2012-07-20 / Columnists

A Prescription For Reason

The Future Of Medicine In A Declining America
Commentary By Dr. Harold Bendelstein

Amid all communities in the area, Rockaway has found itself at the center of the health care debate more than any other. The recent closure of Peninsula General Hospital has diminished our options for effective medical care with no major resurrections of comparable standards in the future. A recent overreaching Supreme Court decision on Health Care Reform has precipitated another even greater crisis of perilous uncertainty in our local and national health care delivery mechanisms. What does all this mean to Rockaway citizens and the country at large? Unfortunately it is virtually all bad news and no planned future interventions seem to be providing optimistic forecasts. Having practiced as a specialty surgeon in our beloved locale for the last 25 years, the entire scenario appears revolting and troublesome.

Over the years the United States has always maintained the greatest Health Care System in the world. We were, and still are, the envy of the world in this capacity. Slowly but surely the last 20 years have presented itself as the erosion of this commodity for a number of highly unfortunate reasons.

As the overall population has aged, concerns began to surface that Social Security and Medicare will require larger expenditures, placing their solvency at risk. The government perception was to then revamp the health care delivery system as a finance saving mechanism. The general premise was reasonable, but its manifestation and implementation embraced political cronyism and heavy concessions to special interests destroying any chance of success. As the overall cost of living spiraled for all Americans, insurance companies were given state blessings and approvals for usurious rate increases, lawyers were left unimpeded to launch medical malpractice suits for even the most trivial reasons. Verdicts began to skyrocket and medical malpractice rates for doctors shot through the roof. In addition to allowances for lawyers, insurance companies and malpractice carriers to garner record profits, doctors had fees for services cut nearly 5 percent per year to where now surgical fees have plummeted over 70 percent in the past 20 years, while physician costs in all parameters keep rising. Bureaucratic authorities somehow reasoned that the only component of the medical system worthy of massive reductions was its actual practitioners and deliverers. All other compartments could somehow maintain upward major profit margins.

Unfortunately, medical doctors are generally cowards and proved totally impotent to halt their victimization at the expense of other more potent lobbying groups. HMOs came into existence to further cut fees and ration procedures through mercenary authorization procedures and government and quasi government organizations like the Joint Commission, the Department of Health, and federal legislators and regulators have done their worst to minimize doctors’ profits and decision making abilities to the patients’ detriments, while other related medical industries such as legal, insurance, malpractice, medical supplies, equipment and Big Pharma drugs have been allowed to thrive with impunity. Contained within all groupings that have ever attempted reform of the health care system have been strong representations from all sectors save the cowardly medical doctors, who have stood like statues of Jello and sucked all these indignities like pablum without protest. Most meetings in hospitals and medical staff communities today all center on how doctors formulate compliance guidelines to outside dictates that totally destroy effective healthcare, while abrogating any means to combat these repulsive policies and advancing putrid state of affairs for doctors and patients.

How has this catastrophic insanity in the medical world been allowed to fungate? Cowardice on the part of the medical practicing doctors is certainly a major contributor. It also has been the public relations juggernaut that has fostered the great myth that American medicine compares poorly to other developed countries, and it would behoove our country to adopt the policies of these more enlightened and professional systems. Within all this our governmental bureaucrats and politicians have managed to dwindle the once serious respect for the nobility of medicine and its doctors in this country to relegate doctors to mere provider numbers in a catalog who can be abused by just about anyone. Such abusive positions are rampant. Peninsula Hospital administration was a veritable Mecca of back-stabbing. Undeserved harassment of doctors floated like water from a ruling cadre of a simply selfish and corrupt leadership. Arrogance and greed caused the hospital’s closure. Other hospitals I am aware of even ticketed doctors’ cars for using an ER parking lot to perform even life-saving measures in the middle of the night reasoning, “What difference can a three to five minute gap lead to?” Such bureaucrats should put that question to the afflicted patient unable to breath or bleeding to death. Those three to five minutes can become critical. Try holding your breath for three minutes non-stop and reasoning becomes more sanguine. There are hundreds of other cases nationwide involving great numbers of hospitals. Thirty years ago such disrespect and lack of physician appreciation would have been unheard of. While state funding may augment the facilities at St. John’s and other facilities such as the Addabbo Center, the excellent Peninsula Hospital ER medical and nursing staff, its crowning jewel is irreplaceable. No amount of financial infusion will shorten the distance between Breezy Point and the Five Towns Border. Peninsula’s unwarranted closure, though deserved in repudiations, is non-replaceable and a major health care loss to the Peninsula.

Political bureaucrats like Health and Human Services Director Kathleen Sebelius claim the United States ranks 33rd in health care just below Slovenia. But these statistics are simply based on life expectancies by the World Health Organization. They do not in any way reflect quality of life issues. People in Finland and Canada may live one to two years longer than Americans, but their wait times for needed procedures is unbearably longer if ever allowed. An American who needs a hip replacement will procure it in a matter of weeks and spend the next number of years walking, while his Canadian counterpart can spend years in a wheelchair awaiting the procedure, but he may live six months longer. So he cannot walk, how important can that be?

Justice John Roberts inflicted a horrific curse upon this country. By rewriting the ObamaCare statute to call a mandate a tax, something President Obama lied about, he stretched the constitution to allow judicial activism to augment an already self-declared imperial presidential executive authority and create the impetus for what if undeterred will be a government takeover of health care. It will herald the death of private insurance, create rationing of procedures through government required authorizations for all interventions, and create a system based on socialism and bureaucratic control rather than doctors’ judgments. The only cure is to balance the entire system. All contributors and components, not just doctors, must make equivalent sacrifices. Doctors need to organize and form influential groups of practicing physicians, who actually treat patients, not academic paper pushers like the AMA. Tort reform with absolute caps is mandatory. Insurance competition should be encouraged even across state lines but regulated so that doctors receive fair reimbursements for their work performed and consumers are charged to pay only reasonable fees for coverage while insurance companies are compelled to deny themselves exorbitant profits yet make a healthy return on their investments. In totality, while even including coverage for pre-existing conditions. This will allow patients to receive the quality of care they need and access to the technology and medically doctor controlled professional judgment that has maintained the historically high quality standard that has made our country the gold standard in the world for medical care. The absence to do so will lead us to failed socialistic rationing policies.

The dilemma is a critical one. Do we believe a government that has machined a 2,400 page regulation written manual with 30 new taxes and mandates under strict federal control? Such gullibility would compel the public to swallow a barrage of misguided promises and proclamations for which the track record of their designers is largely untrustworthy. The difference in our choice is whether to have faith in a government that does not truly respect the people and manipulates the constitution or the greatness and foresight of the historically vaunted American People. It is the disparity between merely having medical coverage and really being covered. How long can you hold your breath? Two minutes or three minutes? Maybe it does not matter. Maybe it is the difference between your life or death.

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