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August 07, 2009
ObamaCare and me ....by Dr. Pollard
ObamaCare and me
By Zane F Pollard, MD
I have been sitting quietly on the sidelines watching all of this national debate on healthcare. It is time for me to bring some clarity to the table by explaining many of the problems from the perspective of a doctor.
First off, the government has involved very few of us physicians in the healthcare debate. While the American Medical Association has come out in favor of the plan, it is vital to remember that the AMA only represents 17% of the American physician workforce.
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.
Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.
Again, extreme rationing. Solution: I have a foundation here in Atlanta supported 100% by private funds which supplies all of these contact lenses for my Medicaid and illegal immigrants children for free. Again, waiting for the government would be disastrous.
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.
Last month I operated on a 70 year old lady with double vision present for 3 years. She responded quite nicely to her surgery and now is symptom free. I also operated on a 69 year old judge with vertical double vision. His surgery went very well and now he is happy as a lark. I have been told -- but of course there is no healthcare bill that has been passed yet -- that these 2 people because of their age would have been denied surgery and just told to wear a patch over one eye to alleviate the symptoms of double vision. Obviously cheaper than surgery.
I spent two year in the US Navy during the Viet Nam war and was well treated by the military. There was tremendous rationing of care and we were told specifically what things the military personnel and their dependents could have and which things they could not have. While I was in Viet Nam, my wife Nancy got sick and got essentially no care at the Naval Hospital in Oakland, California. She went home and went to her family's private internist in Beverly Hills. While it was expensive, she received an immediate work up. Again rationing of care.
For those of you who are over 65, this bill in its present form might be lethal for you. People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British plan. For those of you younger, it will still mean restriction of the care that you and your children receive.
While 99% of physicians went into medicine because of the love of medicine and the challenge of helping our fellow man, economics are still important. My rent goes up 2% each year and the salaries of my employees go up 2% each year. Twenty years ago, ophthalmologists were paid $1800 for a cataract surgery and today $500. This is a 73% decrease in our fees. I do not know of many jobs in America that have seen this sort of lowering of fees.
But there is more to the story than just the lower fees. When I came to Atlanta, there was a well known ophthalmologist that charged $2500 for a cataract surgery as he felt the was the best. He had a terrific reputation and in fact I had my mother's bilateral cataracts operated on by him with a wonderful result. She is now 94 and has 20/20 vision in both eyes. People would pay his $2500 fee.
However, then the government came in and said that any doctor that does Medicare work cannot accept more than the going rate ( now $500) or he or she would be severely fined. This put an end to his charging $2500. The government said it was illegal to accept more than the government-allowed rate. What I am driving at is that those of you well off will not be able to go to the head of the line under this new healthcare plan, just because you have money, as no physician will be willing to go against the law to treat you.
I am a pediatric ophthalmologist and trained for 10 years post-college to become a pediatric ophthalmologist (add two years of my service in the Navy and that comes to 12 years).A neurosurgeon spends 14 years post -college, and if he or she has to do the military that would be 16 years. I am not entitled to make what a neurosurgeon makes, but the new plan calls for all physicians to make the same amount of payment. I assure you that medical students will not go into neurosurgery and we will have a tremendous shortage of neurosurgeons. Already, the top neurosurgeon at my hospital who is in good health and only 52 years old has just quit because he can't stand working with the government anymore. Forty-nine percent of children under the age of 16 in the state of Georgia are on Medicaid, so he felt he just could not stand working with the bureaucracy anymore.
We are being lied to about the uninsured. They are getting care. I operate at least 2 illegal immigrants each month who pay me nothing, and the children's hospital at which I operate charges them nothing also.This is true not only on Atlanta, but of every community in America.
The bottom line is that I urge all of you to contact your congresswomen and congressmen and senators to defeat this bill. I promise you that you will not like rationing of your own health.
Furthermore, how can you trust a physician that works under these conditions knowing that he is controlled by the state. I certainly could not trust any doctor that would work under these draconian conditions.
One last thing: with this new healthcare plan there will be a tremendous shortage of physicians. It has been estimated that approximately 5% of the current physician work force will quit under this new system. Also it is estimated that another 5% shortage will occur because of the decreased number of men and women wanting to go into medicine. At the present time the US government has mandated gender equity in admissions to medical schools .That means that for the past 15 years that somewhere between 49 and 51% of each entering class are females. This is true of private schools also, because all private schools receive federal funding.
The average career of a woman in medicine now is only 8-10 years and the average work week for a female in medicine is only 3-4 days. I have now trained 35 fellows in pediatric ophthalmology. Hands down the best was a female that I trained 4 years ago -- she was head and heels above all others I have trained. She now practices only 3 days a week.
Wild Thing's comment......
I sent this article to 4 senators, 2 congressmen.
Posted by Wild Thing at August 7, 2009 06:40 AM
Comments
You betcha there will be rationing and it will get severe as inflation from government overspending sets in. There will also be that shortage of doctors, especially in selected fields. obama will be laughing as he enjoys the finest special medical care in the world. The same care he promised the rest of us but lied about
Posted by: TomR at August 7, 2009 11:53 AM
This bill is a big pos! I tried to tell my friends and family who swore by Obama the Messiah, the greatest thing since sliced bread, that we would be in trouble and we are. Everything I tried to tell them would happened has happened. It's like they just want to live for today only and not look down the road to see what obstacles might be coming their way. It's like we're the little red hen and they're those who refused to help, but then wanted to eat the bread the red hen made. Did they get any? Nope.
Posted by: Lynn at August 7, 2009 02:08 PM
In Warren Ohio where we use to live. The Ob-Gyn's (only because I can't spell it) are leaving the area because of Lawsuits and the cost of their Mal Practice insurance. In that area at least 3 years ago, Some Doctors were paying as much as a 1/4 Million for insurance.
It has gotten so bad, when someone loses an Arm, Leg or whatever body part due to disease, they have to save the body part until they get a release for that patient, otherwise they can be sued.
One Nurse I know very well, took a dead patient down to the morgue, there was enough room for two patients, one table was full the other had bodyparts and no where to put the fresh cadaver. They wound up packing the body in ice until the Funeral Home could get there. The government regulations, already are massive.
Of course with the new Euthanasia Bill all hospitals will have to expand there morgues 10 fold.
This is nuts, we have the best Health Care System in the World and this idiot wants to change it to compare and be on par with Cuba.
Posted by: Mark at August 7, 2009 02:41 PM
Paying for the antibiotics out of his own pocket. What a great doctor. It would be a shame for this country to lose such great professionals if this bill were to pass the house.
Posted by: Jim at August 7, 2009 08:40 PM
Tom, good point, he will too!!!
"obama will be laughing as he enjoys the finest special medical care in the world."
Posted by: Wild Thing at August 8, 2009 12:31 AM
Lynn, great analogy!! It's like we're the little red hen." I have gotten that
blank look and no emotion, I ask don't you
care??? Did you understand what I said was
in the bill? deep sigh.
Posted by: Wild Thing at August 8, 2009 12:33 AM
Mark,oh my gosh, how awful. Thank you so
much for sharing about all of those things.
Posted by: Wild Thing at August 8, 2009 12:37 AM
Jim, your right, he is a very special
doctor. There are more like him, I wish
they would speak out too. I have known
two awesome doctors over the years. One
has passed away and the other retired
years ago, but he worked till he
was 92 and then he could not see well.
Posted by: Wild Thing at August 8, 2009 12:42 AM
