It is nearly impossible to watch television, listen to the radio, read newspaper or surt the net, without having to hear or read about all the expert opinions of what the health care reform is or is not going to do for (to) us.

This debate includes on one end a complete melt down of the delivery system, if the healthcare reform gets approved, and the other end is healthcare for everyone with all the choices with no additional cost! There is also a minority that things everything is great and we should just leave it as is. I am assuming they include the healthcare insurance, pharmaceutical employees, their families and all the lobbyists that they have bought.

I do try to keep in touch with what is going on, and keep my opinion to myself, however I decided to write this piece for the news letter after I received an email (unsolicited) from a hospital co-worker, with a cartoon that summarized what this entire debate is about. Misinformation! Since I am not sure if the image is copyrighted or not I am not going to post it here.

This cartoon depicted a discussion between member of the current administration and public talking about certain aspects of the health care reform. Those of you that know me are aware of my sense of humor, and with that said, I think it is appropriate that the facts are presented with an objective view, when it comes to preservation of human life.

I believe that as a healthcare provider in a community hospital in private practice gives me a unique opportunity to have an informed opinion of the health of our healthcare system. We are in cardiac arrest! Regardless of you being democrat or republican, or any shade of blue, red or any other color, I ask that you all read this as another opinion. I am sure some will agree and some will disagree with parts or all of it. The purpose of this newsletter is not to changes anyones opinion, but rather make sure that the facts are presented accurately from a healthcare providers point of view.

In no particular order I will touch upon some of the issues surrounding this discussion.

1-Rationing of the healthcare. Not a good thing in any case. The reality is that the health care is already rationed. The access to health care is rationed by all insurance companies except Medicare. If a patient is seen in our office, we can not perform any surgery, unless we get an authorization from an insurance company.

If you did not know, I talk to physicians from insurance companies many times a week for this purpose. They, a physician that you have never seen, have not been examined by will decide if the care that I, your treating physician, is recommending is appropriate. It does not sound that bad, until you realize that the insurance physician is for example not even a Bariatric surgeon dictating what type of surgery should and should not be performed. That would be like me taking and advise from a plumber how to wire an electric plug !

2-Deteriorating level of healthcare provided. The average wait in an emergency room has gone up significantly. The number of emergency rooms has gone down also. Both of these mean that in that critical time frame that some of us will need the emergency room care, expert help will be too far (since other ones that were closer closed due to financial strains in 1990’s) and when we get there, we will have to wait because the emergency room will be packed with patients who are there for runny nose, earaches and other problems that should have been addressed by their primary care, had they had one or could pay for it.

3-Tax credit, employee mandate, Insurance subsidy… In one form or another, all this means is who is going to pay for my healthcare. There is no free lunch. Is there any one out there that expects to get healthcare for free anywhere in the world? We pay it in the US in the form of higher operating cost when running a small business, insurance premiums, taxation etc. Each one of us, is paying for our own healthcare directly or indirectly. If you worked for the now bankrupt GM, you may have had healthcare paid for by the company, who passed on that cost thru each car, that we all bought. In the Western Europe, and Canada, the bulk of the funding is collected from taxes and there may not be a mandate for a small business to pay for health insurance. End of the day we are all paying for it one way or another. It is a mute point to play word games with the payment plan. Call it whatever you want, but someone has to pay for it. Can we become more efficient yes we can if we streamline information exchange channels, educate general population, and look at the entire health from a preventive perspective. Our current health care for the most part is a reactive model. On a personal note, I have family members who lives in Europe. They call the national healthcare phone number with concerns. Their needs are meet, surgeries performed, medication provided without any concerns for deductible, copay, authorizations etc. They have an easier access to all level of care than an average family in US. As I indicated above, In my opinion, the healthcare in US is on life support. I am in support of the government option, and regulation of the healthcare insurance industry, with coverage for all especially children. Health care decisions should not be made by an insurance company but the doctor and the patient. I am not in support of government intrusion in our daily life however to set the facts strait the only health insurance model that has the least amount of “medical bureaucracy” is the Medicare model.

If the healthcare reform passes one of two things is going to happen. It will either provide for health care, competitive market, at no additional cost or a complete melt down of the entire system providing an opportunity to build a new functional environment.