Thursday, August 13, 2009

An ophthalmologist weighs in on the health care bill...

FROM THE AMERICAN THINKER PAPER
August 06, 2009
ObamaCare and me

By Zane F. Pollard, MD

I have been sitting quietly on the sidelines watching all of this national debate on healthcare. It is time for me to bring some clarity to the table by explaining many of the problems from the perspective of a doctor.

First off, the government has involved very few of us physicians in the healthcare debate. While the American Medical Association has come out in favor of the plan, it is vital to remember that the AMA only represents 17% of the American physician workforce.

I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases
the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been
blind in the eye.

Each time the request came back denied. All three times I personally provided the antibiotic for each patient which was not on the Medicaid approved list. Get the point—rationing of care.

Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an
intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post cataract surgery.
By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.

Again, extreme rationing. Solution: I have a foundation here in Atlanta supported 100% by private funds which supplies all of these contact lenses for my Medicaid and illegal immigrants children for free.

Again, waiting for the government would be disastrous.

Last week I had a lady bring her child to me. They are Americans but live in Sweden, as the father has a job with a big corporation. The child had the onset of double vision three months ago and has been unable to function normally because of this. They are people of means but are waiting 8 months to see the ophthalmologist in Sweden. Then if the child needed surgery they would be put on a 6 month waiting list.
She called me and I saw her that day. It turned out that the child had accommodative esotropia (crossing of the eyes treated with glasses that correct for farsightedness)
and responded to glasses within 4 days, so no surgery was needed. Again, rationing of care.

Last month I operated on a 70 year old lady with double vision present for 3 years. She responded quite nicely to her surgery and now is symptom free. I also operated on a 69 year old judge with vertical double vision. His surgery went very well and now he is happy as a lark. I have been told—but of course there is no healthcare bill that has been passed yet—that these 2 people because of their age would have been denied surgery and just told to wear a patch over one eye to alleviate the symptoms of double vision. Obviously cheaper than surgery.

I spent two years in the US Navy during the Viet Nam war and was well treated by the military. There was tremendous rationing of care and we were told specifically what things the military personnel and their dependents could have and which things they
could not have. While I was in Viet Nam, my wife Nancy got sick and got essentially no care at the Naval Hospital in Oakland, California. She went home and went to her family’s private internist in Beverly Hills.

While it was expensive, she received an immediate work up. Again rationing of care.
For those of you who are over 65, this bill in its present form might be lethal for you. People in England over 59 cannot receive stents for their coronary arteries. The government wants to mimic the British plan. For those of you younger, it will still mean restriction of the care that you and your children receive.

While 99% of physicians went into medicine because of the love of medicine and the challenge of helping our fellow man, economics are still important.

My rent goes up 2% each year and the salaries of my employees go up 2% each year. Twenty years ago, ophthalmologists were paid $1,800 for a cataract surgery and today $500. This is a 73% decrease in our fees. I do not know of many jobs in America that have seen this sort of lowering of fees.

But there is more to the story than just the lower fees. When I came to Atlanta, there was a well known ophthalmologist that charged $2,500 for a cataract surgery as he felt he was the best. He had a terrific reputation and in fact I had my mother’s bilateral cataracts operated on by him with a wonderful result. She is now 94 and has 20/20 vision in both eyes. People would pay his $2,500 fee.

However, then the government came in and said that any doctor that does Medicare work cannot accept more than the going rate ( now $500) or he or she would be severely fined. This put an end to his charging $2,500. The government said it was illegal to accept more than the government-allowed rate. What I am driving at is that those of you well off will not be able to go to the head of the line under this new healthcare plan, just because you have money, as no physician will be willing to go against the law to treat you.

I am a pediatric ophthalmologist and trained for 10 years post-college to become a pediatric ophthalmologist (add two years of my service in the Navy and that comes to 12 years). A neurosurgeon spends 14 years post-college, and if he or she has to do the military that would be 16 years. I am not entitled to make what a neurosurgeon makes, but the new plan calls for all physicians to make the same amount of payment. I assure you that medical students will not go into neurosurgery and we will have a tremendous shortage of neurosurgeons. Already, the top neurosurgeon at my hospital who is in good health and only 52 years old has just quit because he can’t stand working with the government anymore. Forty-nine percent of children under the age of 16 in the state of Georgia are on Medicaid, so he felt he just could not stand working with the bureaucracy anymore.

We are being lied to about the uninsured. They are getting care. I operate at least two illegal immigrants each month who pay me nothing, and the children’s hospital at which I operate charges them nothing also. This is true not only on Atlanta, but of every community in America.

The bottom line is that I urge all of you to contact your congresswomen and congressmen and senasenators to defeat this bill. I promise you that you will not
like rationing of your own health.

Furthermore, how can you trust a physician that works under these conditions knowing that he is controlled by the state. I certainly could not trust any doctor that would work under these draconian conditions.

One last thing: with this new healthcare plan there will be a tremendous shortage of physicians. It has been estimated that approximately 5% of the current physician work force will quit under this new system. Also it is estimated that another 5% shortage will occur because of the decreased number of men and women wanting to go into medicine. At the present time the US government has mandated gender equity in admissions to medical schools. That means that for the past 15 years that somewhere between 49 and 51% of each entering class are females. This is true of private schools also, because all private schools receive federal funding.

The average career of a woman in medicine now is only 8-10 years and the average work week for a female in medicine is only 3-4 days. I have now trained 35 fellows in pediatric ophthalmology. Hands down the best was a female that I trained 4 years
ago—she was head and heels above all others I have trained. She now practices only 3 days a week.

Page Printed from: http://www.americanthinker.com/2009/08/
obamacare_and_me.html at August 07, 2009 - 12:37:08 PM EDT

Monday, August 3, 2009

13 hours and 10 Minutes in the Life of an ADD Redneck Software Sales Guy in a Recession

Tragically, this is non-fiction.

12:10 PM – all is going well until I check account balance and notice one of the 4 son’s has breached bank security and ordered iTunes movies, music, new phone, fishing equipment over last 60 days with dad’s card.
12:12 – cancel ATM card, order new one


1:05 – Left home office with wife and #2 son who was leaving for Army basic training. Needed to be at recruiter at 1:30
1:15 – Jeep dies en route with cooling system leak that was supposed to have been fixed (software sales pro should stick to fixing software vs. cars), future soldier blew engine in mom’s car the prior week
1:20 - Call #1 son to pick us up and rush to the crew to the recruiting station.
1:45 – Drop # 2 son off and wait for him to complete his PT test
1:50 – TO Starbucks with wife and #1 son, grab coffee and field con-call

2:30 – Young soldier passed PT at highest level and elevated himself to E3 pay grade upon completion of basic and AIT
2:35 – Young soldier wants Wendy’s bacon deluxe and a can of dip…take him to procure same

3:05 – Drop him back off at recruiting station, tearful goodbye with mom, head back to house
3:25 – Assuming overheated Jeep has cooled, will pick up and drive 1.5 miles to house
3:25 – Pull over after losing power at .75 miles from journey’s end point
3:35 – Arrive home – back to work

5:20 - #1 son takes #3 son to football practice.
5:35 – After dropping of the football player, #1 is pulled over, and upon inspection is found to be without a valid license.

6:05 – Responding officer was later identified as 1 of 4 from a force of 160 that would actually jail a kid for no license and tow his car.
6:15 #1 son finally convinces above referenced prick to call us, debrief the situation and let us know we could pick #3 up at practice.
Level – Set: We’re now out of cars at our house.

7:30 – Family friend Tricia gets #3 from football and # 4 at baseball and returns them to the house.
9:20 – #1 son is processed and calls home. After recounting the exact conversation where I signed the title over to him on the vehicle and explained liability coverage and how important it was. How your life could be ruined, forced into bankruptcy…then I fought back the temptation to say, “Screw you moron, I told you to get this done and you blew it off now spend the night in jail.” As a father I knew it wasn’t the day to do that. I told him that I would see what I could do, but that it was already late.
9:21 – Realize I had just cancelled the ATM (see first item of this chronological listing) and had no access to cash.
9:28 – Call bail bond woman and negotiate terms. OK, I listened to her dictate terms. Bail was reduced by $700 because #1 son (technically adept) was able to correct jail computer browser issue. Jailer commented, “We don’t get to many young sober white kids in here, you know anything about computers?” That was to be the only break we got that day.
9:44 – Call my CEO who is on the way home from a meeting, he graciously insists I have to get #1 out so he drives by the ATM securing bail from his personal account.
9:46 – Call best friend who’s wife just picked up #3 and he brings me by his Expedition to use, but warns me, “Might have a battery problem, but it seems fine now.”

10:00 – Meet CEO at a fruit stand and collect an envelope of cash. He comments while chuckling, “Seems like a dope deal or something.” I clarify, “No dope involved or I would have needed another $400 or so.”
10:04 – I leave for the jail, realize I don’t have directions and then in the same instant remember I know where it is already. Also remember feeling not proud at that moment.
10:25 – Bail bondswoman calls – caught in traffic.
10:45 - Sherri (bail bondswoman) calls again, on her way – should be 10 mins.
10:46 - Cell phone battery low, run to car because friend has a Treo too and plug in my phone. Recalling comment about the battery from my buddy, I decided to start the car for awhile. Too late…it clicked a few times…the battery was too low to crank the engine.
10:49 – Walked back in, told receptionist I needed a jump. Jailer was still enamored with his expanded browser capabilities from #1 son’s work, so he had one of the deputies drive the paddy wagon around front: Yes, I got a jump from a paddy wagon.

11:05 – Sherri pulls up as I am locking keys in with the keyless entry door pad on the Ford truck (close friend’s car so I knew the code). Figured I’d leave the car running to charge the battery while charging phone.
11:07 – Walk inside and conduct bail transactional process with Sherri.
11:24 – Spring #1 son and walk back out leave, find that the problem was not the battery and that the idling vehicles alternator was pushing zero volts to charge while the expansive electronics in the Expedition sucked every remaining ounce of power. As the realization of my situation sunk in, I continued to try and operate the now inoperable keyless entry pad. All the while looking at the keys and my phone locked in the car.
11:27 – As Sherri walked out to her vehicle, the idling truck stopped running all together. She looked for jumper cables while I realize that is the alternator, and that the battery can’t be accessed because the hood release is in the car with my flippin’ phone and the keys.
11:30 – I thank Sherri, who drives off into the summer night with my CEO’s cash.
11:31 – I explain to #1 son that I need a moment, and sit in the front lawn of the jail to quietly reflect upon the events of the day. I have already decided that the tantrum I wanted to have may not play that well on the surveillance cameras in the dispatcher’s office. While I am assessing the situation, #1 son informs me that #2 son had written his name on the ceiling of the same cell he was in. What a coincidence! Again, I settle back into the role of proud parent.
11:35 – Walked inside and called truck’s owner, refusing his offer to come get us as I knew he drove all day from FSU to Atlanta.
11:37 – Called a cab and the dispatcher there gave us a 20 min. ETA.


12:05 AM – Called cab company again…he is 10 mins. away.
12:25 – Now out on Buford Hwy trying to hail a cab.
!2:47 – Cab finally shows up 50 mins. late.

1:15 – Arrive home, manufacture a vodka and ice, and fall asleep on the couch wondering what happened to the really cool life I had before my kids became teenagers.

OK - It's a blog about ADD ... Healthcare in the Future

On this one, I simply beg you to read. You were bcc’d because I sent this to a broad distribution list.

US Representative-6th District Tom Price and I have met several times. Tom Price was a physician for 25 years before moving to politics. The first time was when I was rolled into an ER following a 100 mph impact head-on collision in 1995, Dr. Price reassembled my mangled ankle with screws and pins. I am denied handicap parking permits now because his work that night was masterful. Many people with the type of injuries I presented with have bad outcomes, including amputation. I recovered almost fully and went on to practice martial arts, hike, mountain bike and more.

Accordingly, I was indeed interested in what Tom Price had to say when this arrived in my inbox from a family friend:

Some of what goes on in Congress:

This is a YouTube video that was made of US Rep. Tom Price-6th Dist. on Wednesday. Tom is a member of the House Healthcare Committee, and the video was shot in the Wed. Committee meeting. Please share this with everyone you know.............this healthcare legislation MUST be defeated. Please share this video. Tom has said that our Constitution is being burned right before our very eyes. We must, Democrats and Republicans alike, let our "leaders" know that this plan is unacceptable.
There has to be a better way than a government takeover! If the Government takes over, it will be one of the most colossal blunders in the history of this Nation!

http://www.youtube.com/watchv=SD_YOlUBoIk
His plea is passionate, and he in the 99th percentile of truly understanding the health care system. We must also ask ourselves why this is not mentioned in the media. That’s almost as disconcerting as the process that is going on under the guise of a cooperative elected leadership.

This is not about politics. I have a Canadian friend who can tell you how personal healthcare can get when the government is writing the prescriptions for care. Please share this link.

John Nycz
VP Business Development
c) 404.520.0380

Skype ID - nyczoo
www.ttvsolutions.com