Medical side of Health care reform

I received the following in my e-mail. It was sent by a friend, and since it is so close to home, literally, Atlanta, I decided to post it here. Fact is, if it had been written by a doctor in Fairbanks, AK, I'd want to post it.

Before I get to that, since I'm here, I know you've all heard HO is in Martha's Vineyard, on vacation. Like they say, there goes the neighborhood. Seems they're hitting all the high spots, except church. Have they picked one yet? Or better yet, have they been to church since taking the oath to uphold and protect the Constitution?

I did hear that the recession is over. I was really glad to hear that this morning. I'm sure some of my coffee shop breakfast buddies will be glad to hear it also. And I was almost overcome with joy when I heard Bernanke was going to get four more years, since he did such a good job of guiding us out of the recession...wow!

I feel really bad, because I had not even noticed the recession was over. I guess it was all the success of the CARS program. Maybe I should have bought one while I had the chance. Had I known the recession was ending, I probably would have.

But, back to Dr. Pollard's letter. It includes his contact info, which was on the one I received, so I guess it's okay to pass it on. While I'm on the subject of doctors, I used to think my family physician was such a rebel for not belonging to the AMA. Well, apparently he has lots of company, as only about 17% of MDs belong. Oh, well, he's still pretty cool, except he's a flaming liberal. He's pretty much anti-gun, too, except for once. He was telling me when he lived in this particular place, here in town, someone was trying to break into his house, and he found himself wishing his neighbor was home. His neighbor was on the other side of the gun issue, and at that moment, my doctor friend wished he had access to his neighbor's help. Something scared off the intruder, but one can't always count on that happening. Here's Dr. Pollard's letter:



Zane F Pollard, MD

Eye Consultants of Atlanta
3225 Cumberland Blvd., SE
Suite 900
Atlanta, GA 30339
404-351-2220

By Zane F Pollard, MD

I have been sitting quietly on the sidelines watching all of this national
debate on healthcare. It is time for me to bring some clarity to the table
by explaining many of the problems from the perspective of a doctor.

First off the government has involved very few of us physicians in the
healthcare debate. While the American Medical Association has come out in
favor of the plan, it is vital to remember that the AMA only represents 17%
of the American physician workforce.

I have taken care of Medicaid patients for 35 years while representing the
only pediatric ophthalmology group left in Atlanta, Georgia that accepts
Medicaid.

For example, in the past 6 months I have cared for three young children on
Medicaid who had corneal ulcers. This is a potentially blinding situation
because if the cornea perforates from the infection, almost surely blindness
will occur. In all three cases the antibiotic needed for the eradication of
the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did.
Within 48 hours the form came back to me which was sent in immediately via
fax, and I was told that I would have my answer in 10 days. Of course by
then each child would have been blind in the eye.

Each time the request came back denied. All three times I personally
provided the antibiotic for each patient which was not on the Medicaid
approved list.

Get the point -- rationing of care.

Over the past 35 years I have cared for over 1000 children born with
congenital cataracts. In older children and in adults the vision is
rehabilitated with an intraocular lens. In newborns we use contact lenses
which are very expensive. It takes Medicaid over one year to approve a
contact lens post cataract surgery. By that time a successful anatomical
operation is wasted as the child will be close to blind from a lack of
focusing for so long a period of time.

Again, extreme rationing. Solution: I have a foundation here in Atlanta
supported 100% by private funds which supplies all of these contact lenses
for my Medicaid and illegal immigrants children for free. Again, waiting
for the government would be disastrous.

Last week I had a lady bring her child to me. They are Americans but live
in Sweden, as the father has a job with a big corporation. The child had the
onset of double vision 3 months ago and has been unable to function normally
because of this. They are people of means but are waiting 8 months to see
the ophthalmologist in Sweden. Then if the child needed surgery they would
be put on a 6 month waiting list. She called me and I saw her that day. It
turned out that the child had accommodative esotropia (crossing of the eyes
treated with glasses that correct for farsightedness) and responded to
glasses within 4 days, so no surgery was needed. Again, rationing of care.

Last month I operated on a 70 year old lady with double vision present for 3
years. She responded quite nicely to her surgery and now is symptom free. I
also operated on a 69 year old judge with vertical double vision. His
surgery went very well and now he is happy as a lark. I have been told --
but of course there is no healthcare bill that has been passed yet -- that
these 2 people because of their age would have been denied surgery and
just told to wear a patch over one eye to alleviate the symptoms of double
vision. Obviously cheaper than surgery.

I spent two years in the US Navy during the Viet Nam war and was well
treated by the military. There was tremendous rationing of care and we were
told specifically what things the military personnel and their dependents
could have and which things they could not have. While I was in Viet Nam, my
wife Nancy got sick and got essentially no care at the Naval Hospital in
Oakland, California. She went home and went to her family's private
internist in Beverly Hills. While it was expensive, she received an
immediate work up. Again rationing of care.


For those of you who are over 65, this bill in its present form might be
lethal for you. People in England over 59 cannot receive stents for their
coronary arteries. The government wants to mimic the British plan. For
those of you younger, it will still mean restriction of the care that you
and your children receive.

While 99% of physicians went into medicine because of the love of medicine
and the challenge of helping our fellow man, economics are still important.
My rent goes up 2% each year and the salaries of my employees go up 2% each
year. Twenty years ago, ophthalmologists were paid $1800 for a cataract
surgery and today $500. This is a 73% decrease in our fees. I do not know
of many jobs in America that have seen this sort of lowering of fees.

But there is more to the story than just the lower fees. When I came to
Atlanta, there was a well known ophthalmologist that charged $2500 for a
cataract surgery as he felt the was the best. He had a terrific reputation
and in fact I had my mother's bilateral cataracts operated on by him with
a wonderful result. She is now 94 and has 20/20 vision in both eyes. People
would pay his $2500 fee.

However, then the government came in and said that any doctor that does
Medicare work cannot accept more than the going rate (now $500) or he or she
would be severely fined. This put an end to his charging $2500. The
government said it was illegal to accept more than the government-allowed
rate. What I am driving at is that those of you well off will NOT be able
to go to the head of the line under this new healthcare plan, just because
you have money, as no physician will be willing to go against the law to
treat you.

I am a pediatric ophthalmologist and trained for 10 years post-college to
become a pediatric ophthalmologist (add two years of my service in the
Navy and that comes to 12 years).A neurosurgeon spends 14 years post
-college, and if he or she has to do the military that would be 16 years. I
am not entitled to make what a neurosurgeon makes, but the new plan calls
for all physicians to make the same amount of payment. I assure you that
medical students will not go into neurosurgery and we will have a tremendous
shortage of neurosurgeons. Already, the top neurosurgeon at my hospital
who is in good health and only 52 years old has just quit because he can't
stand working with the government anymore. Forty-nine percent of children
under the age of 16 in the state of Georgia are on Medicaid, so he felt he
just could not stand working with the bureaucracy anymore.

We are being lied to about the uninsured. They are getting care. I operate
on at least 2 illegal immigrants each month who pay me nothing, and the
children's hospital at which I operate charges them nothing also. This is
true not only of Atlanta, but of every community in America.

The bottom line is that I urge all of you to contact your congresswomen and
congressmen and senators to defeat this bill. I promise you that you will
not like rationing of your own health.

Furthermore, how can you trust a physician that works under these conditions
knowing that he is controlled by the state. I certainly could not trust any
doctor that would work under these draconian conditions.

One last thing: with this new healthcare plan there will be a tremendous
shortage of physicians. It has been estimated that approximately 5% of the
current physician work force will quit under this new system. Also it is
estimated that another 5% shortage will occur because of the decreased
number of men and women wanting to go into medicine. At the present time the
US government has mandated gender equity in admissions to medical schools.
That means that for the past 15 years somewhere between 49 and 51% of
each entering class are females. This is true of private schools also,
because all private schools receive federal funding.

The average career of a woman in medicine now is only 8-10 years and the
average work week for a female in medicine is only 3-4 days. I have now
trained 35 fellows in pediatric ophthalmology. Hands down the best was a
female that I trained 4 years ago -- she was head and heels above all
others I have trained. She now practices only 3 days a week.

That's all, folks. But it gives another great reason for cleaning house of every possible senator and representative we can when 2010 rolls around. Please help keep the momentum rolling. We can't afford to forget.

Thanks for reading.

Hurry up, 2010.