Surgery News - October 2008 - (Page 7)

OCTOBER 2008 • SURGERY NEWS OPINION 2008: PHYSICIANS’ PERSPECTIVES ELECTION Obama: Keep What Works, Improve What Doesn’t s doctors, you know well what ails our health care system. Are there any among us who have not cared for a patient without health insurance? Who hasn’t noticed that the cost of care has risen so high that many can no longer afford the care we provide? Who doesn’t sometimes feel that we spend more time on paperwork than we do with our patients, as insurers create an onerous maze of rules and regulations? Though America’s doctors are healers of unrivaled skill, we increasingly practice in a system that strains our ability to practice our craft. That’s why Sen. Barack Obama (D-Ill.) believes that we need health care reform now. His plan is simple: cover everyone, cut red tape, extract more value from our health care dollar, and put patient safety at the center of medical liability reform. All told, this will reduce the BY RAHUL costs of health care RAJKUMAR, M.D. by up to $2,500 for every American family. Here’s how he’ll do it: The Obama plan will guarantee coverage for every American through shared responsibility between employers, private insurers, and government. The plan builds on and improves our current system. Under his plan, if you like the insurance that you have, you keep it. But if you don’t have insurance or if you’re underinsured, you can choose from a range of public and private insurance options that offer the same benefits available to members of Congress. His plan will expand Medicaid and the State Children’s Health Insurance Program. If you don’t qualify for these programs but still cannot afford insurance, you’ll get a subsidy to purchase an insurance plan of your choice. Moreover, Obama’s plan will make it easier for Americans to buy insurance by requiring that insurers charge fair premiums and by barring them from discriminating against people with preexisting conditions. Sen. Obama’s plan also will reduce the cost of care, not by shifting more of the cost onto individuals, as Sen. John McCain’s plan would, but by making our system safer and more efficient. First, he will invest $10 billion per year for the next 5 years to create a national, state-of-theart health information system—an investment that will cut costs and improve the quality and safety of care. This program will make grants available to hospitals and physicians to help them acquire electronic medical records, if they wish to do so. The Obama plan will also invest in comparative effectiveness research, so we can get more value for the dollars that we spend, increase the use of generic drugs, and allow drug reimportation McCain: Control Costs, Ensure Access or the past several months I have insure, including those with preexisting closely followed the health care poli- conditions. There would be limits on precies of Sen. John McCain (R-Ariz.). I miums, and lower-income Americans am impressed how the senator places the would get additional financial assistance. Cooperation among states in the purindividual—patient and physician—at the center of this policy. The McCain plan is chase of insurance would also be a crunot simply about insurance or govern- cial step in ridding the market of both ment programs. It is about opening more needless and costly regulations, and the doors to more Americans dominance in the market of only a few inwhen they find themselves surance companies. Sen. McCain will in need of health care. break down these barriers to competition, Those with insurance, and creativity, and excellence with the goal of those without, will see new establishing a national market to make innovative policies and lowest prices availchoices and new options. The single biggest threat to our health able to every person in every state. It care system is rising costs. Sen. McCain’s makes no sense that an individual in Maryland must pay a higher plan has a set of comprehenpremium than an individual sive policies that will bring who lives in the District of these costs under control and Columbia. This type of disensure access to affordable criminatory practice must care for all Americans. He will change, and there would be accomplish this by promoting concentrated interest from research and development of Sen. McCain to see these new treatment models, enchanges occur. couraging wellness and preIf we continue to cling to vention initiatives, rewarding the ideas of the past, the only quality and coordinated care, BY REP. MICHAEL C. opportunity for savings comes investing in technology, and BURGESS, M.D. in the form of cuts in provider empowering Americans with reimbursement. Jonathan Oberlander, better information. Sen. McCain recognizes the discrimi- Ph.D., writing on the cost of Sen. Barack natory aspects of our tax code, and pro- Obama’s national plan, said “its effecposes changes that level the playing field. tiveness in slowing spending would deEveryone would be treated equally. A re- pend on the political willingness to refundable tax credit of $5,000 for families strain provider payments” (N. Engl. J. and $2,500 for individuals would create Med. 2008;359:781-4). I hear from my physician friends: “I just more choices, including keeping one’s current coverage. Nothing changes as to want to see patients, and yes, I do need the tax treatment for the employer. If to be paid like anyone else operating a there was value in providing insurance small business.” Most don’t care what coverage to employees in the current sys- the source of payment is, whether it’s a tem, there would be no reason not to con- government entity, private insurance, or tinue. On the individual side, the tax the patients themselves. Doctors operate break simply moves from being an invis- in a high-stress environment, and as a ible exclusion to a visible, direct, and consequence ask that the “hassle factor” be kept to a minimum. And continued portable credit. So most families with employer-spon- cuts definitely constitute a hassle. Patients generally want to have care sored coverage would see little to no change under the McCain plan. In fact, when it’s needed, and most are willing to this generous credit will give additional pay for some portion of their care, or help to millions of middle-class American some amount each month to have the families for medical expenses. However, availability of the service. But what they for the first time, those without employ- are disinclined to do is to pay and pay and er-based coverage, or those with no cov- pay, and then be denied coverage when erage at all, will have a refundable tax they need it the most. And they are concredit to help purchase the insurance cov- cerned about continued cuts in reimbursement limiting their access to their erage of their choice. Going from a world that discriminates doctors. Frequently I hear policy makers quote to a world that works is important to Sen. McCain. In addition to retaining the ben- doctors in saying “first, do no harm.” This efit for employer-sponsored insurance, is a reasonable philosophy which has carSen. McCain believes that no American ried many of us through our medical cashould be denied access to quality and af- reers. But there is another phrase, one fordable coverage simply because of a used by Alpha Omega Alpha, the medical preexisting condition like cancer. This is honor society, which designates somea very important priority in his health one as “worthy to serve the suffering.” In care plan. And to make sure people get my opinion, the plan proposed by Sen. the high-quality coverage they need, Sen. McCain provides for both of these lofty McCain has proposed a Guaranteed Ac- ideals. ■ cess Plan that will combine industry, state, and federal resources to help in the pur- REP. BURGESS (R-Tex.) is an ob.gyn. and a chase of coverage for those hardest to volunteer adviser to McCain-Palin 2008. from other developed countries. Because the 5% of people who have the highest health care expenses spend half of our health care dollars, his plan would offer federal reinsurance to employers to make sure that catastrophic illnesses do not make employer plans unaffordable. And, because the best way to reduce costs and improve health is to prevent illness, the Obama plan will make major new investments in preventive and public health services. On medical liability reform, the Obama plan stresses that our goal should be to reduce malpractice suits—that’s why preventing patient injury is key. Investments in health information technology are a start. In addition, his plan would promote alternative models of dispute resolution that would alBY DAVID low doctors to BLUMENTHAL, M.D. learn from mistakes without penalty and report preventable medical errors while being protected from malpractice suits. Above all, the Obama plan focuses on improving systems of care so that the injuries that generate litigation are reduced. We need to let doctors focus on patient safety, not worry about being sued. This is what Sen. Obama’s plan will do. But just as important is what his plan will not do. It will not result in “socialized medicine.” It will not eliminate private insurance or result in the government’s telling doctors how to practice medicine. Unlike Sen. McCain’s plan, which would eliminate the tax exemption for employer-sponsored health insurance and cause millions of Americans to lose their coverage, the Obama plan does not seek a radical overhaul. It aims to preserve parts of our health care system that work and to improve the parts that don’t. And unlike Sen. McCain’s plan, which would reward insurance companies that rely on high deductibles and copayments—shifting the cost of health care onto the shoulders of American families—Sen. Obama’s plan would ensure that American workers are protected against the financial ruin that can result from serious illness. Our nation deserves a health care system that does justice to the tremendous skill and dedication of its physicians. S

Table of Contents Feed for the Digital Edition of Surgery News - October 2008

Surgery News - October 2008 Contents Call to Action Issued to Support DVT, PE Prevention Protocol Changes May Increase Donor Organs CMS Targets 2011 for Switch to ICD-10 Opinion: Election 2008 The 20/20 Vision: Children's Health News From the College: Survival Strategy General Surgery: Innovations

Surgery News - October 2008

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