Thursday, June 11, 2009

More doctors disagreeing with AMA over universal health care

As Congress steps up its efforts to craft a comprehensive health care reform bill, Senator Edward Kennedy (in absentia) is leading the charge for a public health insurance option that can compete with private insurers. As far as I can tell, this would not only involve the expansion of Medicaid to cover people who are currently uninsured and earning below a certain income, but it would also offer a cost-based health plan administered by the government or a nonprofit cooperative (the details haven't been worked out yet) to folks who have had it up to here with private for-profit health plans.

The Republications, of course, are screaming socialized medicine. And rushing to their side is the powerful doctors group, the American Medical Association. According to The New York Times today, the AMA opposes the creation of a government-sponsored insurance plan, claiming it will restrict patient choice by eventually driving out private insurers.

What the AMA is really concerned about are profits -- a public health plan, much as Medicare and Medicaid now do, would reimburse doctors for tests and treatment at a lower rate than private insurers and that would threaten many doctors' six and seven-figure salaries. God forbid!

Fortunately, as Robert Pear in theTimes article and Doug Bremner's blog notes, the AMA no longer speaks for many doctors. Indeed, there is a large group, the Physicians for a National Health Program, which supports a single-payer system of insurance, in which a single public entity would pay for health services but most care would still be delivered by private doctors and hospitals. As Pear notes, many doctors have become so fed up with the administrative hassles of private insurance that they are looking for alternatives.

In an op-ed piece in The Boston Globe earlier this week, Dr.Steven Bergman, a psychiatrist and author of The House of God, expressed these sentiments with particular eloquence. Under a universal, government-run health care system, Bergman says, doctors would no longer "have to spend an evening filling out dozens of different insurance forms -- and then submit them a month later when they are denied or reduced."

What Bergman doesn't mention is how fed up many consumers (who don't have a powerful lobbying group like the AMA to give them voice) have become with for-profit health plans that charge them high premiums and then don't really cover them when they need care. I wrote about the millions of Americans who are grappling with unaffordable medical bills as a result of such deliberate under-insurance for The Boston Globe last year. This problem has only become more acute, as health insurers seek to hold onto their excessive profits,

As Bergman points out, the administrative cost for a private, for profit health insurance system is approximately 33 percent ($300 billion annually), while the administrative cost for the the two government-run health systems, the VA and Medicare, is about 3 percent. Yet "the level of satisfaction with these two nonprofit systems is high; that of the for-profit is low," he notes.

Bergman then asks the pertinent question: Why in the world should health care be for profit? Why indeed. The U.S. is currently the only developed nation in the western world that allows for-profit health systems. Yet despite all the evidence in favor of public health insurance, Bergman is concerned that Congress will fold before the combined juggernaut of for-profit health insurers and powerful doctors trying to protect their profits. If that happens, and there is a strong likelihood it will, Bergman calls on doctors and other health care professionals to go on a nationwide strike. Hear hear!

So what can you, the consumer, do? Call your Congressional representative and tell them that you want a public health plan option as part of the current overhaul. And then call your doctor and make sure he or she is ready to man the balustrades.


Dan said...

What follows are believed to be facts that are believed to exist regarding the present U.S. Health Care System. This may be why about 80 percent of U.S. citizens understandably want our health care system overhauled desperately due to the inadequate health care they receive and access:

The U.S. is ranked number 42 related to life expectancy and infant mortality, which is rather low.

However, the U.S. is ranked number one in the world for spending the most for health care- as well as being number one for those with chronic diseases. About 125 million people have such diseases. This is about 70 percent of the Medicare budget that is spent treating these terrible illnesses.

Health Care costs are now well over 2 trillion dollars of our gross domestic product. This is three times the amount nearly 20 years ago- and 8 times the amount it was about 30 years ago. Most is spent with medical institutions, as far as health expenditures are concerned.

One third of that amount is nothing more than administrative toxic waste that does not involve the restoration of the health of others. This illustrates how absurd the U.S. Health Care System is presently. Nearly 7000 dollars is spent on every citizen for health care every year, and that, too, is more than anyone else in the world.

We have around 50 million citizens without any health insurance, which may cause about 20 thousand deaths per year. This includes millions of children without health care, which is added to the planned or implemented cuts in the government SCHIP program for children, which alone covers about 7 million kids.

Our children.

Nearly half of the states in the U.S. are planning on or have made cuts to Medicaid, which covers about 60 million people, and those on Medicaid are in need of this coverage is largely due to unemployment. With these Medicaid cuts, over a million people will lose their health care coverage and benefits to a damaging degree.

About 70 percent of citizens have some form of health insurance, and the premiums for their insurance have increased nearly 90 percent in the past 8 years. About 45 percent of health care is provided by our government- which is predicted to experience a severe financial crisis in the near future with some government health care programs, it has been reported.

Half of all patients do not receive proper treatment to restore their health, it has been stated. Medical errors desperately need to be reduced as well, it has been reported, which should be addressed as well.

Most doctors want a single payer health care system, which would save about 400 billion dollars a year- about 20 percent less than what we are paying now. The American College of Physicians, second in size only to the American Medical Association, supports a single payer health care system.

The AMA, historically opposed to a single payer health care system, has close to half of its members in favor of this system. Less than a third of all physicians are members of the AMA, according to others.

Our health care we offer citizens is the present system is sort of a hybrid of a national and private health care system that has obviously mutated to a degree that is incapable of being fully functional due to perhaps copious amounts and levels of individual and legal entities.

Health Care must be the priority immediately by the new administration and congress. Challenges include the 700 billion dollars that have been pledged with the financial bailout that will occur, since the proposed health care plan of the next administration is projected to cost over a trillion dollars within the first year or so of the proposed plan to recalibrate health care for all of us in the U.S.

Likely, hundreds of billions of dollars that are speculated to be saved with a reform of the country’s health care system. Health policy analysts should not be greatly concerned on the health care corporate shareholders who may be affected by this reform of our health care system that is desperately needed.

Dan said...

It is estimated that the U.S. needs presently tens of thousands more primary care physicians to fully satisfy the necessities of those members of the public health. This specialty makes possibly less than 100 thousand dollars annually in income, compared with other physician specialties, yet they are and have been the backbone of the U.S. health care system.

The American College of Physicians believes that a patient centered national health care workforce policy is needed to address these issues that would ideally restructure the payment policies that exist presently with primary care physicians.

Further vexing is that it is quite apparent that we have some greedy health care corporations that take advantage of our health care system. Over a billion dollars was recovered for Medicare and Medicaid fraud last year through settlements paid to the department of Justice because some organizations who deliberately ripped off taxpayers.

These are the taxpayers in the U.S. who have a fragmented health care system with substantial components and different levels of government- composed of several legal entities and individuals, which has resulted in medical anarchy, so it seems.

Thanks to various corporations infecting our Health Care System in the United States, the following variables sum up this system as it exists today. Perhaps the United States National Health Insurance Act (H.R. 676) is the best solution to meet our health care needs as citizens, it appears.

We would finally have, as with most other countries, a Universal Health Care system that will allow free choice of doctors and hospitals, potentially, and health care for all completely. It should and likely will be funded by a combination of payroll taxes and general tax revenue which is realistically possible. Because the following seems to be in need of repair regarding the U.S. Health Care System:

Access- citizens do not have the right or ability to make use of this system as we should.

Efficiency- this system strives on creating much waste and expense as it possibly can.

Quality- the standard of excellence we deserve as citizens with our health care is missing in action.

Sustainability- We as citizens cannot continue to keep our health care system in as it is designed at this time- as it exists today.

Dan Abshear

Doug Bremner said...

Fight back! Come on physicians shed these AMA shackles for once and for all! Join my facebook cause 'Protest chowder headed AMA trying to block healthcare reform!'

Dan said...

With the AMA, according to wikipedia:

Almost a third of their existing members are still in medical training and are not practicing medicine.

Overall, the AMA represents less than 20 percent of practicing physicians in the United States. Some have put the number of AMA practicing physician members is actually between 130,000 and 140,000 physicians.

Yes, the AMA is about profit and greed. During the Great Depression, the AMA prohibited its members from working with newly established health maintainence organizations. The AMA constantly attempts to protect their turf.

One way they do this is not acknowledging the degrees of other health care providers, such as Osteopaths, nurse practitioners, or physician assistants.

In the 1940s, the AMA violated The Sherman Anti-Trust Act by monopolizing medicine, or attempting to do so.

The American College of Physicians is the second largest physician group in the United States- with about 120,000 practicing physicians as members.

While all the members have the specialty of Internal Medicine, they are or appear to be more authentic and altruistic than the AMA with their actions and statements as a group.

Unknown said...

You guys have completely lost it! Name one time in the last 40 years year that the gov't has taken over control of anything from the private sector and did it better. You can't. And now you are avocating for the same gov't to fix healthcare by again destroying the private sector. This is one thing that as Americans we cannot allow to happen. BTW, concerning costs. The estimates for cost of medicare implemention was below actual costs by NINE TIMES! No possible way that the gov't can decrease costs without rationing care which would be vehemently opposed by every citizen in this country if they knew the facts!

Unknown said...

With various health care reform bills floating around both the House and the Senate, President Barack Obama is pulling out all the stops to get the votes that the bill needs, which is good news for the public option. President Obama continues to rally behind health care reform. I am really concerned that the fiasco of this reform may make Obama a one-term president.

Koh Samui

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