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The Rush To Rationing. Cont.

Saturday, May 9, 2009  |  posted by Hugh Hewitt

“Stop ObamaCare” by James C. Capretta and Yuval Levin in the new Weekly Standard is a first sign of serious resistance to the Obama/Pelosi/Reid rationing plan due for its public debut in the next few weeks. The key insight:

[T]he Obama plan would involve a profound displacement of currently insured Americans, who for the most part are happy with their coverage and will not appreciate being dumped into a program that could end up resembling Medicaid. A recent study by the Lewin Group estimates that almost 120 million Americans could be forced from employer-based coverage into government-run insurance by the kind of two-step strategy the Democrats envision. Americans with stable job-based insurance do not know this is what Democrats have in store for them, and they will not be happy about it.

There are numerous, other killer flaws in the plan, chief among them the certain and disastrous impact on care for the elderly who will be the first to feel the impact of government imposed limits on their health care choices. AARP may have sold out to the new Democratic majorities, but AARP doesn’t represent the nation’s senior citizens when it comes to rationing, and the seniors will be heard on the Hill and will vote in 2010.

Below are a couple more of the e-mails from doctors which continue to arrive on the subject of what single-payer means. The GOP has got to begin now to demand details and open hearings on the radical attempt to end American medicine as it exists and replace it with a bad version of Canadian rationing.

From the MDs.

Dr. R. in CO:

My background, inspired by my sister’s new husband, a great cardiac surgeon, I decided to become a physician around age 12. Ironically, money had nothing to do with it, but now that I am close to retirement, I am sure glad I that made some. Physician’s pay is about to plummet.
The type of person who will be applying to medical school in the future will be a lot different than me and my classmates. I spent part of my 4th year of medical school in London and saw the future. Students there knew they were going to be low paid but secure drones and didn’t work very hard. I knew that I had unlimited possibilities if I worked hard. I did work very hard, both in training and in practice, and I view myself as a great success. As a student in London, I was in the library reading journals every spare moment. The only English student I ever saw there ( in the library) was planning on going to the States after graduation to do a residency in neurosurgery. None were available in England (topic for another day). All the other students were going to be primary care doctors. They had no other choice. They did no extra studying, just got through the program. They were going to be sent to the equivalent of Appalacia to do primary care for quite a few years to achieve payback for their education.
One of my fellow physicians is a refugee from Canada. He say that it took about two years to implement fully the one-payer system there. Then, healthcare providers got paid under the system just great for the next two years. Then, they ran out of money. Payments were slashed, waiting lists established, and denial of care ( a more realistic term than rationing) was under way. I believe that last year the Supreme Court in Canada ruled that access to a waiting list does not constitute medical care. This came after a man was told to wait months to get an MR scan to find his brain tumor. He didn’t wait, but came to the States and had his brain tumor detected in a matter of days. He returned to Canada to be told that it would take months for him to get in to see a neurosurgeon and some time after that to actually have an operation in a hospital. He went South again and once more had appropriate treatment in a matter of days. The Canadian system declined to pay for the US care and the lawsuit followed. Where are we going to go when we are denied care here? Mexico?, Thailand?, Singapore?, Costa Rica?
Finally, a word about the “uninsured”. These folks, estimated to number ~46 million, are one of the big drivers pushing the nation to a one-payer system. Study after study has shown that most of these patients are 1) eligible for gov’t programs already,2) transiently uninsured because of job change, 3) making good money but have elected not to buy insurance, 4) illegal aliens. The hardcore long-term uninsured only number 10 to 15 million. In a nation of 300 million, this really should not be a big problem. Providing some level of care for the 3-5% that are truly uninsurable should not be a justification for screwing things up for everybody else.
Dr. K. in HI:

I have been a practicing orthopedic surgeon in Honolulu for 17 years. I cannot state strongly enough how concerned I am over impending “universal/rationed” healthcare in this great country of ours.

It is my opinion that the AMA has “sold out” on Capitol Hill. The “11,000 Doctors for Obama” is a fabrication…….even if it was real, it would represent less than 2% of America’s doctors. Virtually every physician I know is strongly against nationalization of healthcare—it will create rationing and restrict American citizens’ access to timely and quality healthcare.
For the past 40 years, Medicare has set physician reimbursements, and then steadily decreased them, accelerated especially in the past 15 years. In Hawaii, the private insurers have taken their cues from Medicare and currently reimburse physicians 10-20% above Medicare rates. Over the past 25 years, a study presented by the American Association of Hip and Knee Surgeons has shown that the reimbursement to a surgeon for a hip or knee replacement has DECREASED by over 80%. It doesn’t make any difference how skilled or how highly-trained the surgeon is—-Medicare pays the same low rate to all surgeons. Patients are uniformly appalled at how little we get paid once they receive their bills! It is a federal offense to charge/collect more than the Medicare set fee, and the doctor MUST collect the patient’s 20% co-pay under the same law. Thus, it becomes impossible to perform “charity work”! To “make up” for this ever-decreasing reimbursement, doctors are having to see more and more volume of patients each day just to “keep the lights on.” This results, in and of itself, in a lessening of quality of care for each patient.
Hawaii has been losing it’s physicians to the mainland due to the high cost of living and the high cost of doing business in our State. No doctors can afford to come in to replace these physicians. Now, the mainland is feeling the same pressures.
New Medicare patients moving to Hawaii are increasingly told by primary-care doctors that they are “no longer taking” new Medicare patients because their practices are overflowing—-now THAT is restriction of access to care.
In 1994 Hillary Clinton held up the State of Hawaii as the “model” for her proposed healthcare reform system (“Everybody in Hawaii is covered by insurance.”). Now, that very State is becoming the first to crumble under the CURRENT system—–and that’s BEFORE the Nation adopts “universal healthcare.”
I have contacted our Federal and State representatives and met with the insurance companies, pleading our case to no avail.
Thus, I have taken my own personal step to attempt to preserve the sacred doctor/patient relationship: I dropped out of Medicare and no longer accept private insurance. Thus, I can set my fees according to complexity of each case, and on patient’s ability to pay….. without fear of governmental retribution. Some patients are upset with this, but the vast majority are very understanding and supportive once the situation is explained to them by my staff and me. Patients really have NO IDEA how their current healthcare delivery system works (nor do many physicians!).
Most doctors became doctors to HELP PEOPLE….not to get rich. The institution of so-called “universal healthcare” in the U.S. will no longer allow doctors to help the very people who need help.

Shrinkwrapped also has some thoughts on single payer.

If you are a doctor with an opinion on Obama/Pelosi/Reid rationing, send it to me via

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