Point/Counterpoint

The following is provided by Frank Rosenbloom, M.D.

Mr. Obama has gone back on the campaign trail to try to sell his health care reform to the nation. Mostly hand-picked, sympathetic attendees have been showing up to his town hall meetings. He continues to make the same points regarding health care reform, which need to be addressed specifically. I hope to address more in future articles.

1. We need health care reform.

We do not need health care reform. We have the best health care system in the world. We need health insurance reform.

2. Free market health insurance has caused our current problem.

It is the government that has caused the current problem. We have not had free market health insurance in this country since 1965. It is not possible to consider our system of medical payment free market when the government controls $.60 of every dollar spent on health care.

3. The evil and greedy health insurance companies have caused prices to skyrocket.

Again, it's the government that has caused prices to skyrocket. Medicare and Medicaid are the 800 pound gorilla and insurance companies are the fleas on the gorilla. Nothing can be done by the private insurance companies that has not been done by Medicare and Medicaid. The federal government opens the door and the private insurance companies follow. It is the government manipulation of the free market that has caused our current health insurance problem. The out of control medical costs in Britain and Canada, as well as in Massachusetts and other states that have tried government health care prove this point.

4. Nearly 50 million Americans are without health care.

Nearly 13 million Americans are without health insurance. No one in the United States is without health care. Government regulations prohibit patients from being turned away from hospitals, which must provide medical care to anyone. The huge number that the Obama administration has used is highly inflated.

5. A government option will lower costs and improve quality of care.

A government option will increase costs and reduce quality of care. In every instance so far government involvement in medical services has caused prices to increase. Medicare spending has increased at a rate greater than 10 times that which was projected. Medicare and Medicaid will be broke in less than nine years. Adding another entitlement program will cause economic disaster. The Congressional Office of Management and Budget has stated that the president's plan is unaffordable. Further, the necessary rationing in order to even begin the program will reduce quality of care.

6. If you like your insurance and your doctor you can keep them.

The same things were said at the inception of Medicare. Medicare was supposed to be a supplemental insurance plan for retired people. It now covers the disabled as well and those over the age of 65, who are now ineligible for any other type of primary medical insurance. The government option will become the only option. Therefore, it's not an option and in the end hospitals, doctors, and all health care companies will be working directly and only for the government.

7. Government medical insurance is more cost efficient.

Government medical insurance is less efficient. The government, by force of law, transfers administrative costs to the private sector. Hospitals and doctors' offices must assume the burden of administration under threat of criminal penalty. This unfunded administrative burden transferred to private individuals and private insurance is then added to the cost of the supposedly free-market healthcare system.
8. The government option is necessary in order to prevent loss of insurance by individuals with medical problems.

Government regulations make it mandatory for hospitals to treat patients regardless of their ability to pay. The government can certainly pass a simple regulation making it illegal for medical insurance plans to be canceled due to illness on the part of the insured. This would be a simple solution but of course would not increase government control over our lives.

9. The government option would ensure treatment for sick individuals who would otherwise have lost health care insurance. It would prevent lifetime limits on medical care.

This is blatantly untrue. There are definitive limits to Medicare that are not being publicized. For example, a review of Medicare regulations shows it will pay up to a maximum of 90 days in the hospital for each medical incident. After that, a patient must be in a rehabilitation facility for 60 days in a row in order for Medicare to begin another cycle of payment. Similarly, there are limits on most other Medicare services. While private medical insurance may have a total lifetime limit on the amount that can be spent, there is almost never a limit on the number of days in the hospital.

10. A government option will not result in rationing.

The major government options already in existence employ rationing every day. Prohibitively difficult preauthorization, statements of medical necessity, convoluted and complicated paperwork, and often impossible to meet requirements result in rationing on a huge scale. Furthermore, delay in payment, denial of payment for services already rendered and other tactics reduce access to medical care on a widespread basis. The government may not call this rationing but it is an insidious form of rationing that will be an integral part of any government plan. Medicare misuses and abuses its funding and is guilty of literally stealing from hospitals and physicians.
As an example of this thievery, due to a change in the corporate status of my practice I was required to apply for a new national provider identification number (NPI) in March of this year. Within several weeks, without exception, all of the private insurance companies had registered the number and were paying on claims. After five months and exhaustive work of over 140 hours by my office staff Medicare and Medicaid had still not paid on a single claim. Finally, on August 14, Medicare made their first payment on claims that were five months old. Yet, if we do not bill Medicare within three months of the date of service, Medicare will not pay us at all. Government regulation and control permeates the entire medical system.

11. A government option will simplify the payment for medical services.

The government has always made things more complicated and expensive. This is part of their rationing system. The government has a habit of requiring new provider numbers every couple of years that must be used for all claims, including private insurance claims. When these are instituted, payment can be delayed for as long as six months. To see how "simple" the federal government makes medical claims, what follows are my required identification numbers.
UPIN #G16766
OMAP#079496
Medicare#R0000BLCGY (PTAN) OLD
Medicare # R147304
(PTAN) **NEW** R147303
Railroad Medicare#110162014
NEW Tax ID # 264520277
OLD Tax ID# 911768627
DEA # BRxxxxxxx (Hidden to prevent use)
Clia# 38D0933946
NPI# 1306924691 (individual)
NPI Group # 1235371485

Every point the president has made regarding his health plan is either a gross misrepresentation or an outright lie. The purpose of this plan is to ensure dependence on government and a financial windfall for his cronies, including trial lawyers, and has nothing to do with concern about the cost of medical care or about the health or lives of American citizens.