Doctor Side of the Healthcare issue

Dr. Nelson is a well respected family Dr. in Merced. Linzi went to school with her sons. She was there to help Sue along when Dr. O was recovering from arm surgery during Sue's pregnancy with Linzi. The following was published in our local paper the Sun Star on Tuesday.

Lorraine K. Nelson, M.D.: How to fix health care

When I first started private practice, my partner and I employed two full-time employees who easily handled all the office services from nursing through billing.

Now, for the two doctors in my current practice we employ almost five full-time employees for the same services. This increase was not due to government programs. It stemmed from private insurance industry changes making it more and more complicated to see the patients and provide the appropriate care.

Patients I had been seeing for years were told by their insurance companies to see someone else with whom they had a better contract. Specific procedures and referrals were delayed while authorizations were sought, denied, and appealed.
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The paperwork inside the office and the frustration for patients, staff and doctors increased, all the while as reimbursement declined for the doctors and profits increased for insurance companies.

Contrary to the assertions of health insurance industry lobbyists, the biggest risk (and cost) for a bureaucrat interfering with your appropriate care is the insurance bureaucracy itself, not your government.

In the current system approximately 31 percent of every health-care dollar is spent on advertising, public relations (lobbying), paperwork, administrative overhead, related salaries and profit for the insurance corporations.

These insurance companies are currently spending more than $1 million per day in lobbying and PR to oppose and delay any meaningful health-care reform that would cut into their jobs and profits.

For every dollar of private health insurance premium, only 83 cents goes to actual health care. Contrast that with the 97 cents on the dollar of patient-care benefits Medicare (our government funded program) provides.

Many Americans cringe when they hear the "R" word -- rationing. Please be aware, we already ration. We ration on the basis of whether the patient has money or insurance and whether the care results in a profit for the insurance company instead of need for service.

Furthermore, the current system actually rewards over-utilization rather than appropriate utilization of services and procedures.

Your doctor, nurse, hospital and pharmacies get paid a fee for service. More "service," needed or not, means more profit. Why else would you be seeing advertisements for costly nongeneric drugs on television.

We need to change the way we reimburse for services to get the most for our money.

There are more than 46 million Americans without health insurance. More than 14,000 people per day lose health-care coverage as they lose their jobs or their employer decides to no longer provide an expensive health plan.

Despite the fact that we pay an average of more than $7,000 for every man, woman and child for health care, our country performs poorly compared to other industrialized countries which provide universal access to care at about half that cost.

Unanticipated health expenses is the single most common reason for bankruptcy in our country.

Our system is broken. We are all at risk. It is time for change. You can help. The answer is universal access to health care for all using a single-payer delivery system. It can be done. The example is Medicare: our government provided tax-based universal health access program for seniors.

This Thursday, California Central Valley Journey for Justice is sponsoring a 40-year birthday party for Medicare with a rally and information picket on the corner of M and 21st streets starting at 3 p.m.

Following the rally, we will march to Rep. Dennis Cardoza's office to show our support for a single-payer system. Please join us and let your voice be heard.

If you can't be there, tell a friend and or call or write Cardoza and ask him to support HR 676, which would extend Medicare-type coverage to all Americans. We can afford this cure. We cannot afford to let the current system fester. We all suffer from this illness and we must all work together to heal it by providing basic health care for all.

Lorraine K. Nelson, M.D., has practiced family medicine in Merced for 30 years.