Archive for November, 2009

Letter to Senators Considering Reid’s Health Care Bill This Weekend

November 19, 2009

Forgive the Skeptic for becoming sidetracked by everyday life, company, housecleaning, car repairs etc. etc.  I’m back now – sorta

Below find my letter, hastily written today, and sent to 14 Senators – two from my state and 12 that are “swing votes” from various states, including:

Sen Collins (R-VT) http://collins.senate.gov/public/continue.cfm?FuseAction=ContactSenatorCollins.Email,

Sen Snowe (R-ME) http://snowe.senate.gov/public/index.cfm?FuseAction=ContactSenatorSnowe.Email ,

Sen Nelson(D-NE)  http://bennelson.senate.gov/email-issues.cfm,

Sen Lieberman(D-CT) http://lieberman.senate.gov/contact/,

Sen Lincoln (D-AR) http://lincoln.senate.gov/contact/email.cfm,

Sen. McCaskill (D-MO) http://mccaskill.senate.gov/contact/,

Sen Hagan (D-NC) http://hagan.senate.gov/?p=contact,

Sen Conrad (D-ND) https://conrad.senate.gov/contact/webform.cfm,

Sen Pryor(D-AR) http://pryor.senate.gov/contact/,

Sen Tester (D-MT) http://tester.senate.gov/Contact/ 

and Sen Landrieu (D-LA) http://landrieu.senate.gov/contact/index.cfm

 

I have not “prettied up” the letter – it remains as I wrote it, with all its shortcomings, but I stand by its major points. 

I encourage all to write their own letter, or to borrow part of mine and make it their own.  This vote in the Senate is up for grabs – unlike the House vote.  The House often votes to reassure their Democratic base, while actually counting on moderation by the Senate.   Even so, the margin of victory in the House was razor-thin.  I think this means the Senate may feel empowered to vote this bill down!  Encourage them to do so – give them an incentive – the loss of your vote!  Here’s my letter –

 

“Senator X,

I notice that the recommendations made by the U.S. Preventive Services Task Force regarding decreased emphasis on early detection of breast cancer via mammography were made without the benefit of having even a single oncologist on the panel. 

 I believe that this kind of bureaucratic finding is not at all limited to breast cancer, but rather is indicative of the kind of consideration that will be given to Public Health under the new Government-mandated health system proposed by (Substitute) H.R. 3590 now being considered by the Senate.   In fact, I believe that once these sorts of Government recommendations start becoming mandated policy, for every anecdotal horror story regarding lack of insurance that has been trotted out by political hacks in the last six months, there will be 100 actual horror stories regarding lack of access to life-saving health care under the “reformed” system.  While Congress will congratulate itself on providing increased health care insurance COVERAGE there will, in fact, be substantially decreased access to actual health CARE – and, yes, this includes decreased access by the poor, elderly, and needy – perhaps more so than by those that have the wherewithal to escape from this wretched and ill-conceived plan.

 Especially at risk will be access to specialized care.  The health care reform measures developed by both houses target specialists and disincentivize them from studying and practicing.  In time, we will lose even our capacity to provide such care to any except the ultra-rich – there simply will be so few such specialists that their services will be essentially unavailable.  Pharmaceutical companies will prosper because the bills under consideration will encourage (often palliative) “pill medicine” by general practitioners in place of more costly therapeutic interventions that we currently see performed by specialists. 

 Also at risk will be the elderly.  Medicare is being severely cut, and many doctors and other service providers will not want to accept Medicare patients because they will be forced to “self-ration” care to these patients.  In effect, if uncorrected, these bills will create a “Medicare Ghetto.”  I note that the recent “Doctor fix” legislation admitted that the cuts were too steep by $247 billion.  This bill was voted down because of the 10-year price tag, but it will need to come back in shorter term format or the “Medicare Ghetto” will become a reality. 

 This brings up the minor matter of cost – not only does the $247 billion need to be added to the balance sheet, but also the true long-term, steady-state costs based on expected per year revenue vs. benefits paid as opposed to the current weighted estimate based on initial deferral of provision of benefits.  Part of the cost of this program is also in the cost shifted to states, the cost shifted onto medical device and drug companies, and the cost shifted into premium increases for individuals and families.  In fact, all of the costs will ultimately be shifted to individuals and families.  There is no free – that is one of the misrepresentations made about these bills. 

 This brings me to one of my “gut” objections to these bills.  They have been promoted based on lies and distortions in the great tradition of American populist rhetoric – from Mr. Obama’s claims of heartless doctors performing lucrative amputations instead of preventive care, to a Florida politician’s assertion that those daring to criticize these disastrous bills just want people to “die quickly,” the whole debate has been a sham debate aimed at our worst fears and weaknesses.  The stronger the rhetoric, the weaker the bill – and these are no exception. 

 Ironically, this week it appears that it might just be the Government that wants women to “die quickly” from breast cancer, and is discounting the benefits of preventive care.  Is it fair of me to say that?  Of course not, but it is fair to say that the Preventive Services Task Force finding illustrates our worst fear regarding Government-guided health care, and highlights the inherent clash of interests between the individual patient, who only desires quality health care, and the Government-guider/provider, whose primary goal is to conserve resources for the bureaucracy and for other, more worthy, categories of patients.

 I guarantee with total confidence based on my years inside the U.S. Public Health Service, that if the Government is vested with the huge range of powers proposed in H.R. 3590, this basic conflict will lead to a nightmare of inefficiency and consequences, intended and unintended, that will decrease the quality of health care for all Americans. 

 I urge you to consider other options – options that actually have a chance of working – next year!!! You don’t even need to wait until 2013 as the current bills suggest!!  If health care is in such crisis, you could help Americans next year if you would only consider a more modest approach that doesn’t add hundreds of billions of bureaucratic inefficiency to an already bureaucratic system – if you would work to improve and extend coverage rather than creating an intrusive and meddlesome system that will change our relationship to our doctors and to our Government and which will lead to the destruction of our health care system. 

 If you care about the health of Americans and about the future of this Country, I ask you to vote “no” on cloture for (substitute) H.R. 3590.

 Thank you for your time.

 Respectfully,”

The Skeptic


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