Educate Yourself: Topic 3 - Why the bill endangers us

With all the effort Obama and the Democrats have spent badmouthing the American medical system, you might not know the following fact: if you exclude homicides and accidents, Americans live longer on average than any other people on earth.  In other words, the aspects of longevity that are affected by the quality of our healthcare system are better for Americans than for the citizens of any other nation on the planet.

Does that surprise you?  I suspect it would, given the way this awful bill had been 'sold' to us.  So with such a top-notch medical system we have access to, why would we we want to mess with it in ways designed to lower the quality of our system?  Good question.

Let's look at how this bill will negatively affect the quality of our health care system.  First of all, the bill creates a number of pressures in the system that will put the squeeze on insurers.  That will translate to additional pressures on reimbursement for medical services.  These pressures appear to me at this point designed to fall heavier on medical subspecialists, and perhaps somewhat less on primary care physicians.  Because only a relatively small percentage of medical costs are paid to physicians for services, this will have little impact on overall health care costs.

At the same time pressures come to bear to reduce payments for services provided by physicians, there are (by reports) 30+ million people being added to the rolls of the insured who would be expected to create a big spike in the demand for medical services.  There will not suddenly be additional physicians or other providers to handle this.  My experiences is that physicians are busy these days.  I doubt there is much "excess capacity" that could handle the extra load.  Perhaps because the bill collects extra taxes for 10 years but doesn't help many people for 4 years or so (accounting games yet again), there may be a little time to try to train more providers, but there's been no talk of this and training people costs money, too.

At the same time the system squeezes payments to physicians and overloads them with work, the government will increasingly dictate medical decisions, and will undoubtedly add more paperwork to the system (doesn't government always?).  Oh, and if there are physicians still doing ok financially, most of the new taxes dictated by this bill are being placed on those making over $200,000 per year.  So take another chunk out.

This isn't a pity party for docs I'm trying to spell out here...it's a reality check.  Many of you are aware of the number of years of intense dedication (and the amount of debt typically) required to become a physician.  People go through it for a number of reasons, but it helps knowing that for the most part you can anticipate a decent income once you've gone through the long arduous process.  I do not think it's a stretch to say the effects of this bill will be deflating and demoralizing for providers of health care.  There will be some who will retire early.  Some will not go into medicine who might have otherwise...but more importantly I fear that the quality of our medical providers will go down.  The "best and brightest" in America tend to go where there is decent income to be had.  If that is no longer in medicine, many of our best and brightest will look elsewhere.

These pressures are also going to affect the quality of service given to people.  How can I say this?  Well, addition to creating another overworked, underpaid work force, there is the simple fact of history...can you give me an example of the federal government aggressively inserting itself to control a system or organization, and that system or organization providing better service than the private sector?

No, at the end of the day, I believe the consequences of this bill on the profession of medicine, and the quality of our health care will be damaged severely, and unless something is done to change what this bill does, it may never recover.  And this (for those of you who know me) from an incurable optimist.

One more little nugget for you to digest.  This bill also adds a tax on companies that innovate and create new and better medical devices and supplies.  What better way to lessen the creativity that makes our medical system, for now, the best in the world.