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Doctors, Patients, and the Need for Health Care Reform
Senator Max Baucus
One Montanan wrote to me recently about her father’s death. Six months away from qualifying for Medicare coverage, he did not have health insurance or the cash to pay for recommended heart surgery. He died on Christmas Day.
Since I began my current fight for health care reform 2 years ago, I have heard from hundreds of Montanans from across the state. So many of them tell heartbreaking personal accounts of tragedy and suffering that have resulted from our broken health care system. In nearly a century of effort, this country has never been as close as we are today to bringing true stability and security to our health care system. We must seize this opportunity on behalf of the millions of people throughout the country for whom this system is no longer working.
There is no denying that our system is broken. Millions of Americans struggle each day because they do not have the coverage they need. Currently, more than 46 million people are uninsured and therefore risk their health and financial stability every time they get sick.1 Another 25 million Americans do not have sufficient insurance to adequately cover their medical needs — a situation that is fueling an increase in bankruptcies caused by high medical costs.2 The United States is home to the finest medical professionals in the world. These professionals are on the front lines of the crisis, witnessing the failings of our country’s health care system firsthand every day, as ever more Americans suffer physically and financially.
Rising costs and abusive practices by the health insurance industry have left the sickest and most vulnerable Americans at risk. All Americans — regardless of their station in life — should be able to get the care they need, not just the care they can afford. The rate of growth of health care costs is unsustainable. Doing nothing is simply not an option. Preserving the status quo would mean that Medicare would go broke in 2017. Preserving the status quo would mean that more Americans would lose their insurance coverage. And preserving the status quo would mean that our country would have to sacrifice other priorities to spend more and more of our federal budget on health care.
For providers, the crisis is equally grim. Impending workforce shortages, excessive volume-based purchasing, rising costs, and unpredictable Medicare payments all plague our system. Just last month, the Association of American Medical Colleges released findings indicating that 15 years from now the United States will have 159,000 fewer doctors than we need. Although there are shortages in nearly every field of medicine, primary care physicians are in particularly short supply. With the heavy burden of medical school loans, which averaged more than $150,000 per medical school graduate in 2008,3 recruiting new physicians will be a challenge in years to come.
Over the past 2 years, I have led the Senate Finance Committee through more than 20 health care reform hearings to learn how we can work together to put an end to the status quo and modernize our health care system. In June 2008, we held a bipartisan health care summit at the Library of Congress that brought some of the best minds together to discuss this issue. In November, that work culminated in my 89-page blueprint for reform. This year, we held three roundtable discussions with experts in each of the three major areas of reform — health care delivery, coverage, and methods of paying for reform — and released detailed papers outlining policy options in connection with each area. The public dialogue about this issue has been extensive.
On October 13, the Senate Finance Committee, which I chair, reported its legislation with bipartisan support. The Finance Committee bill — the America’s Healthy Future Act — lays the foundation for continued progress. According to analysis from the Congressional Budget Office (CBO), our bill would fulfill the promise to slow the growth of health care costs and to provide high-quality, affordable coverage. The bill would increase the percentage of Americans who have insurance to 94%. It would reduce the federal deficit by $81 billion over the next 10 years. In the 10 years after that, our bill, according to CBO projections, would continue to reduce the deficit relative to current law, with a total effect during that decade in the range of 0.25 to 0.50% of the gross domestic product. In today’s dollars, that means a deficit reduction of $450 billion to $900 billion.4
The America’s Healthy Future Act would also reform the system for delivering care by putting in place game-changing policies that would benefit providers and patients. For providers, the bill would establish payment incentives and reallocate unused residency training slots to encourage more doctors to enter primary care. It would reduce unnecessary paperwork and inefficiencies that now keep providers on the phone with insurance companies instead of spending time with their patients. It would promote coordination of care through physician-led accountable care organizations that would allow groups of providers who are delivering high-quality care to share in the savings they achieve for the Medicare program. And ultimately, it would help shift the focus of health care to the prevention of disease and the promotion of wellness.
For patients, the bill would stop insurance companies from denying or dropping coverage on the basis of health status or sex. It would also take the sometimes frightening risk out of seeking needed care by putting caps on out-of-pocket costs and eliminating caps on the benefits patients can receive in a given year or during their lifetime.
Health care reform should also ensure the stability and security of Medicare payments, next year and into the future. The important delivery-system reforms included in the America’s Healthy Future Act will be most meaningful and sustainable if they are built on a solid payment foundation. I look forward to working with my Senate colleagues to find a lasting solution for the Medicare physician-payment system.
In the coming weeks, we will work with senators and representatives to merge our work into a final package. For all our differences on the details, we share a commitment to reform that will help providers deliver high-quality, cost-efficient care to patients. We share a dedication to ensuring that providers have the tools to do their jobs, without having to haggle with insurance companies. And we share a commitment to giving patients the peace of mind to know that no person in the United States of America will go broke just because he or she gets sick.
As patients’ greatest advocates, providers play a vital role in helping to achieve reform. The stakes are high, and now is the time to fight against the misinformation that threatens the promise of reform. Together, we can take the first steps toward lowering costs, improving quality, and expanding access to high-quality, affordable coverage. At the end of the day, Americans are counting on us to end the status quo and bring our health care system in line with the principles and character of this great nation.
No potential conflict of interest relevant tot his article was reported.
Editor’s note: We have also invited Senator Charles Grassley (R-IA), the ranking member of the Senate Finance Committee, to provide his views on health care reform.
See what other readers have to say, and submit a comment to participate in our weekly forum.
Source Information
Senator Baucus (D-MT) is the chairman of the Senate Finance Committee.
This article (10.1056/NEJMp0910001) was published on October 21, 2009, at NEJM.org.
References
- Census Bureau. Health insurance coverage: 2008. (Accessed October 20, 2009, at http://www.census.gov/hhes/www/hlthins/hlthin08.html.)
- Himmelstein DU, Thorne D, Warren E, Woolhandler S. Medical bankruptcy in the United States, 2007: results of a national study. Am J Med 2009;122:741-746. [CrossRef][Web of Science][Medline]
- Association of American Medical Colleges (AAMC). 2008 Graduate student survey. (Accessed October 20, 2009, at http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt.shtml.)
- Congressional Budget Office. Preliminary analysis of the chairman’s mark for the America’s Healthy Future Act, as amended. (Accessed October 20, 2009, at http://www.cbo.gov/ftpdocs/106xx/doc10642/10-7-Baucus_letter.pdf.)
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Other Health Care Professional
Afton Minnesota, USA
Disclosure: None
I believe in government regulated insurance reform to assure adequate care for Americans and I believe physicians should be free to practice medicine without fear of frivilous malpractice lawsuits judged by non physicians. (This alone would be a huge cost saver.) However, I do not believe the government should be in the healthcare business beyond its current involvement. (MC and MA) Two government run programs that are failing as your commentary eludes to. (Not to mentions Social Security) The government has always identified areas of need and tried to meet those needs, (Medicare, Medicade and uninsured children last year…) Lets fix these programs first, while setting up insurance industry guidelines and limit medical malpractice to improve upon a system that is the envy of the world.
Other
Fort Collins Colorado, USA
Disclosure: None
With all due respect, Senator, you have no idea what the real drivers of health care cost are. More importantly, I defy you to name a single government program (any program, not just in health care) that has ever acheived or even approached the economic objectives forecast for it or been able to resist the urges of Congress to continue to expand it beyond its original purpose and cost. This is the thin end of the wedge. The final result will unquestionably be an effort by those who have no idea how the private sector works (because they have no experience in it, and the few who do know better) to control an enoromous segment of the American economy. The misguided incentives and unintended consequences will destroy the health care system as we know it. If this is your goal, congratulations, as you are well on your way.
Physician
Atlanta Georgia, USA
Disclosure: None
If Senator Baucus is so committed to improving health care, why was he so opposed to considering a single payer option?
Physician
grand island Nebraska, USA
Disclosure: None
why is the nejm even alowing this diatribe?? where is the dedication to science. you have tarnished your reputation forever. over the last few weeks you, the editors, have politicized the nejm to no purpose. this is the ultimate bad science in the name of trying to be relevant.
Other
Cartersville Georgia, USA
Disclosure: None
This is pure propaganda and does not belong in a prestigous medical journal. There is clearly a need for intelligent, focused reform; reform that takes place incrementally and reversibly so that reformation errors and mischief can be unravelled without major upset to the health care universe. Massive reform is not reform; it is experimentation on a mass scale Just as the socilaist revolution and the facist revolution and the dozens of South American revolutions have started out as reform movements and ended up setting back their cultures and economies and welfare decades.
Are physicians not to blame for the mess we have today? Did they not abdicate their financial management to the insurance claims processors; their patients rights to the ‘inspectors’; their ‘marketing’ to the employers? All of this was reform of the early attempts to reign in Blue Cross/Blue Shield?
Then physicians should design the change-incrementally and with separate solutions for different sectors.
Physician
Austin Texas, USA
Disclosure: None
The elderly man who died of heart disease on Christmas day is a sad story indeed. But we need to know more about him before we blame insurance companies. Did he have a heart attack? How long had he gone without insurance? Was a he a smoker? Was his diet heavy on fat, salt and sugar with too many calories? Did he exercise regularly? Was he obese? If we took as poor care of our cars as we do our bodies, and if we drove as carelessly and dangerously as most of us live and eat, we couldn’t afford auto insurance either. Would the Congress hold hearings and threaten USAA that “auto insurance is a human right!”
Coverage for pre-existing medical conditions is not insurance. Could I purchase a new homeowners policy from State Farm if my kitchen was in flames and the Fire Department on the way? Could my family purchase a new life insurance policy on my life if I were already dead? Blaming the evil insurance companies for our healthcare problems steers us away from the only solutions that will work. We all have to start taking much better care of ourselves. At 40 I had a health epiphany. Now 75 I promote healthy living and eating at my website nomoremedicines.com. I still do walk the talk. If I can do it so can you.
Other Health Care Professional
Durban , South Africa
Disclosure: None
Healthcare is a basic right of all people and nations. It should afford accesibility and affordability and dignity to the ill and those who are terminally sick.
South Africa has emerged from inequities in the apartheid era and is bent on delivering equity in healthcare to all its citizens.
Equity is a marker of a committed democratic government. I therefore applaud you Senator Max Bacus and your honourable President, Barack Obama, for your pursuance in health reform in the USA.
Other Health Care Professional
Chicago Illinois, USA
Disclosure: None
I question the statement that, “There is no denying that our system is broken. Millions of Americans struggle each day because they do not have the coverage they need.”.
Our system is not perfect by any means. But, it is not ‘broken’. The current state that our health care system is in is fed by misguided political policies. Try to recollect ANY government program that worked? If you can, statiscically look at the gvt. run failures vs. victories.
The current state we are in will shine in comparison to the where health care will be once these misguided policies are implemented. With no real critical analysis and politicians making these decisions over patient care, the US health care will be reduced to a 3rd world status.
If these policies are pursued, the number of these beaureaucratic tragedies of human life will do nothing but skyrocket.
Physician
USA Tennessee, USA
Disclosure: None
Our health-care system has been given to the insurance companies by a fluke of history, not because this was the best way to run the system. The experiment has failed and new model is required. There are ways to do this incrementally, but for anyone to stand there and continue to insist it cost very little is folly. Our healthcare system is an albatross around the neck of every American individual, corporation, and community. Any bill without a public plan designed to cover the gap between those with traditional insurance and whose with Medicaid is an affront to America as it will solve nothing for the people who need the most help, worsen the situation for those who are already insured, and improve the coffers of those who are already rich from their living of selling life vests on the Titanic. I am frequently disheartened by what really moves our government, but if this bill goes out without the dawn of real reform, I will know that we are truly in need of a Bastille storming.
Resident or Trainee
San Antonio Texas, USA
Disclosure: None
It is very interesting to read Rep. Baucus article, and as expected, not find a word about the medical liability reform. Not a single mention of it anywhere!
How he thinks to reduce cost of health care when thousand of test are ordered everyday because of defensive medicine we practice today? How he thinks to recruit more physician to primary care when the PCPs transfer patient to specialist for care, many times, not because they do not know how to treat the patient, but to avoid frivolous law suits that may occur? How does he thinks to recruit more young people to enter the medical field, when his plan is pointing to reduce payment for doctors, who will have to pay high medical school loans, and high medical liability insurances? Please Rep Baucus, why everybody on your side of the aisle avoid talks about medical liability reform? No reform will be meaningful without considering the medical liability costs that doctors, patients, insurance companies pay every day!
Other Health Care Professional
Novi Michigan, USA
Disclosure: None
The Baucus bill will not leave a option for a public plan which is critical to Health Care Insurance Reform. I would vote NO to the Baucus Bill.
Other Health Care Professional
St. Louis Missouri, USA
Disclosure: Financial tie to maker of a related drug or device
112 people die everyday because of the status quo in the USA. Unacceptable!
The most common reason families go bank rupt is because of health care bills.
This is a moral obligation to our citizens! Health Care Reform NOW!
Physician
Calicut , India
Disclosure: None
Health and Education are basic right of every individual, and the nation has a responsibility to provide it without any bias to every citizen. The necessary economic and social reforms should be the duty of the adminstrations anywhere in the world. Some how this is negelected and the rsponsibility of providing health care and education finally ends up in the hands of bussiness interests. Insurance based disease care is anyway a failure, especially so if it is after ignoring basic genuine helath care as is happening in India which is following the US model of disease care. Universal insurance for all citizens run by the state alone is the only option even that becomes unsustainable if bussiness motives come into it. Let us work for providing basic amenities to everyone all over the globe, because all diseases known to us are the result of problems in diet, environment and lifestyle. Once that is achieved we should work for basic disease care facilities.
Physician
Batesville Arkansas, USA
Disclosure: None
All doctors and politicians:
Please look at following study:http://circoutcomes.ahajournals.org/cgi/content/abstract/CIRCOUTCOMES.108.825612v1
The Dartmouth study is flawed! It is amazing that everyone takes one study (and offshoots from the same motivated players) as gospel. Clearly, neutral statisticians and scientists need to look at all the studies out there, and design new studies. It is very disheartening to think so many public policy professors and doctors let their politcal viewpoints, bias there “scientific method”. Variation in treatment is always seen as unnecessary in the places who use more resources, without even a hint at looking at whether the care could be better at the places with higher utilization…better is in eye of beholder. Most things except cardiac arrest can be put off, or delayed or spend less, always, but endpoints of better must include quality of life, less suffering, etc Eg: 8 ear infections before tubes in kids
Resident or Trainee
Mount Vernon New York, USA
Disclosure: None
Great article by senator who has some plan for people I meet everyday. Mount Vernon is a very poor neighborhood of New York city. 22 000 people with disability lives in 4.4 square miles and only hospital ( Mount Vernon Hospital) which serve these vulnerable people for past 100 years is getting closed. Reason: financial. What will happen to these people?
A diabetic and hypertensive lady without insurance wants to continue her medication for high blood pressure even though it causes her to cough like a smoker and doesn’t allow her to sleep at night for past 8 months. Reason, she can not afford it!
Another, a young hardworking business man who earns 52K a year but can not afford health insurance( 600 monthly). He comes with perforated appendix. 20,000 medical bills. Could not pay back. He had to go to court and landed with bad credit history.
How come we doctors who know these stories better than anyone else are opposing the present reform? The greed for money are making us heartless?
Other
Phoenix Arizona, USA
Disclosure: None
I think many of the people agaisnt this plan are bias because they probably have good healthcare plans and they really dont have to worry like many of us do. But we incourage you senator and president Obama many of the unheard voices are behind you and are hopeful that this will help every American.
Other Health Care Professional
El Paso Texas, USA
Disclosure: None
Around 50 million people do not have health insurance and no access to health care in the richest nation on the globe. It is very hard to believe the fact. Most fascinating is around 8 million children are without health insurance and no health care access. The fast food outlets, lack of physical activity, environmental factors, and lack of grounds in the schools all lead to the epidemic of childhood obesity. The children have become vulnerable to the complications of childhood obesity and we do not provider them the health insurance to address their health issues. How sad it is??!! Are we preparing the future of the country to be fit enough to meet their needs??
Other Health Care Professional
Oroville California, USA
Disclosure: None
I believe the debate over health care reform boils down to one fundamental concept, is basic health care a right or a privilege? We have treated it as a privilege similar to driving for far too long in this country…i.e. here’s your drivers license and here’s your insurance card. An alternative to the complex health care reform bill that may or may not pass congress would be to simply lower the age for medicare by 1 year each year (KISS principle). This would slowly phase in a national plan while still allowing those with the $ to purchase whatever policy they wish. The insurance companies would still prosper with a smaller pool of richer clients.
Other Health Care Professional
Hyderabad , India
Disclosure: None
Health care is getting costlier everyday as the industry is a human intensive and technology intensive one which needs lot of investment….given the shortages in the manpower for setting up places of health care delivery, it’s definitely going to get more costlier as we would not be able to find the required human capital and the available man power would be demanding…..i suggest that the state should think of running health care facilities which should be low cost, even though you might have to lower the standards a little…i do not mean lowering the care in clinical and medical aspect but in terms of the operational costs, the technology which might not be up to date but which works and is accepted as a reasonable one….it’s always better you something instead of nothing….i am from India…even best of hospitals here use technology which is treated as out dated there in U. S and the care provided by such hospitals is accepted as high end which saves innumerable lives everyday
Physician
Encino California, USA
Disclosure: None
It is of interest that no potential conflict of interest is reported. Since it is reported that the Senator has received large sums of money from the Health Insurance industry, does this not constitute a conflict of interest?-and should he not, as Judges are reputed to do, recuse himself along with all other Congressmen who receive such money, or would this then leave an empty Congress?
Other Health Care Professional
Woodbury New Jersey, USA
Disclosure: None
Why does one not see reports of those who have gone to Canada, the U.K, India, etc for their medical care while there are countless reports of those from these countries that come here? While the system may have it’s flaws, it is not broken. It is the envy of many requiring complex care.
Mediocraty should not be acceptable in medical care, yet that is suggested by some that say reduce the standards. So what if the technology and pharmaceuticals are not new? Should we return to exploratory surgery to see what is going on or order a CAT, MRI, or other test?
With the government involvement it is no wonder that medical school applicants are down. Why would one want to enter a profession where one is saddled with hugh debts and reduced income?
Maybe we could bring back the shaman.
Other Health Care Professional
Magnerahely , Northern Ireland
Disclosure: Financial tie to maker of a related drug or device
In the US, elected officials who have an intrinsic vested interest in the current system that is Medicare (congress sets the reimbursement payments) cannot be trusted to bring about true heath care insurance reform, much less tort reform or health care reform.
Have you heard any congressperson suggest that they simply make the same programs available to the citizenry as a whole that are available to them? Let me know who has when you hear.
Experience with the Oligarchy in DC would seem to suggest that anything more complex than a single payer system would provide too much temptation for selfish elected officials- and even that might be dangerous.
As to the continuation of employers being involved with health care, this accident of history is so unfair, so foolish (we don’t have them buy groceries) that it ranks with social security which also should have been done away with years ago.
Physician
Shaker Hts Ohio, USA
Disclosure: None
The information and justification, and, indeed, urgency to drastically reform the Health Care System in USA are overwhelming.
There is a powerfull influence to maintain the status quo, and this comes from the Health Care Industry.
If the american people at large would be fully aware that maintaining the status quo will dammage their personal interest, they would put pressure on their representatives in order to move forward, not only the Public Option but a more radical (from root) reform.
Scare tactics, missinformation and the eternal hope that the people who supossedely are happy with the status quo will never fell through the cracks (i.e. will be inmune from bankrupcy due to medical costs) are negative factors. Sooner or later we will have a similar system to the other industrialized countries. Why to wait.
Physician
CHICAGO Illinois, USA
Disclosure: None
The CBO projections that “It would reduce the federal deficit by $81 billion over the next 10 yrs” assumes the sustainable growth rule (SGR ) which would lead to 20-25% REDUCTIONS in physician payments will be CONTINUED. ..Either physician payments will drop by 20% or mainatining payments will ADD billions – to the real cost of this bill.the current estimate is wrong
The bill fails to eliminate or even cosntrain one of the major drivers of cost – our broken medical liability system.
SHIFT HAPPENS..Current providers who participate in medicare are able to do so by cost shifting to commercial payers. So indeed commercial insurance IS expensive because medicare / mediaid are being subsidized.
Having consumers pay for more of the care they receive is one of the most effective ways to add price discipline and competion. High out of pocket + HSA yields better decions. Consider: Lasik prices have plummeted while MRI costs have surged- one is paid directly the other by insurance
Physician
Baton Rouge Louisiana, USA
Disclosure: None
I do not understand how someone is denied care. I am a hospitalist in Louisiana and we treat everyone the same whether they have health insurance or not. Everybody gets the necessary procedures and surgeries and access to specialists in the hospital! How devastating it would be to do something we cannot afford.
Physician
Baton Rouge Louisiana, USA
Disclosure: None
I do not understand how someone is denied care. I am a hospitalist in Louisiana and we treat everyone the same whether they have health insurance or not. Everybody gets the necessary procedures and surgeries and access to specialists in the hospital! How devastating it would be to do something we cannot afford. Since we cannot afford universal healthcare right now, why don’t we fix the economy first. Take our country back from China and India.
Physician
Bayreuth , Germany
Disclosure: None
Living and working as a physician in Germany has taught that this reform is good and is possible.
Costs can be cut, too. Reducing costs would extend to the private sector of insurances as well, for the computer and internet based data can be shared be patients various physicians, helping to avoid repeating unnecessary tests.
Anyone against this reform should be allowed to go without healthcare insurance, get ill, seriously ill, and be required to pay the medical bills out of his own pocket.
Physician
Boston Massachusetts, USA
Disclosure: None
I am struck that Senator Baucus lists no conflict of interest.
According to OpenSecrets.org over his career Baucus has taken donations from:
The Insurance Industry: $1,170,313
Health Professionals $1,016,276
Pharmaceuticals/Health Products Industry $734,605
Hospitals/Nursing Homes $541,891
Health Services/HMOs $439,700
THAT IS A TOTAL OF $3,902,785.
Can we trust Baucus to put aside the profits of the industries that have kept him in the senate? Has he put the people’s necessities ahead of the profits of his contributors?
Many believe that Senator Baucus should be removed from the leadership of health care reform, and should be voted out of office.
Other Health Care Professional
Colgate Wisconsin, USA
Disclosure: None
Baucus left single-payer off the table because the insurance industry paid him to leave it off the table. If it “wouldn’t get the needed votes,” it should have been tested and the senators voting against it would have answered to their voters. Single-payer is supported by 70% of the people, and that would have put dissenting senators in a bind. But bribery in our political system demands this outcome.
For the same amount of dollars we are spending today (16.5% of GDP) we could provide first-class Cheney-care to 100% of our population. Including those in Medicaid, and those who are uninsured and under-insured.
.
It’d be a Medicare-for-all system that would eliminate the insurance bureaucracy waste (31% of our costs) and we’d spend it on patient care instead. We’d pay for the system through our national infrastructure (taxes) and eliminate this cost for businesses. They could spend the savings on keeping jobs in the US instead of outsourcing to countries already with universal care.
Other Health Care Professional
Los Angeles California, USA
Disclosure: None
What was that about your independence, Mr. Baucus? Please then explain this:
According to OpenSecrets.org Max Baucus has taken donations from:
The Insurance Industry: $1,170,313
Health Professionals $1,016,276
Pharmaceuticals/Health Products Industry $734,605
Hospitals/Nursing Homes $541,891
Health Services/HMOs $439,700
——————————————-
GRAND TOTAL: $3,902,785
Please explain YOUR idea of “independence” on this issue.
I am the poor shlep who has to handle the billing and claims management of many an illustrious MD who is likely reading this page on the NEJM site right now. The CURRENT house bill stands to increase premiums on Americans and does NOTHING for we who are already impossibly burdened with billing and managing claims for tons of carriers which routinely take up all of an office’s budget for any and everything BUT healthcare.
This is a mess. Go back and pass the Weiner amendment or at LEAST put back the Kucinich amendment.
Physician
McKinleyville, California California, USA
Disclosure: None
As a 72 year-old physician who proudly delivers and receives Medicare services, I strongly believe that Medicare for all Americans is a moral issue, not an economic, social or political football to be used to further divide this country on ideological grounds. The prevention of suffering and death are foundations of all honorable religions and philosophies and it is time for America to demonstrate that it continues to be an honorable country devoted to the right to a life without suffering, liberty and the pursuit of happiness for all of its citizens.
Moreover, In view of the existence of clear evidence to the contrary, NEJM’s publication, without verification, of the Senator’s denial of potential conflict of interest relevant to this article is worthy of investigation, correction and a public apology.
Physician
McKinleyville, California California, USA
Disclosure: None
Senator Baucus failed to report:
1. According to OpenSecrets.org Max Baucus has taken donations from:
Insurance Industry: $1,170,313
Health Professions: $1,016,276
Pharm/Health Products Industry $734,605
Hospitals/Nursing Homes: $541,891
Health Services/HMOs: $439,700
TOTAL:$3,902,785
2. See the article: “Industry Cash Flowed To Drafters of Reform — Key Senator Baucus Is a Leading Recipient”
http://www.consumerwatchdog.org/patients/article
Resident or Trainee
Birmingham , England
Disclosure: None
America seems quite fascinating. Judging from the responses to healthcare reform and to the article above, it seems the only people who are opposed to improved healthcare availability for the poor are the people who have benefitted from the high charges/fees/retainers etc currently paid out in the insurance-driven market. It is a sad sad sad indictment of the medical profession and I for one am ashamed to belong to the fraternity. I hope people start looking beyond their own selfish needs – yes yes we all aspire to live comfortably etc etc but there is also a point where we stop worrying about whether we will still be able to afford yachts and holiday homes and start thinking about fellow human beings. The insurance industry has made tonnes and continues to make tonnes of money. They obviously do not want the situation to change and they have convinced people that the current system should stay simply because….they still want to make tonnes of money. Come on America wake up!
Other Health Care Professional
Minneapolis Minnesota, USA
Disclosure: None
Private insurance rates are high partly because our premiums subsidize the govenrment programs (medicare & medicaid). Medicare is going bankrupt because of fraud, deceptive practice & abuse of the system by patients & providers. My entire family works in the medical profession – pharmacy, nursing, surgery, ER & physicians. We see many parts of the current system work well and we see the parts that need repair. Why not fix the broken parts and leave the remainder intact? Why conduct a complete overhaul of the system? And why rush to get this done?
Lawmakers listen to representatives from big insurance, big pharmaceutical, AMA & nursing unions but wouldn’t more responsible lawmakers take the time and meet with the doctors, pharmacists and nurses to discuss real ideas for improvements? The people who provide the care know ways to cut costs and improve our current system.
Physician
Portland Oregon, USA
Disclosure: None
Mr. Baucus is not an independent voice without conflicts of interest. He has received millions of dollars in campaign contributions from the health care industry as others have pointed out in detail and hired former executives from insurance giant Wellpoint to write his health care legislation.
It is not surprising, then, that he left single payer health care reform “off the table.” As noted in a New York Times interview with William Hsiao, Ph.D., Professor of Economics at the Harvard School of Public Health:
Q. What’s the most important lesson that Americans can learn from the Taiwanese example?
A. You can have universal coverage and good quality health care while still managing to control costs. But you have to have a single-payer system to do it.
For true reform we should hire true independent William Hsiao to design our system, not Mr. Baucus and his ex-Wellpoint executives.
Physician
Missoula Montana, USA
Disclosure: None
The fact that our elected representatives do not consider large industry contributions to be a conflict of interest demonstrates one of the major impediments to improving US health care. We fail to respond appropriately to objective data demonstrating that we need to do better in access, cost, choice and quality. We also seem to be remarkably unwilling to emulate other, more functional health care systems. We are paying a high price for the illusion that health care delivery can successfully be an entirely free market enterprise, and that greed or profit has any role in in what was once exclusively the product of a learned profession.
Other
Carson California, USA
Disclosure: None
The best primary care is the small private practice on the corner or in the rural country side serving the local community. Primary care is lost when it takes months to schedule an appointment with primary care physician at a large HMO.
Liability insurance makes it cost prohibitive or too risky on a financial future to open a small private practice. Doctors who typically maintain their private practice have to focus heavily on business aspects as opposed to medicine.
This liability cost extends far beyond the doctors malpractice insurance cost. The liability insurance affects all the manufactures that produce equipment and supplies for the doctor’s office and hospitals. Even the plug that connects the medical machine. And there are additional medical tests that are ordered for defensive medicine.
With more than 10,000 doctors unable to be placed in residency programs last year, where do these unused slots exist for primary care incentives?