Project 21 New Visions

Elaina F. George, MD

A Practicing Physician's Prescription for Fixing Health Care


by Elaina F. George, MD (bio)

Despite the desperate attempts at distraction and demonization and the outright lies about what ObamaCare does, the truth remains that having health insurance does not equal getting quality health care.

There are definitely problems with the American health insurance industry. If anyone bothered to ask independent private physicians why they no longer take Medicare or Medicaid, or why many are opting out of insurance towards cash-only practices, it's because the game is rigged.

It is harder for doctors and, by extension, patients to access quality affordable health care these days. ObamaCare expands and empowers the most expensive aspects of our health care system, thereby dooming Americans to higher taxes and rationed care.

Now that ObamaCare is the "law of the land," proponents such as Ezekiel Emanuel and Paul Krugman are finally telling the truth. ObamaCare was always about control of American health care through centralizing power with the government, raising taxes and rationing (what critics call "death panels").

Unfortunately, the 30 million people who previously lacked health insurance will now be exchanged for those who did and were not dependent on government handouts. ObamaCare not only redistributes the wealth of the young and middle class, but as an astute individual commented, it is actually a transfer of health. Americans stand to lose their freedom to choose their doctor and their freedom to choose how they treat their illness under ObamaCare.

For example, under current dictates, people can no longer use a health savings account (HSA) to buy natural remedies such as vitamins and supplements only brand-name prescription drugs. How long will it be before certain vaccines or psychiatric medication are mandated against peoples' will?

Under a collectivist system, costs to the system will override individual freedom. There will be no anonymity within the national electronic medical record database.

A common retort from ObamaCare partisans is that no alternatives exist. Here, however, are some simple solutions:

Change the tax code so private physicians can write-off bad debt. Allowing physicians to write-off delinquent patient bills as bad debt would alleviate collection hassles and remove health care costs as a cause of bankruptcy. It would also encourage more free medical care because physicians could more readily afford to offer it.

Tort reform. Make patients who bring frivolous lawsuits responsible for paying all court costs. Cap damages. Doctors would be encouraged to give free care in exchange for a discount on malpractice insurance. Alternatively, premiums could be waived altogether if they provide a certain amount of free care per year.

Allow Medicare and Medicaid access to cheaper foreign drugs. Allow importation of drugs from Canada to decrease costs to both Medicare/Medicaid patients and the government.

Reform the Emergency Medical Treatment and Active Labor Act, a requirement that hospitals treat everyone arriving at an emergency room. Though well-intentioned, the reality is that the expensive emergency care costs of those who cannot pay must be covered by those who can. Instead, ER patients should be triaged with real emergencies treated immediately and non-emergencies such as common colds or earwax removal routed to outpatient offices or similar clinic care.

Require insurance companies to honor the pre-certification process. If insurers pre-approve a procedure, they should pay for it and not deny it after the fact leaving patients on the hook.

Separate the triumvirate of the pharmacies, insurance companies and pharmacy benefit management companies (PBMs). Their collusion keeps drug costs high while limiting honest competition that could benefit patients.

Do not mandate licensure of physicians to acceptance of Medicare/Medicaid or ObamaCare. Such a requirement guarantees a physician exodus, further exacerbating America's doctor shortage.

If politicians truly wanted to expand health care coverage, all that was needed was to expand Medicaid/Medicare. It would have been a lot cheaper than blowing up the private insurance market.

Empowering independent doctors instead of the hospitals, insurance companies and Big Pharma would have been a much cheaper fix. But that lacks the control big government liberals want. This, unfortunately, will be the undoing of the doctor-patient relationship that was the key to America's health care greatness before the Obama era.

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Dr. Elaina George, a member of the national advisory council of the Project 21 black leadership network, is a board-certified otolaryngologist and host of a weekly talk radio show, "Medicine On Call," that explores health issues and the politics of medicine. Comments may be sent to [email protected].

Published by the National Center for Public Policy Research. Reprints permitted provided source is credited. New Visions Commentaries reflect the views of their author, and not necessarily those of Project 21, other Project 21 members, or the National Center for Public Policy Research, its board or staff.


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