The Doctor Is In: Distorting the facts on health care

In the beginning, there was Sarah Palin. who warned that the proposed health care reform bill called for the creation of "death panels" to decide whether an elderly patient gets to live or die. Then, along came Rush Limbaugh, who referred to the bill as "a Hitler-like policy." Now, critics of the plan are barnstorming town hall style meetings during the congressional recess to protest "Obamacare."

It's one thing for angry citizens to interrupt civic meetings and another for well-known public figures to grossly distort the facts. I am reluctant to use the word "lies," but it's hard to avoid the l-word when talking about the accusations that there is a covert governmental plan to kill off the elderly. I guess the accepted word for this sort of gross misrepresentation is "spin."

Unfortunately, August is a slow news month, so the debate is getting ample coverage by the media. Worse yet, some people actually seem to believe this rhetoric. The New York Timesestimated that about 80% of the Pennsylvanians who showed up at a meeting held by Senator Arlen Spector were opposed to the proposed changes to health care, and many said they heard about the meetings from conservative and antitax groups as well as Senator Spector's mailings. In an email, the Connecticut Citizens Action Group summed it up by saying that "opponents of health care reform are mobilizing turnout at these August recess meetings with one goal: to stifle the voices of the vast majority of Americans who favor meaningful health care reform."

My hope is that Americans see through these tactics and look at the facts, a move ; unfortunately, that's getting harder and harder to do with all the noise out there. "Let's agree over things that are real," President Obama told a town hall meeting in New Hampshire. "Not these wild misrepresentations that bear no resemblance to anything that actually been proposed."

I haven't read the 1,100 page bill, but I am confident it does not call for euthanizing the elderly. The American Association of Retired Persons (AARP) has refuted the notion that health care reform will kill your grandmother or somebody else's, calling these statements "flat-out lies." Apparently, the rumors are based on a section of the bill that calls for Medicare to add voluntary counseling with a physician regarding end of life options.In an interview with The Washington Post, Republican Senator Johnny Isakson from Georgia explained that so much money is spent in the last 60 days of a person's life "because an individual is not in a capacity to make decisions for themselves." However, if everyone had an end-of-life directive you could make decisions about things like advanced life support when you're of sound mind and body.

I suspect this provision in the bill aims to manage end-of-life care in a more cost-effective way as the baby boomers age. As I mentioned in a previous column, we also need to distinguish between care that prolongs life and care that actually heals the sick.

As someone who has spent the past two decades treating Medicare and Medicaid patients, I can tell you that the problem with a government-run plan won't lie in the benefits, or lack thereof. Publicly financed programs are generous almost to a fault when it comes to providing patients with sound medical benefits.

However, the red tape that doctors have to deal with is another matter (as is the incredible fraud and waste with both Medicare and Medicaid). Dealing with Medicare is horrible-from the inability to get a live person on the phone to the long waits to get paid. I have claims sitting on my desk that are a year old. Perhaps worst of all is Medicare's unique coding and reimbursement system, which every doctor cringes at because of its many differences from most private insurers. It's just not a user-friendly system.

But it's not system that is cruel or stingy, and I'm not sure that's true of some private health insurance companies. The idea that the government bureaucrats will take over and deny all sorts of necessary medical care is curious since the insurance industry has been doing that for many years. Some of their practices are shameful, and include denying coverage to people with pre-existing conditions, dropping those who develop serious (ie expensive) illnesses, and hiking premiums an average of 12% per year.

Somehow, in the topsy-turvy world of death panel spin, price-baiting by the insurance companies is acceptable, while the government -- which, by most accounts, has done a decent job of administering Medicare since the Truman administration -- is developing a system to kill off the elderly. Somehow, the whole argument is a bit implausible.

Russell Turk is an obstetrician and gynecologist in Fairfield County, CT.






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