Mike Kueber's Blog

June 21, 2012

Repeal and replace ObamaCare?

Filed under: Medical — Mike Kueber @ 7:23 pm
Tags: , , , ,

Ever since ObamaCare was enacted into law, the Republican mantra has been “repeal and replace,” with the emphasis on repeal.  This emphasis on “repeal” is understandable because everyone knows that it is easier to tear something down than it is to build something up. 

An article by Texas senator Kay Bailey Hutchison in today’s San Antonio Express-News continues the Republican Party’s untoward tendency toward demagoguery (rationing, death panels).  In the article, Hutchison asserts that the medical profession will be irreparably damaged by ObamaCare because a government bureaucracy will soon interject itself between doctors and patients.  As evidence of this evil, Hutchison cites a recent recommendation by a government panel to exclude PSA screening from a group of medical services that an insurance company must pay for without charge (no deductible, co-pay, etc.).

Hutchison’s point is wrong on at least two levels.  The first is she implies that PSA screening will no longer be covered.  That is wrong.  The PSA will remain covered; it is simply not included in the basket of preventive services that ObamaCare requires insurance companies to pay for without charge.  If ObamaCare is repealed, as Hutchison wants, the PSA and other preventative services will be covered just like any other medical service – i.e., subject to co-pay and deductibles.

The second and more important mistake with Hutchison’s argument is her premise that a government bureaucracy or insurance company should not get between the doctors and patients.  That suggests that the patients should have a blank check to incur any medical services and expenses that they and their doctors agree on.  Well, such a philosophy is a major reason that medical insurance has become unaffordable.  Doctors and patients should be allowed to do whatever they want on their own nickel, but when they ask the federal government or an insurance company to pay for a medical service, that service needs to be reasonable and necessary based on objective evidence, not the subjective determinations of the doctors and patients, without any consideration of costs and benefits.  You can’t do a cost-benefit analysis if your costs are zero.

Hutchison closed her column by providing some interesting statistics:

  • A recent survey of 5,000 physicians found that 60 percent believe the healthcare legislation will have a negative impact on overall patient care.
  • More than half believe that increased bureaucracy is reducing the personal interaction that is essential to building better understanding of patients’ needs.
  • One statistic stuck with me as I spoke to those graduates: nine out of 10 would not recommend the healthcare profession to a family member.

 Yes, we can expect physicians to believe that patient care will be negatively impacted if the government and insurance companies stop giving them and their patients a series of blank checks; and that increased bureaucracy is reducing the time that they have to interact with patients.  What else would you expect them to say?

I am struck, however, by the statistic that 90% of the new doctors would not recommend the healthcare profession to a family member.  My second son is a newly commissioned M.D., and he shared that burnt-out feeling a couple of years ago while in the later stages of medical school, while wistfully thinking of the other things he could be doing.  However, I spoke to him last week, after nearly a year of residency, and he enjoyed his work so much that he said he would almost do it for nothing.

So regarding Hutchison’s use of statistics, I think of Mark Twain’s sage comment, “There are lies, damned lies, and statistics.”  I wish Hutchison would use her waning days in public office to educate instead of fueling the fire.


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