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Title: Blog by Novelist William S. Frankl, MD

The President and the Doctors

Well, the health care reform ” fat is on the fire.” On June 15th, Obama addressed the AMA’s annual conference in Chicago. He added a paragraph to his stock speech on his vision of health care reform by raising the issue of medical malpractice reform. He provided few details. He said, ” I do think we need to explore a range of ideas.” But he refused to acknowledge that trial lawyers and enormous jury awards and settlements have resulted in skyrocketing medical malpractice premiums that have played a major role in the rise in the cost of health care.
The majority of lawsuits do not involve negligence, and are settled out of court because settlement is less expensive than a jury trial. Besides the cost of the settlements, the doctor or doctors involved are posted on the Physicians National Data Bank, which impugns their professional status as well as resulting in a huge increase in the cost of their malpractice insurance premiums, or cancellation of their policies. Thus, many physicians in high-risk fields ––– neurosurgery, emergency medicine, obstetrics, anesthesiology, and orthopedics ––– are leaving the practice of medicine or moving to states with more congenial malpractice regulations such as California and Texas. Other physicians practice defensive medicine ordering often unnecessary tests so that they don’t end up being sued.
And then Obama demonstrated how deeply he is indebted to (and manipulated by) the trial bar. In response to his initial few words on the malpractice issue, the AMA delegates applauded. And then came these words from the president: ” Don’t get too excited yet. Just hold on to your horses here, guys . . . . I want to be honest with you. I’m not advocating caps on malpractice awards.” In other words, his trial lawyer friends will continue to run the malpractice show. As he has shown since his inauguration, he is a captive of his many liberal interest groups.
Hopefully, the AMA leadership and its grassroots will understand this and resist the president’s blandishments. The imposition of Obamacare on this country will result in government control of medical practice, rationing, and the deterioration of quality while medicine will continue to be a feeding trough for the trial bar.

But in all these endless discussions about “reforming” health care, the real issues are rarely raised. Meaningful health care reform must include: the preservation of the patient-physician relationship without the government between them; reasonable cost controls without rationing of care; the ability of physicians to provide meaningful individualized patient management without bureaucrats and trial lawyers looking over their shoulders; significant tort reform; no increase in taxes to impose a single payer health system; realistic salaries for doctors and nurses; portability of all medical health insurance, not only from job-to job in the same state, but between states; a change from a defined benefit to a defined contribution by employers; and the provision of health insurance for the uninsured who really need it ( not the 40% who are undocumented aliens or the 20-25% who can afford insurance but decide not to buy it).

All of these can be achieved at a minimal cost and without a federal health insurance plan leading inevitably to a single payer system. But ultimately, in order to succeed with the reform I have outlined, a unified medical profession is necessary to thwart government takeover of health care. Physicians must unite and not fragment into self-serving, single issue groups (primary care vs specialty, surgical vs non-surgical, etc). Without them working together, health care in America is doomed. Doctors, not bureaucrats are the guardians of patients. Their expertise is vital in order to have a vibrant, high quality medical system, which in truth cannot cannot even exist without doctors. They are the key.

2 Responses to “The President and the Doctors”

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