Topeka Docs Speak Out on
Nationalized Health Care
by LISA LOEWEN
The volatile debate about national health care has spilled out of the political circles in Washington and into businesses, homes and doctors’ offices across the country. While a majority of Americans agree that health care reform is necessary in order to curb the rising cost of medical care, they don’t have a clear picture of what a transformed health care system should look like and how much it will cost. Among those searching for answers to the health care debate are physicians who are frustrated with the current system but wary of government intervention in the doctor-patient relationship. Dr. Brian E. Gibson, a family practice physician at The Center for Nutrition and Preventive Medicine, would like to see every American receive health insurance, but is skeptical that this can be accomplished without increasing overall costs. “It makes me think of trying to stop Niagara Falls with a piece of cheesecloth,” Gibson said.
Gibson said the public insurance option under consideration at the moment might work, but only if private insurance companies could still compete, a scenario he doesn’t find likely. A better solution, Gibson said, would be for Americans to take some personal responsibility for themselves and live more healthful lives. He also said that putting more trust in the doctor-patient relationship could drop health care costs dramatically.
“I do my best to practice the best medicine I can,” Gibson said. “And if I have a good relationship with my patient, we may not order an expensive test because I’m not as worried about being sued.”
Dr. Raja Mehdi, a hematologist and oncologist at the St. Francis Comprehensive Cancer Center, believes we have an obligation to set a minimum level of treatment for everyone. Mehdi said that one of the reasons he left his native country of Pakistan was the limitations set on physicians. The government replaced the physician- patient relationship, dictating who could receive treatment based on prognosis, leaving many patients without any medical treatment. However, Mehdi said health care coverage in America often doesn’t factor medical prognosis into determining care a patient receives.
“We have made it unthinkable to factor in life—but we have to,” Mehdi said. Mehdi doesn’t believe a single-payer system is the solution either because it isn’t reasonable to expect a health care provider to charge less than it costs to do business. He would like to see implementation of a tiered insurance system similar to one used in Switzerland. Every American would receive the lowest tier, giving them basic medical care. Individuals could then purchase supplemental private insurance that would provide additional tiers of coverage. The problem, Mehdi said, is defining what that base coverage would be. “Coming as an immigrant, I think we are pretty spoiled here,” Mehdi said.
Dr. James Hamilton, general, vascular and bariatric surgeon with Tallgrass Surgical Specialists, agrees that we are spoiled when it comes to health care in America, but he blames health insurance for the high costs. “The reason health care is so expensive is because everyone has an ‘all you can eat card’,” Hamilton said. “Why would anyone choose to eat ground beef when they can have filet mignon?” Hamilton believes that the only way to reduce health care costs is for people to learn to limit the amount of health care they receive. He said too many people use emergency rooms as their primary care doctors and receive expensive tests that aren’t necessary for diagnosis. If people were responsible for paying for these services themselves, they might be more likely to ration the services they choose to receive. Hamilton would like to see people learn to ration their own care rather than have the government ration it for them. Having practiced medicine in different countries in Europe, Hamilton saw first hand how government-rationed health care works. He said that in the United Kingdom, the government limits health care services as well as the number of physicians’ jobs in the country, resulting in lines to see doctors and waiting lists for procedures. So how does Hamilton suggest people learn to ration health care? He said health savings accounts are the answer. HSAs let people save money in a pretax account and pay cash for services received. This would put the burden back on the consumer and give them the right to bargain for lower prices. People would still purchase insurance for catastrophic events, but premiums would be much lower. Hamilton believes rationing of health care is inevitable. “There’s going to be rationing,” Hamilton said. “Ask yourself whether you want the government to make your choices for you, or if you want to decide for yourself.” TK |
