Doctors Want Real Health Care Reform

By Dr. Stephen R. Keister / The Rag Blog / July 28, 2009

This past Wednesday I listened to President Obama’s press conference at which he discussed his ongoing efforts for reform of our health care system. I thought his presentation was uninspired although, as Dr. Paul Krugman and other economists pointed out, he did lay out the costs involved and the savings to the individual American, as well as the need for better medical care for the nation at large. I was, however, concerned that the “public option” issue did not arise until near the end of the conference, and that the President did not discuss it in any detail.

At times I felt that I was listening to Hamlet’s soliloquy, or perhaps Richard III’s, (Act V, final scene): “A horse, a horse, my kingdom for a horse.” In keeping with the Shakespeare analogy, we can always think of Sen. Baucus as Iago, and any of several Republicans as King Lear in Act 4, Scene 6, as he wears roses as a crown.

In any event several new issues have come to light. There are new television ads supporting universal health care sponsored by the health insurance industry but they stress their support for a BIPARTISAN health care bill. I would think it apparent to any perceptive person that there is no such thing as a “bipartisan” approach to universal health care, making this concern of the insurance industry mere fluff. Another ad in support of universal health care is sponsored by the pharmaceutical manufacturers and Families USA. I have also learned of an upcoming ad from a recently formed physicians group opposing universal health care. One can almost be assured that some well financed spin-off of the insurance or pharmaceutical industries is behind this.

A recent poll of physicians nationwide conducted by the Indiana University School of Medicine shows the following breakdown of support for national health insurance among practicing physicians in a range of fields: psychiatrists, 80%; pediatric subspecialties, 70%; emergency medicine, 68%; general pediatrics, 65%; general internal medicine, 62%; medical subspecialties, 60%; pathology, 58%; family medicine, 57%; ob-gyn, 56%; general surgery, 55%; surgical subspecialties, 45%; anesthesiology, 40%; radiology, 30%.

Obviously the great majority of physicians –- or, in the vernacular, insurance industry “providers” — ARE in favor of universal care. I am certain, as well, that none of the doctors polled received compensation for their participation. Again, be suspicious about any sponsored TV ad showing doctors in general to be against health care. The old admonition: “Follow the money.”

Returning to President Obama’s near omission of any mention of the public option in his press conference. This, I feel, is a cause for great concern, and makes one wonder just what goes on in the legislative process behind closed doors. Are we being hoodwinked? Are we being fed a political fairy tale? Kip Sullivan of Physicians for a National Health Program suggests a frightening scenario, and I would suggest that all interested in health care reform read this rather extensive article and prepare to recalibrate your thinking.

Many of us felt, from the very beginning, that universal/single payer health care was the single viable option, especially when we take into account the fact that insurance companies do not really do anything to make people healthier, but are merely efficient gatekeepers for their shareholders. Profits at ten of the country’s largest insurance companies, according to Rep. Anthony Weiner in Politico, rose 428% from 2000-2007. Yet, many of our elected representatives, the Republicans and Blue Dog Democrats, maintain their allegiance to the health insurance cartel, the pharmaceutical manufacturers, and the medical device manufacturers, rather than representing the public.

Daily I become more concerned about the apathy of the American public concerning this most important legislation, which is in their interest and in the interest of their children and grandchildren. I would guess that 5-10% of the public is actively and passionately involved in the fight for health care reform; from the rest we hear nothing but dead silence.

You can be assured that if the French populace were to be deprived of decent health care the boulevards would be filled with peaceful demonstrators; the unions, which in France work in concert with their employers, would be organizing a general strike, and the age old cry of “liberty, equality, fraternity,” would once again be heard. In the United States? Mostly dead silence!

For more than 200 years the French have been cynical of politicians and their promises. They have learned to question, not to accept everything on blind faith. They benefit from the cultural influence of Voltaire, Zola, Proust, Kafka, and Sartre whose work has served to stimulate critical thought. In France, though there have been great individual achievements, there is a sense of community and of looking out for your neighbor.

In America, many feel that to question authority is heresy. The American culture teaches subservience, uncritical belief in authority, even if morally flawed and bogus; the Horatio Alger myth and Calvinistic theology teach that God rewards the righteous by giving him/her financial rewards. Our educational system, more and more, teaches that one should not question, and as a matter of fact tends to discourage original thought and to fear the truly educated.

Rev. Howard Bess writes in Consurtium News, “One of the ironies of modern American politics is that many people who profess to follow the teachings of Jesus Christ are among the most vociferous advocates of war, the most disdainful of the poor, and the staunchest defenders of personal wealth.” This is worth reprinting and passing out to your more “devout’ acquaintances.” I was amazed some time ago to read in a poll that 60% of fundamentalist Christians had never READ the Sermon on the Mount. Also read Rabbi Michael Lerner’s observations in Tikkum Magazine where he asks, “Why Can’t Obama Convince the Dems?”.

Those opposed to health care reform continue to beat the drum of high costs. The cost is surely much less than our ongoing and highly questionable wars, of our bloated defense budget. Monica Sanchez writes in Campaign For America’s Future that the House’s health Reform Bill would produce a $6 Billion surplus. This bill, of course, includes a public option. Better still, if not too late, would be reconsideration of HR 676 which could actually reduce the costs of health care nationally by 30%.

In any event, how to raise the money? It is immoral not to undo the 2001 Bush tax cuts for the wealthy, and that could go a long way toward financing a program. And since the taxpayer, in reality, is now subsidizing employer provided health insurance — since the employee pays no tax, and it is essentially earned income — I see no objection to a reasonable federal surtax on such insurance. In the long run a true national health insurance plan would more than compensate in savings to the individual, and would provide in return peace of mind regarding health care for his or her family.

The moneyed interests in this country have denied us universal health care since it was first suggested by Theodore Roosevelt nearly a hundred years ago. Remember, as well, that French national health care began its evolution in the late 19th century under a conservative Third Republic; that German care originated at the suggestion of Otto von Bismark , a Royalist, in the late 19th century, and that it originated in the U.K. under Winston Churchill, a Conservative, after World War II.

The only truly “socialized medicine” I am familiar with is at the Veterans Administration, and in military hospitals here in the USA. The Scandinavian nations have social-democratic governments, but their health care gives absolutely free choice of physician (not “provider” as doctors are called here), hospital, specialist, and pharmacy. With certain rare exclusions the physician has free choice of treatment and the management of care. Care is not rationed on ability to pay as it is by the insurance industry in the United States.

One last thought. There’s a fraudulent television ad about a lady who came to the United States for treatment of a “brain tumor” which had not immediately been taken care of in Canada. I have learned that she did not have cancer, let alone a tumor per se. She had a fluid filled cyst near the pituitary gland and optic nerve, which in due time could cause problems with sight. It called for a procedure performed by only certain neurosurgeons, and would have required some time to schedule since it was not an emergency. It was apparently the individual’s decision to opt for immediate surgery and that was the reason for here coming to the Mayo Clinic.

It reminds me of a fine chap I played golf with some years ago who had an atrial fibrillation that could be cured by an ablation procedure done by a cardiologist per catheter. He could have had it done locally within 48 hours, but he opted for a specific cardiologist at an out of town clinic and that resulted in a two month delay. Certain decisions are those of the patient and not of the system.

[Dr. Stephen R. Keister lives in Erie, PA. He is a retired physician who is active in health care reform. His previous articles on The Rag Blog can be found here.]

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