Although they had differing opinions, the one aspect the doctors agreed upon, however, was a limited role by government.
“I’m probably more liberal than a lot of doctors,” Dr. Frank Dehnisch said.
However, No. 9 of a 10-item list of improvements he would like to see in the system is that “the government should set standardized rules to protect the consumer and a basic insurance option, then stand aside to allow innovation.”
“I have some concerns about the government running another aspect of our economic GNP (gross national product),” said Dr. Joseph Larakers. “I’m a free market kind of guy.”
“If we have socialized medicine, it will result in a collapse of good medical care,” said Dr. James Chandler. “Good doctors are going to be gone.”
“I don’t think all their ideas are terrible,” Larakers said. “I think access will be limited. There will probably be some rationing.”
Larakers said he expects that rural areas will be hardest hit by rationing.
“I think fewer people will want to become physicians,” Larakers added. “Most doctors want to treat people, not deal with bureaucratic paperwork.”
Chandler agreed with the impact of more bureaucracy in medicine. He mentioned the current problems with Medicare and Medicaid, the two most prevalent government-controlled medical programs in the country, as examples.
“I’ve got three people and all they do is handle Medicare and Medicaid claims,” Chandler said.
“Medicare is part of the spin,” Dehnisch argued. He said the prescription drug program passed during the George W. Bush administration was a “big giveaway” to the pharmaceutical companies.
“The $500 billion in cuts to Medicare is just taking back what the Republicans gave to the insurance companies and the pharmaceuticals,” Dehnisch said.
Still, Dehnisch believes “the system is broke.”
So many of the current government regulations are so complicated that lawmakers must get the lobbyists to explain them.
Chandler believes the answer to providing quality care for the uninsured and for people who cannot afford insurance is as simple as a change in the income tax code.
He said if he were allowed to deduct the cost of treatment for the uninsured from his income tax, he could afford to treat anyone who needs it.
He suggested allowing a person with AIDS to buy a life insurance policy and then sign that over to the clinic treating him. Then, when and if the patient dies, the clinic is paid.
Chandler also recommended taking the middle men, the government and insurance companies, out of most of the medical care business.
“A lot of doctors are talking about opening an office and taking only cash,” Chandler said.
Both Chandler and Larakers expressed concern about the future of medical care if the government becomes even more involved.
Chandler said he expects that nurses, nurse practitioners and physicians assistants will end up providing most of the medical care.
“The only good thing is that Congress will end up getting the same care,” Chandler said.
“They think they’re not,” Chandler said, mentioning the fact that Congress has been careful to exempt themselves from the same system they are planning for the rest of the country. “They’ve got Bethesda (the Navy hospital in Maryland just outside of Washington, D.C.).”
“But if you’re going to have to graduate bad doctors to fill quotas, they’re going to end up working for Bethesda. If they ruin health care, they ruin it for everybody.”
Larakers agreed that more government involvement could result in fewer of society’s brightest people entering the medical profession.
“As medicine has become more bureaucratic, I think people are already leaving the profession,” he said. “I just don’t think government should take over a major portion of the economy.”
Dehnisch was much more direct in offering his suggestions.
“The health care system is slowed by the bureaucracy and inefficiency of the current billing and record-keeping system and the complexity of the governmental regulations,” he said. “Therefore, health care costs can be reduced by a number of simple maneuvers:
1) There should be a central computerized database for each patient controlled by the patient.
2) There should be standardization of insurance coverage into a number of limited categories.
3) Each patient should have an insurance card that could be swiped like a credit card and their charges immediately calculated and credited to the respective health care provider.
4) Every health care provider should have openly posted prices for all services.
5) There should be a public option with basic coverage.
6) The private insurance companies could offer coverage in one of the standardized categories with a carefully crafted list of hospitals and physicians.
7) There has to be a minimum payment based on a sliding fee scale for each patient’s use of the system.
8) Every individual must have coverage for the system to succeed.
9) The government should set standardized rules to protect the consumer and provide a basic insurance option, then stand aside and allow innovation.
10) The hospitals, physicians, labs and other health care providers should be free to innovate as long as their health care outcomes are good.”