Jewish World Review Dec. 5, 2003 /10 Kislev, 5764
Drs. Michael A. Glueck & Robert J. Cihak
Medicare mop up
There are some periods in history, you just want to reach back in time
and grab them and shake them. "Wake up!"
We're living in one now. And if you don't want to accost the craven
Republocrats, the "bipartisans" who presume to govern us, and holler at
them, "Don't you understand what you're doing?" - you're either brain-dead
or you know, all to well, that they do know what they're doing.
They're marching us, wide-eyed, awake, and deliberately, into
Prior to beating feet out of DC for the culinary (as opposed to
political) turkey fest, Congress acceded to the wishes of the Bush
administration and passed the greatest expansion of Medicare since its
creation in 1965: another year that found the country entering an
interminable, costly war. The 681-page bill - who really understood it all?
- will cost, over the next twenty years, over $2 trillion and add hundreds
of billions to the budget deficits and national debt. If history is any
guide, these numbers will be low. Very low.
Who wanted this bill? The "bipartisans." Republicans wanted it to take
the issue away from the Democrats. Since the bennies don't kick in until
2006, it's an ideal Republican election-year gimmick: Tell the voters about
the wonderful thing you've done, but before the bills come due.
The Democrats wanted it. Those like Senator Tom Daschle, who urged
his colleagues to share the credit in 2004, and who displayed his keen
grasp of the obvious by noting that: "Seniors are a very significant block
of voters." And be ye not fooled by the likes of Teddy Kennedy and all the
liberal moaning - regard all medical "reform" as advances toward full
socialized medicine: including and especially those "reforms" that hasten
the destruction of the present health care system.
The American Association of Retired Persons (AARP), as Beltway-centric
a lobby as ever assembled a mailing list, also wanted it, and spent $7
million on advertising, demanding that Congress "do something now!" It's an
old, old tactic. Take a problem, redefine it as a crisis, then hype it
until it seems the cosmos will collapse unless the government does
something now. The American Medical Association (AMA), ever-eager to
deliver its profession into serfdom, cited a 1.5 percent increase in
physician payments and "regulatory reforms."
Who opposed the bill? A minority of principled legislators, and more
than forty groups, including the National taxpayers Union and the American
Conservative Union, in the Coalition against Higher Medicare Drug Costs. At
a November 20th news conference, the Coalition also demonstrated its keen
grasp of the obvious, pointing out that millions of retirees will lose good
coverage; that Medicare will go bankrupt even faster under this additional
burden; and that this legislation makes real Medicare reform even harder.
And whose opinion didn't count?
On November 19th, the Association of American Physicians and Surgeons
(AAPS) released "Demoralized Doctors, Patient Problems: AAPS Biannual
Survey of Physicians on Medicare and Patients' 'Access to Care.'"
(Available in December in the winter issue of the Journal of American
Physicians and Surgeons, www.jpands.org).
"This study is concrete documentation of the atmosphere of fear and
frustration in which doctors practice today," said Kathryn Serkes,
co-author and public affairs counsel for AAPS. "Money is not the issue;
control is. More doctors would rather treat uninsured patients, possibly
for free, than jump through Medicare hoops."
Among the survey's conclusions:
1. Increasing fear of prosecution or retaliation has had a negative
impact on Medicare patients' access to physicians and their ability to
2. Compliance with Medicare regulations is costly, time-consuming, and
causes reluctance to treat Medicare patients.
3. More governmental interference means less access and quality for all
4. Physicians grow ever-more pessimistic about the future of medicine.
And of particular note: Physicians turn away uninsured patients fifty
percent less often than Medicare patients (17% and 33% respectively).
And so it comes to 'pass' that the new Medicare bill contributes to
the accelerating decline of the health care system and the government's
solvency. It makes you want to scream, "Don't you understand where all this
And makes you fear the answer, whether yes or no or, "Frankly,
America, we don't give a damn. Just let it last during our time."
Michael Arnold Glueck, M.D., is a multiple award winning writer who comments
on medical-legal issues. Robert J. Cihak, M.D., is a Discovery Institute
Senior Fellow and a past president of the Association of American Physicians
and Surgeons. Both JWR contributors are Harvard trained diagnostic radiologists.
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