Wednesday, April 02, 2008

April 2, 2008 - 3 out of 5 Doctors Surveyed Agree

“3 out of 5 doctors surveyed agree...” Sounds like an advertising pitch, doesn’t it? Wonder what miracle tonic is on sale?

It’s no advertising pitch. It’s a statistic from a recent news article, reporting that 59 percent of doctors in this country now favor legislation to implement a national health insurance plan. Only 32 percent are opposed.

That’s a significant change from the last time this question was asked, in 2002. Back then, the vote was 49 percent in favor and 40 percent opposed.

The article quotes Dr. Ronald Ackermann, who helped conduct the survey: “Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy.”

More and more of America’s doctors are witnessing the human wreckage of our broken health-care funding system. When insurance companies incessantly fight their policyholders over the fine print in their policies, and everyone wastes millions on unnecessary paperwork, there eventually comes to be a cost. It’s a cost not only in squandered dollars, but also in lost efficiency. The more medical professionals are preoccupied with insurance red tape, the less time they have for treating their patients. This translates into a heavy cost in terms of our nation’s health – which is why, I think, so many doctors have changed their position.

Vance Esler is an oncologist and blogger. In his April 1st post – illustrated with a picture of a white flag – he interprets the survey results as a surrender on the part of weary doctors, who just want to hang up on the unending phone calls with insurance companies’ managed-care officials and get back to doing what they feel called to do: care for their patients. In earlier posts on the subject, Vance has expressed skepticism that national health insurance will be good for the patients – although he sees it as inevitable. He’s especially skeptical about Medicare – should that end up being the form the national program will eventually take:

“I have been working with Medicare for 30 years. I can tell you that there is no fighting because there is no negotiation. The government's attitude is ‘take it or leave it.’ So we physicians will take the cut in pay, take more time off, and probably be a whole lot happier.

But as one who is at the age where I may become a health care consumer, I'm not so sure I will like it – for the same reason: There is no negotiation.”

That does sound ominous.

Is this a common complaint of doctors in the British, French and Canadian national health-care systems, I wonder? Do they envy their American colleagues their ability to pull on their John Wayne Stetsons, swagger up to the insurance-company storekeeps, and demand what they want for their patients? I have a sense that other nations’ government health-care bureaucracies are less intractable than Medicare – or perhaps, simply better-funded. (They also tax their people at higher levels, which is where the better funding comes from.) Vance is right – these are issues that deserve careful attention.

I say of all political candidates seeking national office – whether the White House or Capitol Hill – if they have ears, let them hear. When even the doctors are starting to favor national health insurance, it’s clear the situation has deteriorated so far that something has to be done. There will be big rewards at the polls for any national leader with the guts to stand up to Big Insurance and do what’s best for ordinary citizens.

1 comment:

Vance said...

Hey, Carl. Thanks for the plug.

You are right that most doctors just want to get on with taking care of patients.

We were taught that we are patient advocates, and for years -- decades, actually -- we have gone to bat for patients when their insurance companies refused to do the right thing.

But there is only so much fighting one person can do. There is only so much time one can spend writing letters to justify the obvious. Eventually you grow tired of banging your head against the wall, and you say to your patient under your breath:

You know, you really have crummy insurance that won't let me give you the treatment you need. I cannot fight with them anymore. YOU and your employer need to do it.

If I may, let me clarify my position on Medicare. Medicare is the EASIEST third party that we deal with. They let patients choose their doctors. They pay quickly (ie, no having to beg for reimbursement).

The problems are that they don't pay enough to cover our costs (we lose money), and they are usually behind the curve on recognizing and covering innovative treatments.

If nationalized insurance means Medicare for everyone, then we can expect that everyone will have access to care, but they will not have access to all services.

This, I think you will find, is the case in Europe, Canada, and other nationalized health services. Everyone has insurance, but only those who can afford to go outside the system can actually avail themselves of the latest treatment options.

In other countries, people with lots of money can bypass the system. In this country, you cannot.