Very Bad Medicine: a Surgeon’s Historical Perspective on Nationalized Healthcare

By Daria Anne DiGiovanni


When my Blog Talk Radio co-host Stephen Rhodes and I sat down to interview Dr. Alphonse J. DiGiovanni, M.D., General and Vascular Surgeon last week (yes, Dr. Al also happens to be my dad) about the Obama Administration’s forceful push to nationalize medicine, I already had a fairly accurate understanding of the points the good doctor would make in defense of the free market, and the best healthcare system in the world.

Among other troubling things, socialized medicine would jeopardize doctor-patient privilege by giving government bureaucrats the power to interfere with the proper course of treatment (e.g. usurping the doctor’s authority to recommend a particular procedure or operation deemed necessary for the patient’s health); potentially force mothers-to-be to abort pregnancies determined to have fetal abnormalities (and pay doctors more money to intimidate parents into choosing abortion); and deny elderly patients recommended care simply because the state decides it is not worth the time and money to preserve a life that’s nearly over anyway.

Dr. Al eloquently opined on all of the above, but he also offered a history lesson as to how it all began, having been in practice since 1965. And just to set the record straight, he is not some wealthy physician born with a silver spoon in his mouth, fighting for a doctor’s right to make a lot of cash. Contrary to what liberals want Americans to believe, not every doctor was once a child of privilege. My father was born to Italian immigrant parents who came to the USA well into their 30s, in order to create a better life for their children. His dad was a humble tailor with a third-grade education; his mother a seamstress who only made it as far as the sixth grade.

The third of only four surviving sons, Alphonse was a hard-working, gifted student and athlete with a dream of playing professional baseball. When a shoulder injury forever shattered that worthy goal, my father turned to his second love—medicine, maintaining excellent grades throughout high school, college and medical school while simultaneously managing three jobs to finance it all. So when he speaks of the horrors of socialized medicine, it is not because he hates poor people; indeed it is because he knows from experience that when the government encroaches upon any industry, the results are bad for everyone.

Doctor, can you give us a bit of history as to how this all began?

“Actually, the first intrusion of government into medicine was the Foran Bill in 1947, which came on the heels of England’s development of national healthcare when they regrettably rejected Winston Churchill. In retrospect, I am glad the Foran Bill did not pass; but at the time I was a real liberal. I’d gone to a public high school for gifted students—Central High School in Germantown, Philadelphia where the social sciences division was totally left. All I got was how bad the Republicans were, and how good the Democrats and FDR were. That was when I first heard the term trickle-down economics, long before that criticism was leveled at Ronald Reagan.

“In college, I participated in a debating session in which I had to argue in favor of the Foran Bill, but as I immersed myself in study, I began to realize what the cons were. I still thought it was good for the country but my attitudes really changed over time with Barry Goldwater, and Ronald Reagan’s impassioned speech on his behalf. That was very telling for me, and it absolutely changed my outlook.

“Then along came the first successful government intrusion into medicine in the form of the Medicare Act of 1969, which was President Johnson’s aim for his historical legacy. And they managed to pass it by throwing an incredible amount of money at hospitals, who were then allowed to triple and quadruple their fee structures. So not only hospitals, but physicians were very well paid, thus blunting all of the adversarial components, as people who were once opposed to it softened. That is how they were able to pass Medicare.

From 1969 to the present-day, there’s been a progressive reduction in fee structures. And from what little is known about Obama’s plan, he is not going to throw the money into it that Johnson did—his plan is cradle-to-grave, purely socialistic. And there won’t simply be rationing of care for the elderly and disabled, but for everyone.”

What about Obama’s plan most concerns you?

“Well, I can’t really discuss specifics, because there’s not a whole lot of information out there yet. All we know at this point is that it is a general scheme of nationalization. And by the way they are attempting to speed it up and get it out there by August. My feeling is that they must already have their objectives in place, since this is a monumental undertaking. In general, I view socialized medicine as a gigantic game of Monopoly in which the government prints out a lot of money and masks the socialistic component in a euphemistic term—a ‘one-payer’ system. I would caution all Americans to be on the lookout for that.”

Are there any medical groups protesting this passage of this potential bill?

“Although it’s been fairly quiet up to this point, I think the response is going to pick up steam and medical organizations will begin to exert their influence on their representatives in D.C. As for the AMA, they’ve been tilting left for many years and are thus worthless, in my opinion.

“I base that on my own experience as a physician in Pennsylvania. Back when malpractice laws were established, the state asked me to give money to capitalize the system, not the insurance itself. It was determined that as a specialist, I owed $2,168, simply to capitalize; that amount was not the insurance premium itself.

“Originally, they’d wanted every doctor in PA to contribute $500, but the problem was that general practitioners and pediatricians balked at paying that much. Therefore, they were permitted to give just $250, while specialists like surgeons were required to cough up $2,168 to make up the difference. Again, that figure does not represent the premiums, which were very high.

“In 1965 when I went into practice, several values of liability coverage were available to suit an individual doctor’s needs. But all of that changed, and eventually it became mandatory that you had to purchase at least $1 million in coverage. Now at first, that didn’t seem so unreasonable, but by 1995 I’d already paid my annual $40,000 premium when they announced in October of that same year that I owed a supplementary charge of $16,000. By 1996 I’d had enough and decided to shut down my surgery practice.”

If you look at Great Britain, the doctors ration in the form of quota. And once that quota is satisfied, they are free to go on vacation. Can you elaborate on that?

“Sure, the British government assigns monetary priorities on healthcare; therefore so much allocated for certain services. And when that fund is used up, that’s it: the doctors have the prerogative to walk away and say ‘I am not going do this procedure again until next year,’ regardless of what is in the best interest of the patient. It’s not very good for anyone, the doctors or the patients.
“It also varies, what services you may get, depending upon surpluses. In Germany for example, their colonoscopy fund was used up in August. So if you needed a colonoscopy, you had to wait until the New Year to get one. You were basically put back at the end of the line, with no consideration of the urgency of your particular medical situation.

“And another thing they do in Great Britain is make patients wait to be seen by a doctor in ambulances in the parking lot, if they are unable to be looked at within four hours. Can you imagine leaving a patient out in the parking lot like that? It’s deplorable. The other negative aspect I hate to admit on the part of my profession is that this system also creates lazy doctors. The free market by nature rewards those who work hard and produce quality work, and this is also true in a free-market-based healthcare system: take away incentives and quality suffers. Again, that is ultimately bad for both patients and doctors.”

What about the effects on would-be doctors considering a career in medicine?

“When you get into these excessive costs, salaries will become stagnant. Over time, the pay scale will be reduced. One of the saddest byproducts of this is that I have many, many colleagues who have discouraged their own children from going into medicine because of the looming disaster, should Obama get his way. Most of the doctors I know are really devoted people who care about doing the very best job they can—not simply based on monetary rewards but because in a free system, they have the motivation do so.”

Do we really have a healthcare crisis?

“You know, one of my biggest problems with this whole debate is this notion that poor people are denied healthcare. This is simply untrue; no one that presents themselves to an emergency room is ever denied care because of their inability to pay. What it should be rightly termed as is a crisis in health insurance, which is due to many factors, including the overly litigious society we are living in and the negative influence of trial lawyers; the inability of consumers to cross state lines when purchasing the plan that best meets their needs; and of course, the growing number of illegal immigrants that overburden hospitals, especially in border states—an issue our government repeatedly refuses to address.

“Further that ‘47 million uninsured’ is a bogus figure I’ve been hearing about for the last twenty years. It does not include young people who choose not to purchase insurance, people who are in-between jobs and thus transitioning into new plans; and the inflationary impact of Medicare, which has made insurance unaffordable for many. There again, far from being a solution, government interference has only created an even bigger problem.”

Doctor, what are some of the moral implications of nationalized healthcare, aside from the rationing of services?

“Well as you know from Daria, I have a son with Down syndrome who is an absolutely beautiful, beautiful person. At the time of his birth in 1959, we didn’t have the diagnostic tests to determine abnormalities like Down’s ahead of time, but even if we had, we never would’ve terminated my wife’s pregnancy. Over thirteen years ago, my daughter Carolyn had a scare with her firstborn son when it was determined he was at a high risk of being a Down syndrome baby, but as it turned out, my grandson Christopher was born perfectly healthy.

“What I fear the most with a nationalized system is that doctors will be pressured to talk patients into having abortions when such diagnostic tests determine the presence of some sort of abnormality, whether it be Down syndrome or anything else. Further, the government could resort to actually paying doctors more money to perform abortions in these situations. Then at the opposite end of life, there’s a high probability that we as a nation could start engaging in euthanasia, based on someone else’s subjective idea of ‘quality of life.’ So it is very troubling from a moral perspective. Who among us is God? Who among us is perfect and empowered to decide who lives or dies? That sounds very much like Josef Stalin or Adolf Hitler to me.”

Finally doctor, what can the average person do to fight this trend?

“I would encourage all Americans to make an effort to get educated, to really understand the dire implications of a nationalized system. Just look at Canada and other places, where even heads of state choose to come to America when they need major surgery. Everyday citizens from Canada regularly cross the border when they’re told they have to wait six months just to have a test.

“There’s a reason why we have the best healthcare system in the world. So get the facts and don’t just blindly accept the media spin. Then lobby your representatives in Washington. On the flip side, I believe it is now imperative for all doctors to inform their patients about the realities facing all of us should this horrendous bill pass. They have got to get over their fears of what their patients might think, and start speaking out. All of us have so much to lose if we don’t.”


Link: http://www.dariaanne.wordpress.com/

Debunking the Myths about Health Care in America

Image by prudencebrown121 via Flickr

By John H. Peloza M.D.

Special Book Review

In “The Top Ten Myths of American Health Care. A Citizen's Guide,” Ms. Sally C. Pipes surgically exposes the misleading arguments of those who support government run national health care. In a time when Americans seem to believe in the competence of government to solve the health care “crisis,” she gives the reader ample reason to think again. There are many examples of how poor government solutions perform in reality as compared to theory and at what cost in both financial and human terms. Ms. Pipes acknowledges the main problems with the U.S. health care system being access and affordability. She clearly demonstrates why this exists and how to address it in a responsible, effective, and workable manner relying on free markets rather than the heavy hand of unresponsive and bureaucratic government central planning.

Each chapter exposes and debunks a commonly held myth about U.S. health care. Myth 1 starts by reviewing whether or not Government Health Care is More Efficient. The author clearly proves that the notion of the government being able to deliver efficient and high quality healthcare to the American public is nonsense. Ms. Pipes demonstrates that government’s administrative costs are passed on to the private sector, price controls lead to doctor shortages, waiting lists, and rationing of care as well as stifling innovation. U.S. government medicine (Medicare, Medicaid, the VA system) with its incomprehensible regulations and bureaucracy is rife with fraud and waste. In Myth 10, Government-Run Health Care Systems in Other Countries are Better and Cheaper than America’s, the author further illustrates the life-threatening limitations of health care systems in Britain, Canada and France compared to care in the United States. The author also explains how crude measures of health care quality like infant mortality and life expectancy are obtained by researchers and manipulated. She clearly points out that when reviewing how well a health care system serves sick people, which is the true quality metric, the United States excels. For example, Cancer patients have much higher survival rates in the United States than any other country and the U.S. also leads the world in research and innovation in pharmaceuticals and medical technology. In Britain, a government agency (National Institute for Health and Clinical Effectiveness – NICE), explicitly limits patients access to the latest and most effective drugs and technology by manipulating data with pseudoscientific cost effectiveness analysis. In the case of life threatening illnesses, “cutting costs, cuts lives.” In France, the government-run health care system is so stretched beyond their limit that a simple heat wave in August 2003 took the lives of 15,000 elderly patients because of a shortage of doctors and hospitals. In Canada, a dog can get a hip replacement “in under a week and in which a human can wait two to three years.” In a landmark decision overturning the ban of private health insurance in the Canadian province of Quebec, Chief Justice McLachlin stated, “access to a waiting list is not access to health care.” Calculating only health care costs without considering value provides meaningless data.

Other chapters are just as devastating to the proponents of socialized medicine. Myth 3: Forty-Six Million Americans Can’t Get Health Care points out popular “sound-bites” that have been especially misleading and misrepresented in the media. Of course, the misrepresentation of the actual data has also been politically useful. The truth is that only eight million (not 46 million) Americans are without health insurance for over one year, and all people residing in the U.S. have access to health care by law. It is against the law for an Emergency Room to refuse care to a person. The 46 million factoid includes non-U.S. citizens (more than 10 million), people with incomes greater than $50,000/yr (18 million, of those almost 10 million have incomes greater than $75,000/yr) who choose not to purchase health insurance, and 14 million low-income Americans who qualify for generous government assistance but do not enroll. The fastest-growing segment of the uninsured population is households making more than $75,000/yr. There are uninsured Americans, and we need to consider this fact, but the number is drastically less than cited by the media and politicians.

There are seven other myths that are explained in similar detail in the book: We’re Spending Too Much on Health Care, High Drug Prices Drive Up Health Care Costs, Importing Drugs Would Reduce Health Care Costs, Universal Coverage Can Be Achieved by Forcing Everyone to Buy Insurance, Government Prevention Programs Reduce Health Care Costs, We Need More Government to Insure Poor Americans, and Health Information Technology Is a Silver Bullet for Reducing Costs. The underlying problem in health care is government policies and regulations that interfere with the normal function of a free market. In fact, according to a report published in 2004, the medical industry spends over $340 Billion each year on government regulation. This is a huge amount that is not even being considered for cost reductions or efficiencies. A cost that simply shows up in the price of drugs and medical services passed on to the patient.

But this book is not only about the diagnosis of health care problems in the United States. It also offers solutions to these issues so that we can lower costs and achieve universal choice in health care and universal coverage. As you might expect, this requires much less government and a freer market. Ms. Pipes cites the example of a free market in health care, Lasik eye surgery. Costs have dropped about 40% over the years and quality has improved significantly. The free market reforms include changing the tax code to allow individuals to purchase health insurance with either refundable tax credits or allow income tax deductions for health care expenditures. Other reforms include reducing costly government mandates and regulations, allow the purchase of insurance across state lines, expand Health Savings Accounts, support retail health clinics, implement tort reform, and provide vouchers for the working poor and chronically uninsured.

This book is important in the health care debate. It exposes the factually incorrect and misleading arguments made by proponents of government-run health care and the devastation wrought by well-intentioned policies. Ms. Pipes gives the reader ammunition when confronting the seductive siren song of free, quality health care for all administered by the thoughtful, caring, and competent bureaucrats from the Department of Motor Vehicles. I highly recommend that you purchase this must-read book and read it’s eye opening conclusions.

Link: http://www.healthandsharing.com/

FREE TO CHOOSE ABORTION, NOT FREE TO CHOOSE YOUR HEALTH CARE: OBAMA'S OBSESSION WITH DEATH

Image by Ted Abbott via Flickr

by Kathy Barkulis


What will it take for ordinary Americans and politicians to wake up to the cold reality of nationalized health care as proposed by President Obama? Will it take a medical crisis in your own family? Will it take a medical crisis in your own personal life? Will it take an anonymous board of people appointed by the government deciding whether you can have life saving medicine or surgery? What has to happen to you before you say "ENOUGH"? It is easy to close your eyes when you and your family are healthy, but are you sure this will always be the case? And why is it that the choices Obama wants us all to have, are choices of death, and not choices of life?

So far, President Obama has not told the American people how he will pay for his grand experiment. They hinted at a national VAT tax, adding 20% on to the cost of goods at the manufacturing level, which will be passed down to consumers. They also hinted at taxes on soft drinks, beer, wine, cigarettes, etc., none of which will cover the entire cost of this plan, but will surely increase the cost of living to middle class Americans. This is the group Obama promised would have no new taxes. While I don't believe you can put a price tag on your healthcare, and easy access to it, I do believe we need to be told how it will be paid for.

But the most egregious aspect of Obama's "Medicare For All" plan is the federally appointed "health board" that will make decisions for the health care of Americans. Obama has insisted that citizens can choose to take the government plan or keep their own private insurance. But did you know that Obama plans to force private insurers to adopt the decisions of the federal health board, or face steep tax consequences? The reality of that situation will be that private insurance companies will not be able to provide health care at any cost, and employers will gladly hand over the responsibility to the government. Only the very rich will be able to afford effective and all inclusive health care. There will be no ability for insurance companies to compete with a "free" government plan. Before you can say "Pap Smear," the whole country will be under the umbrella of a nationalized system that rations out health care like a short order cook rations out hash. The rich will always get the health care they want under Obama's plan, and the rest of us will just get the health care Obama thinks we "need."

It's ironic that the Democrats, and Obama, shout from the rooftops about a woman's right to choose abortion, but none of them want Americans to have the right to choose their health care. Oh they say you'll have the right to choose your health care, but when you read their plan, there will be no choice for you and your family. They are planning to game the system so that you will have no choice left but to take the government plan. In the eyes of President Obama and Nancy Pelosi, it is better for all Americans to have a generic and highly bureaucratized health plan, than for some to have no health plan. Yet, even that argument is a lie. Right now, hospitals cannot refuse medical care to an American brought into their hospital for emergency treatment. And often they don't refuse care to non-Americans either. Just walk into any hospital emergency room in the country on any given day and look at how many people are qued up for treatment. The taxpayers already pay for that privilege, but we will pay far more under Obama's plan.

So I ask you again. What will it take for you to stand up and protest a nationalized health care system where a federal health board will decide what kind of medical treatment you get? Will it be your down syndrome child who needs a new heart valve? Will it be your mother who needs a hip replacement? Will it be your husband who needs an experimental drug for a rare disease? And will it take a federal health board to refuse that treatment for your family members? If so, it will be too late by then to do anything about it.

YOU MUST SPEAK OUT NOW. You can start by calling the four Republicans who plan on voting yes for Obama's health care plan. They are:

Chuck Grassley 202-224-3744
Olympia Snowe 202-224-5344
Orrin Hatch 202-224-5251
Susan Collins 202-224-2523

CALL THEM NOW and voice your opposition. CALL THEM EVERY DAY. Send their names and phone numbers to everyone you know.

Then, send them letters voicing your opposition using email and snail mail.

Second, write letters to the editors of your local newspapers. Send those letters repeatedly until they get published. Tell everyone you know to do the same.

Third, call radio talk shows and make your opinion known.

Fourth, and most important, call and fax members of Congress voicing your opposition. Crash their switchboards. You can go on-line and get phone numbers of Senators and Congressmen on http://www.realclearpolitics.com/ and many other websites, such as C-span.

Talk to your friends and relatives about this issue, and urge them to take action. Start the conversation by asking them this question: IF I FOUND OUT I HAD A RARE FORM OF CANCER THAT A GOVERNMENT HEALTH CARE PLAN REFUSED TO TREAT, WOULD YOU BE WILLING TO SELL YOUR HOME TO RAISE MONEY FOR ME TO SAVE MY LIFE? During the silence that occurs after you ask that question, ask them instead to speak out in opposition of this plan by calling Congressmen and Senators. Ask them to write letters.

Apathy is not an option anymore. Our lives, and that of our families are on the line.

PRESIDENT OBAMA CAN'T HAVE CONTROL OF OUR HEALTHCARE UNLESS WE GIVE IT TO HIM WITHOUT A FIGHT.






Link: http://smartgirlpolitics.ning.com/profiles/blogs/free-to-choose-abortion-not