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Reform Measures Should Not Weaken Our Health Care

June 15, 2009

Over the past several decades, our nation has built the finest health-care system in the world. From birth to death we value and care for life. Surgeons can perform life-saving heart surgery on a child that is still in utero. Expert trauma doctors can save the life of a mother who was badly hurt in a car crash. And end-of-life specialists can provide compassionate palliative care to seniors to ensure their last days are spent in comfort.

This didn’t all just magically happen. But it could all magically go away.
Swirling around us is a great debate that will decide the future of medical care in America. There are those who desire a single-payer system, although the “single payer” would be the 100 million Americans who pay taxes. It would leave the government in charge of our medical choices. But since single-payer advocates know the majority of Americans oppose such a system, they have decided to advance an alternative — known as the public option. 
Either approach would seriously weaken the health-care system we enjoy today. The public option would cost $1.2 trillion to $1.8 trillion to set up. Is that something our nation can afford, especially considering the latest estimates that Medicare is going to be bankrupt in 10 years?
Is it the goal of some individuals to eventually wipe out all private insurance plans and house all health care under the umbrella of the federal government? These types of government-controlled systems already exist in other countries, and all have stories of patients who had to wait months to see specialists. It’s common to hear of patients who were not allowed to get the treatment their doctor prescribed because a bureaucratic decision was made on the value of their life. For example, the agency that makes these decisions in the United Kingdom determined that we are all worth $22,750 for six months of life — or $125 a day. I’m sorry, but $125 is the cost of a nice date with my wife, not the value of life.
The American Medical Association, representing more than 250,000 physicians, and an organization I once led, recently came out in opposition to the proposed public plan, saying that it “threatens to restrict patient choice” and that it “would likely lead to an explosion of costs that would need to be absorbed by taxpayers.”
That position comes from studying government-controlled health care elsewhere. During my year as president of the AMA, I was able to visit and see firsthand the success and failures of other health-care systems. I recall meeting with the chairman of the British Medical Association in June 2003, when he characterized his nation’s single-payer health-care system as “the stifling of innovation by excessive, intrusive audit … the shackling of doctors by prescribing guidelines, referral guidelines and protocols … the suffocation of professional responsibility by target-setting and production line values that leave little room for the professional judgment of individual doctors or the needs of individual patients.”
And what else will happen when the government asserts its control over health care? Medical creativity, discovery and innovation — the same creativity and discovery and innovation that we have relied on for generations — will dry up. Today, millions of Americans rely on statins to reduce their risk of heart attack. The new da Vinci surgical system is already revolutionizing the way surgery is performed in operating rooms across the country. And wounded veterans are being fitted with next-generation prosthetic limbs so they can walk again.
Only in America.
We must find ways to expand access to affordable health care to the uninsured. America can solve the current problems with a system that expands insurance coverage through tax credits, consumer choice and market enhancements. However, in the process of expanding care, we cannot create a weaker system for the 80 percent of Americans who are happy with their coverage. It would be a serious mistake to have a government-controlled micromanaged medical system that would result in diminished quality of care, long waiting lines for doctors’ visits and surgical care, a lack of access to emerging technologies and the virtual end to new and hopeful medical discovery. Health care shouldn’t be dictated to us by a faceless bureaucrat in Washington.
A lot is at stake as the nation engages in the health-care debate. Will we have a system that puts the patient in control with the doctor as trusted adviser, or a government-run system that ultimately rations care and stifles innovation and self-determination? I hope it’s the former.
Dr. Donald J. Palmisano is the spokesman for the Coalition to Protect Patients Rights. He was president of the American Medical Association in 2003-2004.