My last blog was a call to action for the proposed 5% tax on cosmetic surgery. In addition to my blog, I asked all of my existing patients to write to their US senators and object to this tax. Thanks to all who did so and anyone and all who made an effort to have their voices heard. Although you probably already know, I am happy to report that this tax was removed from the final senate version of the health care bill.
What is news is that the entire health care reform is now in jeopardy. Senate democrats lost their crucial 60th vote when Republican Scott Brown won Ted Kennedy's Senate seat in a special election, and he used his opposition to the current health care bill as a central theme to his campaign. The irony that a Republican could win a Senate in a liberal state that has been represented by a Democrat since 1952 and at the same time replace an icon whose biggest interest was health care reform has not been lost on our political leaders.
Democrats, including President Obama, recognize that the people of Masachusetts have sent a message on behalf of the American people that our leaders have lost touch with our interests and needs. The cosmetic surgery tax was just one example of the arrogance that has been at play as they set about to "solve our problems."
Everyone agrees we need health care reform. However, there are two crucial components that have been ignored. The first is some type of reform to reign in the costs of defensive medicine (tests, referrals, and procedures done to avoid being sued). These costs are extraordinary because they happen in every office and hospital in the country every day. Physicians need to be able to practice without looking over their shoulders.
The second is the existence of hospitals and insurance companies publicly traded on the stock exchange. As long as they exist, they have one primary responsibility: to increase profits. As anyone who has taken Accounting 101 knows, there are only two ways to increase profits. The first is to increase revenue (increase premiums); the second is to decrease costs. Yes, you can decrease costs by decreasing payments to caregivers, but this path can only continue so far and then there is nothing left to hold back and no one left willing to deliver health care. In the end, the only way to continually decrease costs is to withhold care, which is what is happening right now, and this is the number one frustration of the 85% of American who have insurance.
It is mind boggling that our leaders could pretend to have solved the health care mess without any meaningful attempt to address these two issues. Since that is not going to happen, we are better off if the changes made are small so they are easier to fix when they fall under the law of unintended consequences.