Health reform redux

Dr. Hal Scherz Contributor
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For the past year, this country has been preoccupied with a health care crisis that was largely manufactured by the White House. President Obama addressed the country in September and told us about his plan, but he never produced it. Instead, he relegated the task of developing a plan to the House, which produced and passed its own bill; but still no Obama plan. Then the Senate got busy and produced and passed its version, but there still was no plan from the president. Monday, we saw the first glimpse of the Obama health care plan. It was not worth the wait.

This proposal starts out badly and only gets worse. It tramples on the Constitution by mandating the purchase of health insurance by individuals. It increases taxes on everyone and redistributes money from higher earners to pay for the health care of others. It shamelessly promotes the fact that the backroom deals like the Cornhusker kickback or the Louisiana Purchase are being dropped, but it protects the deal that the union leaders have negotiated for its members, which is to raise the threshold to tax the high cost insurance plans that unions have negotiated for its members.

The president would have people believe that his plan has been designed by incorporating Republican ideas. Unfortunately, they have selected the items that will derail the Obama agenda the least. They hail the fact that they are embracing the call for personal responsibility by varying health care premiums based on participation in wellness programs, instead of getting behind the expansion of health savings accounts. They point out that there are medical liability provisions in this plan, but they are weak attempts to give the president cover to be able to say that this problem is being addressed. Unfortunately, this is the “third rail” for the Democrats who are never going to have the spine to confront the powerful trial attorneys.

Regardless of what they try to make this plan out to be, it is still the Senate plan, which is a major problem. It calls for massive Medicare cuts with inevitable rationing of care. It still calls for an insurance exchange, only now there will be price controls, which have never worked out in the past when tried before. It has been cobbled together so quickly, that it hasn’t even been scored by the CBO, yet the first estimates indicate that it will be more expensive than the original Senate bill, costing $1 trillion a year. When we learn more about this bill, it is sure to exceed $2.5 trillion per year. Previous estimates of entitlement plans make it likely that we are looking at a plan that will cost $8 trillion-$10 trillion per year, 10 years from now. When the system collapses under its weighty price tag, the federal government will be there to pick up the pieces and take over. This is likely what the advocates of state run medicine are counting on.

If there is but one reason to be afraid, one needs to look deep into the Senate bill for that reason. It states that the Secretary of HHS is responsible for developing treatment algorithms that doctors must follow. If they do not, then they cannot contract with a qualified health care plan. Since all health care plans must be qualified, this means that if the doctor doesn’t follow the government regulations, that they cannot see patients on insurance plans. This is unprecedented in American history. It places the government between a private contract involving two private parties. This should be a clarion call for every doctor in America to do something bold and not just whine about the fact that the government intends to regulate them out of business. They have a duty to protect their profession, but more importantly, protect their patients from a government that fails to comprehend the need to keep doctors unshackled and unencumbered.

Hal Scherz, MD, is a pediatric urological surgeon at Georgia Urology and Children’s Healthcare of Atlanta, serves on the faculty of Emory University Medical School and is president and cofounder of Docs4PatientCare.