Glaringly absent from the current debate about Medicare is the Doctor’s perspective. As a physician who has worked at every level of the health care system and a candidate for Congress, I bring a unique perspective to the Medicare discussion. Twenty years ago, as I graduated from medical school, I recited the modern Hippocratic Oath, a pledge recited by generations of doctors. Central to this pledge are the three sacred tenets of medicine: benevolence: to do good; non-malfeasance: to do no harm; patient autonomy: the right of patients to have a choice in their medical decisions.
It is these three principles that should guide Congress and the President to define the necessary changes to Medicare. Unfortunately, the politicians in Washington D.C. have forgotten who they were elected to serve (We the People), and sadly appear too busy with politics to involve the basic values of medicine in their health care decisions. The Republican plan to dismantle and privatize Medicare—recently passed by the House of Representatives and supported by Congressman Dan Lungren—is a disastrous example of this.
The Republican Plan to dismantle Medicare runs counter to the credo that we physicians live by. It fails in its attempt to “do good” by reducing costs, instead raising total health care costs for seniors on Medicare, according to the non-partisan Congressional Budget Office analysis. It does irreparable harm to millions of American seniors and future generations by eliminating guaranteed health coverage, leaving them without care when they are most vulnerable. Perhaps most damaging, this plan will reduce patients’ power, handing over even more control of our medicine to the big insurance companies.
As a physician, I understand that solving any problem starts with the right diagnosis. For America, that diagnosis is that healthcare costs are out of control. For our nation to regain its economic growth, and for our businesses to start hiring again and increasing salaries, we must contain healthcare costs. By doing so, we can begin to both address our federal debt and strengthen Medicare. Here are some of my initial prescriptions to begin to heal our broken healthcare system: First, we must identify the most efficient delivery systems that direct resources to patient care—not to administration and non-patient care related activities. Since Medicare is by far one of the most efficient benefit systems, instead of dismantling it as Lungren suggests, we should actually be strengthening Medicare for our seniors.
Second, the Medicare system has been the victim of fraud and abuse. Through careful monitoring and aggressive enforcement we can save billions of dollars currently spent on unnecessary and fraudulent surgeries and treatments. Estimates show that the amount of fraud and abuse exceeds $60 billion annually. Let’s close these loopholes, catch these criminals and direct these resources to lower premiums and better care.
Third, allow the federal government to compete on pricing. When it comes to Medicare, the federal government’s responsibility is the taxpayers. By not allowing the federal government to negotiate on a fair playing field, Congress allows our healthcare, pharmaceutical and medical equipment costs to far outpace the rest of the world (for the same treatments). The taxpayer and business owner get stuck with this tab. Create a fair marketplace and costs will come down dramatically.
Lastly, make healthcare about keeping people healthy. I know firsthand that the greatest healthcare advances of the last century have been public health interventions: clean water; vaccination programs; food and nutrition programs; and a reduction in smoking rates to name a few. By giving greater access—not disincentives as the Lungren Plan would—to seek preventative treatment, we can begin to dramatically lower overall healthcare costs by slowing the alarming rates of diabetes, cardiovascular disease and cancer.
The Ryan/Lungren Plan is both a misdiagnosis and a misguided treatment plan. In fact, it is malpractice by our leaders, and it would take America in exactly the wrong direction. Only by returning to the basic principles and values of medicine will we solve this healthcare crisis, lower costs to reduce America’s debt, protect our nation’s seniors, and secure Medicare for generations to come.