Thursday, August 6, 2009

One Doctor's Perspective of ObamaCare

American Thinker has a thought provoking article today by Dr. Zane F. Pollard. He is a pediatric opthamologist in Atlanta. Dr. Pollard has some thoughts on Obamacare (he's not a fan) and offers some personal examples as evidence against government run health care; here is one of several he offers:

"I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

"Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye. Each time the request came back denied. All three times I personally provided the antibiotic for each patient which was not on the Medicaid approved list. Get the point -- rationing of care."

He has many such examples that are, well, scary. Obama likes to say that Republicans are "fear-mongering" when arguing against Obamacare, but Dr. Pollard's stories are truly scary. They aren't fear-mongering; they are true stories of a doctor trying to practice medicine against the bureaucracy of Medicaid and Medicare. He tells of colleagues that have quit practicing because of the government boondoggle and warns of a physician shortage under Obamacare.

Dr. Pollard also writes about his elderly patients, one a 70 year old woman and a 69 year old man; both would likely have been rejected as surgery candidates under Obamacare because of their age.

Consider this anecdote: "Last week I had a lady bring her child to me. They are Americans but live in Sweden, as the father has a job with a big corporation. The child had the onset of double vision 3 months ago and has been unable to function normally because of this. They are people of means but are waiting 8 months to see the ophthalmologist in Sweden. Then if the child needed surgery they would be put on a 6 month waiting list. She called me and I saw her that day. It turned out that the child had accommodative esotropia (crossing of the eyes treated with glasses that correct for farsightedness) and responded to glasses within 4 days, so no surgery was needed. Again, rationing of care."

So easy to fix, but would not have been under Obamacare.

Be sure to read his entire article. If Dr. Pollard has this many examples, what about other doctors? Pollard points out that even though the AMA has come out in support of Obamacare, it only represents 17% of the American physician workforce. I'd venture to say that a lot more doctors are against it than are for it.


1 comment:

Huey L. Golden said...

I was watching Greta the other day. On it, Dr. David Scheiner, Obama's former physician, came out against Obama's plan because it doesn't go far enough.

In that interview (transcript http://www.foxnews.com/story/0,2933,537628,00.html) he makes some statements which, taken at face value, might be persuasive of his position. But, if we've learned anything, it is seldom that anything a liberal says which can be taken at "face value."

He says: "The United States ranks 37th in the world in health statistics."

This figure comes from the World Health Organization. Like any value judgment, the underlying predicates must be examined. That organization weights the five factors as follows: 1) Health Risk - 25%; 2) Health Distribution - 25%; 3) Responsiveness - 12.5%; 4) Responsiveness Distribution - 12.5%; and 5) Financial Fairness - 25%.

As a Cato Institute paper reveals, these factors are almost useless when it comes to the underlying questions, i.e., "Who has access to health care and what is the quality of that health care?"

So many non-health care related factors affect a nation's average longevity that comparing one nation to another is simply not comparing like to like. (Racial make-up, diet, violent crime, rate of vehicular accidents, etc.)

Likewise, what is deemed to be "financially fair" seems to be predicated on an underlying world-view that the rich should pay more for their health care than do the poor. It has virtually nothing to do with whether the nation's populace is receiving quality health care.

I could go on punching holes in the underlying assumptions of this flawed report that liberals love to quote, but the Cato Institute did a thorough job of it.
(See, e.g., http://www.cato.org/pub_display.php?pub_id=9236)

Then the good doctor goes on to say: "Another thing that has bothered me is this attack on Medicare as government-run medicine. Now, in the 40 years that I've practicing under Medicare, Medicare has never -- I repeat, never -- interfered with my ability to take care of a patient. Private insurance interferes with me almost on a daily basis"

Sounds ominous, doesn't it? Private insurance interfering, Medicare not doing so?

But, examine the reality. Medicare/Medicaid have schedules of payment and schedules of what services they will and will not provide. There is no room for interference. When a medical provider accepts Medicare/Medicaid patients, he accepts these schedules.

Period.

You can argue with a private insurance company over what is covered and how much they'll pay. Like any other contract, the one who has to pay tends to read the terms of the contract a tad differently than does the one who is to receive the benefit of that payment.

So, of course -- there's some "interference" when dealing with private insurance companies. That "interference" can only arise in two areas: 1) Whether something is covered, and 2) How much the insurance company is going to pay the medical provider to provide that service.

Those two areas are the very areas in which there is no real possibility of "interference" when dealing with Medicare/Medicaid. The agreed-upon schedules put an end to any discussion in this regard. All "interference" when dealing with Medicare/Medicaid occurred when the provider decided to accept patients who were covered by those programs.

Nothing these liberals say can be taken at "face value."