The national media and the political spinners have never showed up for a debate or Town Hall with a copy of the proposed HEALTH CARE proposal-all 1,000 pages of it, or 1,300 pages or whatever is being bandied around. If they had a copy, then people could actually ask real questions about what is really in the bill.
As a medical professional of some 30 years since medical school, I can tell you first hand how another government sponsored or mandated health "insurance" program will NOT work nor will it do anything that the politicians are saying, including the bald faced lies of the president himself.
There are some basic and simple facts that need to be considered before believing the various hype and half truths, purposeful omissions and outright lies about the proposed wonderful health care for everyone.
First consider just the facts to see if what is being promised makes any sense, and add it to the fact that literally nobody touting the program, including the president has not read any proposed health care bill!
I did, and the medical staff in my practice have..at least what is out there to read.
The legalese is stifling. The descriptions confusing, the rules ominous and very much showing the big fist of government intervention.
Let's take the big picture-they claim that 47 million people are not insured. Forget the illegals, forget the people that want to insurance or pay cash (like many well to do people do or just carry catastrophic insurance).
Now my simple question: If we add 47 million people making appointments for health care how will the system handle that influx, especially as doctors like me are getting ready to leave and retire from the practice?
Second question: If the baby boomer generation is going to add millions and millions of people to the medicare system, and that system is proposed to TAKE OUT $500 billion in funding to support the newcomers into a health care system, how will the Medicare system pay for health care with such reduced funding and such an increase in its participants?
ANSWER: THE PROPOSAL IS NOT BASED ON REALITY.
The older the patient, the more care he typically needs, and Medicare provides that payment (forces one to buy it and use it after reaching a certain age), and if the payment for that patient's services is going to be lowered, why would a doctor accept such patients if their payment rates do not cover the office costs?
It gets worse.
Under the proposal as drafted, doctors can NOT refuse to treat patients on the new system, they are forced to do so and at rates that apparently will also be mandated by the government.
There are countless penalties in the bill for not falling in line. Everyone will pay for this, and those who do not sign up will have a IRS tax penalty at year end. Employer will be penalized, doctors will be, and insurance companies in essence will be PROHIBITED, NOTE-PROHIBITED, from writing new policies for health insurance!
Thus as the president says, you can keep your present insurance, but if you leave, they can not write you a new policy, it will only be made by and through the government.
Eventually, there will be NO insurance companies. Also, currently each state licenses insurance companies and they can not write the insurance in a neighboring state. The government however will write across all state lines thus forcing independent companies to be unable to compete.
As this happens, the government will mandate what will be paid for a procedure.
The president in one of his "explanations" of how bad our health care is, used a totally made up and patently false example of "greedy doctors". You will remember that nutty example and his totally inaccurate speech. To date nobody from the AMA has yet to challenge the crazy example.
The president said something like this....you go to a doctor, you have diabetes, and instead of suggesting a drug treatment or healthy diet, the doctor suggests that the patient's leg be amputated and that he gets $30,000 or so for that procedure...that is wrong, the doctor should not make such a suggestion.
THAT IS SO CRAZY, I WANTED TO THROW SOMETHING AT THE TV WHEN I HEARD THIS RIDICULOUS STATEMENT COMING FROM OUR PRESIDENT.
I was stunned, this statement was pure non-sense and used to sell the wonders of the new propose care...but it was patently WRONG and the president either had no facts or he outright lied.
For the record, as a doctor advising a patient on a diabetic treatment and procedure, that doctor is NOT going to be a surgeon who will amputate the leg of that patient! What crock spoken directly and outright falsely by the president himself.
I rushed to our billing office and asked about the typical procedure payment from MEDICARE or standard insurance policies for an "amputation".
I was shocked and asked if we would receive $30,000 for such a procedure as the president claimed that we would (first of all we do not do amputations) but we could look up the appropriate code for billing Medicare to see what that would be.
I waited anxiously for the reply from the office. As usual medicare or insurance billings are not as simple and straight forward as one would think that they could be. There were apparently lots of different reimbursements for the procedure depending on other factors, and the billing clerk must decide on what CODE number to enter fee reimbursement.
To my shock, the various codes provided for fees of $approximately $500 to $790 for a variety of amputations. The fee was not $30,000 paid to the supposedly greedy doctor as stated factually by the president. This was shocking to me, as millions and millions listened to the speech and now think that a doctor will be getting such absurd fees, while that is not the case.
As a matter of fact, most payments under the Medicare system tend to be below the cost that covers our office overhead but if the patients are a part of others covered by standard insurance and cash payers, we can provide the services and accept less fees.
What happens often is that long time patients who get older and are forced into MEDICARE expect that our practice will continue to provide services to them, and they do not realize that the fees we will be getting through the MEDICARE payments are vastly smaller than we received before. Literally, we will have to stop providing certain services because their payments are not sufficient to cover our costs.
I noticed that we got about $15 for a lab blood test. Our outside lab costs more, so if we send it out we will receive less than its cost!
So my fellow Americans, there will be less doctors to service another 47 million patients, and that is a fact. Younger doctors are more interested in a quality of life that us old guys, and they work less hours, thus providing less access to medical care.
So lastly think about how it will be possible to serve 47 million more people for less money? Does that make sense?
Oh, by the way, Congressmen and senators and staff will NOT be part of the new health care system, they are exempt!
I did not even touch upon the rules, the fines, the penalties for all types of violations throughout the proposed regulations. Note, there will be NO PRIVATE service possible, like in the UK where patients can obtain PRIVATE care as an alternative to unavailable services.
Now it has been revealed that DEATH panels exist in the UK, the model for our new proposed health care. Here is the story:
Patients with terminal illnesses are being made to die prematurely under an NHS scheme to help end their lives, leading doctors warn today.
By Kate Devlin, Medical Correspondent
Published: 10:00PM BST 02 Sep 2009
In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.
Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
But this approach can also mask the signs that their condition is improving, the experts warn.
As a result the scheme is causing a “national crisis” in patient care, the letter states. It has been signed palliative care experts including Professor Peter Millard, Emeritus Professor of Geriatrics, University of London, Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, and four others.
“Forecasting death is an inexact science,”they say. Patients are being diagnosed as being close to death “without regard to the fact that the diagnosis could be wrong.
“As a result a national wave of discontent is building up, as family and friends witness the denial of fluids and food to patients."
The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS.
The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.
Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.
It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.
It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.
Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.
They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.
However, doctors warn that these signs can point to other medical problems.
Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.
When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.
If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.
Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.
He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.
He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.
“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.
“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”
He added: “What they are trying to do is stop people being overtreated as they are dying.
“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”
He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.
Prof Millard said that it was “worrying” that patients were being “terminally” sedated, using syringe drivers, which continually empty their contents into a patient over the course of 24 hours.
In 2007-08 16.5 per cent of deaths in Britain came about after continuous deep sedation, according to researchers at the Barts and the London School of Medicine and Dentistry, twice as many as in Belgium and the Netherlands.
“If they are sedated it is much harder to see that a patient is getting better,” Prof Millard said.
Katherine Murphy, director of the Patients Association, said: “Even the tiniest things that happen towards the end of a patient’s life can have a huge and lasting affect on patients and their families feelings about their care.
“Guidelines like the LCP can be very helpful but healthcare professionals always need to keep in mind the individual needs of patients.
“There is no one size fits all approach.”
A spokesman for Marie Curie said: “The letter highlights some complex issues related to care of the dying.
“The Liverpool Care Pathway for the Dying Patient was developed in response to a societal need to transfer best practice of care of the dying from the hospice to other care settings.
“The LCP is not the answer to all the complex elements of this area of health care but we believe it is a step in the right direction.”
The pathway also includes advice on the spiritual care of the patient and their family both before and after the death.
It has also been used in 800 instances outside care homes, hospices and hospitals, including for people who have died in their own homes.
The letter has also been signed by Dr Anthony Cole, the chairman of the Medical Ethics Alliance, Dr David Hill, an anaesthetist, Dowager Lady Salisbury, chairman of the Choose Life campaign and Dr Elizabeth Negus a lecturer in English at Barking University.
A spokesman for the Department of Health said: “People coming to the end of their lives should have a right to high quality, compassionate and dignified care.
"The Liverpool Care Pathway (LCP) is an established and recommended tool that provides clinicians with an evidence-based framework to help delivery of high quality care for people at the end of their lives.
"Many people receive excellent care at the end of their lives. We are investing £286 million over the two years to 2011 to support implementation of the End of Life Care Strategy to help improve end of life care for all adults, regardless of where they live.”
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