There are “no laudable parts” in the “health care reform” bill, say AAPS members

In a letter to the American Society of Anesthesiologists (ASA), which like many medical organizations has expressed some reservations about reform bills “in their current form,” AAPS President Mark Kellen, M.D., of Rockford, Ill., writes: “The entire logic of H.R. 3200 is flawed and is based on decreasing patient choices and ultimately transferring control to the federal government…. The bill has no laudable parts.”

A coalition of some 17 state medical associations and three specialty societies discussed distancing itself from the AMA and opposing the inclusion of a public insurance option. The Medical Association of Georgia is “opposed to the creation of a public option under any circumstances,” said executive director David Cook (Congress Daily AM 7/16/09).

The American Society of General Surgeons (ASGS) issued a statement opposing certain features of the public option: the use of the Medicare reimbursement system, and the automatic enrollment of surgeons who participate in Medicare.

So far, none other than AAPS has issued a statement of unqualified opposition, and physicians are threatening to resign from societies that endorse the bill or offer only tepid objections.

“This is war,” said George Watson, D.O., of Wichita, Kan., President-elect of AAPS. “This is a bureaucratic boondoggle to grab control of health care. Everything that has been proposed in the 1,018 page bill will contribute to the ruination of medicine” (FOXNews.com 7/22/09). The bill is loaded with rules and regulations that will result in shoddy care and long waiting lines, he added. The provision to force doctors contracted with Medicare into the nationalized plan is a “trap” that he called “involuntary servitude.”

Announcing her resignation from the AMA, Elizabeth Lee Vliet, M.D., of Tucson, Ariz., also an AAPS member, said: “The AMA is not representing patients or doctors anymore.” She noted that 85% of AMA revenue comes from business interests such as CPT codes, not membership dues (ibid.).

Public opposition is rising as Americans learn about what is in the bill. Despite the efforts of left-wing community organizers to mobilize support, calls to Congress are reportedly running 15 to 1 against the bill, according to Greg Scandlen (Consumer Power Report #187, Jul 24, 2009).

Some of the non-laudable features coming to light are:

  • Mandatory “end-of-life counseling” for seniors, at least every 5 years. This amounts to an attempt to convince seniors to die, according to former New York Lieutenant Governor Betsy McCaughey. A “quality reporting initiative” will measure creation of and adherence to “orders for life-sustaining treatment” such as “artificially provided nutrition and hydration” (WorldNetDaily 7/23/09). Further evidence of the assault on seniors is White House budget chief Peter Orszag’s urging Congress to delegate its Medicare oversight authority to an executive agency, thus dodging accountability (Wall St J 7/23/09). “Reform” amounts to a “repeal of Medicare as we know it,” write Dick Morris and Eileen McGann. The elderly will go from being the group with the best access to care to the one with least access (Newsmax.com 7/9/09).
  • Repeal of ERISA. About 75% of employer-provided insurance is now governed by “freedom to purchase” rules under the Employee Retirement Income Security Act (ERISA). This keeps costs down by allowing businesses to avoid many costly state regulations. After a 5-year grace period, all plans would be subjected to “bureaucratic nanomanagement”—and also opened to lawsuits over employee benefits now barred by ERISA. This is one major reason why the Wall Street Journal, in its lead July 21 editorial, calls H.R. 3200 “one of the worst pieces of legislation ever introduced in Congress.
  • Reckless experimentation on the economy. While the President claims that his health care reform is necessary to save us from a health-care system that is “breaking America’s families, breaking America’s businesses, and breaking the economy,” Orszag and congressional staff are flipping through the tax code looking for new sources of revenue (Wall St J 7/24/09). A Congressional Budget Office (CBO) chart shows stepwise increases in revenue ($50 billion, as from taxes on businesses and uninsured individuals, by 2020) and far larger deepening of the deficit (by $250 billion in 2020) (Wall St J 7/21/09). Even Orszag’s proposal for a Medicare-cutting agency would actually save almost no money over 10 years, according to the CBO (Politico 7/25/09).
  • Disappearing ink, invisible ink. Nobody knows what will really be in the bill that Obama wants people to rush to support. It’s hard to rally public support, said Pharmaceutical Care Management Association president Mark Merritt, “around policy that doesn’t exist yet.” People have heard about reform aspirations, but not what reform will look like, or who will pay for it (Politico 7/24/09).
  • A monstrous, ugly bureaucracy. A chart prepared by Rep. Kevin Brady (R-TX) of the proposed structure for controlling medicine is so monstrous that Republicans are forbidden to use the franking privilege to send it to their constituents. If Congress doesn’t really mean for bureaucrats to be in control, why was John Shadegg’s proposed amendment voted down? The amendment reads: “Nothing in this section shall be construed to allow any federal employee or political employee to dictate how a medical provider practices medicine.”.
  • Equal pay for unequal qualifications. Section 1304 would raise Medicare and Medicaid payment to certified nurse midwives to the same level that obstetricians receive for procedures coded the same (CNS News.com 7/23/09). The midwives’ fee is currently only 65% as high. H.R. 3200 not only allows nurse practitioners to lead a medical home, but it changes the very definition of “physician”: on p. 445, the bill states: “(C) PHYSICIAN- the term ‘physician’ includes, except as the Secretary may otherwise provide, any individual who furnishes services for which payment may be made as physicians services.” The bill repeals the definition of “physician” in the Social Security Act, which states: “The term physician when used in connection with the performance of any function or action means (a) a doctor of medicine or osteopathy legally authorized to practice medicine and surgery by the State in which he performs such function or action.”

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13 thoughts on “There are “no laudable parts” in the “health care reform” bill, say AAPS members

  1. Satan himself couldn’t have written a more effective bill to destroy the greatest medical system the world has EVER seen.

    Or perhaps he did…

    Urge every physician you know to opt out of Medicare as rapidly as possible, in order to escape the clutches of this Machiavellian nightmare…

  2. Since these programs are going to be so good one would assume that all governmental and congresional insurance programs would be dismanteled and deleted in orde to sign up, Did not the the Senator Obama say that we would have the same health plan that he and our congressmen and senators have. Dr. Koop, I am told once said that you lood at ACCESS, QUALITY AND COST. YOU CANNOT HAVE ALL THREE WITHOUT BANKRUPTING THE COUNTRY. lOW COST, EQUAL ACCESS EQUALS POOR QUALITY. WE CONTINUE TO PAY FOR NEW SERVICES(NURSE PRACTIONERS) WHO LARGE HOSPITAL ORGANIZATIONS AND PHYSICAIN EMPLOYERS ARE USING TO EXPAND AND INCREASE THEIR INCOME WHEN THERE IN ACTUALITY IS VERY LITTLE PHYSICAIN OVERSITE. PATIENTS ARE BEING MISDIAGNOSED AND MISTREATED AND MILLIONS OF DOLLARS SPENT FOR UNNEEDED TESTS FROM UNTRAINED OR POORLY TRAINED NURSE PRACTIONERS. A TWO YEAR TRAINING PROGRAM AFTER NURSING SCHOOL EQUALS THE SAME PAYMENT A PHYSICIAN GETS IF THEY ARE SUPERVISED. WELCOME TO THE VA, PUBLIC HEALTH AND MILITARY MEDICAL SYSTEM, I HAVE WORKED IN THEM ALL GET READY FOR POOR ACCESS, POOR QUALITY AND INCREASING COSTS. THERE IS NO CONCRETE PLAN ON HOW TO PAY FOR THIS EXCEPT TO DECREASE PHYSICIANS FEES WHICH ARE NOT INCLUDED IN THE PRESENT NUMBERS, INCREASED TAXES THAT HAVE NOT BEEN DEFINED.

    200 YEARS AGO , British historian Alexander Tytler used lessons from the past to make a dire prediction about the future.

    “A democracy cannot exist as a permanent form of government. It can only exist until the voters discover that they can vote themselves largness out of the public treasury. From that moment on, the majority will always vote for the candidates promising the most benefits from the public treasury, with the result that democracy always collapses over loose financial policy, always to be followed by a dictorshsip”

    Alexander Tytler, meet the U.S. Congress and the members of society who want to use someone else’s money to purchase their benefits.

    The quote from Alexander Tytler was taken from a newpaper article and I have not verified its source but it sound right on the money to me.

    Roger D. Neal

  3. Please explain what I can do to put an end to this monster. I am a senior, but I worry for my grandchildren

  4. Email to the American Society of Anesthesiologists tonight:

    I am not an ASA member, nor an AMA member, but am a card-carrying member of AAPS because they represent my interests on a number of issues large & small. I am also a board certified anesthesiologist.

    Precisely what do you find “laudable” in a health care bill that cuts anesthesiologist reimbursement almost 70%, reduces patient choice, and drives private insurance into the ground all in the interests of a naked power-grab by Washington?

    Would you find US army tanks rolling through streets of a major city and reducing buildings to rubble “laudable” as well?

    I had been considering joining ASA, but can not as I am extremely disappointed in you and your positions. What sort of milk-toast, limp-wristed panty-waists are leading you anyway?

  5. I have not read H.R. 3200 involving 1,018 pages of what I would speculate to be painfully written legalese. So, my comments do not come from a place where I can say that I have read this bill, understand it, and find the following faults with it. What bothers me is that I continually see decisions of great consequence made in our country where appropriate analysis has not been even close. The Bush administration’s decision to invade Iraq is one such decision and H.R. 3200 may be on par with it insofar as further disastrous consequences.

    Perhaps others can enlighten all of us as to who constituted the panel of experts that put together HR3200. Are there colleagues of ours having 4-5 decades in the front lines of medical care involved in the origin of this bill, or is the bill another creation of those politicians who talk about healthcare but in the face of the current healthcare crisis are not mandated to use Medicare for their coverage? If that is not an example of hypocrisy and deceit that all Americans should be enraged about I do not know what will really stir the our fellow citizens.

    For myself, I do not at all concur with Gary Mohr’s statement that ours is the “greatest medical system the world has ever seen.” My practice involves patients from around the world and with what I have seen in the U.S.A. I would not be extolling our healthcare system, which has been broken for some time. We have epidemic numbers of Americans with diabetes mellitus, obesity, osteoporosis, neurodegenerative diseases, prostate and breast cancer, and many other illnesses. We have tools to utilize right now an EMR (electronic medical record) that would raise the level of care dramatically but we will end up spending hundreds of millions of dollars devising such an EMR and take another 5 years to do it. We do not reward patients and their physicians for good outcomes nor punish the same for poor outcomes. Even the healthcare plan used by Safeway food stores over the last 4 years shows that to be a way to lower costs and raise the level of care; at least it should be looked at. Hope of reward and fear of punishment is what drives human beings. That’s just reality that is being ignored.
    The bottom line is that it appears that due diligence involving construction and analysis of this bill has not been satisfactory. If there has been an indepth review of this bill by people of expertise and no axe to grind, please share with me details of this information.

    Stephen B. Strum, MD
    Medical Oncologist Specializing in Prostate Cancer

  6. Pingback: One problem with the proposed health care bill | WeeksMD

  7. I live in TN. Our state run Medicaid program (TennCare) was hastily composed and what a nightmare it has been.

  8. I hope that we can defeat this bill. It is a disaster waiting to be ushered in by the thugs in power.

    I’m still in medical school, and I am, quite frankly, terrified of what these foolish brutes are going to do to my (future) profession. When I decided to go to medical school, I didn’t envision being the lackey of a bureaucrat.

    Don’t get me wrong–I love medicine and wouldn’t change my choice of careers in 100 years. I get up every morning excited about what I’m going to learn in class, and I look forward to getting up every morning excited about doing my job.

    If Obama and his thugs get their way, they’ll turn doctors from skilled, caring professionals into something akin to assembly line workers. Hopefully, those of us who are serious about our profession and the care we deliver to patients will be able to opt out, though I suspect that in the future, if things keep going the way they are, there will be a movement to force us to work in the government system.

    I feel a deep sense of sadness for the millions of patients who will inevitably be stuck on a slow-moving government conveyor belt, hoping they get the care they need before they suffer an untimely death.

    People need to understand the stark reality of this bill: It will lead to the untimely death of (most likely) hundreds of thousands of patients every year. That is the change Obama is bringing to America.

  9. From information taken from various sources, I have never in my lifetime seen a bill so antithetical to the heart of medical practice, the doctor-patient relationship. The very creation of a ‘Health Choice Commissioner’ (?Commisar) should tip one off as to who will be making the choices in healthcare; a “public option” promising to quickly extinguish any vestige of private healthcare in America.
    Medical student, Kyle Varner, would seem to speak for many future physicians who may, should this bill or one like it pass, become very reluctant to go into 6-figure debt while pursuing a profession which has been stripped of its idealism in favor of becoming a paid servant of the government.
    The AMA now allegedly represents only about 17% of practicing physicians, and I’m sure their membership will dwindle futher should they persist in their support for this bill, which markedly adds to the onerous debt to be inherited by our children; creates new taxes for a populace already realing from economic hardship; will reduce the number of physicians to serve an added 50 million newly insured, thus creating shortages and rationing–especially for the most frail and vulnerable sector of our society on Medicare–while including funds for abortion to limit population at the other end of the demographic spectrum.
    Although personally pro-life, I believe this ‘Rosemary’s Baby’ should be smothered in its legislative bed before growing to its potentially seething adulthood.

  10. Just saying “no” to Satan isn’t enough. One must champion an alternative. The status quo will not do.

    An effective alternative must expunge the root cause of ridiculously high costs: Present insurance regulations.

    Costs of health care DO come down – if not covered by insurance. Lasik eye refraction, for example, or cosmetic surgery where surgicenters are allowed and not prohibited by “Certificate of Need” laws. On the other hand, new technology never comes down in price if covered by insurance.

    Buying insurance across state lines without in-state mandates is a start in the right direction. Tax deductibility for all and not just employers is another must. Any insurance regulation that reduces competition must be out. If insurance companies are exempted from anti-trust laws, then this must also be changed.

    None of these changes require much of any revenue. Nor is government power over individual lives expanded. These changes get at most of the causes of the current cost crisis [though not all] and the doctors and their patients are properly re-empowered.

    Kyle Ver Steeg, M.D.

  11. Patient Power – cash payment (prefunded for the poor) for health care costs less than ~$2,000/yr, with catastrophic care premiums costing only 1/3 full coverage, (Health Savings Accounts) – is proving thrifty and satisfying.
    Politicians oppose this elimination of their protection racket.

    Medicare and Medicaid HSAs (high deductible prefunded) would save the war games money for recipients and taxpayers – so you won’t hear of it from politicians.

  12. Pingback: More dangerous provisions identified in H.R. 3200, “America’s Affordable Health Choices” « AAPS News of the Day

  13. This message is for Kyle Varner and all other college students planning a career in medicine or in medical school now: DO NOT DO IT. DO NOT GO INTO MEDICINE. ABANDON THE PROFESSION IMMEDIATELY AND TAKE CARE OF YOURSELF. EVERYHING YOU HAVE BEEN TOLD ABOUT THE PRACTICE OF MEDICINE IS A LIE. PHYSICIANS ARE WORSE THAN BUREAUCRAT LACKEYS, THEY ARE BONDED GOVERNEMENT SLAVES, AND THEY HAVE NO ONE TO BLAME BUT THEMSELVES.

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