- - Tuesday, March 16, 2010

Like millions of other Americans, I have watched with a mix of bafflement and frustration as Congress has wrestled with

the onerous task of reforming our health care system. I confess I may have taken the many twists and turns in this process a little personally because in addition to being a practicing radiologist, I happen to be Barack Obama’s second cousin.

It’s difficult for me to speak publicly against the president on his central issue. I wish my cousin Barack the greatest of success in office. However, after many sleepless nights and long talks with my wife and family, I made the difficult decision to “go public” with my opposition to the massive health care reforms under consideration.

I heard about a project put together by volunteers to help citizens like me meet with their representatives in Washington, to ask questions about the health care reform bill.

What perfect timing. I made a few calls and traveled to the Capitol in hopes of meeting with my representative, Dennis Moore, Kansas Democrat. I learned the hard way that members of Congress supporting this bill are very reluctant to discuss what’s actually in it, at least in public. So I’m left with no other choice. I will have to do it for them. After we traded a couple of e-mails and I left a note for him at his offices, Mr. Moore called me. We engaged in a frank and eventually cordial conversation. It turns out that we agree on many points. I appreciate Mr. Moore’s returning my calls and am grateful for his time. All niceties aside, however, Mr. Moore still intends to vote for the Senate health care bill, ignoring the judgment of the vast majority of Kansans living in the Third District.

Had Mr. Moore been willing to visit with me on camera, there were several questions I would have asked him.

We’ve all heard of Sen. Ben Nelson’s infamous $100 million Cornhusker Kickback and Sen. Mary L. Landrieu’s notorious $300 million Louisiana Purchase. But the fact is, many such backroom deals are tucked into the nooks and crannies of this health care bill. The unsavory practice of pickpocketing taxpayers to pay for politicians’ votes is a way of life in Washington. “Mr. Moore, how do you look the good people of Overland Park or Olathe in the eye and tell them your vote will make them pay the medical bills of Nebraskans, Louisianans, Californians and Floridians, just to name a few?”

This bill establishes a new Independent Medicare Advisory Board that is required to recommend Medicare cuts. Its goal is simple: to limit resources going to Medicare patients. Any recommendations made by the commission would go into effect, even if Congress does not act on it. “Mr. Moore, how will you tell the senior citizens in Little Kaw or Kansas City that your vote will create an unelected panel of bureaucrats that will be empowered to raise the premiums of their prescription drug plans or deny them the MRI studies they need?”

A scheme in this bill actually penalizes your primary care physician if he is in the top 10 percent of doctors who refer patients to specialists, no matter how valid the reason. This ignores the expert opinion of the family care physician. It does not consider the need of the patient. It simply establishes an arbitrary percentage of doctors who will be penalized. It’s a preview of things to come from the Medicare “rationing” commission. “Mr. Moore, how will you explain to the parents in Leavenworth or Lawrence that your vote forces family doctors to choose between avoiding a penalty and sending their injured sons or daughters to the orthopedic surgeon?”

Growing government means growing taxes, and health care is no exception. The Senate health bill contains a 40 percent excise tax on comprehensive insurance plans. This leaves difficult decisions for employers and employees facing the heavy hand of government: Maintain your current insurance policy and downgrade your salary or maintain your current salary and downgrade your insurance policy. Difficult decisions, that is, unless you’re in a union - unions are exempt. “Mr. Moore, how will you explain to workers in Stilwell or Shawnee that your vote means they have to choose between compromising their insurance benefits or their salaries? And if it’s such a good idea, why isn’t it a good idea for union members, too?”

Two-and-a-half trillion dollars in new spending. How much is that? It’s $7,100 per person. This Senate plan costs $7,100 for each husband, each wife; for each daughter, each son; for each uncle, aunt, grandfather, grandmother, cousin and friend. It’s $7,100 for each and every one of us that somebody will have to pay. “Mr. Moore, how will you tell of the kindergartners in Bonner Springs or Basehor that your vote will force them to cover our debts because our current Congress just has no self-control?”

Data from the Joint Committee on Taxation shows the Senate plan imposes almost half a trillion dollars in new taxes on patients, families and businesses. Even after subsidies for lower income, these new taxes will reach into the middle class. “Mr. Moore, do you believe the hardworking people of Prairie Village or Piper are being undertaxed?”

Surely there’s room for tort reform in a 2,700-page health reform bill or the 2,900-page so-called “reconciliation shell.” The verdict is in. States with limitations on junk lawsuits have seen both an increased accessibility to care and a decrease in cost. Howard Dean has admitted that Democrats ignored this because they didn’t want to take on the trial lawyers. “Mr. Moore, how do you tell the uninsured and underinsured in Edwardsville and Eudora that junk lawsuits waste at least $100 billion each year that otherwise could have gone to their care? “

This is perhaps one of the most blatant and egregious misrepresentations of this overhaul of American medicine yet. For an overwhelming number of people, their health insurance comes from their employer, not themselves. If their employer is shown that he or she can save an appreciable amount of money by opting to pay the government’s penalty versus paying for your health care plan, guess what? Your health care plan just changed. “Mr. Moore, how can you say that if I like my doctor and my plan I can keep them when this health care plan builds in a number of incentives for my employer to drop my coverage?”

It’s obvious to see why supporters of this flawed plan hope to avoid discussing it publicly. Who wants to defend the indefensible? The typical response I’ve encountered has been to acknowledge the problems but claim they can be fixed with yet another law. This is truly the Washington mind-set: always stacking law upon law, each claiming to solve the previous one’s faults.

I find this approach most unsatisfying. Imagine that a homebuilder presents to you a blueprint of a new house. You realize it is deeply flawed. It has two kitchens and no bathrooms. There are doors leading to nowhere. The roof is incomplete. It’s simply not a good plan. Ever brazen, the builder suggests that you pay him now, let him build it as is, and once it’s complete, he promises to bring in a remodeling crew to tear down the parts you don’t like and rebuild them to your terms - at your additional expense, of course.

If lives weren’t at stake, this would be comical. My patients deserve better. All patients do.

If your congressional representatives won’t answer these questions for you now, I’m sure you’ll give them plenty of opportunities to do so when Congress comes home in a couple of weeks. Or in November.

Dr. Milton R. Wolf is a radiologist in Kansas. He is President Obama’s second cousin once removed.

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