The Press (and Letter Writing Doctors) May Be Getting It Right

Nancy Nielsen MD, President of the AMA, opposes healthcare reform

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Today’s NYTimes carries letters from 6 doctors expressing their deep
criticism of the foot dragging on plans for a major overhaul in health
care financing.

The last letter refers to the Times Op-Ed piece on the same subject
appearing yesterday (11 June) by columnist Nicholas D. Kristof. I’ve
copied his column in addition for your convenience.

Resolving this mess could be a great boon to communities trying to deal
with cardiometabolic disease — especially diabetes.

Henry
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The New York Times

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June 12, 2009 — Letters

One Health Battle: Doctor vs. Doctor

To the Editor:

Re “Doctors’ Group Opposes Public Health Insurance Plan
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(news article, June 11):

The American Medical Association has done it again, coming out on the
wrong side of history regarding health care in the United States.

Whether whipping up fears of “socialized medicine” or more sophisticated
expressions like “government control of health care,” the A.M.A. has
opposed every progressive change in health care financing, including
Medicare, which we now take for granted.

But most doctors do not belong to the A.M.A., and the A.M.A. does not
speak for many of us who believe that the United States should join all
other Western countries in providing universal health care.

Jay V. Solnick
Davis, Calif., June 11, 2009

The writer, a medical doctor, is a professor in the departments of
medicine and microbiology and immunology, University of California,
Davis.

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To the Editor:

The rationale of the American Medical Association in opposing a public
option in the Obama health reform plan is that a public option will
increase government spending and, by decreasing private insurance
penetration, decrease “choice” (though since people will have the choice
to select the public option that is not a rigorously logical argument).

The true rationale is the fear of decreased reimbursement as the
government gains more control of the health care economy.

This lobbying by the A.M.A. goes back many decades; the association
fought all prior attempts at universal coverage and was also dead-set
against Medicare.

As a doctor, I am disappointed but not surprised. The A.M.A. has always
been a trade association first and a force for quality and access a
distant second.

Robert Weisberger
Richmond, Va., June 11, 2009

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To the Editor:

You report that the American Medical Association said it “does not
believe that creating a public health insurance option for non-disabled
individuals under age 65 is the best way to expand health insurance
coverage and lower costs.”

Well, what is the best way?

As an uninsured 25-year-old, recently laid off from one of two part-time
jobs, I would like to know exactly how the A.M.A. proposes that I get
health insurance.

It is despicable to see an organization of doctors oppose the creation
of affordable health coverage without proposing an alternative.

Clearly, the private market has got its moral priorities mixed up, and a
public system is the only way forward. Health care is a human right.

Lee Gargagliano
Chicago, June 11, 2009

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To the Editor:

The private insurance infrastructure drains nearly a third of health
care resources into operational costs, advertising, executive
compensation, profits and huge bureaucracies designed to deny health
care to the sick.

What the United States really needs is a fully public insurance system,
not just a public option.

This would lower overall costs, provide patients the option to see any
doctor, and liberate doctors from the constant hassles of dealing with
insurance companies.

In a public insurance system, the American Medical Association would
have an important role in advocating for adequate reimbursements for
doctors.

The A.M.A. has said it won’t even support a public insurance option in
health care reform. That’s an example of why most physicians don’t
belong to the A.M.A., and why I don’t. The A.M.A. does not speak for me.

Paul Quick
San Francisco, June 11, 2009

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To the Editor:

I read your article with interest. As a young physician, I decided not
to join the American Medical Association as a personal protest against
its consistent opposition to meaningful health care reform that does not
meet the parochial interests of physicians.

The A.M.A. just gave me a reason to regret having never joined the
organization: now I cannot resign in disgust.

Richard Gomberg
Newton, Mass., June 11, 2009

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Meanwhile, in Canada …

To the Editor:

Re “This Time, We Won’t Scare
20time,%20we%20won%E2%80%99t%20scare&st=cse>,”
by Nicholas D. Kristof (column, June 11):

Mr. Kristof’s assertion of national courage captures the telling
clinical benefits of the Canadian health care system.

One might also mention that the benefits of a national health care
system will provide immense economic efficiency and advantage for
businesses, which are otherwise challenged to provide alternate forms of
profit-driven health care.

John Jarrell
Calgary, Alberta, June 11, 2009

The writer is a professor of obstetrics and gynecology at the University
of Calgary and a former chief medical officer, Calgary Health Region.

*

To the Editor:

The lack of a coherent national health care policy has pitted us all
against one another when it comes to financing and allocation of
resources.

Insurance companies just care about profit, and throw roadblocks into
the paths of patients. Health care professionals are under tremendous
stress, lessening, or even obliterating, the quality of mercy in the way
patients are treated.

If as a nation, we come to our senses and decide that health care should
be primarily for people and not for profit, we’ll not only have to do
practical things, like study how the Canadians successfully accomplished
national health care so that we’re not reinventing the wheel; we’ll also
have to retrain our minds to not look upon one another as enemies when
illness enters the picture.

“The quality of mercy is not strained” – if you’re Canadian or Swiss or
British or French.

Arthur Chertowsky
Brooklyn, June 11, 2009
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The New York Times

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June 11, 2009 — Op-Ed Columnist

This Time, We Won’t Scare

By NICHOLAS D. KRISTOF
/nicholasdkristof/index.html?inline=nyt-per>

Perhaps you’ve seen those television commercials denouncing health care
reform as a plot to create a Canadian-style totalitarian nightmare, and
you feel a wee bit scared.

Back in the election campaign, some people spread rumors that Barack
Obama might be a secret Muslim conspiring to impose Sharia law on us.
That seems unlikely now, but what if he’s a covert Canadian plotting to
impose … health care?

Rick Scott, a former hospital company chief executive, leads a group
called Conservatives for Patients’ Rights . He
was forced to resign as C.E.O. after his company defrauded the
government through overbilling and is now spending his time trying to
block meaningful health care reform by terrifying us with commercials of
“real-life stories of the victims of government-run health care.”

So here’s a far more representative “real-life story.”

Diane Tucker, 59, is an American lawyer who moved to Vancouver, Canada,
in 2006. Like everyone else there, she now pays the equivalent of just
$49 a month for health care.

Then one day two years ago, Ms. Tucker was working on her office
computer when she noticed that she was having trouble typing with her
right hand.

“I realized my hand was numb, so I tried to stand up to shake it out,”
she remembered. “But I had trouble standing.”

A colleague called 911, and an ambulance rushed her to the nearest
hospital.

“An emergency room doctor met me at the door, and they took me straight
upstairs to the CT scan,” she recalled. A neurologist explained that she
had suffered a stroke.

Ms. Tucker spent a week at the hospital. “The doctors were great,
although there were also a couple of jerks,” she said. “The nursing
staff was wonderful.”

Still, there were two patients to a room, and conditions weren’t as
opulent as at some American hospitals. “The food was horrible,” she
said.

Then again, the price was right. “They never spoke to me about money,”
she said. “Not when I checked in, and not when I left.”

Scaremongers emphasize the waits for specialists in Canada, and there’s
some truth to the stories. After the stroke, Ms. Tucker needed to make a
routine appointment with a neurologist and an ophthalmologist to see if
she should drive again. Initially, those appointments would have meant a
two- or three-month wait, although in the end she managed to arrange
them more quickly.

Ms. Tucker underwent three months of rehabilitation, including physical
therapy several times a week. Again there was no charge, no co-payment.

Then, last year, Ms. Tucker fainted while on a visit to San Francisco,
and an ambulance rushed her to the nearest hospital. But this was in the
United States, so the person meeting her at the emergency room door
wasn’t a doctor.

“The first person I saw was a lady with a computer,” she said, “asking
me how I intended to pay the bill.” Ms. Tucker did, in fact, have
insurance, but she was told she would have to pay herself and seek
reimbursement.

Nothing was seriously wrong, and the hospital discharged her after five
hours. The bill came to $8,789.29.

Ms. Tucker has since lost her job in the recession, but she says she’s
stuck in Canada – because if she goes back to the United States, she
will pay a fortune for private health insurance because of her history
of a stroke. “I’m trying to find another job here,” she said. “I want to
stay here because of medical insurance.”

Another advantage of the Canadian system, she says, is that it
emphasizes preventive care. When a friend was diagnosed as being
pre-diabetic, he was put in a free two-year program emphasizing an
improved diet and lifestyle – and he emerged as no longer being prone to
diabetes.

If Ms. Tucker’s story surprises you, you should know that Mr. Scott’s
public relations initiative against health reform is led by the same
firm that orchestrated the “Swift boat campaign” against Senator John
Kerry in 2004. These commercials are just as false, for President Obama
is not proposing government-run health care – just a public insurance
element in the mix.

No doubt there are some genuine horror stories in Canada, as there are
here in the United States.

But the bottom line is that America’s health care system spends nearly
twice as much per person
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as Canada’s (building the wealth of hospital tycoons like Mr. Scott).
Yet our infant mortality rate is 40 percent higher than Canada’s, and
American mothers are 57 percent more likely to die in childbirth than
Canadian ones.

In 1993, the “Harry and Louise” commercials frightened Americans into
abandoning health reform. Let’s ensure those scare tactics don’t work
this time.

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