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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 by explaining many of the problems from the perspective 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. 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 to me which was sent 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 onset 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, so no surgery was needed. Again, rationing of care.
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 specifically what things the military personnel and their dependents could have and which things they could not have.
While I was 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.
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 by explaining many of the problems from the
perspective 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. 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 to me which was sent 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 onset 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, so no surgery was needed. Again, rationing
of care.
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 specifically what things the military personnel and
their dependents could have and which things they could not have.
While I was 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 go 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 sort of lowering of fees.
But there is more to the story than just the lower fees. When I came
to Atlanta , there was a
well known ophthalmologist that charged
$2500 for 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 cannot 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 more
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 am not 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
bureaucracy anymore.
We are being lied to about the uninsured. They are getting care. I
operate on at least 2 illegal immigrants each month who pay me
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
this new system. Also it is estimated that another 5% shortage will
occur because of the decreased number of 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 funding.
The average career of a woman in medicine 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 years ago--she was head and
heels above all others I have trained. She now practices only 3 days a week.
Posted: August 10, 2009 4:53AM EDT
Ever tried to perform a simple license renewal at the Department of Motor Vehicles? And there are people that believe a government run health care system will deliver Better care, to More people at a Lower cost? I don�t.
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