy on sale. If you add up my expenses here and my basic expenses in the south where I lived for the past 6 years……I am paying about the same or a little less to live in NYC…..yes, it is the truth…..I have the receipts to prove it. Not to mention that the only times I have had excellent benefits were when I lived in major northern metropolitan cities. Huh, go figure.

    Lastly, I am an artist and I am VERY proud of it. I will never be rich, but that is not why I got into my profession in the first place. I sing because it is my responsibility to the Lord to be a good steward of my gift. Part of that responsibility is being faithful with the little that this career provides. Money isn’t everything. Even knowing all I know about how difficult it is to be an artist now……I would choose it again in a heartbeat. I give something to society that will last forever. Music. If that means that I will never get multi millions, so be it…..I sleep great on my pillow at night. I never fret for money or covering because my faith is in God…..he has lead my steps….and I have never wanted. I am so thankful to be living in this thriving city and am amazed at how much my career has grown in the short time I have been here……it is really exciting. I would have zero career if I lived in Gordo, AL…..or anywhere in Alabama for that matter….so, I will pay the price.

    Healthcare is in bad shape…..I don’t know what the answer is….. but I do hope that the two of your opinions on the matter can meet in the middle and put forth some realistic change in the system. Ok, I am stepping off my soap box…..flame away if you should so desire. That is my story and I am sticking to it.

    Olivia

  4. Ben,

    I agree with many of your thoughts, especially that healthcare is rationed today to those who can afford versus those who can’t. My father recently had a heart attack and thankfully had the right insurance to cover himself – I shudder to think if he didn’t and had perhaps ignored his pain (as is typical for heart attack patients anyway) in worry for his health insurance.

    I respect the views of your physician friend as well, but believe it’s unfair and broadly stereotypical to assume that people who don’t have a basic level of healthcare are spending all their money on the wrong things.

    We all can agree that healthcare reform is necessary. It’s crucial for our country’s survival – I shudder in disgust that we’ve put folks in charge of that reform who are being paid millions of dollars by the insurance industry to make these critical decisions in favor of someone other than the general american public. I’ve sent my congressman a letter and encouraged him to stand up now and decline healthcare lobby and insurance money so he can make independent, informed and reasoned decisions. No response from him, more proof the road to healthcare reform is paved in green and floods red.

    Lorie

  5. Hey, Ben.

    I agree wholeheartedly with Hillman and Olivia. They pretty much took the liberty of doing the hard work for me. The public is very reluctant to see the slippery slope that would occur. from a “public option.” Plus, as a fellow worker that makes relatively low wages, why should I “contribute” more to a ill-gotten program? The government always seems to lowball the initial cost of an initiative and I can almost guarantee (from the history of our republic) that the cost of this monstrosity will just end up hurting everyone in the pocketbook, especially our hardest earners who keep this country afloat, economically. I mean, somebody has to pay for it, right? All this really does is give the government more power, and history has shown that all totalitarian and oppressive governments have been big governments. It’s not really paranoia if it’s true.

    I remember sitting in my Political Science class in college and listening to a Canadian professor lecture us about the wonders of Canadian healthcare. A student raised her hand and asked how much Canadian doctors get paid compared to American ones. He responded, “A third less.” Wow. So, universal healthcare hurts the doctors, too.

    Hillman has the right idea about what needs to be done about our current healthcare system. As a matter of opinion, I think his comments need to be published. A public option is rarely a good thing. So, let’s not gamble with a “public option” when our lives are depending on it. Also, if it’s change you want, don’t rely on the government to do it for you. Eat healthier and stay active. Most diseases and sickness are preventable. I’m currently dabbling into alternative medicine myself because even if the healthcare were free, I would’t want it. There’s too many horror stories out of Canada, the United Kingdom, and our own VA hospitals.

  6. Ben,

    Thanks for sharing your feelings, experience, and opinions on an important issue. And sorry you’re facing some tough choices. While I don’t agree with much of the ideas expressed by your Doctor friend in the comments, I do think he makes an excellent suggestion about getting catastrophic coverage.

    I grew up with a large part of my identity formed from my experiences as the son of an oncologist. I admire that my father has worked day after day for 40+ years to offer treatment, support, and comfort to people facing one of the most difficult challenges of their lives. In turn, I have been touched by many of his patients countless acts of kindness toward our family over the years. And as difficult as I know the job has been at times, I know that his calling to medicine has greatly enriched all of our lives.

    For what its worth, following are some of the opinions that I have formed about the current Healthcare Reform debate.

    For me, that we have been and are rationing care in a manner that does not serve the greater good is not a matter worthy of debate. And I do not believe that private enterprise has effectively demonstrated an ability or willingness to chart the path to a better and lasting future when left to their devices alone. Under the status quo, Americans to subsidize the cost of drug development for the rest of the world. Insurance companies decline coverage and drop the very people who need their service the most. And we face a forecast of prolonged elevated unemployment numbers which defy moralizing and ideology and present a growing threat to the system. Millions upon millions upon millions of jobs that existed a year or two again simply do not any longer. Many of the faces behind those statistics can not afford coverage. In the coming years, shrinking insurance rolls and crowded emergency rooms are only going to get more crowded, exascerbating our current problems.

    I think that the greatest priority of reform should be focused on expanding the circle of affordable quality doctor-patient care. We should be exploring and discussing many tools to help get us there and that includes the public option. But the focus on the public option (from the left as a panacea and from the right as a socialist bogeyman) has really been mostly a distraction to date. I do not think that the Obama administration has done a great job of explaining their blueprint. For example, my father can not even tell you what he thinks the administration stands for on this issue. And that lack of a clear vision and communication strategy has given room for both very legitimate concern and the idiots whospeak about death panels or who deem it useful to bring guns to town hall meetings.

    I don’t have all the answers, but following are some of the changes that I would like to see enacted: I would like to see the government negotiate aggressively with drug companies on the prices they will agree to pay and I would like to see the government be open to buying pharmaceuticals abroad to increase their leverage, I believe the insurance industry should be compelled to accept people regardless of preexisting conditions and not drop people who get sick and that all people should be required to share the burden of the cost of insurance as just as drivers are required to have auto insurance. I think there is certainly room to provide a public option and that tort reform needs to be part of the equation as well. I hope the quality of the debate on this issue improves and like you Ben, I hope people find a way to come together and find a better way forward which preserves the elements that we already do well.

    thanks for the chance to share.

  7. Thanks, everyone for sharing…this is exactly what I’m talking about. Now if only they could have these kind of discussions at the “Town Halls.” A few points…

    – Doesn’t Medicare basically set prices for many procedures now? Insurance companies take their cues from Medicare and set the prices they will pay doctors/hospitals accordingly. So the argument that healthcare providers will not be able to make a good living seems out-of-whack. If we went to a single-payer system (a la Canada) then not much would change as far as compensation goes. Actually, doctors might make more because they would be paid for every procedure as opposed to now where they’re guaranteed payment from only the well-insured.

    – Hillman, I think all of your suggestions are worth implementing (though I do agree with Lorie that it is majorly stereotyping to say that people who don’t have insurance need to cut back on cable…come on) but it’s kind of like encouraging people to recycle or turn off lights when they’re not in the room to save the environment. All great ideas, but not a major enough change to shake the system. The fact is that systematic deficiencies are the problem, so the system should be changed. (I know that tort reform is a major cause of inflated prices – it has to be addressed)

    – The assertion that emergency care (which is mandated by law) is the same as basic care doesn’t make much sense to me. Sure, if you’re dying you can go to the emergency room (and possibly end up in bankruptcy – not be able to buy/rent a home, etc., etc.) but that mole you have suspicions about should be looked at before it turns into cancer. It can be removed before all the $$ are spent trying to heal the cancer for a relatively small amount. But if you don’t know what it is and don’t have coverage, you do not go to the doctor because you have no idea if it will be a couple hundred dollars or the bill that bankrupts. This visit to the dermatologist is not some luxury (eating steak as opposed to peanut butter and jelly) but is a vital BASIC health service. In the wealthiest country in the world, our citizens should not have to live in fear of getting something checked out. Healthcare should be pulled from the “nice if you can afford it” list and put in the essential services pile. It is simply out-of-reach for too many. It is absolutely essential but yet optional and often unattainable. This is not right.

    Here’s a quote from Obama (I know, I know) that I think speaks to the heart of the matter for me:

    “These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation: that is, that we look out for one another; that is, I am my brother’s keeper, I am my sister’s keeper. And in the wealthiest nation in the world right now we are neglecting to live up to that call.”

    So let’s keep talking…we’ll have it figured out before long and we can take our revelation to Washington!!

  8. Another thought…

    This argument that the uninsured are simply spending their money in the wrong places instead of on coverage is just not valid to me. In New York (where I live) a basic private policy (if your employer doesn’t offer coverage) is over $1000 per month. It’s crazy to expect people to pay these prices. Not to mention the poor, but even middle class.

  9. I’ve enjoyed reading everyone’s posts and wanted to share a blog post by Brian McLaren that personally hit home and made me want to stand on my chair and cheer. I think I actually did high-5 John a time or two.

    http://www.brianmclaren.net/archives/blog/an-open-letter-to-conservative-c.html

    If you have any interest (one way or the other) in Evangelical Christian views on health care reform and in the direction conservative Christianity is moving in), I think you’ll find this interesting and thought provoking. I had never heard of Brian but found out that his work is well known (Time magazine lists him as one of America’s top 25 most influential Evangelical advisers). For those of you who don’t know me, normally this designation in itself, would conjure a whatever groan from me. I spent the better part of my early adult life trying to break free from the bonds of the church of christ religion. Some will find the word “bonds” highly offensive, but without being in my situation you can’t understand the rejection, guilt and persecution that comes from family members who practice and claim such devout Christianity that they reject your very presence in their lives if you don’t.

    As I watch the health care debates unfold and read posts on blogs like this, it bothers me to see god mentioned and repeatedly intertwined with the health care system…and for that matter to see Evangelical Christians proselytizing all the horrible things Obama plans to do from killing us if we have a disease and are old to taking away our health choices. These tactics illicit a strong viral reaction in me that turns me as far away from their message as it has their religion (and any religion) in my adult life.

    Brian was a breath of fresh air to me – he has a gift for words but his message was more important to me and struck something in my core that made me question my own stereotypical viewpoints against Evangelical Christians and restores my hope that faith in God isn’t about isolation, fear, guilt or punishment. . Brian’s call to christians is to rise above the fray and stand up for what I believe christianity, religion and god should be all about -civility, humility, integrity and most important to me – the ability to embrace and love those with differing viewpoints.

    So….read it and let me know what you think…. for my part, I don’t know all the facts on the health care plan because frankly they haven’t been revealed. Yes, that is scary, but leave god out of the health care debate unless you are spreading a message of love, faith and POSITIVE hope for the future. I’ve had about 35 years of the fear and it doesn’t work.

  10. That blog by Brain Mclaren was awesome! I agree. The goal of Christians (of which I am one) is to be like Christ — not like the latest political talking head. I don’t read anywhere in Scripture about free market economies. I read about caring for the poor and loving one another. Sometimes these intersect with markets, goverments, etc. in good ways and other times they don’t. No party or individual (or denomination) has a monopoly on God and His ways.

    1 John 4:8
    Whoever does not love does not know God, because God is love.

  11. One small, philosophical point here: The problem with the assertion that health care falls under the umbrella of a basic right provided by the Constitution is that there is no way to really guarantee it without imposing on the pursuits and rights of others. If it requires someone else’s time, energy, or money (in this case, that of a medical professional), then aren’t we bonding someone else for this “right?” That, in turn, affects their rights.

    Thomas Jefferson once said, “A wise and frugal government which shall restrain men from injuring one another, which shall leave them otherwise free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned. This is the sum of good government.”

  12. But, don’t all our rights, in one way or another, impose on someone else’s rights? It cost the very lives of soldiers who fought to establish and keep this country free. I think there’s something about sacrificing for one another that we’ve lost in our modern society. With all the focus on individual rights (which I beleve are great, by the way) we’ve lost the ideal of taking care of each other. Even if it costs us something.

    ***I realize that saying the Declaration of Independence infers a right to basic healthcare might be a stretch, but it’s an idea worth exploring.

  13. Everyone makes good points above. John and Jeremy, I think you are very much on target. The money the pharmaceutical companies make in the USA goes to subsidize cheaper drug costs abroad. Why?

    The Declaration of Independence asserts certain inalienable rights. Among them are life and the pursuit of happiness. The intent of this was to form a government which would not intrude upon your life (or take your life if/when it wished), and allow you the freedom to pursue your own dreams. You guys are artists and musicians. You are pursuing your dreams. You are living daily as a product of those basic freedoms.

    Olivia: to address your physician reimbursement comments. Obviously, you know the intricate details of surgeon reimbursement. However, not every physician’s compensation from private insurers and Medicare correlate. The average Medicare to Private insurance reimbursement ratio for many physicians is 80%. Other physicians only receive ~30% of the reimbursement from Medicare as they do from insurance companies. There is a wide disparity. If you isolate this single issue as a point of discussion for health care reform, then physicians themselves will disagree with each other. For some Medicare reimbursement only covers their costs. For others, they make a little money. Either way, the population getting older, and our government has promised people they will be covered under Medicare.

    I’ll end with the frustration I have in this administration’s plans to pay for this egregiously expensive endeavor. I have a budget at my home. We spend less than we make. Period. In order to pay for this expansion of health care, it will necessitate higher taxes. (Not only on the wealthy, but the middle class will also feel the pinch.) These are the same working class people like you and I who will pick up an even greater portion of the tab for the benefit of someone else. More of this mentality that an expanding portion of our nation’s population “deserves” something for nothing. This government is buying costly programs that do not cost the majority of voters any money. Who pays? Currently 43% of this nation’s *working* population pay zero or negative income tax. If we only limited the “free” health care to the working population, we would still have 57% of the country paying for the other half’s benefits. No matter which way you slice it, this is wrong.

  14. Hillman,

    thanks for your recent post.

    I am sure that we have more in common than we do different in our hopes for the future of US Healthcare. However, I would like to offer a counter perspective to your final point about government and fiscal responsibility. Whatever iteration of “Obamacare” passes the legislature, this plan is sure to be expensive. And in terms of its future effectiveness, the devil will be in the still not fully realized details. But the plan will be no more expensive than a War in Iraq or the Bush Administration Tax Cuts for the wealthy. And for this shift in priorities, I am filled with gratitude. And let us not forget that maintaining the status quo would also come with a high cost

  15. Chris~ in response. Just so you have a little background…..in the 8 years I have worked in the medical field (not a doctor or an expert….but we all know it takes an office full of people who don’t have medical degrees to run a practice and/or a hospital…..believe it or not doctors can’t do it all)….I have had the privilege to work for all types of physicians not just surgeons……family practice, internists, pain management specialists, hospitals (insurance coordinating), nurse practitioners, and surgeons. I have been in the small family private practice to the big hospital……I have been on all sides. I am sure I did not verbalize my point very clearly, so I will try to better explain what I was speaking of. I do not think that the answer to healthcare reform lies in fixing Medicare or it’s pay scale. Let’s face it Medicare will probably not be around when our generation needs it anyway. My point was that Medicare sets the standard for doctor and facility reimbursement…..Medicare pays what it is going to pay. period. Everyone has access to this information and the updated payscale for the fiscal year……it is online. So, in return the Insurance companies use this payscale to set their payscale…..they just follow suit…..there are very few exceptions to this. Now what percentage of that payscale is paid out based on private and public practices/facilities is an entirely different ballgame. Bottom line….Medicare don’t pay jack…..which is a CRIME to the physicians…..I am sure you and I can at least agree to that. I mean seriously a doctor gets $750 to amputate a leg when the actual cost for the surgeon, anesthesia, and facility is in the tens of thousands. Come on. My issue is when people that do not have the privilege to purchase expensive private insurance policies they are stuck with a bill that is so outrageous……when in fact we both know the doctor and the facility would NEVER in a million years get that much of a payout if processed through insurance. That is a LARGE double standard…..I know I send out the bills…..and have been doing so for a long time. It is completely HEARTBREAKING. So, yes will you be able to get healthcare if you need it in an emergency….absolutely….will you have to pay a exorbitant amount….you bet your butt. There has to be some kind of middle ground.

    Believe me I have strong feelings for both sides…..I do work for a very successful surgeon and I see the struggle she goes through to just get paid period. She works more hours than I can count and she cares very, very deeply for her patients well being. The entire system is just bankrupt of any logic.

    Last thing and then I will shut up. Ben and I have also been on a budget for the last 7 years…..we don’t spend more than we make and we make our money work for us down to the penny. We budget out our finances a year in advance, discuss it month by month, and both sign and agree that we are on the same page. We went to a Dave Ramsey live even 7 years ago and it changed our lives. I have insurance and Ben does not….not having a cell phone would not change this status. at all. Not to mention it is unsafe in todays world not to have a cell phone. Ok, I am done…..for now.

    PS. Oh, and Chris…..I love ya, but dude I totally want to punch you in the neck right now 😉 Just kidding…..you are just passionate about your profession….we need more doctors like that.

    Lori~ Thank you so much for the blog post suggestion…..I LOVED it!! I agree with pretty much everything he said…..I hope you know that not all Believers are laced with hate and judgement. I truly believe that goes against everything I was taught and raised to believe. It is ok to disagree….as you can see above….I do it a lot. I think the most important part is to love each other and make sure at the end of the day you know what you believe in. I love to discuss what I believe in and if the person doesn’t agree with me….well, that is ok too…..in the end it only is going to solidify the fibers of my belief system. It really frightens me when people can’t verbalize their beliefs…..especially when they just give you the “Christian Company Line”. Frightening. Thanks again!!! We miss you guys!!

    xo
    olivia

  16. Well, John Younger and Chris Hillman agreed on something…something is definitely happening here :).

    Thanks, everybody for such a great discussion!! This needs to happen more…it’s our country — it’s our lives!

  17. Hillman, where does the bill say the government is going to take our lives if/when it wishes?

    I’ve heard this stated many times lately but can’t find any evidence of where it’s coming from. Can you share why you’ve come to this belief?

    Thanks.

  18. Sorry, where did I say that this bill would allow the government to take your life?

    I said that the Declaration of Independence (and subsequently our Constitution) guarantees us a nation where YOU have the right NOT to have your life taken by the government.

  19. Lorie and John, I think you guys are hearing/reading what you want to hear rather than the intended message. My above comment refers to Ben’s original posting where he asks whether or not “life” as granted by the Declaration of Independence includes the right to basic health care.

    My response is simply meant to remind us all that 230+ years ago, public health care was not part of our founding fathers’ initial intent. Such a thing as public health care did not exist at that time. They wanted to guarantee each citizen’s right to not have a government interfere with his/her private life.

    We live in a different time. For at least 50 years, our government has progressively established more social welfare programs which have encouraged a significant portion of our population to expect something in return for little or no work on their part. Statistics bear witness that this is the truth. I am in no way insinuating that anyone reading these posts wishes to or does currently want “something for nothing”. Unfortunately, the larger these social welfare programs (i.e. public health care programs) become, the less physicians have the freedom to do what is best for the people in their care.

    All the physicians I know, including myself, went into medicine in order to either help those in need or to advance the science of medicine. I now spend too much of my day filling out paperwork required by our government or insurance agencies rather than being able to spend quality time with the people under my care. I can’t even easily donate my time or services because I will be subject to heavy government fines if I waive any fees/charges for a patient. This is stupid.

    Bear with me. Here is a specific example of how our government regulations force my hand, not always with better patient outcomes: CMS has begun to track certain facets of physician practice. These CMS regulations require me to administer certain medications to every patient with a history of coronary artery disease–regardless of whether or not in my professional judgment those medications are beneficial. If I don’t administer those medicines, or appropriately document every reason why I didn’t, I could see my reimbursement cut. On the surface this sounds OK: everybody with heart disease needs certain meds or they could be at risk for a heart attack. No harm, all is better, right?

    The problem is, these arbitrary requirements were instituted (by a government committee, not by a physician’s judgment) after one study was published that patients with coronary artery disease have fewer heart attacks when perioperative beta blockers are administered. Fast forward a few years, and a newer, possibly better study is published. This new study actually states that sure, patients have fewer heart attacks, but they also *die* more often from strokes. I’m now caught between a governmental regulation and what may be best for my patients. If I do what is best for my patients, but forget a single element of the documentation, that data is public record of how “poor” my care is, and I may not get paid. If I do the worse thing for my patient, I can easily get paid, meet all the government’s requirements, and my publicly available data looks good.

    See what I mean? The more control a government (or any regulating body) has in the business of medicine, the more a physician’s hands are tied. Government regulations are instituted with reasonably good intentions: improve patient outcomes, and/or lower costs. Unfortunately, a government committee doesn’t always know what’s best.

    I want MY freedom to do what’s best for MY patients.

  20. Hello again everybody. I’ve been reading/watching some of the links Chris Hillman posted and I can say now, more than before, I believe healthcare is a right in America. I don’t believe it’s a privlege for only those who can afford it. Even if taxes have to go up some for everybody. To read some people’s comments on those links is downright disheartening. I just think it goes back to what I said in the original post: if you have employer subsidized insurance it is very hard for you to undestand the difficulties in wading through this system.

    Everyone keeps using the line that this will put the insurance companies out of business. Well, maybe that’s a good thing. It seems crazy that everyone is defending them when all most people (patients AND physicians) do is complain about how unfair they are. Much of the time they are the ones making decisions on treatments you can have – not the doctor.

    I know conservatives are wary of the government. I believe that is valid sometimes. We all just want to be free to live our lives and pursue our dreams. But good government (not riddled wiith corruption) is a good thing. Without it there is only anarchy. In a democracy, it is up to us to choose those who will govern well and with the good of the people always first.

    The founders of this country could not have imagined the wonders of modern healthcare to keep us alive and, more importantly, really living. These wonders should not be reserved for only the rich. They should not be free, but shoould be affordable. They are not that now.

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