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Thursday, December 17, 2009

"The Problem with HealthCare Reform" by R. Randall Sukman, M.D.

This speech on HealthCare Reform was given by Dr. R. Randall Sukman at the November 21st Branson TEA Party:

This represents Nancy Pelosi's gift to the american people. A 2,000 page, 1.3 trillion dollar new bureaucracy for healthcare. This is CECIL'S TEXT BOOK FOR INTERNAL MEDICINE. If you read this (CECIL'S TEXT BOOK FOR INTERNAL MEDICINE), you may be an internist. If you read this (2,000 BILL), you are likely an insomniac.

We have the best healthcare in the world. When Canadians, who by the way hate socialized medicine, need a knee replacement or timely treatment, they come to the United States. We have the mecca of healthcare, Mayo's Clinic, The Cleveland Clinic, M.D. Anderson Cancer Treatment Facility, Barnes Hospital-Missouri. We have university hospitals which train not only American doctors but many of the doctors that practice all over the world. We have emergency rooms, hospitals and clinics in almost every town. I bet you would be hard pressed to find a person, with or without health insurance, that couldn't find a provider to care for them at times of need.

Yes, Mr. Obama, I will see an indigent patient for free and NO, Mr. Obama, I will not take out a child's tonsils just for a bigger reimbursement.

Lets not try to reinvent the wheel. Our system may not be perfect, but I'm worried. It's about to get a whole lot worse.


The plan is to require employers to either provide "government approved" health coverage to all employees or pay a stiff penalty (a tax). Now I run a small business-it just happens to be a medical clinic. We have 10 salaried employees, including myself. We are a non-profit clinic. At the end of the year, hopefully we break even financially. Now the government says I must supply my employees with health insurance-lets say $500 per month per employee, that's $60,000 per year. Where does the money come from? I have a choice:

1. I can raise my price-but I can't since the government sets my prices.
2. I can lay off an employee-adding 1 more to the already 4million who have lost their job since Obama took office.
3. I can sell my clinic to a larger system,Skaggs, Cox, St. Johns-just another casualty of "Obamacare".

And I represent many other small businesses. Yesterday, I was practicing this talk at the Quick-Mart on Mount Branson. Another Mom & Pop business struggling to survive in today's economy. This becomes very personal to their employees when they realize, with the addition of healthcare they may have insurance, but they won't have jobs. And by the way, if you don't carry insurance you may be sent to prison. I can see it now-3 prisoners in the yard "I was convicted for killing a family of 3"; "I was convicted of armed robbery and arson"; and "Well, you have nothing on me-I didn't have health insurance".


I'm not much of an economist, but this I understand:

Slave 25 50 75 100
Socialism Free

If one makes $100 and goes to a store where everything cost $100 or less, they are free to choose anything in that store. But if someone takes 25% away, they have less freedom, less choice to choose. If one takes 50% from them, they have even less freedom, less choice...and 75%...and if one works all day, and at the end of the day, all of the money they earned is taken from them...they have no choice, no freedom. They are now a slave.

In the United States there are two types that can take our money from us without our permission. The thief comes, sticks a gun in our ribs and demands our pay. We hand him the envelope and he takes the money. Or, the thief comes, sticks a gun in our ribs demanding our pay. We hand him the envelope. When he opens it, it is already empty. He says, Uncle Sam has beat me to you.

This plan is going to be expensive! Nancy Pelosi says this is a 1.3 trillion dollar plan. I suspect this is code talk for 2 to 3 trillion dollars. And that figure doesn't even include the 300 million dollars in pork Louisiana's senator, Mary Landreau, was paid for her vote.

Just to give you a handle on the size of these numbers:

1 million seconds = 11 1/2 days
1 billion seconds = 31 1/2 years
1 trillion seconds = 32,000 years

It is estimated we will need $750 billion dollars in new taxes to pay for this-much of this falling on small business. We are also going to tax the very wealthy-people making $250,000 per year. Now we already take Federal, State, Property taxes, plus taxes on gas, food, ect., ect....., let's say 50% of ones income. So the very rich now make $125,000 per year. Now we are going to tax them some more. We can also tax "cadillac" health plans-except of course if you belong to a union, or if you are a senator or congressman. Now wait a minute, if this plan is supposed to be so good for all of us, but it is not good enough for our elected officials? No it is not. They have exempted themselves from this and will continue to get their "beyond cadillac" plans.

Mr. Obama promises there will be no increase in taxes on the poor or middle class, but we can have a "sin" tax on cigarettes, alcohol, and soft drinks. Who does he think consumes these products. There is even a proposal to tax plastic surgery like BOTOX. Finally, even Nancy Pelosi will have to contribute.

Obama says he wants government to "compete with private insurance companies" to drive down the cost of healthcare and if you like your current health insurance, you may keep it. But the reality is , there is no such thing as the government competing with private insurance companies. Because government writes the rules and is funded through taxation. Private industry focuses on revenue.

Government creates a large Bureaucracy enables it to enforce it's own rules and regulations. Bureaucracies by nature cost a lot of money. The obvious comparison is the Post Office competing with Federal Express and UPS. The Post Office is less efficient, slower, far more expensive to run and always looses your mail. Like the Post Office, if government mismanages or miscalculates their health care plan, they raise taxes or ration benefits. If private insurance or Federal Express or UPS mismanage, they go out of business. The ultimate end game is a one payer system--SOCIALIZATION OF HEALTH CARE.


The debate of abortion comes down to one thing, when does life begin--is it:

1. At conception?
2. When the heart first beats?
3. When the fetus is viable?
4. When the baby is out of the birth canal? or
5. 1 week or 1 year after birth?

The flip side of this debate is when does death occur?

1. When you quit breathing and your heart quits beating?
2. When your cost outweigh your assets?
3. When you are no longer productive to society?
4. At age 85, 75 or 65?

The corner stone of "Obamacare" is to impose a "global budget" on medicare. A fifteen member board, appointed by the President, will dictate what is covered and how it will be paid for. The committee will have to meet certain budget targets every year. Starting in 2015, medicare may not grow more rapidly on a per capita basis than by a measure of inflation. By the way this plan has been touted as not adding to the national debt. This is because we start paying for it in 2010, but the benefits of insurance don't begin until 2015. That is, we collect for 10 years and only pay for 5 years. After 2019, it could only grow at the same rate as GDP + 1%. These hard budget caps means there is only so much money to be divided up for care, with no account for demographic changes, longer life spans, higher incidence of diabetes, heart disease, cancer or other diseases. It leaves little room for medical innovation. The commission is mandated to go after "sources of excess cost growth", meaning treatments which are too expensive.


Just this week we then heard about the new recommendation that women not needing mammograms until the age of 50 and them not yearly. According to this month's Internal Medicine News, "Breast Cancer Deaths Higher without Routine Screening." Did you know your doctor will be penalized financially if they order too many referrals or too expensive tests on you? "If it bothers you, but you aren't going to die from it, please just live with it." It means you may wait weeks or months to get an appointment with your primary care provider, and specialty care-it will be a long time. As President Obama put it in June, "Maybe you are better off not having the surgery, but taking the painkiller".

The Medicare Commission will function much like the National Institute for Health and Clinical Excellence, which rations care in England, or a similar board in Washington state created in 2003 to control costs. The Washington Commission, called Health Technology Assessment, is composed of eleven bureaucrats, including a chiropractor and a naturopath. If they determine something isn't cost effective, it isn't covered. This year it is targeting frivolous luxuries like knee replacement, spinal cord stimulators, specialized care for autism, MRI of the abdomen, pelvis and breast for cancer patients.

I'm also frustrated by the AMA (American Medical Association). I have never belonged to the AMA, and I know few physicians who do. The AMA does not speak for me any more than AARP does.


First we need to allow small businesses to pool together and acquire health insurance at lower costs, jut like corporations and labor unions do.

Second, we need to establish access programs allowing individuals with pre existing conditions access to quality, affordable coverage.

Third, we need to be allowed to purchase health insurance across state line, just like we purchase auto insurance, thus allowing competition for insurance companies.

Fourth, we need to promote increased patient accountability through healthcare savings accounts.

Fifth, there must be malparactice reform--protecting doctors and hospitals from frivolous lawsuits.

The only way to take the politics out of health care is to give the individual more power to control medical dollars. And the first step should not be to create even more government spending commitments. The core problem with government run health care is that it doesn't make decisions in the best interest of patients, but in the best interest of government.

This ends the formal presentation I prepared, but someone in the crowd asked me: "Why with the majority of Americans opposing Nancy Pelosi's healthcare plans, do they continue to push them so hard?" Just a thought, Social Security was the greatest Ponzi scheme ever perpetrated on the Atmerican people. Bernie Madoff doesn't have anything on our government. All entitlement programs are basically Ponzi schemes-medicare, medicaid, welfare, ect.....Maybe we are just out of money to continue paying for these, so now we need a new Ponzi scheme.

1 comment:

  1. While you are certainly entitled to your opinions, I don't believe a professional such as yourself, Dr. Sukman, should place political signs in your office window, nor place religious pictures in your restrooms. Your political and or religious views are none of my business, just as mine are none of yours. Whether or not I agree or disagree with those views is immaterial.


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