Tuesday, October 27, 2009

A question for Dr. Wade : The Winchester Star, Letters to Editor

A question for Dr. Wade

I read with great interest the letter submitted by Dr. Karen Wade (Your Views, Oct. 17). I’m sure that all of her patients were already aware that she feels the single biggest problem with our system is the epidemic of honest, overworked, underpaid, and under-worshipped physicians being driven mercilessly into bankruptcy by legions of greed-driven ingrates.

Who hasn’t seen the sad spectacle of a physician trying to selflessly improve the lives of his or her patients only to be financially ruined by these hyper-litigious rubes. If only once these same patients could see what it is like to lose everything they’ve worked for, if only they knew the horror of being sued! It is a shame that any physician should have to worry about being hauled into court for maiming or killing the occasional patient.

I’m sure the insurance industry deplores having to charge Dr. Wade and her colleagues such astronomical malpractice premiums, I know they are lying awake at night thinking of ways to absolve our physicians of these onerous fees.

I do have one question for Dr. Wade: Which line is longest: the physicians litigated into abject poverty and shame, the Canadian refugees clogging our hospital corridors around the clock seeking quality care, or the working under-or uninsured Americans sued into real bankruptcy and foreclosure by their own providers or hospitals?

If Dr. Wade defers, perhaps a representative from WMC will answer it.

Dwight Sowell
Stephens City
October 27, 2009

Do not be surprised Mr. Dwight Sowell if you do not receive an answer from anyone within the walls of the Valley Health System.

First step is . . . tort reform

I was very pleased to see The Washington Post article on the Mayo Clinic in the Oct. 5 Star. It was the perfect rebuttal to Carl Ekberg’s letter, “A Mayo clinic in Winchester?” published Sept. 28.

There are clearly many factors besides the salaried status of its physicians which contribute to the excellent reputation of the Mayo Clinic. In the United States at the present time, a large number of physicians are salaried employees. The fees for their services, however, are still paid by insurance companies, and their employers (hospitals, large practices, etc.) expect them to generate enough income to justify those salaries.

One cannot legitimately compare outcomes (life expectancy and infant mortality) in the United States to those of small countries with populations that are much less socially and ethnically diverse. Making every physician in the United States a salaried government employee would not solve the problems of the obesity epidemic, teen pregnancy, or drug abuse.

The first step in reducing the cost of medical care in this country should be tort reform. Imagine how much fees could be reduced if each physician did not have to generate an extra $50,000 to $100,000 or more in income each year just to cover the cost of malpractice insurance. There would also be a decrease in “unnecessary” tests and treatments ordered by physicians practicing “defensive medicine” out of fear of lawsuits.

We should also put the control of health-care spending back in the hands of patients. We should encourage the use of Health Savings Accounts to pay for routine care, and reserve insurance (at much lower premiums than currently charged) for major illness or hospitalization. People will be much more prudent in their health-care choices if they feel they are spending their own money rather than the insurance company’s.


October 17, 2009

A Mayo Clinic in Winchester?

Karen Wade's letter, “In the interest of fairness” (Your Views, Sept. 16), concerning physicians’ incomes was cute, sarcastic, and totally uninformative.

So here’s bit of information to raise the level of the discussion: In the United States, where fee-for-service (“cowboy capitalism” in the words of David Ignatius) is the usual practice, people live less long and more babies die within the first year of life than in any other modern industrialized country in the world.

In countries where physicians are on salaries (generous salaries), people live longer and fewer babies die. Moreover, within the United States, the best health care is provided at institutions (like the Mayo Clinic and the Cleveland Clinic) where physicians are salaried.

Wouldn’t it be salutary if Valley Health Care created a clinic here in Winchester (modeled on Mayo and Cleveland) where physicians would be on salaries, generous salaries?

Carl J. Ekberg
September 28, 2009

In the interest of fairness

As a practicing Ob/Gyn physician, I think that Jim Silvester’s suggestion (Open Forum, Sept. 5) to cap doctors’ incomes at $150,000 per year is great, provided that, in the interest of fairness and equality, we apply the same cap to all other professions, including attorneys, hospital administrators, legislators, insurance company (and other) CEOs, talk-show hosts, entertainers, athletes, etc.

Of course, this may somewhat limit the pool of wealthy people to tax, so we might have to tax the not-so-wealthy a bit more. And while we’re at it, could we please pass a law requiring all babies to be born between 9 a.m. and 5 p.m. Monday through Friday?

Dr. Karen E. Wade
September 16, 2009

Health-care folly
Forget the hogwash, it’s time to provide health care to all
Jim Silvester
September 5, 2009

This author has traveled widely with academic colleagues in the United Kingdom and has friends and business associates who call their home Canada.

Upon query about their national health-care systems, not one raised a voice of significant dissatisfaction, and none would agree to substitute their health system for that offered here in America.

Why does the United States spend $2.6 trillion annually on health care, 16 percent of its GDP, and only rank 37th by the World Health Organization (WHO) in terms of quality of health care?

America spends more on health per person than any country by twofold, yet it is rated between Costa Rica and Slovenia in quality of care accordingly to the WHO.

Back in time, families were afforded medical insurance provided by Blue Cross/Blue Shield, which was run as a nonprofit conglomerate managed by medical professionals. The other insurance players at the time followed the BC/BS model.

The price was uniform and reasonable, and there were no pre-existing condition exclusions and the local hospitals and some Good Samaritan doctors would take care of the poor.

In the 1980s, the medical and insurance industries, through intense lobbying efforts in Washington and the state capitols, pushed through “individualized underwriting” and “deregulation” of the industries.

“Pre-existing condition” exclusions were added to insurance contracts, and people were no longer premium-rated by demographic group but stood alone. Many lost insurance coverage and were denied access to health care, as is the case today.

Some insurers spend millions on analyzing how to reject claims or slow the payment process and deny claims because of small errors on initial applications after years of paying premiums.

Doctors and insurance agents disappeared from the middle-class neighborhoods and ended up in huge palatial estates that would make a southern plantation owner blush, or McMansions sitting on huge tracts where homing pigeons would be needed to communicate with the nearest neighbors if it weren’t for telephones.

And going to the hospital or doctor nowadays is a lesson in Economics 101. “Where’s the insurance card or checkbook” is the new greeting even before the temperature or pulse is taken.

Republican and conservative credentials of this author notwithstanding, when it comes to national health care and 54 million uninsured citizens, labels need to be dropped.

People often complain without offering solutions. As a trained economist and practicing entrepreneur, this author offers the following humble opinions as to a health care fix:

* Doctors’ income should be capped at $150,000 per year.
* Cap tort settlements to stop unfair jury awards and contain malpractice insurance costs.
* Forgive medical school tuition pro-rated based on length of service.
* All pre-existing conditions covered.
* All insurance is portable with job loss or change.
* All medical insurance business should be private but non-profit.
* All hospitals and clinics should be nonprofit, and accept payments as outlined by a non-governmental insurance exchange.
* All citizens are covered with government subsidies for the poor, unemployed, and underprivileged.

The day of rising insurance premiums, cherry-picking patients, running away from health claims, not covering the poor with adequate care, while the few who control the process become increasingly fat and wealthy must end.

Simply put, the American people are being ripped off.

Before the MDs jump off Old Rag Mountain or drink tainted Kool-Aid at the mere mention of those nasty words, “insurance reform,” please take note that their esteemed and practical input is needed on this important issue.

Stop the “take it slow” or “be patient” hogwash as this theme doesn’t hold water since the debate started in the Truman years, and almost 1 in 6 Americans are without health care and increasing.

And the scare tactics must stop. The Canadian and British health systems do not employ death panels or rationing of health care anymore than does the U.S. model. American health insurers routinely cut off benefits to terminal patients, kick them out of the hospital, and send them “home to die.” And waiting six to eight weeks to see a doctor for 10 minutes, as is common here, is just another form of “rationing,” but no one dare say it.

The political extremists must stop the folly, get down to business, and do what all other modern western countries do — provide adequate, affordable health care for all of its citizens.

Jim Silvester, a resident of Frederick County, is a professional business journalist.

Source : The Winchester Star

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