A Dangerous Topic - the new health care plan

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Dr. Zane Pollard PRACTICES AT ST. JOSEPHS HOSPITAL, ATLANTA , GA.

If we have doubts, the email below should help clear them. It comes from an Atlanta doctor who just could not sit back and be quiet any longer.



Friends:
I have been sitting quietly on the sidelines watching all of this national debate on healthcare. It is time for me to bring some clarity to the table and as your friend by explaining many of the problems from the aspect of a doctor.
First off the government has involved very few of us physicians in the healthcare debate.While the American Medical Association has come out in favor of the plan, it is vital to remember that the AMA only represents 17% of the American physician workforce.
I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid.Why is this. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list. Each time I was told to fax Medicaid for the approval forms which I did. Within 48 hours the form came back tome which was mailed in immediately via fax and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye. Each time the request came back denied. All three times I personally provided the antibiotic for each patient which was not on the Medicaid approved list. Get the point-rationing of care.
Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time. Again extreme rationing. Solution- I have a foundation here in Atlanta supported 100% by private funds which supplies all of these contact lenses for my Medicaid and illegal immigrants children for free. Again waiting for the government would be disastrous.
Last week I had a lady bring her child to me.They are Americans but live in Sweden as the father has a job with a big corporation. The child had the on set of double vision 3 months ago and has been unable to function normally because of this. They are people of means but are waiting 8 months to see the ophthalmologist in Sweden. Then if the child needed surgery they would be put on a 6 month waiting list. She called me and I saw her that day. It turned out that the child had accommodative esotropia (crossing of the eyes treated with glasses that correct for farsightedness) and responded to glasses within 4 days , no surgery was needed. Again rationing of care.
Last month I operated on a 70 year old lady with double vision present for 3 years. She responded quite nicely to her surgery and now is symptom free. I also op erated on a 69 year old judge with vertical double vision. His surgery went very well and now he is happy as a lark. I have been told- but of course there is no healthcare bill that has been passed yet that these 2 people because of their age would have been denied surgery and just told to wear a patch over one eye to alleviate the symptoms of double vision. Obviously cheaper than surgery.
I spent two year in the US Navy during the Viet Nam war and was well treated by the military.There was tremendous rationing of care and we were told specificially what things the military personnel and their dependents could have and which things they could not have. While in Viet Nam, my wife Nancy got sick and got essentially no care at the Naval Hospital in Oakland, California. She went home and went to her family's private internist in Beverly Hills. While it was expensive, she received an immediate work up. Again rationing of care.
For those of you who are over 65, this bill in its present form might be lethal for you. People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British plan. For those of you younger,it will still mean restriction of the care that you and your children receive.
While 99% of physicians went into medicine because of the love of medicine and the challenge of helping our fellow man, economics are still important. My rent goes up 2% each year and the salaries of my employees goes up 2% each year. Twenty years ago ophthalmologists were paid $1800 for a cataract surgery and today $500. This is a 73% decrease in our fees. I do not know of many jobs in America that have seen this lowering of fees.
But there is more to the story that just the lower fees. When I came to Atlanta there was a well known ophthalmologist that charged $2500 f or a cataract surgery as he felt the was the best. He had a terrific reputation and in fact I had my mother's bilateral cataracts operated on by him with a wonderful result. She is now 94 and has 20/20 vision in both eyes. People would pay his $2500 fee. However then the government came in and said that any doctor that does medicare work can not accept more than the going rate ( now $500) or he or she would be severely fined. This put an end to his charging $2500. The government said it was illegal to accept=2 0more than the government allowed rate. What I am driving at is that those of you well off will not be able to go to the head of the line under this new healthcare plan just because you have money as no physician will be willing to go against the law to treat you.
I am a pediatric ophthalmologist and trained for 10 years post college to become a pediatric ophthalmologist ( add two years of my service in the Navy and that comes to 12 years).A neurosurgeon spends 14 years post college and if he or she has to do the military that would be 16 years. I am20not entitled to make what a neurosurgeon makes but the new plan calls for all physicians to make the same amount of payment. I assure you that medical students will not go into neurosurgery and we will have a tremendous shortage of neurosurgeons. Already the top neurosurgeon at my hospital who is in good health and only 52 years old has just quit because he can't stand working with the government anymore. Forty-nine percent of children under the age of 16 in the state of Georgia are on medicaid so he felt he just could not stand working with the beaurocracy anymore.

We are being lied to about the uninsured.They are getting care. I operate at least 2 illegal immigrants each month who pay m e nothing and the children's hospital at which I operate charges them nothing also.This is true not only on Atlanta, but of every community in America.
The bottom line is that I urge all of you to contact your congresswomen and congressmen and senators to defeat this bill. I promise you that you will not like rationing of your own health.
Furthermore, how can you trust a physician that works under these conditions knowing that he is controlled by the state. I certainly could not trust any doctor that would work under these draconian conditions.
One last thing, with this new healthcare plan there will be a tremendous shortage of physicians. It has been estimated that approximately 5% of the current physician work force will quit under thi s new system. Also it is estimated that another 5% shortage will occur because of decreased men and women wanting to go into medicine. At the present time the US government has mandated gender equity in admissions to medical schools .That means that for the past 15 years that somewhere between 49 and 51% of each entering class are females. This is true of private schools also because all private schools receive federal fundings. The average career of a woman in medicne now is only 8-10 years and the average work week for a female in medicine is only 3-4 days. I have now trained 35 fellows in pediatric ophthalmology. Hands down the best was a female that I trained 4 yea rs ago- she was head and heels above all others I have trained.She now practices only 3 days a week.

Zane Pollard, MD
 
Sounds a lot like OHIP in Ontario...

The email above makes it sound like you won't have a choice of who your doctor is. Of course you do, if it works anything like our system in Ontario, you choose your doctor and they treat you and the government pays for the cost of treatment. Some things are not covered by our government program and so nearly everyone still has some form of a drug plan or health insurance, but you can live without health insurance. We have healthy insurance mostly for an extended drug plan.
 
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I would love to see a nationalized health care plan. It would be the best thing. I don't have any hope that it will ever happen though. There are too many corporations that would lose money if that happened. They can spend 100's of millions of dollars and still be money ahead if they can defeat this reform. So I don't hold a lot of hope. It's a great pipe dream though. At the rate health care cost are rising we will all be without health care in another 15 to 20 years. It used to be that most employers that employed over 100 people would offer a decent health plan. More and more employers are dropping that now. It is just too expensive. So the gap will just keep getting larger.Our country will keep getting closer and closer to a 2 class system. The rich have managed to move most of the manufacturing to other countries to make a better profit margin. They have managed to get their taxes lowered. Now they are fighting tooth and nail to keep the lower middle class people from getting health care. Medicare will be bankrupt within 30 years without health care reform. At that point all our old people really will start dying. It won't be because of death panels. It will be because of the party of NO that is spreading all the lies. It will also be because of the blue dog democrats that are taking all the donations from big pharmacy and health insurance giants. They care more about their re-election campaigns than about their fellow countrymen. Our current system is broken. Sure it works for people that make decent money and for really poor people and for disabled people. For a lot of people in the 20 to 50k range it isn't working. It needs to be fixed.

JMO
 
I don't think the proposed plan is the answer, but I agree something has to be done.

I've been paying in to health care all my adult life, haven't even had a physical since the Army in 1986. I think I've been to a doctor about 4 times in 20 years.

When my kids were born, the insurance company denied coverage on seemingly random items on the bills. I fought them all the way to the state insurance commissioner on this, more on principle than over the $100 here and $200 there. I won on all counts, but it cost me far more in time than the money was worth.

I'm sure the insurers count on this. Deny a few hundred $$ per client, they won't fight it. There should be some sort of penalty when they can't justify denials of coverage and then lose when they contest it.

We're captive customers under the present system. The insurer only has to keep my employer happy, not me.

I'd prefer an option for catestrohic coverage only, and pay routine stuff out of pocket. We've reached our deductible limit twice in 20 years, the two times we had kids born.

The only other benefit we get is the scam where the doctor charges $300 for something, the insurer "negotiates" a $100 discount, and we get stuck paying the balance. I'd rather be paying out of pocket, I can negotiate my own darn discounts.
 
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I personally don't think that anyone should try to "fix" something that isn't broken.
 
I literally just saw a story on the tv about this LOL. There seemed to be a lot of concern over losing the private health care and insurance all together. That is not exactly what the government is trying to do from what I can see. What they are trying to do is give you a basic amount of health care that is covered and extras be covered under health insurance. This means that those who cannot afford health insurance and don't qualify for government run programs can have access to basic health care and the like.

IMO this benefits the average family in a recession. If my family had to pay for all of our health care we'd be on the street, we are very thankful for OHIP.
 
I don't know the particulars of this health plan, but I know something is needed. My sister had cancer. Her husband left her and dropped her off of his insurance. Now, she and her family have to pay $1400.00 per month for insurance. They can't do it, but they HAVE to because they have a new baby. It is unreal.
 
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1400.00 per month ! Thats a mortgage and a half !!! 2 months rent ??? Schooling savings !!! her Retired money savings .....!!! A month ????? ... But she has a baby???

Speaking of Babies ....I have a teacher friend in Mich.....who makes me laugh because she has planned all three pregnancy's so she has 6 weeks off from school with the new baby and then summer vacation starts for the school kids .....I am expecting a phone call from her soon because she'll be crying not wanting to leave her baby so soon ....compared to our year off with our babies ....
 
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Why should i have to opt out? I've been paying taxes ALL my working life.. So, i've already paid into social security and Medicare.
Anyways its a moot point, we wont even have Social Security when i retire..its already almost gone.. Thanks to our govt.
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To those who think that I'm advocating giving a "freebie" to those who don't want to work. Sorry, but that's NOT my point of view and never will be. I was stating what my parents said and I do respect their views and agree with them as far as treating people for illness.

In case you missed it, until I got laid off this past fall (along with a bunch of others who've never gone without working), I've worked hard, paid my taxes, and expect anyone else who is able to do the same. I, too, would prefer to choose who I help out and how and don't want freebies. I don't think the government should ask for or get any more of my money than is necessary. I've been in the situation more than once where I would be eligible to get on the dole but I never have been; I'd rather work, be independent, and be a contributor to my community. I'm going back to school now TO HELP ME GET ANOTHER JOB so I can be a productive citizen and not have to rely on someone else for financial security.

I, too, hate fraud because I don't want to give my money away to people who don't deserve it and I don't want anyone else choosing my morals or dictating theirs to me. I DON'T WANT THE GOVERNMENT INVOLVED IN EVERYTHING IN MY LIFE AND I DON'T WANT TO BANKRUPT EVERYONE WHO WORKS HARD! HEALTH CARE IS DIFFERENT from almost anything else we pay for; NO MATTER WHAT WE WANT, THINK, OR DO, WE ALL END UP PAYING FOR THE UNINSURED! It's a case of pay-me-now-or-pay-me-later. In short, whether you are a conservative or liberal, it doesn't make sense to choose our current health care system over some sort of universal health care system.

I just thinksome of you missed a huge part of the argument: you're paying more now, you're already paying for everyone, and with universal health care, yes, you'd still be one of those paying for everyone, but more of them would be paying a share and you'd be paying around half as much! You also wouldn't have to go without health insurance during a major, long economic crunch, or being able to afford or get health care when you can no longer work or retire.

FYI, I'm not including illegal immigrants in that picture. With the current system, they can get health care, even if only emergency care, but they usually aren't paying anything into the system. Personally, I think that if they're here, they should be buying and paying for health care just like the rest of us. Under universal coverage, they would be required to have (pay for) insurance just like the rest of us; no free lunch!

Those neighbors who couldn't be bothered to take their kids to the free clinic (probably due to extremely long lines and some of the "free" clinics which are now sliding-scale clinics), would be paying as long as they're working at ANY job (self-employed or not), and they'd have absolutely NO excuse for not having their kids treated! Still no guarantee that they'd actually take the kids in but a better likelihood and at least you wouldn't be paying so much of their medical bills! I can pretty much assure you that both you and I (as soon as I can get a job again) will be paying medical bills for that family. At least with universal health care, they wouldn't have the choice to NOT pay; they'd HAVE to contribute part of their income to it, just like you do.

As obnoxious as your neighbors are, the truth is that MOST of the people in the US who are now uninsured or severely under-insured are people who DO work for a living, NOT people trying to get a free ride. Many of them have children who also don't have insurance. It's also true that it's a heck of a lot cheaper to avoid a disease or catch it early than pay for it later. After all, why do we give immunizations to children and take tetanus vaccines? And why do we REQUIRE that children going to school have immunizations? Because fewer people die, it's a heck of a lot cheaper, and we are all more likely to stay healthy as a result.

You're obviously upset about how high taxes currently are; so am I! Who DOES love paying taxes? What I DON'T think some of the people replying are getting is that while you may currently have access to good doctors through private insurance, in 10 years, with the current system, you won't be ABLE to buy insurance unless you're both totally healthy, you're rich, and (probably) there's no family history of diseases that might make you a less than optimum client. As long as you are single and have an income in the 6-digit range, you may have a chance at insurance.

One thing is sure; even 5 years from now, unless you are pretty rich, you WILL NOT HAVE WHAT YOU CURRENTLY HAVE NOW!!!! You WON'T HAVE YOUR CURRENT CHOICES!!! None of us really currently have the luxury of deciding that we like the ability we have now to choose our insurance or to say that we won't pay for others who can't afford and/or can't get insurance; I wish it were that simple and that we could continue to argue those points. Unfortunately, we truly no longer can.

If you're employed by a company that provides you with insurance, where do you think they're getting the money to pay the exorbitant costs they're paying? As a former bookkeeper/accountant, lI can tell you it is included as part of an employee's compensation, just like your salary and the money they pay to Worker's Compensation insurance. In short, you'd be more accurate if you viewed the money your employer pays for health insurance and their share of Social Security withholding as money YOU ARE PAYING RIGHT NOW for health insurance!

Guess what? Employers are now caught in the current system's spiraling cost and many are now hitting the point where they have to make the decision to drop health care insurance completely, make employees pay all of it, or have the employee share more of the cost. To make a long story short, when you get paid, you get cash and, if you're lucky, you get health insurance as well (even if you still have out of pocket costs), and you're paying for Medicaire, and some of the increased premiums and out-of-pocket costs are due to the costs of treating the under-insured and uninsured.

Every time health care insurance goes up, it's coming out of your pay. For every person who looses insurance, you're going to end up paying more. If we stick with the current system, you'll also be paying more taxes and more for health care, even if you're on Medicaire when you retire.

As far as not going into debt, I don't currently have a credit card and haven't had one in years. I took out loans for college because I got laid off and didn't happen to have 2 1/2 years worth of income in the savings account. Hm, come to think of it, one good reason for that is because I was paying for insurance and co-pays. I'm going to have to pay off those loans plus interest and am highly motivated to pay them off as fast as possible. I am lucky because father was so proud of me going back to school despite my medical problems, that he volunteered to pay part of my costs. He knows I'm doing it to increase my ability to get a job and to be financially independent. I didn't ask him; he volunteered out of the blue (heck of a wonderful father). Even so, I will be probably be working until I am dead or otherwise physically unable to do so.
I have paid off my car, it's got over 230, 000 miles on it and I don't plan on going into debt soon to get another one unless this one falls apart. I've gotten lots of offers for credit cards over the years and am still getting some but I refuse to get one; it's too easy to get further in debt and I don't like being in debt.

Having said all that, I didn't do anything to get cancer other than being one of the 1 out of 3 women who get it before they die. There's no way on God's green earth that I can or could afford to come up with the thousands of dollars the treatments cost, despite my doing as much of my treatments myself as I could. I physically COULDN'T work during that time, either, but did everything I could to get back to work asap. I also know that the cost of the insurance came out of my paycheck in the form of lower pay and fewer raises. I know because I was the bookkeeper!

Like many others, despite paying as much as I could towards my health care and doing as much as I could to stay healthy, I got a major illness and the costs bankrupted me. The older I got, the more I was hit by medical problems that were genetic or affected by genetics. One of them is are rare form of severe osteoarthritis; I had to have both knees replaced before I hit 50. Another big medical expense that no one thought I'd have, including the doctors in my family! It was only after I got it that we found out it had a genetic basis. Most of us and/or someone in our family WILL get hit by at least one major expense like I did. (I'm just particularly unlucky since I personally have 4 such problems!)

Although you have insurance now and can now (hopefully) afford treatment, in 10 years with the current system, you'll be facing a worse situation than I did when I had cancer. Insurance and medical costs are much higher, insurance won't now pay for some of the treatments (not radical or experimental,etc.) that was covered for me, and, with the current system, you may well not even HAVE any insurance by that time for a major medical disease.

Although not the cheapest, my cancer treatment costs were nowhere near what many people now have to pay. I truly pray that none of the people on this list ever get it or another major disease but I've learned the hard way that you can be healthy for 38 years and then be hit by a major medical problem out of the blue and it is likely to be absolutely devastating financially (amongst other things). And that was despite having parents who were doctors who got me the right treatment asap, and as cheaply as possible without endangering my life.

As far as HMO vs. insurance; I've had both and had crummy experiences with both. HMOs started making more money than insurance companies so the insurance companies have been increasingly using the same methods. I currently have Blue Cross/Blue Shield and have had both their HMO and am currently using their health plan. I have been equally satisfied with both and both gave me a very wide choice of health care providers, more than any of the other insurance companies, so don't assume that an insurance company is necessarily better than an HMO; I've had better experiences with the BCBS HMO than with any non-BCBS private insurance company and I've been covered by almost all of the big ones, including one crummy HMO.

In short, this isn't about Big Invasive Government or Freebies for Everyone; it's about something that's going to provide decent, affordable (but not extravagant) health insurance, getting better overall health care, and living longer. Oh, yea, and you can still make choices if you want to; you'll just have to go BACK to paying more more money.

Good luck!
 
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