Monday, September 14, 2009
Dr. Tyler Taylor delivers a physician's view of the Public Option.
Just this year, I had my 30th anniversary as a family physician. During all that time, I have worked in small towns, and cared for patients in offices, hospitals, ERs, nursing homes, and in their homes. The last 9 years I have been in Los Alamos. My career has given me quite an opportunity to observe our health care system where the rubber meets the road. Sadly, I have come to the conclusion, as have many others, that we are witnessing a relentless implosion of that health care system.
I don't want to bore you or depress you, but it's important, as a starting point, for me to share the kinds of problems that I see getting steadily worse over the years:
-Increasing insurance company intrusion into patient care.
-Steadily more arrogance and deceitfulness on the part of insurers.
-Incomes of specialists rising much faster than those of PCPs.
-Increasing numbers of elderly, and of middle class folks, who can’t afford important medicines.
-Rising confusion and anger among patients about how complex and unfair their health coverage has become.
-Worsening problems in finding affordable mental health care for my patients.
-Medical software at times being used in ways that are meaningless, and that obscure the truth,
-Increasing number of doctors no longer willing to take patients with Medicare or Medicaid,
-Billing functions in offices and hospitals getting to be huge and complex, as payers create ever more complex games to avoid paying for services. In a 2009 survey, the cost of dealing with these insurers was found to be $68,000/per doctor/per year.
-Having a flood of reliable and unreliable healthcare information coming at physicians each month, making it very hard to know what are truly the “best practices” we’re supposed to follow
primary care organizations. Seven of them, representing over 450,000 family physicians, internists,
pediatricians and medical students have put out a joint letter this summer. It clearly says that we are very supportive of the healthcare efforts currently in Congress, and believe that moving forward in 2009 is urgent. I’ve brought copies of that joint letter, if anyone would like a copy after today's program.
I am convinced that more than 80% of the healthcare reforms before Congress will become law this year – an incredible historic achievement. But what about the Public Option? It is a hugely important component that would begin to slow down healthcare inflation, saving Americans $1-3 trillion over the next 11 years, according to the Commonwealth Fund. A Public Option plan would also offer 3 other things: planning and procedures not distorted by fickle Wall Street pressures, a great chance to improve the incentives for providers of healthcare, and a new standard for insurance company business transparency. These 4 features make it a dynamo of positive change among health insurers.
But if it doesn’t pass in 2009, I say “Don’t despair”. Having lived in Alabama in the 1950’s, ‘60s and ‘70s,
I’m keenly aware that making America more just is a slow, steady process. For African-Americans, it took 25 years to go from integrating the military to opening to all the buses, restaurants, schools, voting booths, housing and job opportunities. 25 years of battles, and step-by-step recognitions that everyone in the U.S. deserves basic civil rights.
Today we are rallying for the right to be free of excessive and unjust fear: Fear of getting sick, or having sick children, or dying, for lack of health insurance. Fear of going bankrupt, of losing one’s employer-based insurance, or having to choose between buying medicine and paying rent. But when universal coverage with much fairer insurance has a strong likelihood of becoming law before Christmas, we are living in an exciting time! We must keep pushing for it, to make sure the scales tip in our favor. But remember that greater justice in any social sphere takes years, maybe decades. If there is no Public Option this year, the continued skyrocketing of insurance premiums means it will be back on the table soon. And we’ll be ready for fight for it again then.
Thank you for all you are doing to make sure America takes the biggest possible stride for healthcare sanity and justice in 2009.
at 7:15 PM