Advice for President Obama on Getting Medical Support for Legistlation

Max's advice for February 27, 2009

Dear President Obama,

Max grew up as the son of a man who knew 'ALL' the answers to the problems of the world. Max's father said so! Many times, his father let everyone know that anyone who didn't know that he had the answers was a turkey or a knucklehead.

The famous Ma Bell, the second most powerful force in the world (next to God of course), thought so much of Max's father's opinions, that she made him 'Supervisor of Troubles'. This is true!

The advice Max promised you, President Obama.

Find a way to get more doctors on your side!

Max, like millions of Americans, has a number of visits with doctors every year. Whether it is due to the influence of the pharmaceutical industry or the legal industry, many of the doctors get very nervous when anyone talks of healthcare reform.

It isn't that the doctors don't know the system isn't working; the issue appears to be that the system is working all right for them. They pay huge upfront costs for insurance with a certain knowledge that soon or later some patient or relative of a patient will sue them. Yet in their minds the Democratic party is the culprit behind this legal environment.

These same doctors hate having to work with managed care and multiple insurers who pay different rates for every procedure and require extensive paperwork. It is a pain in their .... You know.

Yet the same doctors that hate high insurance fees, managed care, pushy pharmaceutical representatives and huge administrative overhead do not see anything in what they believe you are proposing that makes it anything but worse.

Reforming the health system should be about the whole system and not just the simple cost of patient coverage issue. Shifting money around the system may help some but it will, at the same time, hurt others if a more thorough change doesn't take place.

Finding ways of limiting health care claims when the doctor did what he or she could in attempting to resolve an illness or injury would be a first move that might be helpful.

Finding ways of removing doctors and nurses from the field who are not practicing medicine in competent and safe ways would limit the risk of injuries.

Reforming the way research is funded and new drugs enter the market could help reduce costs that are tied to these drugs. Up to half of the cost of delivering a new drug to the market place can be related to the cost of sales forces. If doctor education processes could be instituted to inform doctors nationally when advances occur, this cost might be reduced. This is a rather difficult area as in-person representatives (in spite of the cost) may be providing first hand training to doctors and their staffs on how to administer new drugs. Dropping the current approach to representatives familiarizing doctors before an adequate educational process is in place could disrupt both new drug introduction and best medical care.

Most doctors and nurses are in health care because they have an interest in helping people live better lives. They are also in the field because the pay is higher than many other fields.

There are a lot of legitimate concerns about any single payer approach to healthcare. In a multiple insurer environment, some doctors have the ability to leverage their specialties for higher payments. When insurers refuse to pay fairly, they stop taking certain insurances. With a single payer system, these same doctors fear that they will have no leverage to keep the payment in line with their cost of living. They took extra education with the hope of helping people and living a good life style.

The present system clearly needs to be reformed in major ways. Doctors choosing to be family physicians are choosing to help people while limiting their earning power. In small towns and in parts of some cities, there are no family physicians and no new ones being trained. This is a basic need of any modern society, yet the current medical schools are not meeting this need because students are choosing to specialize.

Giving everyone insurance will not increase the number of nurses or doctors by even one. Bringing in people who were excluded from coming in the front door will tax many facilities that are in areas where shortages of medical personnel already exist.

Something must be done! The time for doing something has long since passed. It is important that when you start to do the things that need to be done, the things that enable the change in coverage take place at the same time.

The issues of doctor and medical facility liability and insurance need to be addressed.

The issues of training sufficient doctors and nurses of the right type needs to be addressed.

The issues surrounding the incentives for finding and developing new drugs needs to be examined.

The issue of introducing new pharmaceuticals and techniques to doctors while changing sales practices needs to be researched.

Getting feedback from the new and old generation doctors and nurses similar to the economic round table might be one way of starting the conversation.

Max wishes you well in your choice of your new Secretary and her efforts on this.

Max writes about greenways, rare diseases, timely topics, places to eat, travel and other issues of interest. He encourages you to add your comments.

Link one is about what is happening in Hawaii over insurance issues.

Link two is California's approach to malpractice costs.

Link three is insurance issues for cancer patients.