Health information and news

By: Norman Traverse, M.D. Editor

President Obama wants Congress to create and send him a completely remodeled healthcare system in just a matter of weeks for his signature. He says it can’t wait any longer because there are 45+ million people without health insurance. This is about 15% of the population. About 85% of the population does have some form of health insurance.

It is estimated by the congressional budget office that it will cost between one ($1,000,000,000,000) to two trillion dollars ($2,000,000,000,000) to cover most of this group. The GOP points out that a just released study pegs the cost of  health care reform at 3.5 trillion dollars ($3,500,000,000,000)

This money will have to be borrowed from China or middle eastern countries or printed by the Treasury. If the treasury can’t borrow the money, it will be forced to print more currency, the dollar could be devaluated with resulting inflation and high interest rates. In four months the President and Congress already have committed to spend over 4 Trillion ($4,000,000,000,000) of other expenditure before they authorize the borrowing the trillions that are to be spent on “reforming health care.” How and where are we going to get all this money to pay back and at what interest rate? This is more money than has been borrowed since the founding of the United States and more money than any country in the world has ever borrowed!

It has just been reported by the MarketWatch newswire that Li Lianzhong, who is head of economics at the China’s policy research office, said the U.S. dollar is poised for a fall, making gold and land better investments for China’s $1.95 trillion in foreign exchange reserves, the report said. It quoted Li as saying Beijing should also focus on buying up energy and natural resources.⁽¹⁾ What is going to happen to our economy if the Chinese demand a much higher rate of interest on the trillions of U.S. Treasury notes we are trying to convince them to buy? It certainly means that home and small business mortgage and lending rates will go up dramatically and dollars will be drained out of the productive economy that pays our taxes! China and middle eastern countries could buy up our industries that are profitable.

Our fragile recovery could be derailed if we continue to spend ourselves into deepening deficits that are beyond the ability of US taxpayers to repay.

Health care is the largest industry in this country representing about 20% of the gross domestic product. The delivery of healthcare is very labor intensive with the hospital labor costs amounting to about 70% of the total hospital costs. If the hospitals do not receive enough money to cover their labor costs they will have to lay off many workers.

Congress is the one that designed and implemented our health care system over forty years. It has created Medicare and Medicaid.  In addition, there are hundreds of other healthcare programs large and small that are being funded. These programs have resulted in over 150,000 pages of regulations which are growing on a daily basis. It consumes vast amounts of time and money just trying to interpret them. Once regulations become law it is quite difficult to change them.

This means any major changes that are forced on the private sector of the economy may destroy a system of delivery of health care that most Americans are quite happy with. Once it is destroyed, it will be almost impossible to restore. The main two areas the public is concerned about is access to physicians and costs according to most polls.⁽²⁾

If the government takes over health care with a single payer system they will then have make up  extra portion the private payers have been paying to the hospitals. Hospital profit margins now average only 1-2 percent before the proposed cuts in reimbursement. Hospitals are already starting to close some emergency rooms and if further cuts that President Obama is suggesting are mandated by Congress, your local hospital might have to close because they would not have enough money to pay staff.⁽⁶⁾ The alternative is to fire many nurses, other technical support staff and ration hospital care according to a new government formula. Older patients, who are usually sicker, will be the ones to suffer most because they require more skilled care!

Access difficulty is directly related to the overall shortage of doctors in the specialty of Primary Care (Internal Medicine, Family Practice and Pediatrics).  As older doctors are retiring, there are few young Primary Physicians coming out of training who are willing to replace them by going into Primary Care.⁽³⁾ Congress has made a series of bad decisions, freezing and reducing reimbursements, while mandating increased paper work for which the physicians are not paid. This has created a very serious situation that is decreasing the availability of healthcare, reducing access and dramatically adding to healthcare costs.

Instead of choosing  Primary Care, physicians in residency training are going into other specialties such as Cardiology, Gastroenterology, Hematology and Pulmonary Disease because these procedure oriented specialties are reimbursed by Medicare at a much higher rate.⁽⁴⁾ In fact, the Congress has decided to decrease pay for primary care physicians by twenty-one percent in the near future. With increasing medical insurance liability costs many primary care physician are leaving this field or retiring. Patients who cannot find a primary care physician are going to a variety of specialists, who order many more tests because of the need to practice “defensive medicine” because they are afraid of being sued by America’s very aggressive trial lawyers.

One of the major reasons America’s health care costs are so high is the cost of malpractice frivolous lawsuits. This explains one of the major reasons medical costs are much higher in the United States than anywhere in the world. No other country in the world has an aggressive trial lawyer system which costs taxpayers hundreds of billions each year in increased costs. Trail lawyers are major contributors to the reelection fund of congressman and exert so much influence that Congress has made no mention of the cost of these frivolous law suits in its reform proposals. President Obama has told the AMA that the caps on damages for medical liability for pain and suffering will not be discussed, during his recent speech to the AMA. This news was not well received by the doctors.”

The Pacific Research Institute (a not for profit, nonpartisan organization supported by contributions) is the first to do a detailed study quantifying the total cost of tort litigation in our country. They have calculated that the excessive tort costs in the United State due to lawsuit abuse totals $589 billion each year. ⁽⁵⁾

The average person, not involved in any lawsuits pays for lawsuit abuse in many ways, reduced access to healthcare, much higher health insurance premiums and increased Medicare costs. The medicine you take costs much more and some potentially lifesaving medications are not even being developed because the cost of drug development and testing for rare diseases is increased by lawsuit abuse.

No private business would survive if they planed and implemented their business plans the way Congress conducts its business.

The bills that members of Congress write are constantly changing to accommodate the special interests they are trying to please. Congress allows “earmarks” to be inserted into bills at the last minute which caters to special interests that spend millions of additional dollars reducing the amount of money that should be devoted to vital healthcare needs. This is equivalent to writing a business plan and passing it around to over 535 members of Congress who each makes changes, often with the aid of special interests, who have parts of the bill already written and quietly insert them into healthcare legislation.

When the final bill is presented, it is often so many pages that the members of Congress have no time to read it fully. The recently passed “Stimulus Plan” is a prime example. A Senate vote was forced by the leadership before the 600 page+ bill could be read and analyzed! It is almost impossible to accurately predict the short and long term costs, let alone know the damage from unintended consequences.

Congress should take time to study and test legislation before it is implemented into law. Haste causes waste of the taxpayer’s hard earned money, especially when the public does not have time to give its input. When Congress rushes thru trillion dollar bills in the middle of the night after being prodded and threatened by their leadership it appears that they are afraid that the taxpayers will find out what is in the legislation, that they could never pass if it was carefully examined.

One solution is to have proposed healthcare legislation tested before it is implemented on the country in several states who volunteer. Outside accounting firms should be hired to audit the results. Teams representing the medical profession, (especially those that practice in community hospitals where 95% of patients are treated), hospital administrators, healthcare statisticians and the bipartisan representatives of the public should be part of the process. They should find the mistakes, modify it or throw it out if it creates more damage than it helps. The public should know what the final cost of the trial period is compared to what Congress predicted. Is it cost effective or should it be modified? Once it has been shown to result in very significant statistical improvement it should have further gradual implementation.

We have to be careful not to destroy the parts of our healthcare system that is giving excellent outcomes to the vast majority of patients. Haste could result in depriving the public of lifesaving procedures and staggering disruptions.

There can be no expansion of healthcare to meet the needs of the increasing numbers senior citizens without doctors. The Primary Care Physicians are the foundation of our health care system. In tort cases the amount awarded for “pain and suffering should be caped”, similar to what has been so successfully done in the state of Texas.⁽⁷⁾ This would save billions that could be devoted to improving access and reducing costs.

I urge you to write your Congressional representatives and find out where they stand. We have been promised prior to the election that all legislation would be posted on the internet five days before it is brought up for a vote in the  House of Representatives or in the Senate. This is one of the many promises they have already broken! Congress should not rush into a vote any legislation that the public has not had their input, allowed to read, and time to comment on the proposed bill. I think many in Congress have forgotten they work for the taxpayers who expect to be kept informed before it is too late to influence legislation.

Wishing you the best of good health.
Norman Traverse, M.D.
Editor - www.HealthMadeEasy.com

1. MarketWatch June 24 10:43 p.m. EST Chinese official urges buying of gold, U.S. land: Report
2. Gallup Organization Polls Nov 11-14-2007, Health and Healthcare poll with charts showing results of previous polls, using identical questions, dating back to 1999.
3. Harvard Researchers Say Medicare Worsens Primary Care Doctor Shortage Boston Business Journal - by Mark Hollmer July 7, 2008 http://www.bizjournals.com/boston/stories/2008/07/07/daily9.html
4. Primary Care Crisis is Here The Healthcare Blog Front Page, Bob Wachter July 21, 2008, http://www.thehealthcareblog.com/the_health_care_blog/2008/07/primary-care-cr.html
5. Mcquillan, Abramyan and Archie, Jackpot Justice, The True Cost of America’s Tort System ,    p.35Pacific Research Institute ISBN-13:978-1-934276-00-06 March 2007 -- http://www.pacificresearch.org
6. Emergency Room Visits Hits Record High, by Jacob Goldstein, August 6,2008 Wall Street Journal  Blog on Health http://blogs.wsj.com/health/2008/08/06/emergency-room-visits-hit-record-high/
7. Doctors laud 5 years of malpractice relief, El Paso Times, September 14, 2008 http://www.tortreform.com/node/475