Update: physicians speak out more on healthcare reform

Texas and US government compete with me, a primary care physician, to provide medical care, strangling impetus for reform. It's competition which removes the fluff resulting from the unnecessary utilization of resources. Below are some of the concepts being discussed by "Million Med Marchers", a conservative group of doctors and patients who want the government out of medicine.

I keep adding to this, but try as I may, can't get it up to 2074 pages.

1. Make insurance portable across state lines.

2. Make insurance subject to the same anti-trust limitations as all other businesses. Repeal the McCarran-Ferguson Act of 1945 (isn't that about when the trouble began?)

3. If a new law must be passed, how about one that forces government and big corporations to offer a choice of insurance companies? In Texas, all state employees have but one choice: Blue Cross Blue Shield. BCBS has 1/3 of the Texas healthcare insurance market. BCBS owns the Texas Academy of Family Physicians, the Texas Medical Association, and the Texas Medical Board. Nice and tidy, isn't it? Unfortunately, many doctors are for sale; many others "fear retaliation" and thus don't speak out.

Wonder how many docs, other than the ones I know about, were bribed by BCBS in order for them to reach a 1/3 share of the market...

4. Give small businesses and individuals the same tax credits for the purchase of insurance as are available to large corporations.

5. Elected government officials should accept the same plan, with the same restrictions and mandates, as everyone else.

6. Listen to healthcare workers who are whistleblowers; we are telling you where the problems are.

7. Healthcare licensing boards around the country are for sale. They do not generally serve the public need and are compromised by conflicts of interest. Contrary to what is commonly thought, medical boards are not dominated by the AMA. The AMA is dying and does not represent the views of the majority of physicians. It is rife with conflicts of interest. This is not good for healthcare. In Texas, the Texas Medical Board protects bad doctors and harasses conscientious doctors who blow the whistle.

8. Make generous use of high deductible health plans; limit restrictions; encourage small businesses to self insure in order to increase deductibles even further. An individual working for a small business could, for example, choose a plan with a $10,000 deductible; the business might self insure its employees up to $25,000. Combine this with judicious use of tax credits for healthy habits and preventive care.

9. Health Savings Accounts UN-tethered to health insurance companies.

10. Medicaid abuse and Social Security Disability abuse overwhelm us now. With Obamacare, everything will be either Medicaid, Medicare, or VA. It's going to bankrupt us. Medicaid consumes over 25% of the Texas state budget. In Tennessee, it's over 40%. What is it in your state?

11. A few states, thankfully, have meaningful caps on noneconomic damages for medical malpractice. This doesn't make the lawyers happy, but when lawyers are happy, the rest of us aren't. Texas' $200,000 cap has brought companies back to Texas so that there is more competition. Malpractice rates have gone down. Other states with caps in this range are seeing malpractice litigation turn the corner.

12. Require Medicaid recipients to pay co-pays and allow them to part of their fees in the form of work.

13. Limit advertising for durable medical equipment paid for by insurance and Medicare.

14. Limit advertising for medical malpractice.

15. NO PUBLIC FUNDING for law schools!

16. Require, incrementally, every US physician, in a random rotation, to review medical malpractice cases and medical board cases for evidence of either malpractice or for determination of a need for discipline; give Continuing Medical Education credit for hours worked.

17. Provide other protections from retaliation against whistleblowers.

18. Protect healthcare workers from retaliation by law in both government and private industry. Require due process and other constitutional rights in hospital peer review and medical licensing.

19. Who in the heck do the so-called "experts" in healthcare policy hired by the think tanks think they are? Yes, they have some good ideas, but they have no idea, for example, what it will do to medicine in the long run to have nurse practitioners practicing medicine and not doctors.

Do you hear Obama making any of these suggestions? I don't. Could it be that he really doesn't want private healthcare to survive?