A doctor's take on health care - very interesting

The below letter is written by Zane Pollard MD (pediatric ophthalmologist in
Atlanta who works at St. Joseph 's Hospital) regarding the proposed
healthcare bill that the current administration is trying to pass. Please
read and pass on. His words really bring home the massive impact of this
proposed plan.

Friends:

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
as your friend by explaining many of the problems from the aspect 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. Why is this?

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 mailed 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, the vision is rehabilitated with an
intra ocular 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 - 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 year in the US Navy during the Vietnam 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 in Vietnam , 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
goes 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 lowering
of fees.

But there is more to the story that 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 him $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 on 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 S new system. Also
it is estimated that another 5% shortage will occur because of decreased
men and women wanting to go into medicine.

Zane Pollard , MD