Guest Column: Dr. Alieta Eck

If ObamaCare is Bad, What Would Be Better? By Dr. Alieta Eck, http://www.aapsonline.org

ObamaCare is a wildly unpopular law for anyone who knows anything about health care.  The election proved that.  Physicians came together in Washington, DC to film the following national ad: http://www.youtube.com/watch?v=aPwEVXstFdA&feature=youtube_gdata_player Perhaps it is time for the politicians to admit that the government cannot provide health care.  Period.

All government can do is set up an administrative scheme that pays many people to decide who qualifies for which government program, gives out entitlement “insurance” cards, but then underpays for the actual care.  Bureaucrats get paid while physicians do not.  Taxpayers get fleeced. Before 1965, the administrative costs in a doctor’s office were negligible, especially when it came to caring for the poor. Typically the doctor would not even bother to write out a bill.  For the average patient, the doctor charged a reasonable fee and if the patient had insurance, it was his job to get reimbursed.  People bought “hospitalization” insurance policies.

Today the poor seek Medicaid– the huge federal/state program that entitles the recipient to “free,” care. But since the physicians must fill out forms only to be given a fraction of a reasonable fee several months later, most refuse to take Medicaid at all. So Medicaid recipients with sore throats inappropriately clog up the emergency rooms with twice the frequency of the uninsured.  The system is expensive for taxpayers, demeaning to patients and generally unworkable.

An innovative solution to our health care crisis would involve several layers of care.  The first layer could involve the average person paying his doctor directly for services rendered.  Paperwork would be minimal, patient-physician confidentiality would be maintained, and prices would be kept down by simple competition.  Living healthy lifestyles would save money. A second layer would be personally obtained, non-cancellable health insurance for unforeseen major medical maladies and accidents. These policies should have the coverage and deductible that fit a family budget. The states should merely oversee that the contract terms are met, but not mandate what is to be covered.

Thirdly, safety net non-governmental charity clinics could to be scattered throughout every county in every state with each clinic deciding ways to determining the eligibility of those seeking the free care.   The Zarephath Health Center was started in central New Jersey in 2003 and uses volunteer physicians and nurses to provide free care to the poor.  Patients include the homeless, the mentally ill, the jobless, the undocumented immigrants and even patients with Medicaid cards.  Physicians there diagnose and care for patients with acute and chronic illnesses.  The patients are treated with kindness by those who are willing to donate their time, and currently 300-400 patients get free care each month.

The cost to provide services at the ZHC comes to $15 per patient visit compared to $150 per patient visit at the federally qualified clinic in the neighboring town. The latter clinic has huge bureaucratic administrative overhead and collects funds from the federal and state governments and the patients.  They are constantly asking government for more money. The Federal Tort Claims Act of 1996 provides free medical malpractice coverage for professionals who volunteer at any free clinic. Freed from the specter of frivolous lawsuits, the physician can offer common sense care leaving compliance up to the patients.

Why not devise a similar plan with state rather than federal government involvement? We could set up a system where the physicians donate, say, four hours per week in free care.  A surgeon might agree to take on one charity case per week.  Then, to compensate the professionals who donate their time and expertise, each state could agree to provide full medical malpractice coverage for their entire practice.  Such coverage is already provided for physicians who work or teach in medical school university hospitals. The state would not be laying out money for medical malpractice insurance, but just agree to pay the costs of litigation and payouts. The result?  Poor patients would get care.  Physicians would be rewarded with lower office overhead, not having to pay expensive medical malpractice premiums.  Taxpayers would not have to fund the enormous Medicaid bureaucracy or payments for actual office-based care to the poor.  Unnecessary defensive medical tests would be eliminated causing health insurance premiums to drop for everyone. The number of lawsuits would diminish.

It is time to think “outside the box,” come up with workable solutions, and lower the cost of health care for all.  President Obama said he is willing to entertain any reasonable proposals. Let’s start the discussion.  Charity care and tort reform– perfect together! .

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