Health care bill won’t bring needed changes

No one in their right mind would argue that changes in our form of health care needed some adjusting. It is true that no one in this country should go without access to adequate health care or the means to pay for it, period!

The question has always has been and remains how?

I did not and do not support the President’s plan, not because I disagreed with the objectives, but because of the questions left on the table. I’ve just experienced the answers to some of those questions and, as a consequence, am convinced that we’ve just made the third worst mistake in the history of the Republic. Here is why.

The internist who’s been responsible for my personal health for the past three decades has been forced to change his practice. While this was not solely due to the new national health care plan, its enactment was a contributing factor.

My doctor, a board certified physician in internal medicine, has been working long, long hours each day nearly seven days a week for a number of years.

The first question you might have is why didn’t he reduce the number of patients he sees? The fact is that the cost of delivering adequate health care is high and growing. Considering that Medicare already pays below the level necessary to support a truly viable practice the more obvious solution would be to not see Medicare patients. Trouble is that this “solution” is a difficult decision for doctors whose principles dictate that they care for all who seek their help. (I know that principles and honor are strangers to many but they do still exist for some, particularly physicians.)

While many doctors do not see Medicare patients, my doctor is not one of them. Between the regularly scheduled visits, emergencies and hospital rounds, the only way the practice could survive financially was to see as many patients as possible.

The result: overall quality suffers as does the health of the tending physician. Sooner or later something had to give.

Enter the new national health care plan. The first thing to take a hit was Medicare with a nearly $500 million reduction in its bottom line. While it hasn’t hit yet, the promise it holds is that Medicare will be an even more austere program, from the physicians pointof view, than it is today.

Today’s medical practitioner has a choice to either wait until his or her practice is no longer sustainable or make changes in order to avoid the consequences later. My physician opted for the latter. Here is what he has done.

The first order of business is, if you are going to continue to deliver the best possible care, is that you need to maintain your own health by limiting your patient load. Seems easy enough. However, there’s a bottom line cost that must be recovered and how can one do that and remain committed to supporting Medicare patients?

If you increase your prices to those who are not dependent upon Medicare, all you have accomplished is to make health care even more expensive to those who are not supported by an entitlement program resulting in rising insurance premiums and eventually even fewer people with coverage of any kind.

What we have is a real Catch 22.

Still, there was a way for my Doctor to deal with this. He has limited his practice to 600 patients, including Medicare recipients, and is charging $1,500 up front to be included in that list. The fee is not covered by private insurance or by Medicare and, furthermore, not deductable on your income tax.

I am and have always been in good health so cannot gauge the quality of care I’ve received in light of any major problems. I guess one could consider my care exemplary in as much as I’ve never had any real difficulties.

Having said that I consider the $1,500 an investment in continued good health and, should I find myself in difficulty, would probably consider the cost appropriate considering that my doctor has a more limited patient load. But the real bottom line is that the dynamics of his profession have changed and those changes have led to decisions that restrict his services to fewer people.

Trust me, this is only the beginning of the changes we’re about to see and last thing these changes will bring is any real improvement over the health care to which the vast majority of us have become accustomed.

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2010-06-17 digital edition

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