ObamaCare and me
By Zane F Pollard, MD *
Contributor
The American Thinker
August 06, 2009
http://www.americanthinker.com/2009/08/ ... nd_me.htmlI 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 by explaining many of the problems from the perspective 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. 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 sent 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 responded to glasses within 4 days,
so 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.
* * *
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 go up 2% each year. Twenty years ago, 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 sort of 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 the 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 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 on 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 the
decreased number of 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 funding.
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.
