Reforming or ruining health care law?

With the Supreme Court decision looming, we offer two views on health care reform: A Morehouse School of Medicine doctor charges that Georgia congressmen who are also physicians fail their professional oaths by fighting to eliminate provisions from President Barack Obama’s Affordable Health Care Act that protect the less fortunate and those with pre-existing conditions. In a response piece, one of those congressmen doctors, Tom Price, says the law increases costs and reduces accessibility to care.

Tom Sabulis is today’s moderator. Commenting is open below Rep. Tom Price’s column.

By Harry J. Heiman

The health care landscape in our country remains both challenging and confusing. Political rhetoric and the pending Supreme Court decision on health reform legislation add to the confusion.

While there are strong feelings about the Affordable Care Act (ACA) on both sides, there is relative consensus about the value and importance of certain key provisions of reform, especially among doctors and their patients.

This makes recent comments from some of our Georgia physician legislators all the more baffling and disturbing.

Most Americans support the goal of access to affordable, high-quality health care for all U.S. citizens. While there is disagreement about how we get there, provisions that allow young adults up to age 26 to remain on their parents’ health plans and that prevent insurers from excluding children and adults with pre-existing medical conditions from coverage have wide support.

Intuitively, it makes sense, especially to those of us who take care of children and adults with chronic illnesses, that excluding these people from access to health insurance coverage not only precludes them from taking responsibility for their own health care needs, but also puts them at risk for poor health outcomes and significant financial exposure.

Physicians accept a profound and sacred responsibility for the patients and communities they serve. We, more than others, see firsthand the consequences of being uninsured and not having access to health care. Patients come into our offices with uncontrolled high blood pressure and high blood sugar, because they can’t afford essential medications for their hypertension and diabetes; patients are diagnosed with late stage breast cancer or colon cancer because they delayed getting mammograms and colonoscopies; patients end up in the emergency department or hospital with preventable illnesses and complications they failed to get care at an earlier stage.

These are the patients that make physicians frustrated and heartsick.

As professionals committed to promoting health and treating illness, we often feel handcuffed by a health care system that for too many, including the 1-in-5 Georgians who are uninsured, is neither affordable nor accessible.

As a Georgia physician, I was hopeful that our physician legislators in Washington would provide informed and committed leadership. Unfortunately, Georgia’s physician leaders seem to have forgotten their Hippocratic Oaths and their professional responsibilities as physicians and healers.

This past week, when asked about the plan Republicans would put forward if the Supreme Court ruled against the ACA, Rep. Phil Gingrey stated that, while not opposed to states addressing coverage for those under age 26, he did not support the federal legislation.

With regard to those with pre-existing medical conditions, Rep. Tom Price said “Preexisting illnesses and injuries for children — there isn’t anything that we would do that would preclude a health coverage entity, an insurance company, from excluding those.” He was also quoted as referring to regulations that preclude pre-existing exclusions as “a terrible idea.” Really?

Is it really OK to tell a family with a child with congenital heart disease that they are uninsurable? What about the child with diabetes, asthma, autism, or, if we need to make it more real, to an orthopedist, congenital hip dysplasia or osteosarcoma, a pediatric bone cancer?

It appears that once again, politics have trumped reason, compassion, and in this case, professional oaths to “do no harm.” To suggest that requiring insurers to cover the most vulnerable in our society is “a terrible idea” is beyond belief and challenges the tenets of our professional ethics.

By Tom Price

Before serving the constituents of Georgia’s 6th Congressional District, I spent more than two decades treating patients as an orthopedic surgeon. That’s why, as a physician, I remain deeply troubled by the government-centered reforms in President Barack Obama’s health care law. With it, we will see health care costs rise while diminishing quality and accessibility.

One of the reasons the majority of Americans object to the law is that it cedes decision-making authority to Washington. Allowing the federal government to define what healthcare is and isn’t, what illnesses qualify for inclusion as pre-existing or not, or what quality treatment is or isn’t, will be the end of any possibility of patient-centered healthcare.

Right now, to “control cost,” the FDA has sought to deny breast cancer patients access to life-saving medication, despite the pleas of numerous cancer advocacy groups, demonstrating to women the starkness of government-controlled healthcare. The U.S. Preventive Services Task Force recently ruled that prostate cancer screening was unworthy of coverage, despite the American Cancer Society stating that “there is no question that screening can help find many prostate cancers early.”

And this is only the beginning. President Obama’s health care law threatens the sacred doctor-patient relationship with a board of unelected, unaccountable Washington bureaucrats who may effectively deny care to seniors by deciding whether to pay doctors for certain treatments and services. This is not hyperbole. This is reality.

That’s why an overwhelming majority of doctors elected to the U.S. House and Senate oppose President Obama’s health care law. We know that it will make health care less accessible, compromise patients’ rights, discourage innovation, impede provider responsiveness, raise costs and drastically lower the overall quality of care.

As the Supreme Court is poised to rule on the constitutionality of the president’s law, one thing is certain: Regardless of their decision, the status quo is unacceptable.

The good news is that there are wonderful, positive solutions. HR 3000, the Empower Patients First Act, is one such proposal that would first, provide the financial incentive for every single American to be able to afford the health coverage they want for themselves and their families, not that the government wants for them; second, solve the insurance challenges of portability and pre-existing conditions by allowing everyone to take their health coverage with them if they change or lose their job and have access to robust pooling opportunities so that no one is priced out of the ability to purchase insurance, regardless of health status; and third, save hundreds of billions of dollars by ending the practice of defensive medicine.

Those who favor a greater role for government in America’s health care system will likely continue to ignore our positive, patient-centered reforms and cling to the notion that their approach is the only offer on the table.

That’s unfortunate because there are many solutions to fix what ails our health care system without giving greater authority to Washington.

Compassionate care begins and ends with patients, not government. Let’s empower patients first.

Tom Price,  R-Roswell, represents Georgia’s 6th District.

37 comments Add your comment

ragbatz

June 16th, 2012
12:10 pm

Price claims that HR 3000 would solve the insurance challenge of pre-existing conditions “through robust pooling opportunties” which somehow make insurance available and affordable to all, regardless of health status.

It’s a fantasy. No matter how large the pool, it will always be in an insurance company’s interest to cleanse that pool of high risk patients. The only known way to overcome this iron law of insurance is to ban discrimination based on pre-existing conditions, a step Republicans refuse to take and one that Price himself calls “a terrible idea”.

He also writes that HR3000 would “provide the financial incentive for every single American to be able to afford the health coverage they want for themselves and their families”. Does he mean the incentive to purchase health coverage? The incentive “to be able to afford”? What does that mean?

Price’s double talk is meant to stand in for what Price can’t say: that HR3000 has fig-leaf size subsidies that entirely fail to cover the massive exposure to health care costs to which persons of modest means are exposed. For a family of four with both parents holding full-time minimum wage jobs, HR3000 offers a $5000 subsidy. Sure, that is a large share of their $30,000 family income, but the average cost of an employer-offered insurance policy for a family of that size exceeds $15,000 – even using the group purchasing power that enables employer plans to get good quality at discounted rates. So, even with HR3000’s “financial incentives” “to be able to afford” the health insurance “they want for their families”, a policy would still cost that family over a third of its pre-tax income.

Take a refusal to reform the worst practices in regard to pre-existing conditions. Tether it to a refusal to offer serious help to people of modest means. The result is what the GOP’s go-to-guy on health insurance calls Putting Patients First. I call it a fraud.

middleground

June 15th, 2012
9:49 pm

People do not want Obamacare because it gives Drugs Companies even more power and influence with bought off elected officals. We are all going to be overpaying for horrible care. Great Doctors are now requiring cash and people who can will pay.

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Bernie

June 15th, 2012
6:01 pm

zeke@1:38 am – My Friend you need to pull your Head out of that very dark place wherever you have it lodged and look around you. I challenge you to take a trip over to the Grady Hospital’s emergency room anytime from Friday afternoon to Sunday evening. After you have spent some time in the waiting room, then come back here and lets see if your opinion has changed. If it has not, you are without a soul or a conscious.

bob

June 15th, 2012
2:08 pm

> Most Americans support the goal of access to affordable, high-quality health care for all U.S.
> citizens. While there is disagreement about how we get there, provisions that allow young adults
> up to age 26 to remain on their parents’ health plans and that prevent insurers from excluding
> children and adults with pre-existing medical conditions from coverage have wide support.

Really? From the comments and the vents on the AJC you would think otherwise. The attitude I see in Georgia is that people like punishing the poor for, you know, being poor. It doesn’t matter if the poor are working one job, two jobs, three or more jobs, disabled, or not working at all, somehow they all get treated as if they are lazy and unworthy of help of any kind.

too little time

June 15th, 2012
12:52 pm

Unfortunately, Georgia’s physician leaders seem to have forgotten their Hippocratic Oaths and their professional responsibilities as physicians and healers.

Sorry, but nowhere in the Hippocratic Oaths does it say that doctors should support legislation and takes money from one set of patients and gives it to another.

Is it really OK to tell a family with a child with congenital heart disease that they are uninsurable?

Is it really OK to tell taxpayers and other insurance rate payers that you must pony up hundreds of thousands or millions of dollars for someone else’s health care? You pick the most pitiful corner case you could find, but what about the 40 year old 350 lb man with diabetes who refuses to lose weight or be medically compliant. Are we going to give this guy insurance at the expense of everyone else? A law or society that does not distinguish between those who need care through no fault of their own vs. those who abused themselves can expect to get blowback from those who pay for everyone. And seeing how the upper 51% of taxpayers are going to be footing this bill or subsidizing for the vast majority, you can expect little tolerance for those who will not do for themselves. For every 1 child with congenital heart disease, there will be 10 adults who are 100lbs overweight (actually, the ratio is probably much higher). In fact, it is the morbidly obese who utilize nearly 70% of all healhcare. If it wasn’t for them, there would be PLENTY of money to cover the child with a congenital heart defect. So if you want support for the child (from me), find a way to reduce/cut healthcare to those who could prevent their own problems by leading a healthier lifestyle.

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