November 10, 2009 Urgent Update on Healthcare Legislation

 
Make no mistake about it. We are engaged in a crucial struggle for the future of American Medicine versus a slide into the failed European models of government run care and its attendant rationing, needless cancer deaths caused by delayed diagnosis and therapeutic interventions, and financial insolvency. Whether we prevail and preserve the primacy of the doctor-patient relationship in a private sector healthcare system or fail may well depend on what We the People can accomplish in the next six weeks, if we have the chance amidst this rushed chaotic political process.

The first week in November in Washington, D.C., there was a meeting of the Physicians Council for Responsible Reform Strategy Meeting. A group of approximately 120 physicians from around the country met with key Congressional Leaders in an interactive format to discuss the status and implications of current proposals. Dr. Tom Price, an orthopaedic Surgeon and U.S. Representative (R-GA), organized the meeting. It was an incredible opportunity for physicians to have a chance to listen, make comments, and ask questions of such leaders as Representatives Paul Ryan (R-WI), Pete Sessions (R-TX), Mike Simpson (R-ID), John Fleming (R-LA), and U.S. Senator John Barrasso (R-WY) to mention a few. Those who volunteered were interviewed on camera to offer practicing physician opinions regarding the "Pelosi" bill, tort reform or lack thereof, and what they had to say to Congress. Here is what was learned.

Mrs. Pelosi's bill was being analyzed as they were meeting, and was worse than any of the previous bills. Considering that it was crafted to "increase access, lower costs, and make sure all Americans have insurance," it is an abject failure. The CBO estimates its cost at $1.055 trillion over the first 10 years, and the Republican House Budget Committee finds the real cost may be $2.4 trillion for its first decade of operation. The bill calls for $572 billion in new taxes, including 5.4% surtax on anyone making more than $500,000 per year. There is a $2 billion tax on those who already have health insurance, $20 billion in taxes on medical devices, $8 billion in taxes on anyone who buys over-the-counter drugs with money from health savings accounts, and $140 billion in higher taxes on drugs. This is going to decrease the cost of drugs? There is also a $60 billion per year surtax on medical device companies proportionate to their share of the "market" as well as a similar yearly surtax on the pharmaceutical companies. It doesn't take an economist to understand the chilling effect this will have on research and development and jobs.  And you can be sure that these companies will not absorb these increased costs.  They will pass them on to the ultimate end user, us!

Mrs. Pelosi's bill will drive up premiums for families. A family of four with an income of $78,000 would pay $13,000 per year by 2016 compared to $11,000 without the bill. Everyone is required to buy health insurance or be fined up to 2.5% of their income! And, the CBO estimates the public option will have higher premiums in spite of the $2 billion interest-free start-up loan from the government. The $426 billion in Medicare and Medicaid cuts is hardly going to increase access. There are more than 30 new bureaucratic agencies created that insinuate themselves into every aspect of your healthcare, not to mention research grants, innovate device creation, and drug studies. Had enough? There's no proof of citizenship required for the public option, and revenue (taxes) and benefit cuts start in the first five years before benefits (cost outlays) and deficits begin in the second five years. That must be Mrs. Pelosi's idea of not adding to the deficit??? You can read an analysis of various sections of the bill at www.HeritageFoundation.org or see it posted at www.FixHealthCarePolicy.com.

Thephysician group learned that people in Congress are aware of the coercive tactics being used on medical organization groups, more conservative Democrats, and the healthcare industry businesses to support GovernmentCare. That is one reason, coupled with the uncertainty about what was going to be in the bill, that there has been so little public opposition to this healthcare takeover. The AMA represents fewer than 15% of physicians, and in fact owes its existence to selling the government required billing and procedure coding books to physicians. Like the remora needs the shark, the AMA needs government rules and regulations to exist, as their membership has continued a steady decline. Their endorsement does NOT represent a physician endorsement!

Congressional members with whom the doctors spoke were very knowledgeable about the political "tricks" that have been threatened to circumvent the normal congressional process, as well as the available parliamentary counters to those tactics. The Republican bill was introduced while they were there. It is 200 pages long, supports private sector solutions, and offers no-cost solutions to the major healthcare issues, including pre-existing conditions. An excellent summary is in archived in the WSJ entitled "The No-Cost Path to Cheaper Healthcare" by Congressman John Shadegg (R-AZ). (www.wsj.com November 5, 2009). However, what is the real status of all of this?

The assessment the group received was that Mrs. Pelosi would most likely get the votes she needed to get this through the house, which of course has occurred. However, if it does not appear that there are the votes in the Senate short of utilizing reconciliation (a controversial means to quash debate, prevent filibuster, and pass a Senate bill with just 51 votes), Mr. Reid may put off calling for a vote until after January 1, 2010 to allow time to "persuade" the swing votes to support the bill. This is where We the People re-enter the picture.

First, decide what you believe. If you believe that preserving the doctor-patient relationship as the center of our healthcare system is crucial, you cannot support this bill. If you believe that parts of our system need improving but the quality of care we receive when we are sick is the envy of the world, you cannot support this bill. If you believe that the government has bankrupted the two health insurance plans they currently run (occurring in 2014 and currently carrying in excess of $40 trillion in unfunded entitlements), you cannot support this bill. If you believe that the government takeover of 16% of the private sector economy is bad for America, you cannot support this bill. Next, decide if you are a "subject" or a "citizen". If you are a subject, stop reading here! As citizens we are called upon to become informed, stay engaged, and when necessary take action. Now is the time to take action.

Every one of the Congressional leaders said that public contacts matter. They do pay attention to 20,000 people peaceably protesting as happened the day the group of doctors left Washington. They do notice a million people assembled on the Washington Mall as happened at the September Tea Party Protest. They do notice the switchboards flooded, faxes stacking, and e-mail comments. The reason they notice is because they know that in 2010 the entire House of Representatives is going to be up for re-election and the special elections provided a reminder. Therefore, if given a 6 week reprieve, we have a chance to kill this bill.

If you agree the bill is bad for patients, bad for doctors, and bad for America, here's what you can do. Contact all of your friends and relatives in as many states as you can. If they hold similar views, ask them to contact their U.S. Senators to tell them to vote NO on the government takeover of our healthcare system. Have them contact their friends and e-mail contacts as well. Engage in civil discussions with people and refer them to sites where they can gain more information. "United with Solutions for American Healthcare" at www.usaHealthalert.org has some useful information and links. Keep the pressure on.

What am I doing? I am contacting as many physicians as I can by utilizing various lists to which I have access and urging them to contact their specialty organizations to join forces to publicly oppose this takeover of medicine. Our organizations need to remember that their primary mission is the support and protection of the care and interests of patients and physicians. I have and will continue to write letters to various publications. I am talking with my patients about these issues. I have spoken to business leaders and industry representatives urging them to encourage their upper level people to actively support private sector solutions and doctor-patient centered healthcare.  I have and will continue to contact my elected officials with my opposition of GovernmentCare and support of private sector plans.

Jane Lindell Hughes, M.D., F.A.C.S., a Texas physician, gave a video interview while in Washington.  In response to the Pelosi bill she commented that all three of the mandates that were the reason behind tackling healthcare reform - more affordability, greater access to care, and insuring all Americans - were not met in this bill. In any other industry that would be a failure, but in Washington it appears that merely coming up with a bill is success. She was proud to be able to say that her opinion regarding the value of tort reform was based on what has been experienced since Texas enacted tort reform. Her insurance premiums have dropped by 38% over the last four years, the Valley now has obstetricians and neurosurgeons, the number of lawsuits has dropped by 50%, and individuals still receive compensation for malpractice events. Only pain and suffering amounts have been capped at $250,000. Also, doctors are flocking to Texas. She closed with this: "Except as crafted in Washington, American healthcare is not a Democrat or Republican issue. It is one that affects each and every citizen at some of life's most important and intimate moments. You, Congress, have not earned the trust to take over private sector care after running the two insurance programs you have, Medicare and Medicaid, into financial insolvency. Stop this legislative push. Your mandate should be to fix the programs you have. Place a two year moratorium on federalized healthcare initiatives to allow the States to convene healthcare summits with all of the real world players at the table. We Americans are innovative problem solvers. We can and will fix the system and preserve the finest health care in the world."