When my car needs servicing, I call a mechanic. When I need help managing money, I contact a financial adviser. When I want medical expertise, I call a physician, not a politician. My doctor, who is no dummy (he has an M.D., a Ph.D., and decades of experience), thinks the politicians have duped people into believing that the so-called "patients' bill of rights" is a good deal. He thinks government intrusion into medicine has created many of the problems government wants to repair. The last thing this overly litigious society needs is another reason for people to file lawsuits. Trial lawyers are already gorging themselves with more money than most doctors will make in a lifetime of practice. My doctor says managed care organizations don't deny care; they can only deny payment for care. Many, if not most, physicians and hospitals treat their patients professionally and well, he says, whether or not they get paid. No doctor he knows will allow a patient to die just because of the stinginess of an HMO. The basic problem, says my doc, is not that patients are being denied care. It is that providers are not being paid for what they do and those providers are understandably reluctant to treat people for free. My doctor reports he is $150,000 in debt, mostly because insurance companies argue over the tiniest of fees and then sometimes refuse to pay. He also suffers financially because of second-guessing government bureaucrats from Medicare and Medicaid who have never seen his patients but dispute charges as small as a $20 office visit. He has rent to pay and costly malpractice insurance to maintain, because too many patients already file too many lawsuits. After years of expensive education and dedication to helping others, he justifiably resents being seen as a money-grubbing cheat who must be dictated to by politicians interested only in reelection. My doctor's solution to improving doctor-patient relations is one the politicians will never accept because it would deprive them of power. He would restore medical decision-making to the physicians. Doctors have the moral, ethical and legal responsibility for their patients, so why not restore the autonomy they have lost to managed care organizations and the government? Providers should be paid for what they provide, according to some reasonable scale. That might reduce costs. My doctor thinks health insurance premiums should reflect reality. By that, he means at least the following: (A) We are all going to die and our health insurance, lifestyles, and expectations should be designed with that in mind; (B) medicine has allowed us to live longer, but health costs increase commensurate with our advancing age; (C) we have more disposable income than any other nation in the world. It is a myth that health costs are going up "too fast." Too fast for what in terms of what we get in return? No one complains about the cost of chiropractors, aromatherapy, gourmet dog food, vitamins, or herbal health remedies. Let people spend their money on what is important to them. Let society help the poor, partially through government, but also through private agencies, and let the well-off choose how much, and what kind of health insurance they wish to purchase. Opening up medical savings accounts for all, which are now restricted mostly to the self-employed, would expand treatment options. The Wall Street Journal recently editorialized: "We in the United States seem to have arrived at the point in our social relations where many people, and certainly the entire Democratic Party, believe that no private institution will act in good faith absent the possibility of being torn to pieces by a lawsuit." A major reason medical costs have escalated is because of government controls and regulations. Allowing lawyers more avenues to file suit would ensure even higher costs and less care, as many physicians would simply close their doors because they can't afford to practice. This would bring us closer to the nationalized health care program Sen. Hillary Rodham Clinton (D-N.Y.) has said she intends to legislate "piecemeal" since her failed 1993 attempt to unilaterally impose it on the country. It will be as big a disaster in pieces as it would have been if it were served-up whole.
-© 2001 Tribune Media Service, Inc.