Monday, September 7, 2009

Doctors endorse Obama's Health Care Reform plans

I do not live in USA and therefore should not be interested in the Health Care reform debate raging there. But it is a subject I cannot stop posting about. Why?

In my view USA's health care system is the worst example of high cost-low coverage health care system in the Developed World. Most of the developing countries like my own, India are following USA's example.

In spite of the amount spent on health care in the US, according to a 2008 report, the United States ranks last in the quality of health care among developed countries. The World Health Organization (WHO), in 2000, ranked the US health care system 37th in overall performance and 72nd by overall level of health (among 191 member nations included in the study). The US pays twice as much yet lags other wealthy nations in such measures as infant mortality and life expectancy, which are among the most widely collected, hence useful, international comparative statistics. The USA's life expectancy is 38th in the world, after most rich nations, and just after Chile (35th) and Cuba (37th).

According to the Institute of Medicine of the National Academy of Sciences, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage" (i.e. some kind of insurance).

In 2007, the U.S. spent $2.26 trillion on health care, or $7,439 per person, up from $2.1 trillion, or $7,026 per capita, the previous year. Spending in 2006 represented 16% of GDP, an increase of 6.7% over 2004 spending. Growth in spending is projected to average 6.7% annually over the period 2007 through 2017. Health insurance costs are rising faster than wages or inflation, and medical causes were cited by about half of bankruptcy filers in the United States in 2001.

If Obama succeeds in radically reforming the Health Care in USA during his term, I am sure that it will have wide range of positive effects World over.

How doctors in USA view Obama's health care reforms?

American Medical Association [AMA], the largest organization of doctors used to oppose Government involvement in health care. They had opposed the failed Clinton plan of 1990s. But in a surprising turn around the AMA has voiced its broad support to the health reform bill now under consideration of the Congress.

More inspiring was to read the support of the American Diabetes Association [ADA], the largest organization of Diabetic specialists in the World.

Separating myth from fact about health care reform

The right wing politicians who are hand in glove with Health Care Industry [which includes the Pharma Companies and Insurance Companies] are opposing the Health care reforms propagating lot of lies and myths about the reforms. Here is what American Diabetes Association says about the myths.

MYTH: Health care reform will lead to negative changes in diabetes/health coverage and care.

FACT: Health care reform will protect people with diabetes by requiring all health insurance companies to accept all applicants for health coverage regardless of pre-existing conditions. Under health care reform, if you are happy with your current health care team and wish to keep your health insurance plan, you can do so. Otherwise, you can purchase health insurance in the individual market without fear of being denied coverage due to your diabetes.

MYTH: Health care reform aims to ration access to health care, including diabetes services and supplies and care for Medicare seniors.

FACT: Health care reform will not lead to rationing access to health care including diabetes services and supplies. Currently the U.S. spends the largest amount (and highest percentage of GDP) on health care in the world, yet we have some of the worst health outcomes. Health care reform does not aim to cut health care costs by rationing care, rather health care reform focuses on ensuring that the money we do spend on health care goes to high quality and appropriate care. Health care reform attempts to redirect spending to high quality care and reducing unnecessary, poor quality expensive sick care.

Health care reform will protect Medicare patients' access to their health care providers and reduce the costs of preventive care to help seniors live healthy lives. Health care reform will not cut Medicare benefits, reduce access to Medicare services or give the government the power to make treatment decisions for anyone regardless of age.

MYTH: Health care reform will lead to government-run health care and enable the government to decide which treatments people with diabetes receive.

FACT: Under health care reform, neither the government nor a government committee will be responsible for determining which health care treatments people receive from their health care providers. Decisions on how to treat and manage one's diabetes will still be made by the person with diabetes and his/her health care providers. Under health care reform, the government will work to ensure that information about the quality and effectiveness of treatment and care options are readily available and properly disseminated to health care providers and patients.

MYTH: Health care reform will make health insurance more expensive, especially for people with diabetes.

FACT: By prohibiting the current health insurance practice of charging higher premiums to people with diabetes and other health conditions, health care reform will actually help make health insurance more affordable for people with diabetes. Health insurers will no longer be able to charge individuals higher premiums based on health status, race or gender; nor would they be able to target people with illnesses or their employers for premium increases based on health status. Health care reform will also limit annual out-of-pocket costs for covered benefits, with currently proposed limits of to $5,000 for an individual and $10,000 for a family.
MYTH: Health care reform won't benefit people like me who already have health insurance.

FACT: Health care reform will reduce swelling health care costs for all Americans, improve the quality of care  all patients [particularly people with diabetes] receive by rewarding better care, prohibit insurance companies from denying coverage based on pre-existing conditions, limit the out-of-pocket spending on health care for individuals and families so that they do not go bankrupt trying to pay for necessary medical care, and provide consumers with more choice in health insurance coverage.

Read more about the issues involved here.

Physicians for a National Health Program  is a non-profit research and education organization of 17,000 physicians, medical students and health professionals of USA who support single-payer national health insurance. Read here  the online petition to President Obama they are circulating among fellow physicians endorsing more radical health reform.


  1. The basic problem with the US is that lobbyists have a large role in policy making...The Conservatives are opposing the Obama Health Plan because their profits will go down...

    I was reading somewhere (I can't find the article) that the reason child mortality is so high in the US is because the govt. spends less on children under 6 than other developed countries...

  2. I was always curious about this, I have heard endlessly about how bad the system is but didn't understand exactly what. This was informative!

  3. I too am endlessly fascinated by what happens in other countries and I think its important and relevant to compare. Specially the US as we seem to be following their model. Its unnerving to know what is happening there and how exclusive their quality medical care is. overall a complex subject.

  4. I have been reading up more on this subject...It seems that for actual reform to take place, the entire system needs to be revamped...

    Over the years, America (knowingly or unknowingly)has built an incentive based health care system which results in uneven results...All of the participants in the system (doctors, insurers, pharmaceutical companies) work in a heavily regulated, employment based, insurance based, massively subsidized industry full of structural distortions...Mostly, they all mean well but human nature being what it is means that they respond more to the economic incentives those distortions create...These incentives emphasize treatment over prevention and discourage transparent competition based on price or quality...

    For true reform to take place, policy makers in Washington have to realize that health insurance is NOT health care...

  5. Currently in the US, health insurance is being used to pay for nearly all health care expenses and this has led to a rise in costs...Insurance is a very complex and costly method of financing an activity and that's why it is usually used to finance only rare, unexpected and large costs...For every 2 doctors in the US, there is one health insurance employee; in 2006, it cost $500 per person to administer health insurance...Much of this cost would vanish if the public paid for routine and predictable health care expenditures themselves...

    If the current health care system broke away from this insurance based system and the government concentrated more on prevention than cure (by spending more on energy, the environment etc.), the health care bill would drastically reduce...

  6. Bones good to see your interest in this topic. The problem is considering health and health care purely as a commodity that can be sold for profit. Thus preventive measures that do not give profit to companies are not encouraged. More over non productive members of the society who cannot pay premiums are not able to buy insurance. To increase profit the insurance companies avoid giving policies to those with pre exisiting diseases . As you said doctors who increase profits to the institution they work for are only given incentives.

  7. You have selectively exaggerated some facts while suppressing others.

    In some metrics, the US medical system in number one in the world. America is the undisputed leader in medical innovation. A major contributor to the high costs is that pharma and biomedical companies use American system and American funds for their research activity. The other major factor is the medical litigation - it benefited some trial lawayers and insurance companies while raising costs to a majority of patients. Litigation also discourages students from taking up certain fields like OBGYN.

    Yes, this system is not the best. The high healthcare costs are affecting other sectors. Higher workers' health benefits have already affected American Auto industry. Comparatively, German and Japanese auto makers have negligible costs in this area. But I should say you were not objective in your analysis.

  8. IHM,
    Much more information are available on the web.Do read them.

    Nita, To know what is happening in other Countries especially the developed ones is important to understand what is happening in ours.
    My view is simple. ALL should get essential health care even if they cannot pay a single cent.State should somehow ensure that.

  9. Not sure it will wrk out or not since other nations under same type of system say it's should be more restrained so not just anyone can get access from hard working tax payers dollars??? I don't want anyone to take food out of my mouth and give it to someone who is sitting around doing nothing-or should you/I???

  10. Phase shift,welcome here.

    It was really not an analysis.There are numerous websites giving very good analysis.I was stating my support and highlighting the support of major medical associations to Obama's health care plans.I also stated some statistics to show why American health care system is in a poor state.

    You said "A major contributor to the high costs is that pharma and biomedical companies use American system and American funds for their research activity."

    The truth is only 5.6% of USA's huge health expenditure is spend on bio-medical research.The spending on health care research which can improve the efficiency of the system is a poor 0.1%. Most of the money in this 5.6% goes for costly clinical trials to prove a drug is marginally better than competitor drug,which is not much use for the community..
    Please read this JAMA article for more data

    I agree with you about litigation increasing the health care cost.

  11. Isa Lube,

    Most people living in nations having universal health insurance are satisfied with their system and will never want a system like that in USA.Even many in USA are moving out to Canada to reduce the health care expenditure.

    You, and others like you who can afford a good health insurance policy is being robbed by the Health Insurance Industry while 47 million others who work like you are denied health insurance because they cannot afford the high premium.Obama plan will lower the health insurance premium for you and also will provide health insurance for the un-insured.Only the insurance Companies will suffer a reduction in their profit.

  12. I'm agree with "indianhomemaker's" statement. This is informative..

  13. I always wanted to read more about this, never got the time too. Thanks for sharing this!


    In the last 25 years, on only 5 instances an American did not win Medicine Nobel Prize. Isn't that something! Now we know what Americans are paying for!

    Yes, the system is really costly and absolutely unsuitable to India or any other developing country. But not incompetent or incapable, no sir!

    Obama plan, as it has been laid out, is for a "Public Insurance" option. Not government run hospitals. It is the fear of eventual government takeover of healthcare system that makes a majority of Americans oppose it today - although for some of us, it doesn't sound so evil to be frightened of!

  15. Phase shift,
    As you rightly said USA boasts of great scientists and best technology. Still it is lagging behind badly in most public health indicators. Priority in the current Health care model in USA stresses on costly interventions as treatments for diseases. The money spend on prevention is less.Till recently the health science in USA is a prisoner of profit hungry Corporations with the Govt showing a hands off attitude. It is not incompetent or incapable but have a lot potential for improving not only USA's but that of the whole World's health problems.
    As you rightly said Govt run or regulated health care is not frightening to most ppl as evidenced by public opinion in Europe.

  16. Excellent article by Atul Gawande. Thought you would be interested.

    If for any reason the link doesn't work, Google this: "The Cost Conundrum - What a Texas town can teach us about health care.
    by Atul Gawande "

  17. Phase shift, thank you for the link to that excellent article.

  18. I enjoyed reading your article. I share some of the same opinions in my blog:

  19. Sometime back, Forbes listed the highest paid jobs in USA. 17 of the top 18 were Medicine related - surgeons, radiologists, dentists etc. I know Doctors in USA who have severe daily stress trying to decide where their next investments should go.

    You will get an idea of Doctors' lobbying power if you read this:

    Latest Threat to Health Reform: Docs' Reimbursement,8599,1931330,00.html

    Both Democrats and Republicans want to further increase disbursements to doctors even as USA faces collapse of its healthcare system! They will do anything but increase the number of seats in Med schools.

  20. Phase shift, I do not deny some doctors especially those who do procedures earn huge money in USA. Precisely that is the problem of Market/Pharma run health care system. Those docs who are involved in primary care and preventive services are grossly underpaid.Thus system rewards coslty procedures and prescriptions.Health care reform with a public option and a greater Govt say will reduce overall health spending and will decrease the disparity in earning of doctors.Many highly paid doctors are against it. AMA as I said in the post was always against it. But now as the system is abt to collapse most of the doctors and AMA have agreed for some form of reforms with greater Govt role.


Comments are welcome especially if you do not think like me. But anonymous comments behind masks and those not relevant to the post are not encouraged.