Sunday, November 15, 2009


I title this "Health System Reform" instead of health care reform. The system needs revamping to reduce the obstacles that doctors face daily in trying to provide quality care for our patients. Government mandated paperwork for hospitals and doctors is taking away from valuable quality time with our patients. Insurance paperwork, administrative burdens and hassles, both private and government, require attention. Reforms in the insurance industry that expand choice of affordable coverage and eliminate denials for legitimate medically indicated care need to be addressed. In addition, insurance company denials for pre-existing conditions, and cancelling policies because patients get sick (and require treatment with state-of-the art technology), should be eliminated. If insurance companies want to pay their CEO's millions of dollars yearly, that's their choice, but please, take care of the patients that have paid their premiums. Medical liablity reforms must be included in any reform to reduce the cost of defensive medicine. Patients deserve the right to choose their physician, and this needs to be a part of any system reform. Health care decisions need to remain in the hands of patients and physicians, not insurance companies or government bureaucrats. Can we afford health insurance coverage for all Americans? - I do not know the answer to that question.

                      CBO says Senate healthcare bill costs $849 billion.
(ABC World News (11/18, story 2, 00:30, Gibson) reported, "On Capitol Hill, after weeks of delay, Senate Democrats" released "a cost estimate on their healthcare reform bill. The total cost is pegged at $849 billion over ten years." )

Ideally, it would certainly be nice, but the hassles and waste associated with any government run entity may not be the answer. The Senate bill is over 2000 pages, and probably not read nor understood by most of the Senators. The latest "political genius" from Washington is a 5% tax on cosmetic surgery procedures as part of the Senate's so-called health care reform. This is a tax that disproportionately targets women in every socioeconomic level. This type of law was enacted in New Jersey a few years ago. After unmet expectations, it was considered a failure and the original author of the bill introduced and shepherded a repeal of the tax which was unanimously approved by the Legislature but vetoed by Governor John Corzine. These taxes are arbitrary and difficult to administer because many times cosmetic and reconstructive procedures blend together.

Doctors have always, and will continue, to take care of people regardless of their ability to pay. If patients without insurance present to the emergency room for any condition, hospitals and physicians are required by law to take care of them. This is a financial burden, but never-the-less, it is our responsibility to take care of those in need with the very best care possible. Patients certainly need to take responsibility for their health and destiny. If they can afford to have insurance, they should choose to be covered. Addressing self imposed destructive behaviors (smoking, obesity, alcohol & drug abuse, etc.) will also lessen the burden on the system. End of life decisions and the large amount of health care dollars that are spent in certain terminal conditions need to be looked at closely, maintaining compassion and dignity in any decision. In conclusion, health care system reform needs the wisdom from physicians and their patients to guide the politicians in formulating the correct policies.