Saturday, September 12, 2009

No Crying Towel Needed Here

Today's Spokesman Review presents an opinion piece by Dr Robert Golden concerning Medicare and what a contrast to Dr Condron's piece last week.

I am a urologist, providing medical and surgical care to my patients with diseases of the urinary tract. Over 75 percent of my patients are on Medicare.

Medicare allows me the freedom to provide quality health care with the interests of my patients as first priority. Medicare is a single-payer, government-sponsored health insurance plan and yet imposes no restrictions or arbitrary rules between my patients and me. The health care decisions are only between my patients, their loved ones and me. Yes, there are guidelines for best practice, which I honor and embrace.

But he does take a poke at the insurance industry.

That nearly 50 million citizens in our country are uninsured is a travesty and, frankly, embarrassing. Every year, more than $400 billion of private health insurance money (paid for by subscribers of the insurance company like you and me) go to profits, marketing, executives, buildings, etc. The president of United Health Care makes $102,000 an hour. Of the money flowing into for-profit private insurance, only 65 percent is used for actual health care services. This is in contrast to Medicare, where more than 95 percent is directly used to provide health services to our seniors.

And while he comes across as a bit altruistic, I don't think that's a bad thing.

These issues are complex – financially and ethically. Standing by and listening to the verbiage by the profit-seeking, fear-mongering insurance and pharmaceutical industries is no longer an option for me. What makes this country great is our willingness to sacrifice our excesses for the general greatness of the whole.

Personally, I became a medical doctor to serve with compassion and love – to relieve pain and suffering. At the end of the day, I do not ruminate about money. Rather, I hope I’ve contributed to my patients’ journey toward a greater understanding of the wonder and blessings of life.


Spokane Al said...


“. . . profit-seeking, fear-mongering insurance and pharmaceutical industries . . .” I tend to believe that making a profit is a good thing for companies, employees and this country.

“What makes this country great is our willingness to sacrifice our excesses for the general greatness of the whole.” I suspect the good doctor is no fan of Ayn Rand and her book, Atlas Shrugged. And I am a bit concerned when the government is the one to determine the definition of excess.

While I do think that the doctor’s heart is in the right place, and hope my doctors have the same empathy and concern for me, I believe that one can make a living and a profit while doing the right thing. It kind of sounds like the doctor believes that those two goals are inherently at odds with each other.

P.S. I hope you have a great time at Spokefest. I will be doing the Spokane Triathlon at about the same time.

Hank Greer said...


Profit seeking in itself is not the problem. It's the profit seeking at all cost. Companies are under pressure to make money for their shareholders. The creative technicalities used to drop customers because they cost too much to cover are rampant. Sick people, especially those with "pre-existing conditions", are not insurable at a reasonable cost if at all.

By all means let the health insurance companies make a profit, but let those people who can't get or can't afford health coverage at least have an option. In this case, the public option.

Have a blast at the Spokane Triathlon. You triathletes rock!

Lucas said...


The government is us. WE elect the representatives. The people who work in government are your friends and neighbors (and me). I think one of the problems we have in this country is that we have created a disconnect where people don't think of the government as an extension of "We the people".

We can look at the evidence and see where the low-tax, anti-government ideology has gotten us over the last 30 years. While the following link is from an article about the decline in income for the wealthiest Americans, it goes back far enough that you can see how the rest of society did starting under Reagan.

We have created a perverse set of incentives for business. For-profit, publicly-traded companies are in business only to deliver returns to their shareholders. At the end of the day, the shareholder is so removed from the company they own stock in they don't feel responsible for the actions the company took to deliver returns.

Since we tax dividend income at a lower rate than regular income, there is an incentive for CEOs to take compensation in the form of stock options, as they will be taxed at a lower rate once they are exercised. Once the CEO of a company is sitting on a large pile of options, it is in their own best interest to do things that will drive up the price of the stock (thereby enriching themselves further) at all cost. CEOs don't typically last very long, so they must work hard to deliver short-term gains to feather their own nest.

The only way to make more money in the insurance industry is to spend less paying claims, which means denying care for individuals. I have a friend in Texas who just had his yearly physical denied. They had to spend the better part of a day on the phone, trying to get the insurance company to pay for something which no reasonable person could claim was excessive. He was eventually able to get the claim paid, but it should never been denied in the first place.

In the pharmaceutical industry if you want to make money you have to sell drugs. Pfizer was just fined BILLIONS of dollars related to promoting its drugs for off-label uses. That means in order to make more money Pfizer was suggesting to doctors they should prescribe drugs for things they had not been tested and approved for. How many people were hurt by that? How many times have we seen pharmaceutical companies have to pull some drug the rushed to market because it wasn't safe?

Making a profit isn't the issue. The issue is how that profit is made.