Greg Williams: Too little input on health reform from doctors

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1:40 PM Friday, November 6, 2009

Few things spark ones memory like the crinkly sound and feel of paper over the firm vinyl cushions of the doctor’s exam table. The debate over health care reform brings back one such memory for me.

It was some 15 years ago, and I was talking with the young man whom I had chosen as my new doctor. He had recently opened a new office in town and started a family medicine practice. I was suffering from a peculiar malady that was more nuisance than illness, but I wanted to know why.

The doctor informed me that tests results had ruled out the most serious or likely causes. He concluded that additional testing was unlikely to shed further light, and would probably be a waste of money. Instead, he recommended that I focus on improving my overall health and see if that helps.

My response was: “I’ve got good insurance. Let’s do all the tests we can.”

The doctor lowered his head, looked at me over his glasses, and said “Let’s think about that, because wasting money doesn’t make sense — regardless of whether it is your money, my money or insurance money.”

I reluctantly agreed and decided to take his advice. When I quit smoking a few months later, my little nuisance went away.

In the years since then, I have benefited many times from those emphatic looks over top of his glasses and the prudent wisdom that remains a principle of the good doctor’s practice. It’s unfortunate that the health care reform proposals that currently are making their way through Congress lack the benefit of such wisdom.

The fundamental problems with current health care reforms are rooted in the fact that input from doctors like mine has been minimal. Politicians, lawyers, insurance executives and lobbyists have dominated development of the legislation. This has left gaping holes in the feasibility of current plans.

Serious reforms of the legal practices, which feed off the health care industry, are almost non-existent. Reforms that would reel in the wasteful practices and obscene profits of huge insurance and pharmaceutical companies are inadequate. Incentives to grow and support the type of care providers that will be required to meet the demands of the aging American populace are not included.

It’s not all bad, but it’s far from good enough. Consider these examples.

The funding strategies for the proposed reforms baffle me. How can new taxes and fees on health insurance and many parts of the health care industry possibly help to lower the cost of health care? Wouldn’t the best way to pay for health care reform and reduce health care costs be to target the things that injure us and make us unhealthy?

Sin taxes on things like alcohol and tobacco are common. Why not expand upon that model to include taxes on foods high in fat, sugar and salt to pay for health care? What about a surcharge on speeding tickets and seat-belt violations? Risk-based and unhealthy revenue sources are plentiful and would spread the burden widely over the economy while providing incentives for changing behavior that could ultimately reduce the need for health care in general.

Another problem is timing. Hospitals, clinics and doctors have been hit hard by the recession like other businesses, but recovery of the health care industry is tied much more closely to employment than Wall Street. The costs of charity care and unpaid fees for services that must be absorbed by health care providers are at all-time highs. The unemployment crisis needs to be fixed before any health care reform plan would have the best chance of succeeding.

Leaders in Congress deserve credit for certain elements that are constructive, such as insisting that a viable public option is a requirement to bring meaningful reform to the private health insurance industry. But they must resist the temptation to rush this important process.

In talking with my doctor about health care reform, one of his main concerns is that if the government doesn’t take the time to get it right, fixing ill-conceived regulations and bureaucracy after the fact will be extremely difficult. That type of perspective, from someone who has grown a key practice in an increasingly difficult profession, is exactly the type of input that has been lacking.

Congress has taken some steps in the right direction, but they have a long way to go. If they intend to stop now and make law with what they have, the message from the American people should be simply: Keep working. What you have now is the wrong plan at the wrong time.

Greg Williams is a Middletown businessman.

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Mr. Williams: I suppose I may be somewhere in the middle on this healthcare issue. First, I recognize many of us have some bad habits such as smoking, not eating properly and so on. We are human. I don't want to see us taxed or pay higher premiums or deductibles because we smoke or are over-weight. Come on! We are human. Yes, educate. Yes, encourage people to head the right direction. My doctor tells me like it is. I don't want to see the government telling him how to treat me.

James Dunham
7:53 AM, 11/9/2009

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Sorry Mr. Williams, The conservatives spent more time as an obstruction to reform than anyone could have imagined. All the bunk about being locked out by the Dem's is just cover for turning into the party of "NO & STATUS QUO." The public want's health care reform, not petty obstruction.The right has been on the wrong side of every social safety-net for the last 100 yrs, Social Security, Medicare, Civil Rights, Fair Housing, Woman's Reproductive Rights, American Disability's etc, etc.etc.

Conservatives / Out of Touch
9:20 PM, 11/8/2009

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