-By Warner Todd Huston
Woodrow Wilcox, a fellow that operates a Medicare advice and assistance website, was contacted not long ago by a local Indiana doctor that read the entire bill of H.R. 3200. Once he was done he had some deep and troubling concerns about Obamacare. The doctor, Stephen E. Fraser, M.D., then sat down and wrote Senator Evan Bayh about these concerns.
Here is that letter:
Dear Senator Bayh,
As a practicing physician, I have major concerns with the health care bill (HR 3200) before Congress. I spent the last week reading this bill, which at over 1000 pages is quite difficult to get through. Have you read it? I’m shocked by the brazenness of the government’s intrusion into the patient-physician relationship. I’m especially concerned about the creation of a central committee to decide medical coverage decisions.
Every physician and nurse I work with agrees that we need to fix our health care system. Our President’s statement last week in his health care press conference that physicians are likely to make a patient care decision based on reimbursement rather than a patient’s best interest is not helpful in moving this discussion forward.
As an anesthesiologist I’m responsible for life and death decisions on a daily basis. I always have my patient’s best interests at heart and I’m sure my physician colleagues around the country do as well.
I ask you respectfully and as a patriotic American to look at the following troubling sections I’ve read in the bill. How can the following be in the best interests of the country and our fellow citizens? Capitalized words within quoted text are my emphasis.
SECTION 123 HEALTH CARE ADVISORY COMMITTEE
“A committee composed of 18 President-appointed individuals and 8 Federal employees (26 non-elected citizens) to consist of providers, consumer representatives, employers, labor, health insurance issuers, experts in health care financing and delivery, experts in racial and ethnic disparities, experts in care for those with disabilities, representatives of relevant governmental agencies and AT LEAST ONE practicing physician OR other health professional and an expert on children’s health.”
This group will set coverage for the country…and other than the surgeon general, a physician is not even guaranteed to be on the committee. Is our country ready to let 25 or more non-elected, non-physicians make these decisions? This is a direct intrusion into patient care and I for one do not want a community organizer to have input on what type of care my patients can receive.
SECTION 141 HEALTH CARE COMMISSIONER
The health care advisory committee will report to the Health Care Commissioner, another non-elected Presidential appointee who will make the final decisions for the nation’s healthcare benefits.
SECTION 246 SUBSIDIES FOR UNDOCUMENTED ALIENS
“Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.”
This states that taxpayer subsidies will not be given to illegal aliens to obtain coverage but says nothing about preventing them from obtaining healthcare in the US. Under current law NO patient, illegal or otherwise can be turned away from an ER if urgent care is needed. Section 152 states that “all health care and related services including insurance coverage and public health activities covered by this Act shall be provided without regard to personal characteristics.” Will the current law be changed thereby withholding care from a vulnerable group of individuals?
SECTION 204
Language translation and linguistic appropriate services is mandated. This seems to apply to undocumented individuals as well.
SECTION 205
The government will use community organizations to sign up eligible citizens for health plans. Do you support using an indicted organization like ACORN to do this?
SECTION 225 PROVIDER PARTICIPATION
This section states that Physician salaries will be dictated on an annual basis. How can you support taking over the livelihood of all physicians and dictating the terms? This is pure socialism and to call it anything else is disingenuous.
SECTION 131 REQUIRING FAIR MARKETING PRACTICES BY HEALTH
INSURERS
This section gives the government veto power over advertising by private companies. Again this is an example of socialism where the government decides what the public is allowed to be told. How can you support this?
SECTION 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS
EMPLOYEE AND DEPENDENT COVERAGE.
This Bill mandates employer-paid coverage for part-time employees and families which will be a huge burden for small businesses. Overall, the compliance regulations and associated costs for physicians, employers and insurance providers is enormous. Also, random audits are authorized with the full cost of the audit to be paid by the person or entity being audited. Do you support random, costly intrusions into physician’s offices?
SECTION 431 DISCLOSURES TO CARRY OUT SUBSIDIES
The Health care commissioner and others in government will have full access to your tax returns. On Pages 58 and 195 Government will have real-time access to individuals finances & a National ID Healthcard will be issued. Officers & employees of HC Administration will have access to ALL Americans finances /personal returns. Quite an intrusion of privacy.
SECTION 1128H
Under Medicare, every prescribed drug, device or medical supply has to be disclosed to the government or a penalty of $10,000 to $100,000 applies. Just think of the cost of complying with this rule.
SECTION 1501
The health commissioner will approve expansion of physician residency training positions with preference being given to primary care and disadvantaged applicants. Do you want the best and brightest to be our future doctors or those selected by the government? This section also suggests that specialty positions will not be expanded. This will lead to a diminishing specialist base and a loss in quality care. The obvious intention is to limit specialist care and I think the country needs to be aware of this.
SECTION 155 SEVERABILITY.
“If any provision of this Act, or any application of such provision to any person or circumstance, is held to be unconstitutional, the remainder of the provisions of this Act and the application of the provision to any other person or circumstance shall not be affected.”
Why put this in? Do you think the bill is so radical that you are trying to block the Supreme Court from striking it down?
SECTION 1233 ADVANCE CARE PLANNING CONSULTATION (pages
424-431)
Page 425 Lines 22-25, 426 Lines 1-3: Government provides approved list of end of life resources. Government MANDATES program for orders for end of life every 5 years. The Government decides it should be involved in end of life care.
Page 428 Lines 17-25: Additional advanced care planning consultations will be used frequently as patients health deteriorates.
Page 429 Lines 1-3: “advanced care consultation” may include an ORDER for end of life plans.
Page 429 Lines 13-25: The Government will specify which Doctors or other individuals can write an end of life order.
Page 431-2 The Government mandates that “quality measures on end of life care” be measured and reported.
While advanced planning is always a good thing, this decision is best made with the physician, patient and family. The majority of health care dollars are spent in the last year of a citizen’s life. Mandating government intrusion and reporting of end of life care brings up the question of rationing. This section is quite vague on listing protections for seniors. Can you reassure me Senator that rationing is not the goal of this section of the bill?
Other troubling sections I discovered:
Pages 65-66 Section 164: Describes a subsidized plan for retirees and their families in unions & community organizations. Why the special treatment?
Page 84 Section 203 HC bill: Government mandates ALL benefit packages for private care plans in the Exchange.
Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans = The Government will ration your Healthcare!
Page 85 Line 7 HC Bill: Specifications of Benefit Levels for Plans. AARP members – Will your Health care be rationed?
Page 102 Lines 12-18 HC Bill: Medicaid Eligible Individuals will be automatically enrolled in Medicaid. No choice.
Page 121 lines 11-17: Doctor or provider payment will be at Medicare rates under the public option. Medicare pays well under market rates and many physicians currently subsidize or cost-shift from private patients to provide care to seniors. If Medicare rates are mandated, access to care will suffer. Do you support paying physicians at Medicare rates under the public option Senator?
Page 124 lines 24-25 HC: No company can sue the government on price fixing. No “judicial review” against Govt Monopoly.
Page 203 Line 13-15 HC: “The tax imposed under this section shall not be treated as tax” Why the deception?
Page 265 Section 1131: Government mandates & controls productivity for private HC industries.
Page 268 Section 1141: Government regulates rental & purchase of power driven wheelchairs.
Page 272 Section 1145: TREATMENT OF CERTAIN CANCER HOSPITALS
Cancer treatments are expensive and represent the latest in research, technology and understandably cost a lot of money. This section, like others is vague in details. Senator, how will rationing of the latest advances be avoided?
Page 280 Section 1151: The Government will penalize hospitals for whatever Government deems preventable re-admissions. A good medical outcome is never guaranteed! This is a crazy rule and may actually increase costs as hospitals and doctors will be hesitant to release sick patients!
Page 316-317: PROHIBITION on doctor ownership/investment. Failure to disclose ownership is a 10,000 dollar fine for each occurrence. Government again dictating to Doctors what/how much they can own!
Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion
Government is mandating hospitals or surgery centers cannot expand. Hospitals have an opportunity to apply for exception BUT community input is required. Will ACORN have a say in this?
Page 335 L 16-25 Pg 336-339: Government mandates establishment of outcome based measures.
This is another way to justify rationing care. Every physician learns early in their training that each patient is unique and that a mandate for care will work for some but not for others. Learning to accept uncertainty is part of what makes our profession special and different. Rigid care mandates will result in decreased quality of care. This type of mandate also implies that physicians don’t have the best interests of their patients in mind which is nonsense. In other single-payer systems outcome based measures are ROUTINELY used to ration care. In the UK, a patient with macular degeneration must become blind in one eye before treatment is offered to the other eye!
Page 354-355 Sec 1177: Government may RESTRICT enrollment of
Special needs people to certain times and will review special needs plans and make recommendations, “as the secretary of HHS deems appropriate.”
Something the public needs to know.
Page 379 Sec 1191: Govt creates more bureaucracy -Tele-health Advisory Committee.
Page 469: Community Based Home Medical Services = Non profit organizations.
Should we expect ACORN nursing homes in the future?
Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED ORIGINATION. One monthly payment to a community-based organization. Like ACORN?
Page 489 Sec 1308: The Government will cover Marriage & Family therapy.
Why should this be a mandate that all taxpayers pay for?
Page 494-498: Government will cover Mental Health Services including defining, creating, rationing those services.
As for the dangers, costs, and failure of electronic communication upon which this bill is dependent on, the following article must be studied: The computerization of Britain’s National Health Service has been an expensive fiasco. Why does Obama want to emulate it?
It is also apparent that the Congress will not require themselves to use the public plan as required for most Americans. Why the double standard?
Will abortion services be covered with taxpayer money?
Why is there no mention in HR3200 of malpractice reform? Many studies show that defensive medicine is a major contributor to the cost of medical care in our country.
Senator, I guarantee that I personally will do everything possible to inform patients and my fellow physicians about the dangers of this legislation. Our country was not founded on the socialist principles that make up this bill. There are many other ideas and policies that could be adopted that will not destroy the good aspects of our current health system and cover those who currently are without coverage. I implore you to use a nonpartisan mind to consider these other options. If you vote for a bill that destroys private medicine and the doctor-patient relationship, I will do everything in my power to make sure you and other supporters of this flawed bill lose your job in the next election.
Respectfully,
Stephen E. Fraser MD
Woodrow Wilcox contacted Dr. Fraser and conducted an interview with him, as well.
(Cross posted at HealthcareHorseRace.com.)
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Warner Todd Huston is a Chicago based freelance writer, has been writing opinion editorials and social criticism since early 2001 and is featured on many websites such as NewsBusters.org, RightWingNews.com, CanadaFreePress.com, StoptheACLU.com, TheRealityCheck.org, RedState.com, Human Events Magazine, AmericanDailyReview.com, and the New Media Journal, among many, many others. Additionally, he has been a frequent guest on talk-radio programs to discuss his opinion editorials and current events and is currently the co-host of “Life, Liberty, and the Pursuit of Conservatism” heard on BlogTalkRadio. Warner is also the editor of the Cook County Page for RedCounty.com.
He has also written for several history magazines and appears in the new book “Americans on Politics, Policy and Pop Culture” which can be purchased on amazon.com. He is also the owner and operator of PubliusForum.com. Feel free to contact him with any comments or questions : EMAIL Warner Todd Huston
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