- The Washington Times - Sunday, November 22, 2009


Americans are among the most compassionate people on Earth. We all want our fellow citizens to have access to quality health care. Who argues with that sentiment? In this context, government compassion sounds so noble.

But the fact remains: Whoever pays holds the power to choose. There lies the rub.

Though often missed, the fundamental question at the center of today’s health care debate is: Who should control the personal and complex process of medical decision-making? Patients and their physicians? Or Washington?

Barbara Wagner was a patient under the Oregon Health Plan, a government-run plan similar to what Washington is proposing for the rest of the country. After two years in remission, Ms. Wagner’s lung cancer returned. Her oncologist recommended treatment with Tarceva, an aggressive new chemotherapy. However, the Oregon Health Plan sent Ms. Wagner a letter stating that it would not pay for her chemotherapy. Instead, it offered to pay for hospice or physician-assisted suicide.

In 1994, Oregon created the Oregon Health Plan to give its residents access to health care. It wasn’t until 1997 that the state legalized physician-assisted suicide. In the end, the state gained control of its financial risk. It replaced a patient’s hope of life with the decision of how to die. This was not the original intent of the legislation, but for Ms. Wagner, this was the final result.

Twice Ms. Wagner appealed this ruling. Driven by fiscal considerations, the Oregon Health Plan twice denied her treatment. Again I ask, who should control the personal and complex process of medical decision-making? Patients and their physicians? Or Washington?

“We the people” become powerless in dependency. Common to every major health care bill under consideration in Congress is a transfer of $1 trillion from the American people to Washington. With this massive transfer of wealth comes the transfer of power over medical decision-making

Even now, Washington is proposing more than $400 billion in cuts to Medicare. The elderly are being sacrificed for the “greater good” of society.

America, there is a better way. Three years ago, I founded Physicians for Reform to make sure patients and physicians remain at the center of medical decision-making. Our patient-centered plan includes:

c Insurance reform: Let individuals and businesses purchase insurance across state lines and encourage lower-cost higher-deductible plans along with Health Savings Accounts. These two measures would immediately increase choice and competition and drive down costs without a public option.

c Tax reform: Give individuals the same tax advantages that businesses have. This would increase portability.

c Tort reform: Physicians spend approximately $120 billion every year in defensive medicine. Escalating malpractice premiums burden medical professionals. However, it is the ordering of excessive studies to prevent a possible lawsuit that devastates the U.S. economy by fueling the skyrocketing cost of health care.

Taken together, these reforms would save enough money to help our fellow Americans who cannot afford insurance purchase private plans and fund personal Health Savings Accounts. This plan gives patients control over their own health care dollars and in turn gives them the power of medical decision-making. Because, in the end, whoever pays holds the power to choose.

Dr. C.L. Gray is president of Physicians for Reform, a nonpartisan advocacy group for patients and physicians in the health care debate.

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