Political Doctors Verses Rational Doctors

Many doc­tors have weighed on the health care debate, and one can roughly divide the camp into two fac­tions: the lib­eral and pro­gres­sive polit­i­cal doc­tors and the one who look at the issues rationally.

What do I mean by “ratio­nally?”  Most of the lib­eral and pro­gres­sive polit­i­cal doc­tors out there have very lit­tle knowl­edge of, barely even any respect for, eco­nom­ics and pub­lic pol­icy. Though they deny it, all they really have is left­est ide­ol­ogy. Why? Because every­thing comes down to a blind faith in the “plans” of Big Gov­ern­ment. They don’t really have to think — they just have to “fact check” claims against “state­ments” in the “Plan.”

For exam­ple, Dr. Ron Chusid, one of the more widely read and polit­i­cal doc­tors out there, con­stantly “fact-checks” claims and asser­tions against exist­ing “plans,” e.g.,

The e-mail says that “non-US cit­i­zens, ille­gal or not, will be pro­vided with free health­care ser­vices” but points to a pro­vi­sion that pro­hibits dis­crim­i­na­tion in health care based on “per­sonal char­ac­ter­is­tics.” Another pro­vi­sion explic­ity for­bids “fed­eral pay­ment for undoc­u­mented aliens.” (Twenty-six Lies About H.R. 3200).

This is absolutely true. It’s not in “The Big Gov­ern­ment Plan,” and because Big Gov­ern­ment Plans are effec­tively “real­ity,” the “real world” to polit­i­cal doc­tors, the “Plan,” the “bible,” if you will, is all they need to con­cern them­selves with. To them, that’s objectivity.

Any­one who sim­ply, unques­tion­ably believes this type of gov­ern­ment plan­ning “fact” is a sim­ple­ton, a fool.

First, on the ground, in the real “real” world, no doc­tor will turn away a non-citizen for med­ical care. Sec­ond, for bet­ter or worse, the president’s plan would, in his words, insure ille­gal immi­grants. Var­i­ous fed­eral agen­cies, immi­gra­tion crit­ics, and the media all acknowl­edge that a small num­ber of undoc­u­mented aliens obtain Med­ic­aid ben­e­fits despite being inel­i­gi­ble. The pres­i­dent seeks to expand Med­ic­aid, which would cre­ate greater oppor­tu­ni­ties for inel­i­gi­ble aliens to enroll. Third, the left already believes med­ical care is a uni­ver­sal right. From the most vocal and stri­dent sup­porter of government-driven health care reform, there’s no moti­va­tion to really take the nec­es­sar­ily steps to keep ille­gals out of the sys­tem.  The gov­ern­ment can’t stop or even reduce Med­ic­aid fraud now. It’s going to be eas­ier with even more bureau­cracy?  Please.

This is blind faith in “The Plan.”  It’s like like the Bible. The Bible says man dece­dened from Adam and Eve. “Fact check” evo­lu­tion­ary claims against the Bible, and yup — they’re “lies.” In the end, in the main, this is the level of crit­i­cal think­ing that a polit­i­cal doc­tors like Dr. Chusid uses to sort it all out.

Check out the fol­low­ing link: it high­lights the essence of polit­i­cal dis­course: dis­hon­esty with­out lying: It is a good thing that other con­gress­men did not fol­low Rep. Joe Wilson’s lead. If they yelled out every time Pres­i­dent Obama said some­thing untrue about health care, they would quickly find them­selves grow­ing hoarse.

Health Care Reform: A Market-Based Proposal

Doc­tor Barry Jacobs, a Repro­duc­tive Endocri­nol­o­gist, has served on the fac­ulty of sev­eral med­ical schools and was direc­tor of Repro­duc­tive Endocrinol­ogy at Texas Tech Health Sci­ence Cen­ter in Amar­illo. Cur­rently, in addi­tion to his clin­i­cal activ­i­ties car­ing for infer­tile patients and those with recur­rent preg­nancy loss, he is Chair­man of the IVF com­mit­tee at Bay­lor Med­ical Cen­ter in Carrollton.

Dr. Jacobs under­stands eco­nom­ics, and he under­stand the Big Gov­ern­ment plans are never equal to the “real world” as it will be in the future, and he has a ratio­nal approach to reform­ing health care:

The media is full of dis­cus­sion of health reform pro­pos­als being con­sid­ered in Wash­ing­ton. So far, noth­ing I have heard addresses any of the stated prob­lems. I immod­estly believe that, after years in many dif­fer­ent capac­i­ties prac­tic­ing med­i­cine, and con­fer­ring with oth­ers of sim­i­lar expe­ri­ence, I have a solu­tion that will cover the over­whelm­ing major­ity of the issues. I think, even more impor­tantly, the cost to the tax­payer would be min­i­mal, if the entire pack­age were to be adopted. The price tag cer­tainly would not be a tril­lion dollars.

I would like to begin with a hypo­thet­i­cal. If I sold a card, on an annual con­tract, for $500 a month that allowed the holder to shop and buy almost any­thing for a $20 co-pay, it would be heav­ily used. Next year, I would have to increase the cost of the card. That is where our health care sys­tem is, today. It is the Fed­eral Gov­ern­ment which caused our cur­rent prob­lem when “man­aged care” was man­dated in about 1984.

I pro­pose:

Save money – increase the effi­ciency of health care uti­liza­tion:

1. Have peo­ple pay for a per­cent­age of what­ever health care they con­sume, up to a pre­de­ter­mined max­i­mum, when insur­ance will cover expenses at 100%. Before “man­aged care”, patients were wise shop­pers when pur­chas­ing med­ical tests or treat­ments. Not now!

Save money – reduce the num­ber of tests:

2. Tort reform is essen­tial. It works fairly well in Texas. Texas caps awards on non-economic dam­ages at $250 thou­sand. Per­haps, the looser should also bear legal the expenses of the win­ner. The neces­sity of prac­tic­ing “defen­sive med­i­cine” is expen­sive and inhibits good med­ical judgment.

Incen­tivize pur­chase of health insur­ance:

3. Give employ­ees a tax credit for what they spend on health insur­ance pre­mi­ums. That way, the employee is rev­enue neu­tral and has insur­ance. Also, the employee owns the pol­icy and is not depen­dent on an employer. Also, if younger healthy peo­ple have an incen­tive to join the risk pool, insur­ance com­pa­nies have no great excuse to increase pre­mi­ums because they are only insur­ing sick peo­ple. If this were the law, who cares if an ille­gal alien has insur­ance. He paid for it.

Pro­vide porta­bil­ity:

4. Bar employ­ers from buy­ing health insur­ance, but give employ­ers a tax deduc­tion for what­ever they give employ­ees for the employee to pur­chase health insur­ance. The employee needs to own the pol­icy. Porta­bil­ity is achieved.

Make health insur­ance pre­mi­ums com­pet­i­tive:

5. Require health insur­ance car­ri­ers to pub­lish an audited report as to what per­cent of the pre­mium dol­lars are actu­ally spent on health care. Clin­i­cal audits are not health care. Help pur­chasers see what they get for their money. I am aware of one HSA pol­icy that only spent 9% of the pre­mium income on health care and still demanded a dou­ble digit increase in the pre­mium pay­ment the fol­low­ing year.

Make health insur­ance pre­mi­ums com­pet­i­tive:

6. Allow sale of health insur­ance across state lines. That will increase the risk pool for insur­ance com­pa­nies, and make it more prof­itable to lower their pre­mium rates. In return, they must be required to pay a “clean claim” within 30 days, and not hold on to the pay­ment for sev­eral months. Penal­ties for not pay­ing claims in a timely fash­ion should be sig­nif­i­cant. In Texas, the insur­ance com­pany which delays claim pay­ment looses part or its entire “nego­ti­ated” dis­count from billed rate. Physi­cians should not be forced to pro­vide inter­est free loans to multi-million dol­lar com­pa­nies. Prompt pay works in Texas where a “clean claim” is defined by law.

Assure avail­abil­ity of health insur­ance cov­er­age:

7. Pro­hibit denial of cov­er­age on pre-existing con­di­tions and can­cel­la­tion of a pol­icy for ill­ness. The larger risk pool will help decrease the risk of coverage.

Pro­vide for the few who still can­not afford health insur­ance pre­mi­ums:

8. Pro­vide Fed­eral sub­sidy for free or part pay clin­ics for the indi­gent, and those who still do not have health insur­ance. If some­one makes enough money to buy insur­ance and does not, he/she pays more than some­one who still can­not afford the pre­mi­ums. Pro­vide tax deduc­tions or cred­its for hos­pi­tals, imag­ing cen­ters and lab­o­ra­to­ries which donate facil­i­ties to pro­vide care for the indi­gent. We had a sys­tem sim­i­lar to this before “man­aged care”. Most hos­pi­tals were oper­ated by local gov­ern­ment, under terms of a bequest with char­i­ta­ble con­tri­bu­tions, or faith based orga­ni­za­tions. Give the same induce­ments to phar­ma­ceu­ti­cal com­pa­nies to pro­vide med­ica­tions. They already pro­vide sam­ples of newer med­ica­tions and have pro­grams for those who can­not afford to pay for prescriptions

Pro­vide for those who still can­not afford health insur­ance pre­mi­ums:

9. Give physi­cians who vol­un­teer time to work in the clin­ics described in item 8 a tax deduc­tion or tax credit for their ser­vices. The amount of the tax break should be the aver­age billed rate for the ser­vice in the area being served.

Pro­tect physician-patient rela­tion­ship:

10. Remove third party intru­sion into the physician-patient rela­tion­ship. Today, when peo­ple call to poten­tially sched­ule a new patient appoint­ment, they do not ask about train­ing or expe­ri­ence of the physi­cian. They do not ask about cost or fees. They ask, “Is the doc­tor on my plan?” If they do not have to pay more than a small co-pay, all that mat­ters is the insur­ance cov­er­age and not value of ser­vice ren­dered. To repeat, patients need to be wise shop­pers for health care, like every­thing else they buy.

Give vol­ume buy­ing power to reduce pre­mium rates for indi­vid­u­als:

11. Allow mem­ber­ship stores like Costco and Sam’s Club to become out­lets for health insur­ers. Insur­ers should bid for the right to mar­ket to club mem­bers. The result is expected to be rates for indi­vid­u­als in line with what large cor­po­ra­tions cur­rently pay for their employ­ees, and attract more mem­bers to the stores.

In clos­ing and sum­mary, instead of using a stick to try to beat the Amer­i­can pub­lic into sub­mis­sion, use a car­rot as induce­ment to do what is in the best inter­est of each and all of us. (Health Care Reform: A Market-Based Pro­posal).

Tagged as: Liberal H, Liberal Health Care Reform