Docs offer diagnosis

Three area doctors sat down with The Tribune in interviews recently to discuss their views on health care reform.

While each agreed the system is in need of changes, they offered different solutions.

Dr. Richard A. Wiethoff, Dr. William Blaisdell and Dr. Kenneth Bobb have more than 100 years of combined experience providing health care. They discussed the changes they have seen in health care since their start in medicine, as well as their opinions on the future of health care in America.

On Nov. 7, the U.S. House of Representatives passed, with a 220-215 vote, a health care reform bill that would cost $1.2 trillion and provide insurance to 96 percent of eligible Americans within 10 years, according to reports from The Associated Press.

The bill is now in the hands of the Senate.

Bobb, Jackson County’s health officer, said a universal health care system looks better than what the nation has now.

“Medicare has worked pretty well, Medicaid has worked pretty well and so we already have a track record as to how to operate this kind of system,” he said.

Bobb would like to see people who can’t afford health insurance enter such a program with their premiums subsidized by the government.

The system would allow some people not to pay anything, some people to pay a little and some people to pay a lot to get into that program, Bobb said.

He said such a system would be a competitive force for private insurance companies in that they would have to be more frugal in their operations.

“There is a lot of fat in the health care system that needs to be directed in a different way,” Bobb said.

Bobb acknowledged that one of the problems with a universal health care system is people can have long waits for their elective surgeries and people can’t get what they want, when they want it.

“There will be a demand for health care out there that we don’t have the facilities and capabilities to take care of,” Bobb said. “So the answer to that is to increase the amount of care capacity you have, increase the number of doctors, increase the number of nurse practitioners and physician assistants, operate your hospital operating rooms 24 hours a day,” he said.

Although that could take three shifts of people to operate, it would result in more employment, he said.

“So you can’t develop that kind of system overnight, but you can work in that direction,” Bobb said. If the goal was to meet a demand of health care providers in 15 to 25 years, he said, then this is where money could be spent to educate more doctors, nurses and ambulatory health care providers.

Wiethoff said he has reviewed much of the Democrats’ bill. He’s not happy with where the proposal could take the country.

“This will lead, without question, to socialized medicine and if that’s what the country wants, then that is what they are going to get,” he said.

Wiethoff said he would like to see the Democrats’ bill include tort reform as well as portability. Generally speaking, tort reform would limit a person’s ability to sue for damages in cases of malpractice.

Portability with insurance would allow consumers to purchase health insurance across state lines.

“Why would anybody be against that, unless it would create competition that the health insurance companies don’t want to have?” Wiethoff, a Seymour surgeon, said. “Competition is good for any segment of our society; it is what makes things get better.”

Before the bill passed in the House on Nov. 7, an amendment was made to prohibit abortion. That had also been a concern for Wiethoff, and a change in the proposal that Indiana 9th District Rep. Baron Hill of Seymour cited in explaining his vote for the bill that passed.

The amendment prohibits federal funds for abortion services in the public option, according to the purpose of the amendment on the U.S. House of Representatives’ Web site. It also prohibits individuals who receive affordability credits from purchasing a plan that provides elective abortions.

However, according to the amendment’s purpose statement, it allows individuals, both those who receive affordability credits and those who do not, to separately purchase with their own funds plans that cover elective abortions. It also clarifies that private plans may still offer elective abortions.

Blaisdell, speaking of the House Democrats’ bill, said with such a large bill and having only 72 hours to look at it, nobody has a chance to know what’s in it.

He said it should be debated for weeks, not one.

Blaisdell said what doesn’t work in a government-run program will be government guidelines. He said a “cookbook” method of treating patients is not the way to go.

An example of the cookbook not working in medicine is the case of beta blockers, Blaisdell said.

Citing the use of beta blockers being taboo for about 20 years, Blaisdell said it is “now heresy” if beta blockers are not used for congestive heart failure.

“Agencies, once they gain control, they will enforce this stuff, and if you don’t do it their way, you will be wrong,” he said.

Future of health care

Wiethoff has been practicing medicine since 1976 and said he has never enjoyed practicing more than he does now, but he worries doctors his age will leave their practices.

“So many of the people my age in medicine are just going to walk away, because it’s just not going to be worth it anymore,” he said.

“Doctors my age who are the mentors of the younger doctors, who have the advantage of all of these years of having practiced, witnessed different situations, made mistakes, learned from them, are going to walk away in droves,” he added. “You go to any medical meeting and talk to guys my age and they say, ‘I’ve just about had it,’ and if they have what they need to retire, even though they love being a doctor, that’s going to be it. They are going to walk away.”

Blaisdell said he is also concerned about the future of medicine and the possibility of doctors leaving their practices if bureaucracy takes too big of a role. He has been practicing medicine since 1966.

He said if studying in the technical areas becomes too unappealing, it is going to be difficult to find people to fill them. He said already medical schools are having difficulty finding qualified applicants because word has gotten around about the future of medicine.

Wiethoff said he feels he is doing what he was meant to do, but he has mixed feelings about telling a young person to “go for it” when thinking about medicine. He tells young people to weigh their options and think about the future of medicine.

“On the one hand, it’s the best of times with regard to what we are able to do for people, the treatments, the drugs, the technology, the diagnostics tools, all of this. On the other hand, it’s never been worse with regard to lots of other issues.”

He said as a doctor himself, “I haven’t enjoyed practicing medicine anymore in my career than I do now. I love it. I love the people. I love taking care of people. I swear to you, 98 percent of the people in this area are wonderful people. They are the salt of the earth. That’s what gets me up every day, makes me want to come in and do it. I mean it’s so rewarding to see somebody who’s really sick and to know you had a part in seeing them walk out of the hospital, it’s fun. It’s a real kick.”