As a physician who has been in practice for 27 years -- including private practice for 17 years, in consultancy at a veterans administration hospital for five years and the past 9½ years as an employee of a local hospital -- I have a different perspective than some of my colleagues whose opinions recently have appeared on News Tribune Opinion pages.
Whether you refer to it as Obamacare or the Affordable Health Care Act, the bottom line, I believe, is that our health-care system needs to be reformed, not transformed.
Clearly, patients should not be denied coverage for pre-existing conditions, and the idea of being able to provide coverage to our children up to age 26 also is a good one, particularly at a time when many of our youth are graduating from college and having a difficult time finding full-time employment.
For most of the working population covered by private insurance, innovative ideas -- including deep discounts for making healthy lifestyle choices, allowing insurance policies to be sold across state lines and offering a menu of policies with full transparency tailored to individuals in different age groups -- should help to bring prices down.
At a time when our national debt is close to $16 trillion and growing by $3.9 billion daily, the government cannot afford a giant undertaking like health-care reform. The law was passed before our elected officials even had a chance to read it. Nancy Pelosi famously said Congress had to pass it to learn what was in it.
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It is estimated that about 20 percent of Medicare costs go to cover fraud and waste. Can anyone imagine what that cost would be if you extrapolated that to the rest of the population?
On a more personal level, I recently was wearing the other hat as a caretaker for my elderly mother. In the last month of her life she ended up in a nursing home and, on two separate occasions, was transferred to a hospital despite the request my mother and I made that we did not want her to go to the hospital given her terminal condition. Both times I had to call the physicians to explain the situation and that we did not want expensive tests and so forth. I reassured the physicians I would not initiate a lawsuit because they did not do a CT scan of the brain to see if the tumor had spread.
And here is the other issue: Any meaningful conversation regarding health care has to involve tort reform because the perceived threat of liability drives up the cost of medical care. This is something the new health-care law fails to address.
Lastly, we have the issue of the uninsured, who, by some estimates, constitute 15 percent of the population, or about 46 million people. I believe local initiatives to provide health care to those who are poor and homeless will have far better results than any bureaucracy originated in Washington, D.C. A case in point is the Camillus House in Miami, which has been providing care to the homeless and poor for more than 50 years.
There are many retired physicians in the community who have been local proponents of the health-care law. This is the time for action: Start a free clinic, recruit volunteers and get the state to offer malpractice coverage for the volunteer doctors. Many of us still in practice would give of our time for such an endeavor. Depending on the nanny state in Washington to take care of our problems locally is not the answer.
Waldo L. Avello of Duluth is a gastroenterologist at St. Luke's Hospital. In 2001, while practicing in Palm Beach Gardens, Fla., he was named Volunteer Physician of the Year.
