Like Rep Boustany (who gave the GOP response to Obama) I'm a physician from Louisiana. I live/work/breath healthcare everyday as a vitreoretinal surgeon. I'm informed and aware of the issues at hand and I and my patients are worried to death that Obama's plan will kill our healthcare system if it is passed.
There are major portions of this bill that are great. The health-insurance "exchange" is a very good idea. Making insurance portable as people change/lose jobs is also a must. Providing more accountability/liability to insurance companies who drop people when they get sick needs to happen. I'm even for a "mandate" that all people get some type of catastrophic care coverage . . . this is only because there is already a "mandate" on ERs/Hospitals to treat the uninsured; the resulting costs are already being paid by all of us in the form of higher taxes and higher insurance premiums.
It is no coincidence that all of these laudable points above find their roots in the Mass plan that ROMNEY helped develop under the watchful care and advice of the HERITAGE FOUNDATION think tank. Sure, the Democratic legislature and current Gov in MA have expanded that plan, and it was never perfect, but IT'S A SCARY THING WHEN THE FEDERAL GOVERNMENT IS TRYING TO PASS A HEALTHCARE BILL THAT IS MORE LIBERAL AND EXPANSIVE THAN THE RECENLTY PASSED PLAN IN OUR MOST LIBERAL STATE!!
Obama's deceptions were manifold:
- 1) The bottom line for this plan and last night's infomercial is that it doesn't pass "the smell test." How in the world is it going to offer care to 30 million more Americans, improve Medicare coverage, and force insurance compainies to enroll/keep the sickest people on their rolls AND BE CHEAPER AT THE SAME TIME?!?!?! That's what Obama is promising folks, and he's lying through his teeth. He says that the savings will be found in current Medicare/Medicaid waste/fraud, eh? Well prove to us over the next few years that you can glean this money back out of the system and put it in a trust fund to help pay for any future plan. Essentially Obama admitted that he has been derelict in his duty up until now in allowing this fraud and waste to take place . . . that he'll only go after it if we pass his plan. Can you say "SMOKE AND MIRRORS?"
- 2) He said that Abortions won't be covered in the new plan . . . I'll believe that when I see it. That flies in the face of what he's said in the past as he's promised that "woman's health" and "reproductive" services would be central and covered in any public option plan. If he's really changing his tune on that then I'm excited . . . but none of the current bills have a "Hyde Amendment" equivalent that will be necessary to ensure that the courts don't find a "fundamental right" to abortion in the public plan after it is passed. America, don't fall for any bill that does not have a Hyde Amendment equivalent to gaurnatee no tax-payer funded abortions.
- 3) Tort Reform: I loved it when the GOP section cheered for about a minute when he brought up this issue. NONE OF THE BILLS currently have any mention of tort reform. The direct costs of malpractice to the current system are only 2-3% of the current healthcare total . . . but the indirect costs are estimated to be upwards of 20% through the practice of "defensive medicine." As a physician I can truly attest that physicians are now trained and conditioned to "treat the chart" more than we "treat the patient." But Obama just paid "lip service" to Tort Reform by saying he was having his HHS secretary look into pilot programs for tort reform. WHAT A COP OUT! Like I'm supposed to trust a trial lawyer/politician like Obama to go against the trial lawyer lobby and make tort reform happen . . . Did you know that trial lawyers political donations go 99% to Democrats? Hmm . . . IF IT'S NOT IN THE BILL THEN IT WILL NOT HAPPEN UNDER OBAMA'S WATCH! VOW TO NOT SUPPORT ANY HEALTHCARE BILL THAT DOES NOT INCLUDE VITALLY NEEDED TORT REFORM.
- 4) Insurance Industry Mandates: Maybe laws do need to be written that insurance companies have to do all the things he mentioned last night, but don't think for one second that your premiums won't shoot up in cost as a result. How can they 1) not deny people for pre-existing conditions, 2) not charge women more than men, 2) not drop sick people, and 4) have to offer all the preventative care imaginable and NOT have to pass those increased costs/risks/liabilities on to the rest of the consumers? It is well known that women use healthcare dollars at a higher rate than men (more likely to seek out a doctor, more likely to ask a physician for medication/tests, reproductive issues, etc . . .). I know I pay more for auto insurance because of my sex and I'm fine with that since males do drain auto insurance dollars with more risky driving behavior. Why doesn't the same common sense apply to healthcare? I actually could be talked into not allowing one's gender to alter healthcare premiums, as long as this "ignoring of gender" applied to all realms of insurance as well . And I'm still not sure how to process a company not "Denying someone with a pre-existing condition" . . . that's like calling to get fire insurance as you stand outside watching your home burn down. It's a horrible situation to be sure, but to make insurance compainies bail out irresponsible people doesn't sit well either. I've got a solution to this below!
The biggest problem with all the plans offered so far is that there is NO plan to reduce healthcare costs . . . it's all focused at expanding coverage and is abhorrently fiscally irresponsible. Also, the plan(s) completely ignores the laws of economics. With a public option available, it has been shown that many physicians will take and early retirement or switch careers. Even if none did, there would be 15% more insured people to take care of. The principles of supply and demand don't figure well with those statistics and fears of "rationing of care" and "wait lists" are well-founded.
Also, although one must admit that Obama is a good "salesman" and an effective communicator, his tone was dissappointing. He spent soooo much time attacking critics of his plan dishing out terms like "obstructionist, Un-American, liars, Fear-mongering, riled-up," and many more. This tone made it a highly partisan attack on his detractors and wasn't Presidential at all IMO.
The Fuller Fix to Healthcare:
- 1) Set up an insurance exchange which will allow interstate selling of insurance policiesand will allow for all types of insurance plans to be offered (including catastrophic care plans, expanded health-savings accounts, etc . . . ) State legilsatures have run-amok with mandates on insurance providers requiring all policies to their citizens offer services like accupucture, sex-changes, substance abuse recovery programs, mental health coverage, fertility treatments, etc . . . These things have been pushed through for decades with pressure coming from these specific lobbies and from union/labor special interests. While most of these services may have their place in the system, to require they be covered for everyone in the state is just absurd. And we wonder why insurance premiums and healthcare costs are rising . . . geez!
- 2) Tort reform . . . do it! See the practice patterns change as we're able to focus more on patient care and worry less about getting sued frivilously.
- 3) Allow physicians to deduct the free healthcare they provide in their offices from their personal income tax filings. Do this and there will be much less of a strain on the ERs and the total healthcare costs will be much less in office-based care than in ER-based care. This would also allow much greater access and care to those with "pre-existing conditions" as mentioned above. Obviously, this system would have to be monitored for potential fraud and abuses on both sides (those receiving the free care and the physicians), but it would solve the problem of "the uninsured" withough creating a huge new government plan and beaurocracy.
- 4) Allow more "co-op" options for healthcare, where people who maintain a certain level of healthy behavior can buy into plans with large communities and/or large companies at reduced costs. This would encourage more healthy behavior and would be a great long-term cost-saver.
- 5) Don't allow any expansion of government-provided healthcare . . . and if possible, reduce it. Medicare/Medicaid are already too large and have severely hampered the insurance industry from following free-market trends. Any new "public option" is absolutely going to be a Trojan-horse as publically admitted by nearly every proponent of a single-payer system. Don't give them that chance to absolutely destroy our system that allows for the highest quality care anywhere in the world.
Romney got healthcare reform in the most liberal state without a new "public option" . . . why would the nation as a whole accept a plan that has it?