A doctor responds to Obama's NYT op-ed

G. Wesley Clark, MD
Mr. President, I just read your op-ed in the New York Times.  You must either be incredibly ignorant (e.g., pediatricians performing tonsillectomies, surgeons being paid $50,000 for an amputation), or else you believe that Americans are incredibly stupid.  

You justify a hasty and massive healthcare "reform" to save money, by spending an additional trillion dollars.  You would fix a "broken" and broke Medicare system by adding another 47 million beneficiaries to government programs while arguing this will reduce overall costs.   

I've itemized your inaccurate claims, with my comments in italics.

You assert that your healthcare reform will:
  • Force insurance companies to insure pre-existing conditions. That's like allowing bettors to wait till after the race has been run, to place their bets. That won't cut costs.
  • Eliminate lifetime limits on coverage. Unlimited lifetime coverages must increase premiums to pay for them and will raise total costs.
  • Require insurance companies to pay for routine examinations, preventive care, and screening tests like mammograms and colonoscopies. Once again, how can you be insured against a sure thing? The only way my company can pay for a colonoscopy is to add enough onto the premium to pay for it, plus their overhead.
  • Make Medicare more efficient, so tax dollars won't enrich insurance companies. Insurance companies do not derive income from Medicare, because it is a federal program. Incidentally, its costs per patient have increased much faster than private insurance.
  • Cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid. These programs have been in effect over 40 years -- and I've seen the waste and inefficiency for most of that interval. Did you just find out about the waste and inefficiency now, and why hasn't something already been done about it?

You claim that:

  • "If you like your health care plan, you can keep your health care plan." But didn't you just imply this week that Medicare Advantage subsidizes insurance companies and should be eliminated to save money?
  • "If you like your doctor, you can keep your doctor." But large numbers of doctors have indicated that they will quit or retire if this plan is enacted
  • "You will not be waiting in any lines." Maybe you won't but we will. Your plan will add up to 47 million new insureds, with no increase in the supply of primary care physicians that are already in short supply.

We physicians live with our healthcare system, all day and every day.  We care about being able to heal.  We hate disputing with insurance companies, and especially with government bureaucrats.  Certainly changes in insurance practices are needed, and would have occurred long ago, absent a government record of 60 years of meddling with the market. 

As you say, "...let's disagree over issues that are real, and not wild misrepresentations" such as those in your op-ed, "that bear no resemblance to anything that anyone has actually proposed."

And I agree, this is about America's future:  whether Americans will remain free, or be ruled by an increasingly intrusive and authoritarian statist government.

G. Wesley Clark, MD

(Doctor Clark is not related to the retired general of the same name)
Mr. President, I just read your op-ed in the New York Times.  You must either be incredibly ignorant (e.g., pediatricians performing tonsillectomies, surgeons being paid $50,000 for an amputation), or else you believe that Americans are incredibly stupid.  

You justify a hasty and massive healthcare "reform" to save money, by spending an additional trillion dollars.  You would fix a "broken" and broke Medicare system by adding another 47 million beneficiaries to government programs while arguing this will reduce overall costs.   

I've itemized your inaccurate claims, with my comments in italics.

You assert that your healthcare reform will:
  • Force insurance companies to insure pre-existing conditions. That's like allowing bettors to wait till after the race has been run, to place their bets. That won't cut costs.
  • Eliminate lifetime limits on coverage. Unlimited lifetime coverages must increase premiums to pay for them and will raise total costs.
  • Require insurance companies to pay for routine examinations, preventive care, and screening tests like mammograms and colonoscopies. Once again, how can you be insured against a sure thing? The only way my company can pay for a colonoscopy is to add enough onto the premium to pay for it, plus their overhead.
  • Make Medicare more efficient, so tax dollars won't enrich insurance companies. Insurance companies do not derive income from Medicare, because it is a federal program. Incidentally, its costs per patient have increased much faster than private insurance.
  • Cut hundreds of billions of dollars in waste and inefficiency in federal health programs like Medicare and Medicaid. These programs have been in effect over 40 years -- and I've seen the waste and inefficiency for most of that interval. Did you just find out about the waste and inefficiency now, and why hasn't something already been done about it?

You claim that:

  • "If you like your health care plan, you can keep your health care plan." But didn't you just imply this week that Medicare Advantage subsidizes insurance companies and should be eliminated to save money?
  • "If you like your doctor, you can keep your doctor." But large numbers of doctors have indicated that they will quit or retire if this plan is enacted
  • "You will not be waiting in any lines." Maybe you won't but we will. Your plan will add up to 47 million new insureds, with no increase in the supply of primary care physicians that are already in short supply.

We physicians live with our healthcare system, all day and every day.  We care about being able to heal.  We hate disputing with insurance companies, and especially with government bureaucrats.  Certainly changes in insurance practices are needed, and would have occurred long ago, absent a government record of 60 years of meddling with the market. 

As you say, "...let's disagree over issues that are real, and not wild misrepresentations" such as those in your op-ed, "that bear no resemblance to anything that anyone has actually proposed."

And I agree, this is about America's future:  whether Americans will remain free, or be ruled by an increasingly intrusive and authoritarian statist government.

G. Wesley Clark, MD

(Doctor Clark is not related to the retired general of the same name)