A Dr. Point of View on Healthcare reform

I have not verified any of this, but look at the article below that I have copied and pasted into the blog.  It is reportedly from a physician in Atlanta.  This written piece is circulating on the Internet, so take it for what it is worth, but there are many good points made regarding where our current government healthcare is (Medicare and Medicaid) and the proposed overhaul of the system.  Again, I have no verification of the info, so just keep that in mind.

Letter from local Atlanta Doctor  with Childrens Healthcare of Atlanta
      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 and as your  friend by explaining many of the  problems from the aspect 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. Why is this. 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 mailed 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&n bsp; responded to glasses within  4 days, 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 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 goes up 2% each year. Twenty  years  a go 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 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 he 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 on 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 in 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 decreased 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 fundings. 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.
Zane Pollard, MD

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