Tuesday, September 1, 2009

A Few Words to Our Patients

This is a letter that I recently received from Dr. Cameron Schaeffer, pediatric urologist in Lexington, Kentucky. It stands out due to its clarity and creativity. I very much agree with him!

Begin quote:

We, the undersigned physicians of this community, are concerned that expansion of the role of the Government in our nation’s health care system will significantly harm our nation, our profession, and our ability to care for you. We fear that we are on a path well-traveled by other nations and with a destination so predictable that the journey need not be repeated. Despite its faults, America still has the best health care system in the world as evidence by the hundreds of thousands of people who flock to this country every year for training and care; for critics to claim otherwise for political gain and without scrutiny is unconscionable.

We adhere to the following:

Privacy: Third party involvement in the doctor patient relationship is a fundamental violation of patient privacy and our Hippocratic Oath. Personal health information of the most sensitive nature already resides in the vast databases of insurance companies and governmental agencies. A centerpiece of proposed Government health care reform is the expansion of these databases, which are NEVER secure. We do not want your most personal secrets to leave our offices without your explicit permission.

Freedom: This Nation and its economy were founded on the right of independent parties to contract freely for goods and services in a competitive market, and this includes doctors and patients. Free markets lower costs and improve services. Goods and services are exchanged based on price, and prices for health-related services should be negotiated in advance of illness by insurance companies on behalf of their clients or by patients contracting directly with doctors and hospitals. Government price schedules have no market basis and often do not adequately cover physician costs, which is why many doctors do not accept Medicare and Medicaid. For markets to function properly, people must understand what they are exchanging. Our health care system woefully lacks transparency in price, cost, reimbursement, and quality of the services provided at every level. Reforms should empower all parties in the health care economy to contract freely, intelligently, transparently, and in good faith. Your freedom to determine what happens to your body must not be abridged.

Cost: The costs of Medicare and Medicaid are already staggering and unsustainable, and the Congressional Budget Office has stated that additional programs will incur more debt. Our debts, mostly carried by foreign countries, must be paid by our children or by devaluing the dollar. This course threatens our economy and our future as a Nation. Our health care system is based on, and our tax laws promote, third party payment schemes which are inherently inflationary because the patient and his doctor are incentivized to consume. Until we are incentivized to shop wisely as individual consumers caring for our own bodies, the problem will continue. As long as third parties, i.e. the Government an insurance companies, are paying the bills, they are incentivized to limit and to ration care.

Insurance Reform: We need fundamental insurance reform in this country. We can start by making health insurance about insuring risk of serious injury or illness, not a prepayment scheme for every sniffle. We have auto insurance for accidents, not oil changes. New private risk pools for individuals and not-for-profit insurance companies would enhance competition, i.e. improve services and lower costs. If insurance companies are required to accept all applicants, including those with preexisting conditions, they will create larger risk pools to manage the risk. The Government should not be allowed to “compete” because it is impossible to compete against an entity that prints money, does not have to collect premiums, does not have wellness programs, and does not pay taxes. Patients should be allowed to purchase health insurance across state lines like everything else that is sold in this country, and it should be tax-deductible. They should buy it as individuals for life, like life insurance, which makes it guaranteed, portable, and not subject to preexisting conditions. Freed of the need to provide health insurance for employees, employers will pay higher wages to stay competitive in the labor marketplace. Insurance companies need to improve transparency in physician contracts and quit playing reimbursement games with doctors.

Caring for the Uninsured: The Government cannot make uninsured patients disappear by passing laws. They are a societal problem. To ask providers to shoulder most of the cost of caring for the uninsured is unfair. The Government should allow providers to deduct the cost of caring for the uninsured from their taxes, like any other act of charity. Rather than create new programs for the uninsured, the Government should create a mechanism to allow immediate enrollment of the uninsured in Medicaid at the point of service. The insurance status and personal financial liability of these patients can be evaluated retroactively by Medicaid.

Malpractice Reform: The cost of medical liability insurance for physicians is high, and the cost of defensive medicine is real and enormous. Ultimately, these costs are paid by all of us. The utter absence of any discussion of malpractice reform in Washington is a disgrace and fundamentally dishonest. We believe that patients should be compensated for economic damages caused by medical malpractice, but we also believe that our legal system is a circus of blackmail and jackpots, disconnected from true medical malpractice and true damages. Furthermore, and cruelly, it takes years for deserving patients to receive compensation, long after they most need it.

Regulatory Burden: Our regulatory burden is onerous both in time and money, and it frequently contributes nothing of material value to you, our patients. We need relief from this burden to better care for you. Any proposed reforms should diminish, not expand, this regulatory burden.

Personal Responsibility:
We all have a civic duty to buy health insurance, and those who cannot afford it should be subsidized, perhaps through taxes on unhealthy foods and non-essential purchases. Some people, particularly the young and healthy, choose not to buy health insurance, even when they can afford it. These individuals must be incentivized to buy health insurance to spread the risk.

Wellness: Under our current system, patients have almost no financial incentive to lead healthy lifestyles. Mechanisms to incentivize wellness could be created, and patients who take care of themselves should be rewarded with lower health insurance premiums.

We are professionals, not commodities. Our training required years of dedication, and it came at a great cost, personally and financially. The assets of the businessman reside in his building and its contents; ours reside in our heads and in our hands. They belong to us, not the insurance companies and not the Government. These assets have real value, and we passionately want to use them to heal you when you are sick, on mutually agreeable terms. Any attempt to force us to work for the Government, without our individual consent, is a form of theft, a corruption of our relationship with you, and an assault on our professionalism.

Stand with Us: Send this advertisement to your representatives and tell them that free market principles can work in health care, just as they do in other service industries. Demand that they fix Medicare, Medicaid, and every VA Hospital BEFORE creating any additional programs. Demand removal of distortions in the tax code that promote third party payment and thus health care inflation. Demand the expansion of tax-free medical savings accounts which empower you, the patient, to find good care at a good price. Demand policies that incentivize providers to discuss their results and disclose their pricing. Remind them that “health care” starts with individuals and that all Americans must be incentivized to stay healthy. Tell them that jackpot justice has no place in the compensation of patients who have been injured while receiving medical care, irrespective of the cause of injury. Stand for freedom, dignity, and respect for the individual citizen, and oppose any reforms that might imperil your right to determine what happens to your body.


Contact information for Kentucky Congressmen:

Email: www.webslingers.com/jhoffman/congress-email.html

Jim Bunning 316 Hart Senate OB Washington, DC 20510
Phone: 202/224-4343 Fax: 202/228-1373
Mitch McConnell 361-A Russell Senate OB Washington, DC 20510
Phone: 202/224-2541 Fax: 202/224-2499
Ed Whitfield 2411 Rayburn HOB Washington, DC 20515
Phone: 202/225-3115 Fax: 202/225-3547
Brett Guthrie 510 Cannon HOB Washington, DC 20515
Phone: 202/225-3501 Fax: 202/226-2019
John Yarmuth 435 Cannon HOB Washington, Dc 20515
Phone: 202/225-5401 Fax: 202/225-5776
Geoff Davis 1108 Longworth NOB Washington, DC 20515
Phone: 202/225-3465 Fax: 202/225-0003
Hal Rogers 2406 Rayburn HOB Washington, DC 20515
Phone: 202/225-4601 Fax: 202/225-0940
Ben Chandler 1504 Longworth HOB Washington, Dc 20515
Phone: 202/225-4706 Fax: 202/225-2122

This advertisement was wholly purchased by the physicians listed above, unconnected with any political party or interest group

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