Fwd: Health Care Reform Webcast Event on Sept 23, 2009 at WDTN-NBC Channel 2

[dhnpe...@aol.com]

Friends and Colleagues:

The following email was sent to WDTN-NBC Channel 2 today. Peter Bour is the Director and Lisa Barhorst is Vice President. The others are the anchor individuals/reporters. 

I just got off the phone calling in to Sen. Voinovich (202-224-3353) to voice my support for Health Care Reform and the public option. They didn't take names, zip codes, or anything. I did tell the staffer that I am a physician from Dayton. The staffer just wants to know if you are a constituent.  Please make the call. The Senate Finance Committee is debating about the public option today as we speak and will put to a vote as early as Tuesday.  Please, Dayton and Ohio!

Don Nguyen, MD, FAAP

Gary LeRoy, MD

The Audacity of Health Care for All

-----Original Message-----
From: dhnpe...@aol.com
To: Peter...@WDTN.com; lbar...@wdtn.com; mal...@wdtn.com; mbon...@wdtn.com; koli...@wdtn.com
Cc: alonzo.p...@primedphysicians.com; ped...@aol.com; margar...@wright.edu; megan...@drsforamerica.org; mandy.kr...@gmail.com; alex...@gmail.com
Sent: Fri, Sep 25, 2009 1:15 pm
Subject: Health Care Reform Webcast Event on Sept 23, 2009 at WDTN-NBC Channel 2

Dear Peter, Lisa, Mark, Marsha, and Kennan:

First and foremost, I want to express my thanks and appreciation to all of you for having organized such an event at such a crucial time in history. This shows leadership and foresight on your part in the community of television media and you deserve to be commended for such. The format was not conducive for a give-and-take and therefore we missed an opportunity for a much more lively and substantive debate if the panelists could interact among themselves. The question posed to me by Mark about the insurance reform should have been less about me than about the people or patients. The lack of insurance is estimated to be responsible for 45,000 lives annually according to the most recent Harvard study (American Journal of Public Health, 2009), which is 2.5 times higher than 7 years ago. This translates to 1 patient dies every 12 minutes. Patients without insurance are 40% at a higher risk of dying compared to patients with insurance. This rate was only 25% in 1993. The study was controlled for socioeconomic status, health behavior, and baseline health (meaning these factors are the same in both groups). As the number of uninsured increases and combined with the failed medical safety net currently present in our health system, the number of lives lost will continue to rise due to a lack of health coverage. 

When people do have some form of insurance, they can be denied coverage because of a whole slew of reasons, such as pre-existing conditions, because of the practice of "rescission" and "purging" of businesses as you all are aware of. But, let me be more specific. Guidelines to deny coverage include conditions as laughable as acne, hemorrhoids, bunions, as well as police officers, fire fighters, pregnancy, and "expectant father". Pacificare (a subsidiary of United Health Incorporated) lists ineligible occupations as stunt people, pilots, circus workers, and police officers. These occupations used to raise a red flag when it comes to disability and life insurance, but now they can be denied health coverage as well. Health Net has in their guidelines to charge higher premiums if patients are on the medications Zyrtec (for seasonal allergies) and Lamisil (used to treat toe fungus, remember those commercials of people wearing sandals?), or if one is an expectant father. The only thing I can think of is Lamisil can very rarely have a side effect of liver damage and eventual liver failure and transplantation. Can you think of all other medications that have the same potential side effects? An expectant father means there is another child to care for? Blue Cross of California can deny coverage if you have a history of tonsillitis and varicose veins. Health Net is known to pay bonuses to employees as a reward based on the number of patients dropped from coverage. There are more than 100 cases in California pending in the court system against California insurance companies with 90 cases already settled over the last 3 years. Fortis (previously Assurant) Insurance was recently fined for $10 million in South Carolina, for dropping a policy of a 17 year old patient who was diagnosed with HIV after the policy was written. The House Energy and Commerce Committee investigated in June 2009 the 3 biggest ins urance companies and found that they saved $300 million using the practice of "rescission" after they dropped more than 20,000 policies. Worse, when the CEO's of these 3 companies were asked under oath whether they would stopped this practice, all 3 answered "NO". As a consequence of such immoral practices, the average annual profit from the top 10 companies increased from $2.6 billion (in 2000) to $12.7 billion (in 2007) despite an economic slowdown for everyone else. Greed is good by some people's standards, but on the back of sick and dying patients, who represent merely "benefit ratios" to Wall-Street Insurance Health Care.

Regarding the "public choice option", polls after polls have shown 76 - 79% of the general public supporting such choice (SurveyUSA, AARP, NBC/WSJ June and July, 2009), and unlike the individuals that Kennan interviewed on the street of Dayton, the national pulse is clearly palpable regarding a strong support for another choice. The physicians have also spoken in the most recent article published in the New England Journal of Medicine Sept. 2009 (the oldest and most prestigious medical journal in Medicine, more so than the Journal of the American Medical Association), where 73% of physicians favor a public option. Interestingly, the majority of physicians also favor extending Medicare coverage to those between age 55 - 64, because physicians overwhelmingly like the simplicity of the Medicare system. The list of organized Medical Associations who endorse Health Care Reform includes the American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Surgeons, the American Osteopathic Association, the American College of Obstetrics and Gynecology, the American College of Cardiology, and the American Gastroenterological Association. Others are awaiting for further details. 

There has been a tremendous consolidation of insurance companies over the last 15 years such that most metropolitan centers in the US have at the most just a few companies dominating the free market landscape. Examples: only 1 company has more than 80% of the market in the entire state of Alabama; only 2 companies in the Greater Cincinnati area; in Philadelphia, the home of CIGNA, only 2 large companies dominate and they are Blue Cross and Aetna (CIGNA cannot even compete with these 2 giants in its headquarters home town, so you can forget about co-ops too!). When AHIP (American Health Insurance Plans) says they represent 1300 companies and the force of the free market hand is going to solve this problem, well, we have seen insurance premiums for a family increase by 131% over the past 10 years compared to a wage increase of only 38% and an inflation rate of 28%.  If health costs continue to rise at this rate, in 2019, the average premium will cost $30,803 for a family.  This is why a public option is an absolute to keep the insurance companies in check. Keep in mind also, that United Health Incorporated owns 29 of companies or more, all in health insurance (like Golden Rule, Pacificare), so AHIP essentially only represents just  a hands full of monopolies.

Regarding the reform of medical liability, one needs to keep in mind that only 5% of malpractice lawsuits actually go to trial, according to the Physicians Insurance American Association (PIAA). 80 % have a verdict for the defense and only 0.9% have a jury verdict for the plaintiff, meaning only 0.9% of all cases may be subject to "damage award caps". The much bigger issue is "defensive medicine practice" as I mentioned. I have mentioned the issue of improvement in care coordination, the investment in Health Information Technology such as implementation of the EPIC system at Children's and Miami Valley Hospital and soon at KMC, measures that will help eliminate medical errors and save money in the long run. The "Disclosure and Offer" program has been a success story at the University of Michigan (I know, we are in Buckeye country). When doctors come out upfront and early to disclose unpredicted and untoward outcomes, patients are 50% less likely to file negligence malpractice lawsuits, and tend to settle out of court in appropriate cases, thereby saving an average of $30,000 of litigation costs per case. If I had more time, I would also add the formation of Health Tribunal made up of health panels or judges with a strong medical background and expertise rather than the current jury system with little or no medical background. The establishment of federal "Safe Harbor" based on evidence based research or comparative effectiveness research, which would protect physicians from lawsuits if they practice within these guidelines that are based on sound research and science. The American Urological Association endorses the Comparative Effectiveness Research (CER) Act which was passed this year. 

Regarding the COST of  such reform, I am not an economist but I do want make a request to you all in the media. When the cost of a plan is mentioned on the air, you should state for example that the Baucus plan costs $775 billion or the House Bill HR 3200 $1 trillion, but you should always qualify the amount as OVER 10 YEARS. The Baucus plan would be $77 billion per year, which is a bargain considering that the military budget is $600 billion per year (I may be off by a few billion here). The House Bill HR 3200 with the savings of the public choice option would cost about $60 billion per year. Lastly, during the event, I could not hear the other panelists very well due to distance from where we were seated, but I sensed that those, who were worried about their livelihood or their going out of business running hospital systems or insurance companies, would still be doing fairly well and would not risk bankruptcy, unlike the million of patients that lack health care.  Again, because I could not hear very well, I could not tell if these individuals even mentioned, showed care or compassion toward  the PATIENTS at all, or they were merely interested in their own bottom line and their own employment.

I can only speak for myself and my colleagues at Doctors for America and Dayton Docs for America, so again, congratulations to you and WDTN on a great event and showing your leadership in the Greater Miami Valley and Dayton. Now I can say that I have been on the same set where Brian Davis works, my tennis teammate and your illustrious meteorologist.

Sincerely yours,

Donald Nguyen, MD, FAAP

State Director for Doctors for America, Ohio

Pediatric Urology,

Children's Medical Center of Dayton