A couple days ago, I was lamenting the state of the healthcare debate to my wife. In the public debate, and in the legislative chambers, the HMOs and conservative ideologues are kicking our asses. By “our,” I mean anyone in America with a pulse. Makes me depressed.

The very next day, my wife sent me the op-ed below, written by her father for his local paper. Dr. Jay Kaplan has been advocating for reform for decades. It’s inspiring to see that advocacy take form in a well-articulated public statement.

Bravo, Dr. Jay!

Why We Need Health Care Reform
Jay Kaplan, M.D.

I am a primary care physician and have been practicing for almost thirty years. I have had the opportunity to experience the many changes in health care over these years. The very positive changes are offset by the fact that many Americans lack health coverage. This group of nearly 50 million people includes recent college graduates looking for their first job, workers who own their own business, the recently unemployed, day laborers, and a host of other people.

Without health insurance, a major medical problem can quickly lead to bankruptcy. Doctors are reluctant to care for the uninsured due to the great liability issues in this country. The inappropriate use of the emergency rooms by the insured and uninsured alike greatly increase the overall cost of health care.

The cost of health care insurance has increased yearly. The use of generic drugs, decreased hospital stays, and the expansion of HMO’s has failed to control health care costs. Insurance companies deny coverage for patients with pre-existing conditions that make many uninsurable. Reports show that Americans pay the most for health care in the world yet health care charts do not place us near the top with regard to outcome data. We must demand coverage for all and better efficiencies with decreased costs. Incentives for preventative care for all patients are needed.

Our technology in medicine is very advanced with CT and PET scans, robotic surgery and very sophisticated ICU’s. With all the state of the art machines, we lack in fundamental health information systems that link doctors to specialists to hospitals. Often our privacy policies prevent the transfer of this essential information. How efficient is our information system when we cannot even identify the patient’s primary care physician? Why are medical reports not automatically sent from the emergency room to the correct primary care doctor? Why are patients in the VA system going to the VA Hospital to obtain their medications and again to their local physician for medical care at a double expense to the health care system? Why does Medicare not cover a yearly preventative physical for the population who is most in need of preventative therapy?

Data generated by the Red Cross, life insurance companies and worker’s compensation companies are often not shared with the patient or his personal physician. This expensive data is lost in the system and more often than not, repeated.

Public programs such as Medicare, Medicaid and the VA system provide quality healthcare for the elderly, poor and members of our armed forces. These programs work but there are many inefficiencies. Why are all the health care providers aware of these basic problems but the people who make the laws are not? We all hear about the $1000 wheelchairs, the $100 canes and the $10 aspirins. I am sorry to report that the system is as bad today as it was 30 years ago.

We need more primary care physicians. I suggest asking all the medical students in training programs how many plan to spend their time working in an expensive, inefficient system with high overhead and increased liability. The crisis is noted by the lack of obstetric physicians in certain areas. The ER’s and walk-in clinics keep expanding. This is not an efficient way to provide coordinated healthcare. We must encourage healthy life styles, diet, exercise and smoking cessation. People have to be more responsible for their own health. Inappropriate lawsuits do not help the system.

If done correctly, we should be able to recreate a better system. Discussion, not obstruction will enhance the health care system for all of us.