ChesterCountyMedicineSpring2020 - 7

www.CHESTERCMS.org

Politics in Medicine
BY STEVEN B. SIEPSER, MD, FACS

t is imperative that physicians
address the "root cause" that has
placed individual health care
workers at a distinct disadvantage
in the democratic process. The
changes in the laws for political
contributions have allowed large
corporations to make oversized
political contributions that have
distorted the democratic process.
The results of this change have
particularly resulted in a significant
decrease in the political voice of
physicians and other skilled care givers in medicine.
Insurance companies and pharmaceutical companies have
coalesced into monstrous sized
corporations with enormous
political clout. They advertise
that they provide the finest level
of care and services and then
turn around to physicians and
medical care delivery systems and
negotiate services to the lowest
price. Insurance companies are
misleading their subscribers by
calling the least expensive hospitals
and doctors, Tier One and the
most expensive services Tier Three.
It is intellectually dishonest to
present these insurance options in
the reverse order of common use
of these quality measures. Caregivers have gone from getting 50%
of healthcare dollars down to 9%. How did this happen? Part of it
is a "tailing reference" point and the other is the political clout of
major corporations in this country.
As the political insurance complex tries to decrease the cost
of medical care they go after the soft underbelly of unorganized
medical care workers. The tailing reference is that as they negotiate
down reimbursements, they find little resistance from doctors, so
their last offer is the beginning of the next downward negotiation
creating the "tailing reference" of the spiral down.
The political problem goes back to the 2010 landmark
supreme court decision "Citizens United (a conservative nonprofit) v. Federal Election Commission." This decision opened
the floodgates for large corporate political donations and Super
PACS making politically motivated contributions to individual
election campaigns. Barack Obama stated that this decision
"gives the special interests and their lobbyists even more power in
Washington.''

We know we have the best government money can buy
(famous words of Mark Twain). The oversized contributions of
financially driven organizations gain the insurance companies a
significant place at the negotiating table, while individual citizens
or professionals no longer have a seat. They are on the menu!
The behind the scenes ETF (exchange traded funds) removes the
competitive edge so there is no incentive to create new entities and
innovate. This is the real crux of the issue and why physicians find
themselves in the position they are in today.
Patients are getting an economic hosing from the insurance
companies that charge high rates and provide mediocre coverage.
Doctors hear from their patients all day about high drug costs.
Patients often blame the doctor! Caregivers are highly idealistic,
dedicated people who want the best for their patients. If they had
a political voice, they would bring pressure to bear on the decision
makers. This makes medical
professional serfs in that they no
longer "own the land" or have any
say in their daily lives and future.
This has led to salary and
compensation compression as
control of the industry is taken
over by those with the funds to
donate to a political candidate.
By eliminating a fair process of
recourse, physicians, nurses, and
professional caregivers suffer
inordinate economic pressures
that have led to an emotional,
intellectual and psychological
crisis in healthcare. Our dedicated
physicians and nurses are being robbed of their voices and
subjugated to abject servitude by the bottom-line folks who are
now calling the shots in medicine, because of their absolute control
of the political process.
Doctors need to band together and not accept less than their
value. Pharmaceutical Executive salaries go from an equivalent of
a physician's compensation to obscene multiples. The executives
are only interested in profit to their company and the results have
been near catastrophic decline in reimbursements for doctors and
medical workers. It is time to take on the political system working
first to reverse the economic prejudice promulgated by the political
contribution distortion and create a level economic playing field.
Please consider getting to know and support your local politicians,
they come to our meetings and want to hear from us. Express
the concerns of your patients and yourself directly to those who
can make a difference. Chrissy Houlahan attends our meetings
and she is just the type of Congresswoman who has our basic
democratic rights in mind.
SPRING 2020 | CHESTER COUNT Y Medicine 7

http://www.chestercms.org

ChesterCountyMedicineSpring2020

Table of Contents for the Digital Edition of ChesterCountyMedicineSpring2020