An MD lists 10 health care concerns.

[AztecWilliam]

I wish the President would satisfactorily address these issues regarding health care and health care cost.

www.washingtonpost.com/wp-dyn/content/article/2009/09/04/AR2009090402274.html

AzWm

[AlwaysAnAztec]

Agree with most of his "concerns" at least in part.

He is looking at the issue from the standpoint of a elite cardiothoracic surgeon and so his views are skewed. Note: I worked for a provider of medical services to these types of guys for 12 years so I understand them and their egos.

[aztecwin]

All ten of these issues are important and were not covered last night in any depth or at all by Obama. I am afraid that the speech was long of empty rhetoric and short on any concrete specifics. It was very disrespectful of that Congressman to shout out at Obama as he did. It would have been much worse for him if it was not the truth.

[Bob Forsythe]

I find these to be the most operative:

1. Private insurance companies escape real regulation.

This is what makes my colleagues and me so cynical about the reform proposals. Every physician has insurance company horror stories: patients who went untreated because their carriers wouldn't pay, endless hours on the phone to get administrators' approval for necessary tests and mountains of paperwork to collect reimbursements. It will be hard for doctors to buy into health-care reform if insurance companies get a free pass.

2. We urgently need tort reform, but it's nowhere to be seen.

Malpractice costs rise each year, as do the number of frivolous lawsuits. Our practice has seen a 10 percent increase in malpractice expenses this year. Sure, doctors make mistakes, and patients deserve fair compensation for their injuries and lost wages, but in this area of the law, physicians and hospitals are too often at the mercy of capricious juries.

There is virtually no regulation of insurance companies because they dump vast amounts of bucks into congressional campaigns. It's likely the Supremes will rule that it's a free speech issue, but that does not mean that Congress is unable to pass regulations regarding health insurance profit margins or, even better, to require insurance companies to index premiums based upon income levels.

As for tort reform, in California and Texas, where tort reform has been in place for many years, the cost of insurance has not gone down despite the fact that malpractice judgments have been lowered to levels that were appropriate in the '80s but have not been raised since that time. In fact, the cost of health insurance goes up every year. My retirement association sent out a letter a month ago stating that negotiations were starting with health plans and it was expected our cost, depending on the plan, would rise by 8-12 percent even though we've had tort reform for something like 20 years.

This is always the nonsense corporations offer. I saw it over and over with land developers who bitched constantly about the cost of doing business with the County - that the County should lower its fees in order to bring down the cost of housing while there wasn't a single developer who would be willing to lower the price of their houses. And there was one simple reason for that - who in their right mind would lower the price the market can bear just to offer the consumer a break?

It would take a really stupid capitalist to lower the price of an item if people are willing to pay a higher price for that item. And because of that, I do not believe for one instant that the health insurance oligopoly will cut back on its constant price increases if it gets tort reform.

This country was built upon the ideal of competition, but there is no real competition in this country when it comes to health insurance. It's sad that the right wing, who claims to be based in the notion of competition, is willing to allow oligopolies to exist.

=Bob

[AztecWilliam]

One of the biggest contributors to the lack of competition in the health insurance field is the inability of companies to offer policies on a national basis. Right now companies have to have separate operations in every state. Of course, that is not possible for reasons of economy (i.e., cost of doing business), so often times there are only a handful of companies offering policies in a given state.

Also, the risk pool in individual states is small; that would be remedied if the risk pool were nationwide. It's because of government that companies have to operate on a state by state basis. How would you like a system in which automobiles could only be manufactured and sold on a state by state basis? Let's see, maybe I could build and sell Fallbrookmobiles and Bob could sell Forsythe Speedsters! Now that would be a really good idea!

AzWm