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The Reality: Government is Already in Healthcare

Friday, September 12, 2008

I listened to Senator John McCain’s rousing acceptance speech at the Republican National Convention. I was stunned to hear him explain that, if elected president, he vowed to keep big government out of healthcare. He stated he wanted to make sure a bureaucrat didn’t stand in the way between you and the doctor you choose. I don’t want someone interfering with my physicians but I do want a government that oversees healthcare.

Despite all the campaign chest-thumping about love of country and concern for our brave men and women in uniform, one kind of healthcare the government is supposed to be in charge of is Veterans’ medical care. At times, the Veterans Administration (VA) seems to have evolved into a healthcare delivery system that combines the efficiency of the Post Office with the compassion of the Internal Revenue Service. From personal experience as a physician, I know that the VA clinics and operating room schedules are so full, that veterans within the our VA hospital in Tucson, AZ have had to wait more than three months to see a doctor–even when they were suffering from severe spine problems. I’ve met patients who have been on the waiting list for clinic appointments for so long, they were actually paralyzed by the time they finally got to see a doctor. Once they finally got into a clinic, they were told that, so far out after the injury occurred, it was too late. There was no longer anything could be done. Every year, the VA has to purchase cheaper brands of artificial hips and knees for their surgical inventory. And when they run out of their budgeted allotment, those procedures simply are canceled until the next fiscal year. I don’t blame the hardworking employees of the VA system. Most of them are fiercely dedicated to getting our veterans the healthcare they deserve. The answer, however, does not lie in getting rid of bureaucrats, it is about empowering the right ones to oversee the process and make sure the VA gets the support and budget it needs and deserves.

Senator McCain claims he will improve healthcare by making available more privatized healthcare insurance. The word “privatized” means “more for-profit private sector companies.” These are the same health insurance companies that have been making huge revenue surpluses by systematically spending as little as possible for their customers’ health as possible. These same insurance corporations also have paid out their top executives some of the largest bonuses in corporate America. These third party payors are precisely the private institutions that not only determine which doctor you can see and when, but also whether you should even get care. Ultimately, most of these decisions are based on the company’s bottom line and not your health. These same insurance companies are pouring millions into McCain’s campaign. Why? Precisely because they don’t want any federal bureaucrats in the middle of their business, looking over their shoulder, or regulating how they provide services to their patients. They do not want a federally appointed overseer who can evaluate and enforce the fairness of the medical decisions made by these companies. Nor do they want to pay any mental health care services–as sorely needed as they may be.

Lastly, like it or not the government is in the healthcare business—for good. Medicare already provides fifty-five cents out of every healthcare dollar spent in this country. Government is the largest single healthcare-providing organization we have. Senator McCain, you can’t get the federal government out of healthcare, because it is healthcare. In fact, only government can make healthcare better and fairer. For example, Medicare instituted sweeping reforms to reduce hospital infections (link to blog on infections) by requiring steps to ensure the administration of antibiotics before surgery. Before that, nearly fifty percent of patients did not receive the medications as ordered by their physicians. Government agencies investigate “sentinel events”—preventable accidents severe enough to require an investigation of how they happened and an explanation of what steps will be taken to ensure they will not recur. Finally, government had kept the cost of healthcare down by regulating how it reimburses doctors and hospitals.

No, I’m sorry, Senator McCain, when it comes to healthcare, the government needs to put a bureaucrat in place to watch over us, to see that our waiting times in Emergency Departments are kept to reasonable lengths, and to ensure we get the tests and procedures our doctors have recommended. We need federal oversight to make sure medical care is not being withheld. To check that high-risk patients are not excluded from coverage by insurance executives who want profits to grow and client expenditures to shrink. And, finally, I want an ombudsman in the hospital looking out for me, making sure mistakes aren’t made, corners aren’t cut, and only the most qualified doctors are working there. I want the peer review process for medical errors to move out of the shadows and be opened for more honest scrutiny by impartial, federally appointed physicians. Senator McCain says he doesn’t want Big Brother in healthcare. Well, I do. I want government taking care of our country’s health and well-being. I want the government to make sure that health care does not become a business. It’s not about profits. It’s about living or dying. I want my government to ensure that doctors, hospitals, and insurers are doing their jobs as efficiently and fairly as possible. I want someone in the government to guarantee that Americans will receive the healthcare they deserve and that means every, single American–man, woman, or child.

Read the Presidential candidate’s proposals on healthcare

John McCain’s Health Care Privatization Plan

Barack Obama’s Health Care Reform

Reports and Articles on Veterans’s healthcare:

Congressional Committee on Oversight and Reform Veterans Healthcare excerpt:

“President Bush’s budget plan would have a dramatic impact on veterans. According to Bush Administration estimates, they will force over one million veterans, almost half of the Priority 7 and Priority 8 veterans, to drop out of the VA healthcare system. And veterans who remain in the VA healthcare system will be forced to pay hundreds of dollars annually in new costs.”

Southern California Veterans Wait Months For Disability Benefits

A new report released by Rep. Waxman finds that thousands of disabled veterans in Southern California wait months before receiving veteran’s disability benefits.

NPR – Veterans React to Report on Care

The Washington Post ‘It Is Just Not Walter Reed’
Soldiers Share Troubling Stories Of Military Health Care Across U.S.

Substandard Conditions at VA Centers Noted

90% of More than 1,000 Problems Reported Are Routine, Officials Say

Stars and Stripes Neglected by DIA and VA, defense employee suffered alone after stints in Iraq

Think Progress - IAVA Director: If McCain Thinks The VA Isn’t Working, ‘It’s In Part Because He Hasn’t Funded It’

Vet Voice -]AFGE Says McCain Wrong on Veterans Health Care

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