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David Gray MD: Rx for health care

David Gray MD
Breckenridge

Last week, our president made a statement to the effect that “doctors take kids tonsils out so that they can charge more.” I am deeply offended by that sweeping generalization, which is also a lie. Of all people, this president should be sensitive to the injustice of branding a group of people. Its called bigotry. Prior to that he told a crowd in Green Bay that “doctors order duplicate lab tests because they make money doing that.” Doctors don’t earn a dime from lab or x-ray; that is illegal. Its called the Stark amendment.

Almost makes me miss George Bush.

This president wants to reform our health system, and I applaud that. He wants to expand coverage, and lower costs. These are mutually exclusive goals, without addressing the real causes of medical inflation.

Twenty years ago, health insurers operated on a 2 percent profit margin. Today, that is 20 percent. They do this by denying claims, or making it so difficult to collect that people give up. Just enough to keep themselves out of jail. Where did that 18 percent increase in profit come from? And, when did it occur? By my reckoning; over the past 20 years. The second cause, also occurring over the past 20 years, has been the dramatic increase in law-suit abuse. In a courtroom, emotion can trump truth and common sense. All it takes is one doctor to get the shaft, and thousands change their practice, not based on science, but on fear. John Edwards successfully sued an obstetrician in North Carolina, using bogus expert testimony, and the C-section rate went from 8 percent of births, to 24 percent, almost overnight. Obstetricians all over the country took note. The maternal death rate increased after that.

That’s the tip of that iceberg. I’ll give one concrete example to illustrate how we might save billions immediately. If you bring your 3 year-old child to a Hospital Emergency Room with an earache, it should take me from 6 to 15 minutes to examine, diagnose, and reassure you as a parent, if appropriate. The reality is that the visit will take three or more hours, and cost six times what it should, because, as a physician, I’ve been conditioned to think as follows:

If this kid is diagnosed with leukemia 2 years from now, and the family happens to find their way to a lawyer’s office, I know they will scrutinize medical records, and possibly find me negligent for not having ordered a complete blood count in the ER two years earlier, when the child came in for an ear infection, and I might have uncovered the leukemia then. All it takes is for one ER doc to experience this, and thousands change their practice. Want to lower medical costs? Get lawyers out of medicine. Think this will happen when a lawyer is president, and the majority of his party’s representatives are lawyers? Have you even heard the president address this driver of health care costs? Don’t hold your breath.

My suggestion: call your representative; ask three questions:

1. Will you read, thoroughly any health bill, before you vote. 2. Are you willing to join me in this health plan you design, and give up your Cadillac version you designed for yourself. 3. Are you willing to ignore the money and power wielded by Insurance companies, pharmaceutical companies, and lawyers, and address the real problems?


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