Socialized medicine kills patients...Oh...I mean...Socialized Medicine "un-blocks" beds for others to use!

Universal Care (read Obamacare) has ways to "un-block" hospital beds. Ready for....Just unplug the ventilator and pull the feeding tube!

 

Killing patients who are difficult to manage is wrong, but who would want to go on living as a vegetable?

By Robert Lefever

PUBLISHED:07:52 EST, 21 June 2012| UPDATED:11:13 EST, 21 June 2012

Old people are difficult to care for in hospital. They tend to have multiple medical problems and may be very confused. One specialist believes that, for these reasons, the NHS is in effect using euthanasia to un-block hospital beds.

Professor Patrick Pullicino says that doctors use a controversial ‘death pathway’, the Liverpool Care Pathway, when they believe that it is impossible for a patient to recover and that death is imminent.

This process may involve withdrawing treatment, including water and nourishment by tube. Death usually follows within 33 hours. Almost a third of all deaths in the UK each year come about in this way.

Prof Pullicino says that far too often elderly patients who could live longer are placed on the LCP so that it is now an ‘assisted death pathway rather than a care pathway’ in terminal care.

It would be very wrong if patients are being killed because they are difficult to manage. But I myself would not wish to go on living unless I have reasonable control of my body and full control of my mind.

Just because something medical can be done, it does not follow that it should or must be done.

My father's mind went to heaven three years before the rest of him. From his private pension, the family paid for his care in a private nursing home. Eventually he had a stroke. Technically, it might have been possible to keep him alive even then. His heart and liver and kidneys and all other body organs were working well. Only his brain had gone.

If he had been in an NHS hospital, with a readily available 'crash team', it might have been possible to keep him alive, more as a vegetable than as a sentient human being. But what for?

In that state, I believe that it would have been better for him to be treated on the Liverpool Care Pathway. He should be allowed to die in peace, rather than officiously kept alive.

As the man he was, and as the father I loved, his life was over. Only parts of his physical body would have been ticking over.

It might have been possible to continue that pathetic existence for weeks, months or even years, until one organ after another finally gave up.

But should each of them have been treated with a transplant, simply because that might have been possible with the miracles of modern science? And should the state pay for that, while inevitably limiting the resources available to other people who might gain greater benefit?

If he had been capable of paying for his own continuing medical 'treatment', would it have been right for him to be given it?

In that circumstance, would the doctors really have been helping my father or would they simply be demonstrating their own cleverness?

And if he had been in a private hospital, would they have kept him alive in that wretched state, purely because it paid them to do so?

And if I suggested that life support should be turned off, would I have been thought to be motivated by protection of my own inheritance?

It seems to me that Professor Pullicino, may not have thought sufficiently deeply into these issues. He may see them purely from his own professional perspective. His ideas make news but would they bring happiness or, alternatively, prolonged wretchedness?

Is he truly considering the interests of patients, or of their families, or merely those of his own professorial department?

Death Panels in Obama Care...Yep, in the UK they call Death Panels "The Liverpool Care Pathway". Still does kills the old and sick!

The best way to get around the fact that Death Panels are an essential part of Nationalized Health (read Obamacare) is to simply call it (the Death Panel) something else. In the UK, the NHS call this the “The Liverpool Care Pathway”. Easy….We don’t have Death Panels….we have the more compassionate Liverpool Care Pathway! Just…Sounds as creepy to me!

 

By Steve Doughty

PUBLISHED:18:08 EST, 19 June 2012| UPDATED:11:58 EST, 31 August 2012

Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year

• Professor says doctors use 'death pathway' to euthenasia of the elderly
• Treatment on average brings a patient to death in 33 hours
• Around 29 per cent of patients that die in hospital are on controversial 'care pathway'
• Pensioner admitted to hospital given treatment by doctor on weekend shift

Worrying claim: Professor Patrick Pullicino said doctors had turned the use of a controversial 'death pathway' into the equivalent of euthanasia of the elderly. NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia of the elderly. He claimed there was often a lack of clear evidence for initiating the Liverpool Care Pathway, a method of looking after terminally ill patients that is used in hospitals across the country. It is designed to come into force when doctors believe it is impossible for a patient to recover and death is imminent. It can include withdrawal of treatment – including the provision of water and nourishment by tube – and on average brings a patient to death in 33 hours.

There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP. Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’. He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.  Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated. He said this showed that claims they had hours or days left are ‘palpably false’.

In the example he revealed a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy was put on the LCP by a covering doctor on a weekend shift. Professor Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP. ‘I removed the patient from the LCP despite significant resistance,’ he said. ‘His seizures came under control and four weeks later he was discharged home to his family,’ he said. Professor Pullicino, a consultant neurologist for East Kent Hospitals and Professor of Clinical Neurosciences at the University of Kent, was speaking to the Royal Society of Medicine in London.

Distressing: The professor has claimed an approved technique of looking after the terminally ill is not being used in all hospitals. He said: ‘The lack of evidence for initiating the Liverpool Care Pathway makes it an assisted death pathway rather than a care pathway. ‘Very likely many elderly patients who could live substantially longer are being killed by the LCP. ‘Patients are frequently put on the pathway without a proper analysis of their condition.  Predicting death in a time frame of three to four days, or even at any other specific time, is not possible scientifically”.

This determination in the LCP leads to a self-fulfilling prophecy. The personal views of the physician or other medical team members of perceived quality of life or low likelihood of a good outcome are probably central in putting a patient on the LCP.’ He added: ‘If we accept the Liverpool Care Pathway we accept that euthanasia is part of the standard way of dying as it is now associated with 29 per cent of NHS deaths.’ The LCP was developed in the North West during the 1990s and recommended to hospitals by the National Institute for Health and Clinical Excellence in 2004.

Medical criticisms of the Liverpool Care Pathway were voiced nearly three years ago.

Experts including Peter Millard, emeritus professor of geriatrics at the University of London, and Dr Peter Hargreaves, palliative care consultant at St Luke’s cancer centre in Guildford, Surrey, warned of ‘backdoor euthanasia’ and the risk that economic factors were being brought into the treatment of vulnerable patients. In the example of the 71-year-old, Professor Pullicino revealed he had given the patient another 14 months of life by demanding the man be removed from the LCP.  Professor Pullicino said the patient was an Italian who spoke poor English, but was living with a ‘supportive wife and daughter’. He had a history of cerebral haemorrhage and subsequent seizures.

Professor Pullicino said: ‘I found him deeply unresponsive on a Monday morning and was told he had been put on the LCP. He was on morphine via a syringe driver.’ He added: ‘I removed the patient from the LCP despite significant resistance.’  The patient’s extra 14 months of life came at considerable cost to the NHS and the taxpayer, Professor Pullicino indicated. He said he needed extensive support with wheelchair, ramps and nursing.

After 14 months the patient was admitted to a different hospital with pneumonia and put on the LCP. The man died five hours later. A Department of Health spokesman said: ‘The Liverpool Care Pathway is not euthanasia and we do not recognize these figures. The pathway is recommended by NICE and has overwhelming support from clinicians – at home and abroad – including the Royal College of Physicians.

‘A patient’s condition is monitored at least every four hours and, if a patient improves, they are taken off the Liverpool Care Pathway and given whatever treatments best suit their new needs.’

Best States to practice medicine! Top compensation and low stress!

What are the friendliest states for physicians? Here are America's best places to practice

Publish date: Jul 22, 2009
By: Locum Life Staff

Primary care physicians in demand almost everywhere, there's not a region in the nation that wouldn't love to claim you as its own. The question is: Which state is best for your bank account, your career, and your peace of mind?

To determine the best states in which to practice, we evaluated a number of factors: overall compensation, malpractice liability insurance rates, cost of doing business, health insurance competition, and the mix of public and commercial payers. We also considered quality-of-life factors such as residential real estate prices, natural amenities, and weather.

We talked with physicians, state medical societies, and physician placement experts who recruit doctors to hospitals and group practices around the country. We tapped into survey information from the Medical Group Management Association and the Medical Liability Monitor, which publishes an annual state-by-state review of malpractice liability insurance rates. We also pored over data from the U.S. Census Bureau, the National Association of Realtors, and the Kaiser Family Foundation, among other sources.

Here's hoping the greenest pastures are just outside your window.

10 ALASKA

Why doctors love it here: If the mere thought of Alaska makes you shiver, you may be in for a surprise: Even northern climes break 70 degrees during the summer, and two of Alaska's largest cities—Anchorage and Juneau—have predictable seasonal changes. Also, hospitals and groups are offering bonuses up to $50,000 to primary care doctors who relocate.

Why you might not: Alaska's vast wilderness can be a shock to some. Statewide, food and housing costs are higher than the national average for cities its size, and if you're looking for a more relaxing schedule here, forget it: There were 267 outpatient visits to for-profit healthcare facilities per 1,000 Alaskan residents in 2007, compared to a national average of 146, according to Kaiser Family Foundation's State Health Facts Web site. Average annual primary care compensation: $310,000 (internal medicine, based on Delta Physician Placement data over several years)—plus, Medicaid fees are more than twice the national average, according to Kaiser.

Malpractice liability insurance annual rate (for internal medicine, from the Medical Liability Monitor 2008 Annual Rate Survey): $8,856 to $10,891

Major health systems: Banner Health (Fairbanks), Providence Health & Services Alaska (Anchorage)

Best town you've never heard of: Sitka (population: 8,800). The state's fourth-most-populous city boasts a rainy but mild year-round climate compared to most of the state. This gulf-coast town is a whale-watching destination with plenty of water and wildlife recreation, and numerous seafood restaurants. It's home to the Sitka Medical Center and Community Hospital.

9 WEST VIRGINIA

Why doctors love it here: West Virginia's 7.5 percent unemployment rate in April didn't reach the 10 percent mark of neighbors Ohio and Kentucky, according to the U.S. Bureau of Labor Statistics. And while the rest of the nation saw its income drop last year, the Mountaineer State's personal income and wages went up, according to West Virginia University. One recruiter has seen primary care physicians land annual compensation offers of $200,000 to $225,000.

Why you might not: Despite reforms in 2001, malpractice liability insurance rates, while on the downward trend (most dropped by 9 percent in 2008), are still some of the most expensive among the 10 Best Places to Practice. The state is also gradually enacting a number of corporate and income tax reforms, which add to an already higher than average tax burden, according to the Tax Foundation.

Median annual primary care compensation (all primary care specialties, based on MGMA 2009 survey data): $151,500

Malpractice liability insurance annual rate: $20,528 to $23,057

Major health systems: Partners in Health Network (Charleston), West Virginia University Hospitals (Morgantown)

Best town you've never heard of: Beckley (population: 16,830). A longtime coal-mining hub, Beckley, located in southwest West Virginia, about 45 minutes south of Charleston, is home to the 8,200-student Mountain State University.

8 ALABAMA

T. Michael Harrington, MD, family physician in Birmingham Harrington is the chair of the Department of Family and Community Medicine at the University of Alabama at Birmingham

Prior to moving to Alabama in 1984, the Virginia native practiced in the U.S. Navy and in a rural Florida town on the Alabama border. T. Michael Harrington, MD "It's a good medical practice environment," he says. "Our malpractice premiums are reasonable, we have good support from our medical societies, and from a primary care physician point of view, we've got great specialty support."

Why doctors love it here: Primary care physicians are landing $250,000 to $300,000 in some areas of the state. Alabama had low medical malpractice activity in 2007 in terms of both number of claims and dollars, according to the Kaiser Family Foundation. In fact, a 2008 study by a medical law journal found Alabama to be the "most difficult" environment for malpractice plaintiffs among two other neighboring southern states. The cost of living in this low-tax state is below average, with an average single-family home in the Birmingham metro area selling for $130,400 in the first quarter of 2009.

Why you might not: If it weren't for Medicare and Medicaid, Alabama might be considered a single-payer state. Blue Cross Blue Shield of Alabama controls 95-plus percent of the health insurance market in most of the major population areas, according to the American Medical Association's "Competition in Health Insurance" market study released last year.

Median annual primary care compensation: $263,687

Malpractice liability insurance rate: $7,484

Major health systems: Baptist Health (Birmingham), DCH Health System (Tuscaloosa), University of Alabama at Birmingham Health System (Birmingham)

Best town you've never heard of: Scottsboro (population: 14,863). In the northeast corner of the state, Scottsboro is nestled along the Cumberland Mountains and 70,000-acre Lake Guntersville. Aside from the outdoor activities, Scottsboro is home to the Unclaimed Baggage Center, which sells luggage and personal contents that go unclaimed by airline passengers. It's like the world's largest garage sale, every day.

7 MINNESOTA

Why doctors love it here: Minnesota offers some of the lowest malpractice rates in the country and the opportunity to consult with (or work for) one of the world's most respected health systems: Mayo Health. Though Minnesota is a high-tax state, the cost of real estate has remained stable, according to the National Association of Realtors, with an average single-family home in Minneapolis dipping from $199,000 to $174,000 last year.

Why you might not: Independents need not apply. Mayo Health, Allina Hospitals & Clinics, and MeritCare HealthSystem dominate the state, but if you're looking to switch from private practice to working within a giant, integrated—highly efficient—system, Minnesota is for you.

Median annual primary care compensation: $176,764

Malpractice liability insurance rate: $3,375 to $5,106 (Median: $4,500)

Major health systems: Allina Hospitals & Clinics (Minneapolis), Mayo Health (Rochester), MeritCare HealthSystem (statewide), Sanford Health (statewide)

Best town you've never heard of: Waconia (population: 9,151). Located on the shores of Lake Waconia, just 30 minutes west of the Twin Cities, Waconia boasts plenty of natural beauty as well as its own community indoor water park and health club.

6 OREGON

James Lace, MD, pediatrician and founder of Childhood Health Associates of Salem

Lace founded his solo practice right out of residency in 1977. Today, it includes 11 physicians, 2 physician assistants, and 2 pediatric nurse practitioners. "Liability reform is and will remain an elusive goal for the foreseeable future in Oregon," says Lace, alluding to the 1999 expiration of a limit on pain and suffering malpractice awards. "Despite the negative aspects of practice here, I have no reservations in recommending Oregon as a great place to practice pediatrics and to raise a family."

Why doctors love it here: Despite its politically liberal legislature, Oregon has consistently ranked as a business-friendly state and last year placed No. 9 in the Tax Foundation's State Business Tax Climate Index. The health insurance market is only moderately concentrated, according to the AMA's study, making it easier to negotiate better rates. Oregon did not suffer a drastic plunge in real estate values, according to the National Association of Realtors, with an average single-family home in Portland dropping from $286,000 to $264,000 last year. Oregon also has 13 national forests, more than 200 state parks, and 363 miles of public coastline.

Why you might not: Oregon has one of the largest uninsured populations in the country at 22.2 percent, according to Kaiser—a figure that will likely increase with the state's high unemployment rate (12.1 percent in April).

Median annual primary care compensation: $172,495

Malpractice liability insurance rate: $5,479 to $10,568 (Median: $8,111)

Major health systems: Legacy Health System (Portland), Oregon Health and Science University (Portland), Providence Health & Services (statewide)

Best town you've never heard of: Klamath Falls (population: 19,662). Just north of the California border, Klamath Falls has lured many former Californians with lower housing costs and an alleged 300 days of sunny weather each year, according to the city's Web site. Klamath Falls' largest employer is the Sky Lake Medical Center, a hospital and outpatient clinic.

5 NEW HAMPSHIRE

Why doctors love it here: With high taxes, high costs of managed care, and high malpractice premiums in Massachusetts, New England earns a bad rap as a challenging place to practice. New Hampshire, on the other hand, has a 1 percent state income tax, low malpractice rates, and a diverse commercial payer mix that keeps reimbursements competitive. The Granite State also boasts classic New England beauty and more affordable housing in most areas than you'd find in Connecticut or Rhode Island.

Why you might not: Compared to other states, New Hampshire dedicates fewer funds to loan repayment and forgiveness, and receives less support from private organizations for those purposes, according to a study released last year by the state's medical society, which also pointed out that New Hampshire is often not competitive with surrounding states on recruitment incentives for primary care providers.

Median annual primary care compensation: $157,015

Malpractice liability insurance rate: $9,429 to 16,810 Major health systems: Capital Region Health Care Corporation (Concord), Dartmouth-Hitchcock Health System (Lebanon)

Best town you've never heard of: Littleton (population: 4,631). "Nineteenth-century inns are flourishing on Main Street," according to New Hampshire magazine. "Upscale restaurants and galleries are sprouting in once-abandoned storefronts." Littleton is big on picturesque small-town New England qualities, but it's only a few hours by car from Boston or Montreal.

4 NORTH DAKOTA

Robert Beattie, MD, family physician, chairman of the Department of Family and Community Medicine at the University of North Dakota School of Medicine and Health Sciences

Prior to joining the university in 2005, Beattie, a North Dakota native, spent 15 years with a rural, 15-physician group practice that covered 22,000 square miles and 25,000 people. "Practicing in North Dakota is about relationships," says Beattie. "We take care of people we know, we know their families, and as a family doc, I also take care of those family members. It's a very comfortable environment in which to live and practice."

Why doctors love it here: Follow the money. North Dakota is perched atop the largest contiguous oil deposit in the lower 48 states, and new drilling techniques have created something of an oil boom here. Demand for physicians is peaking, thanks to the thousands of people relocating to operate the hundreds of new wells. Compensation is strong: One recruiter reports seeing family physicians earn $350,000 a year, including bonuses. Moreover, Medicaid reimbursement in the state is 43 percent higher than national averages and about even with Medicare reimbursement. Unlike the rest of the country, North Dakota home values actually rose through last year (an average single-family home in Bismarck sold for $134,900 in 2006 and $155,200 at the end of 2008, while Fargo showed a smaller increase, according to the National Association of Realtors). The state is paradise for fans of the outdoors, boasting 17 state parks, 1,300 designated campsites, and the 70,446-acre Theodore Roosevelt National Park.

Why you might not: While population has been on the rise in the last three years, North Dakota remains the third-least-populous state in the country, so feelings of isolation could be considerable. Plus, the northeast corner of the state has an average winter temperature of about 3 degrees.

Median annual primary care compensation: $184,418

Malpractice liability insurance rate: $6,021 to $12,770

Major health systems: MeritCare Health System (Fargo), SMP Health System (Fargo), Trinity Health (Minot)

Best town you've never heard of: Williston (population: 12,512) is one of the oil boom towns in the northwest corner of the state. As a result of the employment demand, the town is home to Mercy Medical Center, which includes a cancer center, primary care clinic, and wellness center. Williston's average high temperature of 19 degrees in January is comparable to most Upper-Midwestern states.

3 INDIANA

Why doctors love it here: The Hoosier State was the first in the nation in 1975 to enact medical malpractice reforms and has consistently performed as a low-tax, affordable, and rewarding state to practice in, with a high quality of life. There are excellent medical centers in multiple parts of the state. The most recent real estate bubble didn't have much effect here: An average single-family home in Indianapolis sold for $111,000 last year, down $8,000 from 2006, according to the National Association of Realtors.

Why you might not: Although by no means unique to Indiana, the state is dominated by two commercial health plans, so about 75 percent of your commercial revenue (if you go into private practice) could be dictated by those two plans. And if you're a downhill skier or love the mountains, Indiana may not be the place for you.

Median annual primary care compensation: $183,555

Malpractice liability insurance rate: $8,752 to $11,576

Major health systems: Clarian Health (statewide), Community Health Network (Indianapolis), Parkview Health (Fort Wayne), St. Vincent Health (Indianapolis)

Best town you've never heard of: New Castle (population: 18,347). Situated 49 miles northeast of Indianapolis, New Castle offers small-town living close to the city, but is also home to Henry County Memorial Hospital.

Notable landmark: The New Castle Fieldhouse, with a seating capacity of 9,375, is reportedly the world's largest high school gymnasium.

2 WISCONSIN

Why doctors love it here: A progressive state legislature capped non-economic damages for medical malpractice liability before it became a crisis, as it did in other Midwest states such as Illinois, Michigan, and Ohio. Wisconsin is the second-most-insured state, and more than 61 percent of its residents carry employer-sponsored coverage—more than 10 percentage points above the national average. With more than 15,000 lakes, it's a great place to live if you love watersports and the outdoors.

Why you might not: The Badger State ranks higher than average for state and local tax burden per capita, and most areas get four feet of snow each year—even more in the northernmost reaches.

Median annual primary care compensation: $190,240

Malpractice liability insurance rate: $3,946 to $8,236 (Median: $6,923)

Major health systems: Aurora Health Care (Milwaukee), Ministry Health Care (Milwaukee), University of Wisconsin Hospital and Clinics (Madison)

Best town you've never heard of: Ripon (population: 7,619) is about 90 minutes south of Green Bay and the home of Ripon College and Ripon Medical Center, which includes a heart and lung center and cancer clinic.

1 TEXAS

Robert Frischer, MD, solo gynecologist in Wichita Falls

Originally from New York, Frischer completed medical school and residency in Cincinnati, joined the Air Force, and was relocated to Texas in 1978. He opened his solo practice in 1980. "Texas is a great state, and I am originally a New York City Yankee," he says. "The liability situation is very good, with continued drops in malpractice rates. Insurance problems, at least in my area, are not as bad as what I hear from docs in other states and in larger cities."

Why doctors love it here: The Lone Star State offers the best of all worlds for physicians: a variety of cities with excellent medical centers, no state income tax, great compensation, and low real estate costs—an average single-family home in the Dallas-Fort Worth area sold for $135,700 in the first quarter of this year. Tort reform in 2003 makes Texas a leader in low-cost malpractice liability insurance despite being the second-most-populous state in the nation. Texas's median annual malpractice liability insurance rate is $16,655 (compare to $21,052 in New York and $32,328 in Florida).

Why you might not: Almost one-quarter of Texas's population was uninsured in 2007, according to the Kaiser Family Foundation, and less than half of its residents had employer-sponsored coverage. Hot, humid weather dominates the southern portion of the state.

Median annual primary care compensation: $197,042

Malpractice liability insurance rate: $8,839 to $31,668 (Median: $16,674)

Major health systems: Texas Medical Center (Houston), University of Texas Southwestern Medical Center (Dallas), Seton Healthcare Network (Austin)

Best town you've never heard of: Huntsville (population: 35,078). This bucolic town, situated between Dallas (pictured) and Houston, is surrounded by the Sam Houston National Forest and includes Huntsville Memorial Hospital and Sam Houston State University.

 

People with pre-existing conditions will get coverage under Obama care, but they won't get treatment!

Under Obamacare patients with pre-existing conditions will get coverage (a government run plan), but the concern is whether the government plan will allow those same patients the treatment they would need. Sick people will be viewed as “a drain" on the finances of the system! That's just what happens under socialized healthcare!

By Ira Brodsky

Author, "The History & Future of Medical Technology"
People with serious medical conditions often achieve miraculous results in the U.S. thanks to a private health care system that gives them the freedom to track down and go to doctors with the right knowledge and experience. These people, who have the greatest and most urgent health care needs, will be stymied by Obamacare’s new layers of bureaucracy. Instead of swiftly obtaining the right diagnosis and treatment, they will lose precious time submitting forms and filing appeals.

As every physician knows, it’s important to arrive at a correct diagnosis as soon as possible because medical conditions are most treatable in their early stages.

A recent article in The Wall Street Journal illustrates the point. “Facing Lifesaving Heart Surgery, Twice” bemoans the plight of people who had heart surgery as children only to experience further heart problems as adults. Doctors were often baffled because their hearts had been reconfigured during childhood. In some cases, the best course of action proved to be going back to the pediatric hospitals and surgeons who performed the original operations. This is possible in a private health care system because patients are correctly viewed as customers. Under Obamacare — a system that perceives people with serious medical conditions as financial burdens to a government already deeply in hock — these patients are more likely to find themselves boxed in by rules designed to contain costs.

People with serious medical conditions quickly discover that there are three key components to effective medical care. The first is a timely and accurate diagnosis. Getting the right diagnosis may require not just a second opinion, but a third and a fourth. The second component is a complete list of treatment options. Multiple opinions and options require the free flow of information that only a competitive health care marketplace can deliver.

The final component is the freedom for patients to choose what they judge to be the best course of treatment. Patients and their families are best qualified to make these decisions because they are the ones most directly affected. Under Obamacare, it’s presumed that government officials are better qualified to make these decisions, and it’s a safe bet that they will be instructed to weigh each patient’s anticipated future contributions to society against the long-term costs of keeping that patient alive.

President Obama made it clear that this is exactly where we are headed when he said, “Maybe you are better off not having the surgery, but taking the painkiller.” He was doubtlessly thinking ahead to a time when the cost to government will take precedence over what’s best for the individual. Government-run health care is the most cold-hearted health care. For example, the U.K.’s National Health Service denies kidney dialysis to patients over the age of 55 just to save money.

Another way that Obamacare will hurt people with life-threatening medical conditions is by stifling innovation. Today, the U.S. has more CT scanners, PET scanners and MRI machines than any other country. And as the country that pioneered implantable cardio-defibrillators, the heart-lung machine and robotic surgery, the U.S. offers more and better treatment options. Thanks to our private health care system, entrepreneurs are free to develop powerful new solutions, and if government ever gets out of the way they will be free to drive down costs. In stark contrast, public health care systems start by constraining costs; most innovative solutions never get off the launching pad.

It’s understandable that people with life-threatening conditions are attracted to government programs such as Obamacare. Many of these people feel they have twice lost life’s lottery: first by having a medical condition they did not ask for, and second by being saddled with extraordinary health care expenses.

Unfortunately, Obamacare provides only false security. Subsidized or even free care is of no value if it doesn’t provide the right diagnosis and the right treatment at the right time. Nor does it help to encumber hospitals, doctors and patients with massive new regulations. The only way to reduce the cost of health care while maintaining or improving quality is to permit and encourage vigorous competition.

Give the patients who consume the most health care the freedom to shop for services and make their own buying decisions and they will help drive down prices for everyone else.

Ira Brodsky is the author of The History & Future of Medical Technology.

Surgeon’s Malpractice has doubled from 2009 to 2011, and OB/GYNs has quadrupled from 2005 to 2011!

Doctor's malpractice insurance cost rise has little impact in Pittsburgh region so far Sunday, November 11, 2001 By Christopher Snowbeck, Post-Gazette Staff Writer Pennsylvania doctors predicted in January that escalating malpractice insurance premiums would force many physicians to flee the state, but that hasn't occurred in the Pittsburgh area. To be sure, defections are increasingly common in the Philadelphia area. Last month, a group of 18 orthopedic surgeons said they would stop performing surgery, though they continue to practice in Delaware County, rather than pay malpractice premiums of $130,000 per doctor, up from $65,000 two years ago. But such announcements are practically nonexistent in the west, where work force numbers suggest the region isn't suffering from a lack of doctors. For example, while the birth rate has declined in Western Pennsylvania in the past 15 years, the number of doctors specializing in obstetrics and gynecology has boomed, according to the state's Medical Professional Liability Catastrophic Loss Fund, or CAT Fund. Whereas 388 ob-gyns were practicing in Western Pennsylvania in 1987, the number had grown to 513 by last year, an increase of roughly 30 percent. "The statistics that are in hand at this time do not reflect a mass migration," said John Reed, director of the CAT Fund, which defines Western Pennsylvania as a 27-county area. "That does not, however, answer the question about whether physicians will leave in the future. At this point, we're fortunate that most physicians are still here." Like other doctors, Dr. Jeff Baum, president-elect of the Pennsylvania Orthopedic Society and a surgeon at UPMC St. Margaret, says excessive jury awards are to blame for the fast-rising malpractice insurance premiums, and the solution is tort reform. Among other things, that means passing laws to cap the amount of money juries can award for the pain and suffering of injured patients in medical malpractice cases. But John Gismondi, a trial lawyer in Pittsburgh, countered that problems in the malpractice insurance market stemmed not from large jury awards but from the insurance companies' stock market investments and previously underpriced policies. Doctors should focus on preventing errors, Gismondi said, rather than asking the Legislature to curtail the rights of plaintiffs. Despite the higher premiums at his office, Dr. Frank DiCenzo, an obstetrician in Sewickley, is sticking around, but he predicts other doctors will leave or, in the case of his specialty, will stop delivering babies. Six years ago, DiCenzo's practice paid $78,000 for malpractice insurance covering five ob-gyn specialists and a gynecologist who didn't deliver babies. Some doctors have come and gone since then, but by last year, the tab for the same mix of doctors was almost $286,000. Barb Condit, the practice's business manager, expects next year's premiums to exceed $300,000. The increase in malpractice premiums has been coupled with stagnant reimbursement rates, which leaves reimbursement for specialists in Western Pennsylvania well below the national average, according to DiCenzo. "At the current reimbursement level, we are receiving about $40 to $60 per hour for each hour of direct patient care," DiCenzo said. "This is the equivalent of what a lawn mower repairman, plumber, car mechanic or painter gets reimbursed for his or her services." Further complicating the fiscal picture is the rising cost of technology that doctors must buy to improve their practices, said Dr. Helen F. Krause, an ear, nose and throat surgeon at UPMC Passavant. But physicians' arguments about reimbursements, compensation and the impact on the physician work force don't always fit with national studies on the subject. Physician reimbursement here, for example, might not be what it once was, but it's not necessarily out of line with national averages, according to a recent study by the Pennsylvania Medical Society. The study found that Pittsburgh physicians rank 17th among the 25 largest metropolitan areas in HMO reimbursements, a rank commensurate with the cost of living and size of the area. The study did find problems with physician reimbursements in Pennsylvania, but, as with malpractice premiums, the worst of it is in Philadelphia, where physician pay ranked dead last. "HMO payments to doctors in Philadelphia are some of the worst payments in the United States," said Dennis Olmstead, chief economist with the Pennsylvania Medical Society. "But I couldn't sit here today and tell you that physician payments in Pittsburgh are 20 percent lower than they are in Ohio or New York." At least two national reports published this year suggest that some doctors have been enjoying pay increases. Medical Group Management Association reported this year that median compensation for specialists increased 6 percent to $256,494 between 1999 and 2000. Orthopedic surgeons saw their median compensation increase by more than 5 percent to $335,646. Pay for ear, nose and throat surgeons declined less than 1 percent to $235,415, but ob-gyns' median income increased about 2 percent to $236,353. A survey released last month from Merritt, Hawkins & Associates in Dallas found that practices looking to hire specialists were paying more, too. And there's a question as to whether the flight of doctors would dangerously deplete the overall supply of physicians here. It's hard to get a precise picture of the local physician work force, but 1993 and 1995 numbers from the Dartmouth Atlas of Healthcare show that Pittsburgh had about as many doctors as the national average in the three specialties being hardest hit by the premium crunch: orthopedics, neurosurgery and obstetrics. More recent CAT Fund figures show a decrease in the number of neurosurgeons in Western Pennsylvania since the mid-1990s. Whereas there were 80 neurosurgeons in 1995, the number fell to 72 by 2000. But the number of ob-gyns increased from 455 to 513 over that same period, and the number of orthopedic surgeons grew even more dramatically, from 278 to 354. Orthopedic surgeon Baum said part of the reason for the increase in physicians in his profession was that doctors are more specialized in the procedures they perform. What's more, the research community has grown, he said, meaning that not all of the new doctors are providing care to patients. Baum acknowledged that the increasing ratio of physicians to patients could be a factor in why doctors can't afford higher premiums, as more providers compete for the same number of patients. But the MGMA salary figures are higher than what many orthopedic surgeons here make, he said, and rising malpractice premiums are being eclipsed as a problem by insurance companies that have stopped offering policies here. "I just heard today that [for] 60 percent of the orthopedic surgeons in the Greensburg area, their insurance carrier would not renew their insurance," Baum said. "Have droves of orthopedists left the western part of the state yet? No, they haven't. But I don't know what's going to happen come the new year."