Response to another doctor's blog post

I wrote a response to Dr. Kristie McNealy's blog post. I think it's still awaiting moderation on her blog, so you may not see it there yet.

Here's her original post: ObamaCare: A Physician’s Point of View On The Negative Ramifications of America’s Affordable Health Choices Act of 2009

Here is my response: Thank you for taking the time to read the bill and to post your thoughtful insight. I’m glad for healthy debate. I am a family physician practicing in Pennsylvania, and I disagree with your reasoning.

#1 Opting out and paying for your healthcare elsewhere IS an option, provided you carry an approved plan. If you carry only cheap catastrophic insurance, then you are not trying to stay healthy and therefore costs society more.

#2 I’d be surprised if any significant number of people on Medicaid can afford any other insurance. The supposed lack of choice is just fear-mongering for 99% of Medicaid patients.

#3 Ditching the healthcare plan with this complaint doesn’t make sense. At least it’s an option, while not perfect, it’s better than what 20% of Americans have now, which is NO coverage for basic healthcare. And in 3 years, it will likely be improved.

#4 That’s because the private insurers are wasteful. Medicare spends 3% on administration. Private insurance spends on average 15% on administration. If they get their act together, stop generating excessive paperwork by denying tests, or paying their CEO $3 million annually + $750 million in stock options, then they will be just as competitive.

#5 Your interpretation is wrong. Note that it says “grandfathered.” In lawyer-speak, that mean if your current health insurance doesn’t meet the provisions in the new laws (like not being able to drop you at a whim, not covering a pre-existing condition, or not cover preventive care like an annual exam), then you can still keep it because it’s “grandfathered.” You can OF COURSE still buy your own private health insurance! You actually have more choices.

#6 I don’t like that the government has excessive power either. But look, the benefits of the bill still outweigh the problems. Perhaps that clause will be stricken or not enforced.

#7 I’m glad they will be looking at cost effectiveness. Our country (its individual citizens and the federal government) need to control our spending in all areas. The government is in debt because WE are in debt. Stop pointing fingers. Do you have your house paid off and all bills settled? I know I don’t. Is your net worth in the red or in the black? It’s been 8 years since I graduated from med school, and I’m still in the red. Unless we change, our government can’t change.

I know you disagree with this, and this is my own opinion. Some very young NICU babies live a horribly disabled life and cause severe anguish for their parents. Some of those NICU babies are from young drug-abusing mothers who could not possibly give them adequate loving care. And if the parents manage to care for them into adulthood, they would will have to place them in a group home when they get too old. If the parent feels guilty or just really wants to save a 24 week old preemie, then they can certainly foot the bill on their own. If my elderly mother had cancer and just wanted to die a natural death rather than live through the torture of multiple ICU stays, I would respect that. Similarly, if I had a 24 week preemie, I know it would lead a tortured life in and out of hospitals, required various surgeries that it would not understand and would suffer through, causing frequent anguish for me and my husband and other kids. I would give it the grace of death, not life at all cost. In my opinion, it’s the humane thing to do.

All of the money in the world can't always relieve suffering. Look at Michael Jackson. I believe in a holistic wellness. Not everything is black and white. Wellness is gray. Patients must be fully informed of the risks and benefits in major decisions. If we as doctors act as god and impose an artificial right or wrong and tell patients they must preserve their life irrespective of their suffering, that's wrong. Patients have a right to choose how much suffering they are willing to endure for preserving life.

If you want to pay the money to save someone denied by the government plan, you have the right to do so. Doctor generally will not refuse treatment (especially if it's life-saving - we LOVE saving lives) if you request it. You would just have to understand that it will go on your tab.

A comment in there said that the Canadians come across for their healthcare, paying out of pocket. Hey, if you’re willing to pay, you’ll be able to find a doctor to take care of you! The Canadians pay for their basic care through taxes. We’ll have basic care through our insurance. If you want to pay more for extra luxury care, you have the right to do that.

Other responders to the post talk about how scared they are. Being afraid is not a good feeling. Take control and become informed. Don't listen to Glenn Beck and get more scared, unless you're masochistic. Change that fear to action - please read the bill. If you don't understand it, discuss it with your friends to figure it out. I think that if you overcome fear and actually learn about the issues, you'll see that having this healthcare reform is better than not acting at all. You know very well that by delaying this bill this time, we won't have it again before Congress for another 4 years. A lot can happen in 4 years. Many Americans will die because they do not have basic coverage in 4 years. Will you stand by and just be scared? Or will you act to save lives? Read the bill.