Re: NEWSFLASH: 9.2 MILLION in the USofA already have government-run single-payer -- it works fine and is solvent

On Jun 27, 8:01 am, "Pfisher*King!" <Gill...@xxxxxxxxxx> wrote:
"Kickin' Ass and Takin' Names" <old_redn...@xxxxxxxxxxx> wrote innews:5debf4dd-bf41-4fa1-a4bf-f6eeafde6e6c@xxxxxxxxxxxxxxxxxxxxxxxxxxxx:





http://tinyurl.com/pnjjn9

Frequent lurker, first time poster so please bear with me. I am
watching with acute interest the current healthcare debate that has
consumed many words and opinions. I by no means claim to be an expert
in legislating or policy making or all things political positioning,
as a physician in the Armed Services I would like to comment on some
of my experiences and perspective.

One obvious omission in the discussion, both on interwebs and tv tubes
to me is the current single payer healthcare system that the
government is currently funding—TRICARE!

Update: My apologies to all. I initially misquoted the number of
Tricare beneficiaries, astutely noted by Cinnamon Rollover. My intent
of this diary was certainly not to overstate Tricare numbers. I made
the changes to the diary to reflect a more accurate number of
beneficiaries (teh damn google). Thanks for the catch Cinnamon. So
much for the perfect first post.

According to the GAO website:

TRICARE is the Department of Defense’s (DOD) health care system for
active duty
and retired uniformed service members and their families. TRICARE
consists of four
separate programs. Three of these programs—TRICARE Prime, a managed
care
option; TRICARE Extra, a preferred provider option; and TRICARE
Standard, a fee
for service option—cover active duty personnel, their dependents, and
retirees under
age 65.

According to the 2008 Tricare Stakeholder's Report:

More than 9 million Americans rely on us for their health care needs

9.2 Million active duty and retired uniformed service member and their
families receive their healthcare from the federal government. My
family and I receive free healthcare from the federal government. 9
million citizen already receive their healthcare from the federal
government. I provide healthcare for the federal government. I'm an
active duty obstetrician/gynecologist in a major medical facility on
the East Coast. I'd like to share a couple of observations regarding
the current single payer healthcare system that I work in and for
which my family receives its care.

"Rationing" of healthcare in this single payer system is simply not
reality. As a physician in one of the busiest departments in the
military, I practice with the same diagnostic technology, with the
same subspecialty support as my civilian colleagues.  If I have a
patient who is in preterm labor, I simply walk down the hallway, talk
to the maternal fetal medicine specialist (high risk obstetrician),
admit her to the hospital with the utmost confidence that she will be
taken care of in the best way possible and the utmost confidence that
if she does deliver early the Neonatal Intensive Care Unit (NICU) will
use every available technology to rescucitate and care for the
premature baby. If my patient has pre eclampsia or postpartum
cardiomyopathy or any other serious conditions, she is cared for in
the exact same way as any civilian hospital in the country. Only one
caveat- when they get discharged, their bill is always the same: $0.
Single payer healthcare does not eliminate scientific inquiry,
research, or the pursuit of evidence based medicine. In fact, quite
the opposite. In my department alone, over 90 peer reviewed journal
articles have been published since 2002. Research is vital to the
medicine and anyone in who goes through four years of undergraduate
education, followed by four years of medical school, followed by three
to six years of specialty residency obviously has an intellectual
curiosity which will occur no matter who is "paying" for it.
Additionally, some of the best research and scientific breakthroughs,
comes from physicians in those "socialized" European countries. To say
that progress and research in the field of medicine can only occur in
our current system is disingenuous at best and insulting at worst.
Pre existing conditions don't prevent patients from receiving care in
our system, rather if it is identified and considered in their current
medical situation. I'm glad to know if my patient has diabetes or
hypertension prior to her pregnancy and it simply allows me to give
the best evidence based treatment during the time of her pregnancy.
When a patient sees me, she is my patient. If she wishes to see
someone else, she can see one of my colleagues. I believe that is
called choice. Physicians, in general, like to see their patients and
follow their progress and offer interventions when indicated.
I can prescribe any medications I wish if I believe it is the best for
my patient. Sure, there is a DoD formulary that guides many of my
decisions, but this formulary if not static. In fact, there are
committees who meet regularly to add or subtract drugs based on (I'm
hoping I establishing a pattern here) the best available evidence. If
a medication is not on the core formulary, I simply put a notation in
the prescription that states "nonformulary" and provide a reason that
this medication is indicated. While I do not prescribe nonformulary
medications often (there is often no need), I have never had a
medication prescription not filled in the six years I've practiced
medicine.
This system is far from perfect. The administrative bureacracy can be
frustrating and often painful and confusing to patients and providers
alike. The electronic record that we use as providers called AHLTA is
the most nonintuitive, mind numbingly inefficient program I have ever
encountered. There are many issues that could make this system better.
The point of this diary is not to suggest that the system I work in
that all taxpayers are currently funding is the solution to our
nation's healthcare ailments.  I am struck however that nobody has
brought up the simple fact that the government already provides free
healthcare in a single payer model to over 9 million of its
population. While this system is not perfect, I believe I provide that
same quality of care, offering empathetic, evidence based (one more
time for good measure) care as any other physician who practices at
any hospital in the country.

If you spent the time to read this, thanks for your time. This
community is vital to the progress of this issue and I value many of
the opinions here. After completing this, I also respect all who write
diaries way better than my effort. Let's get universal healthcare for
all! Peace.

Not only that, but there is the Veterans Administration Medical Centers
where a significant number of exservicemen and women are treated. The VA
has taken it's raps for bad care in the past (The film "Born on the
Fourth of July" comes to mind.), but it has improved dramatically since
then.  The lesson was learned.  I have been using the VA for more than 25
years and have had nothing the but the best care one could get.  Most of
the major VA hospitals are connected with major teaching university
hospitals: UCLA, Vanderbilt University in Nashville, University of
Cincinnati, The Cleveland Clinic, the University of Iowa, and the list
goes on.
I've had two hip replacements, a bone graft, cancer surgery, steroid
injections in my back. For the last ten years I've had the same GP doctor
seeing me on a regualr basis just like any civilian doctor. And the guy
is great.  He's a reserve Air Force Lt. Colonel flight surgeon who's
regular day job is as a VA physician.  And for all of you more
conservative people out there, he's also a very conservative Catholic
with a whole host of kids. And I wouldn't trade him for any "civilian"
doctor out there.

--
"The better educated a person is, the less likely it is that person will
be a conservative."

"Reagan proved deficits don't matter"
*** Cheney- Hide quoted text -

- Show quoted text -

Since I retired in 1995, Sweet Thing and I have been on TRICARE
Standard -- never had a problem with finding physicians, treatment, or
payments. When she turned 65, she went on Medicare with Tricare For
Life as secondary -- premiums are deducted from our pensions. I'm
still on TRICARE Standard but will go to Medicare with TFL secondary
when I turn 65 later this year.

Single-payer guvmint-run health insurance works -- and the program is
solvent.

But that's all irrelevant -- Glenn Beck has medical insurance and
that's all that matters.

.

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