DO Day on the Hill

DO Day on the Hill

April 27th, 2006 (4/27/06)

Posted 5/2/06

This past week/weekend I attended the AOA (American Osteopathic Association) sponsored 'DO (Doctor of Osteopathy) Day on the Hill' and the SOMA (Student Osteopathic Medical Association) convention in Washington DC. It was a great experience and we had a blast. I thought some of you might find a little write-up on it interesting and, since this is largely a political site, I'll stick to that aspect of it. :)

I have been to DC before, curtesy of ABC (Alternative Break Corps), lobbying on behalf of the National Homeless Coalition, which was somewhat of an irony considering that our experiences, sleeping on the streets etc..., only served to solidify my belief that a good initial measure to combat homelessness in this country would be to eliminate the National Homeless Coalition, a bloated taxpayer funded agency with a socialist agenda that, in my opinion, perpetuates and increases homelessness rather than reducing it. They did not take too kindly to our not supporting their bills.

However, the AOA was much more welcoming and presented us with a number of bills they supported and then gave us the leeway and choice to lobby our representatives on the bills and issues we were passionate about. Shawn Martin, our head lobbyist, gave us good information about the bills, is a great guy, and works hard to represent DOs on Capital Hill.

The night before our 'DO day on the Hill' we heard from a number of great speakers, including Rep Tom Price, MD (R-GA), who spoke eloquently about the problems resulting from government control of physician salaries and of medicine in general.

Another interesting speaker was William Prentice, Associate Executive Lobbyist from the American Dental Association. He spoke with pride about how dentists in the United States, unlike those of, say, Great Britain, are lucky enough to be the least regulated of all health care professionals: patients typically pay out of pocket for a high percentage of their bill, dentists have little to do with Medicare and Medicaid, and consequently, the result being, in his and my concurrent opinion, increased access and quality of care, along with low costs for patients and high salaries for dentists. Indeed, our friends on the Left often seek to chisel cohabiting groups into artificial categories: rich against poor, worker against business, doctor against patient, without the understanding that the end result of a policy generally affects all involved parties similarly, with little exception. What is good for docs is good for patients and vice versa. I would like to learn more about how the free market and dentistry have resulted in such positive results. I rather wish the AOA and the AMA would follow in their footsteps.

But, I must say I was disappointed to hear some of our lobbyists extol the virtues of the free market and capitalism, but then begin to hedge their opinions with regard to Healthcare. A common statement I always hear is, "Healthcare is too important to be left to market forces." In reality, precisely the opposite is true, Healthcare is too important not to be left to market forces.

There was one common theme I heard over and over throughout the week, from every single doctor, every single lobbyist, and every single politician, Democrat or Republican. They all agreed that Medicare and Medicaid were broken, especially that the physician payment/reimbursement formula was convoluted, contradicting and ultimately, unworkable.

Now, I doubt this is any surprise to regular readers of this site, who probably yawningly view this as merely another predicable government debacle, but I was a bit surprised at how willing those with Liberal leanings were to admit this. But, most surprising of all was that no one, well, perhaps besides the dentists, seemed to comprehend that these problems were only the natural result of socialism. By definition, the system has to be broken! Yet, what we heard was the need for new formulas, smarter calculations, and the 'proper adjustments' and, even with all of these 'patches', they all admitted none of the fixes could make the system 'properly functional'.

Despite all this, the AOA and, I'm assuming the AMA (American Medical Association), and most of the Medical Students in attendance went out and lobbied for increases in Medicare and Medicaid reimbursement. To be perfectly frank, and in my opinion, this whole approach is a useless and counterproductive exercise. The pervasive socialism of the Healthcare industry must be ended, pulled out by its roots. Medicaid and Medicare must be abolished. By abolished, I mean 'phased out', because, misguided thought they were, government promises need to be honored for current enrollees of these programs. Even such 'drastic' and 'extreme' measures as totally ridding ourselves of these harmful programs are really only the first step in reducing the massive government entrenchment and hurtful involvements in Healthcare.

As previously mentioned, Medicare is an especially egregious program, considering it is essentially a government sponsored, mandatory, pyramid scheme, which increasingly takes money from younger people, who tend to be poorer, and gives it to older people, who are, demographically, the richest segment of society.

My grandparents' generation thought being on the government dole was a disgraceful, a blight on the family honor. Today's senior citizens blithely cannibalize their grandchildren because they have a right [to as much] 'free' stuff as the political system will permit them to extract.

- CA Justice Janice Rogers Brown

However, the arguments against Medicaid, the health program for the poor are the most insidious, as opponents usually state as fact that poorer citizens will loose their health care and die or become ill and then the debate often shifts from a rational policy discussion to an evaluation of your personal intentions. Of course, this was the same line used with welfare reform and in fact, as documented, the repealing of socialism and the taking away of government benefits from the poorest Americans resulted in an increase in their prosperity, not a decline. In fact, the well intentioned government programs were found to be the very reason for the poverty!

In addition, both Medicare and Medicaid, being government programs, are racked with fraud, theft, waste, and, being government programs, offer incentives for poor care and disincentives for excellence, entrepreneurialship, and humane care.

In arguing for increasing physician reimbursement rates for both Medicaid and Medicare (H.R. 3617), the AOA tells lawmakers that physicians will stop accepting Medicaid and Medicare patients, thus decreasing patient access, if the compensation is not increased. Do you see the problem with this? Imagine if instead the AOA encouraged its members not to accept Medicaid and Medicare programs and urged Congress to phase out the programs. Don't hold your breath on that one... :)

Another bill we could choose to advocate for was a bill (H.R. 1380) which would help us lower our rather substantial debt as we emerge from medical school. It involves special tax breaks and more subsidies and who knows what other forms of measures that are, in my opinion, nothing less than outright theft. Unfortunately, as one can imagine, this was a relatively popular topic among many of the students. Most times, this brought smiles of understanding and something along the lines of "We'd like to work with you on that." or, "I understand that is quite a burden.", from the various legislative aides and/or Congressmen we met with.

The correct rebuttal came from, Senator Tom Coburn, MD (R-OK), incidentally my favorite Senator, who, according to second hand information, tartly asked a student: "Ok. So who do you want to pay for this?"

Of course, Senator Coburn's refreshing response is the correct response; as William E. Simon said:

If you would not confront your neighbor and demand his money at a point of a gun to solve every new problem that may appear in your life, you should not allow the government to do it for you.

In fact, the government already subsidizes our tuition and loans through various programs. But, more importantly, it also dramatically increases our tuition, via the aggregate effect of the massive regulation and meddling the government inserts throughout all US Medical Education, from the beginning of medical school all the way through residency and CME (Continuing Medical Education) programs. Yet, again, our lobbying focus appears to be in the wrong place. The battle is not being fought with government in the proper role as enemy, but rather as some sort of corrupting friend, who, with a wink and a nod, will help us loot the American people.

Another bill (H.R. 4403/S 2071) actually did address some of this, and tried to remove some of the regulation of residency programs from rural health care programs. I commend the AOA for their work on this bill.

Proponents of the subsidized tuition bill sometimes opined that a doctor's education needed subsidizing because their work was much more important and critical than a lawyer's or engineer's or psychologist's, or any other graduate program, or, apparently, any other education program. First, I'm not sure how one judges how 'important' someone's work is; we certainly don't want government to be doing this sort of 'evaluating'. Secondly, even if a doctor's work is that much more important, than it is all the more critical that government be kept out of the profession. Again, these constant attempts to treat medicine differently than other businesses has, in my humble opinion, resulted in the very problems which more hurtful government expansion has been proposed to treat.

So, seeing as I disagreed with the AOA's approach on many of these bills I did not bring them up in conversation. But, the bill or subject I discussed with nearly all the legislators I met, and indeed, was stated as the highest priority for the AOA, was a Medical Malpractice bill (S. 22), sponsored by Senator John Ensign (R-NV), who, by the way, has a great Senior Health Policy aide in Michelle Spence. :) Basically, this bill would nationally place a cap on non-economic damages in Medical Malpractice cases. There was some confusion about what exactly this bill does, as we heard variously that if States had a cap that was below this, then the State cap would stand, but higher State caps would be preempted by the new Federal law, and we were also told by different sources that this new national bill would only apply to states that did not have some form, with higher or lower caps, of Medical Malpractice reform. So, I tried not to get into the meat of this, and mostly just talked generally about the need to reduce Medical Malpractice.

Interestingly, did you know there is no such thing as 'Lawyer Malpractice'? There is no 'standard of care' that car mechanics are held to. Neither are engineers or electricians or any other non-health profession. Also, all are free, unfortunately only within 'reason', to make legally binding contracts with their customers. Yet, health care is different we say, lives are at stake we say, the free market cannot properly regulate health care we say. A bunch of rot I say. :)

One of the funniest moments, although to remain polite, I didn't laugh, came when a Democratic staffer brought up State's Rights as reason enough to vote against this national Medical Malpractice law. Now, I wasn't laughing at their argument; it was actually relatively sensible; I don't believe Federal power should be expanded except in what was previously termed, "negative power", whereby the Federal Government limits the power of the States, preventing them from committing acts of tyranny on their citizens, yet it, the Federal Government, is not empowered to garner 'positive power' or 'do anything' itself. I'm not sure quite where Malpractice falls in this framework, however, I suspect upon closer analysis we might find the root of the Malpractice problem is related to government's violation of one of the most basic human rights: the right to freely contract. All States currently do not allow a patient, if they so choose, to waive their right to partake in the current Medical Malpractice legal system. In other words, even if a patient wants to, they cannot sign a legally binding contract pledging not to sue their doctor, regardless of medical outcome. From my perspective, this is a violation of the Constitution, the right to liberty, and States that willfully violate the liberty of their citizens in this way, should be subject to Federal oversight.

In any case, returning to the moment of humor, my inner laughter was directed at the capricious irony of a Democrat talking about State's Rights regarding Medical Malpractice, when they are simultaneously in favor of expanding the Federal Government into nearly all other areas. Let's talk about State's Rights with Medicare or Medicaid! Just give us somewhere to run!

Another argument we frequently encountered was less humorous, as it was more indicative of a fundamental ignorance: the attacks on the companies that insure doctors for Medical Malpractice. Just like Big Phrama, Big Oil, and Big Wal-Mart, Big Insurance has been delegated resident villain by those on the Left, and demonized as responsible for at least some of the Medical Malpractice woes (same with workers comp). However, the facts are that insurance companies flee states with skyrocketing Malpractice verdicts, and flock to those with lower more stable rates, giving doctors greater choice of provider. The idea that insurance companies would just increase their profits, leaving rates unchanged if Malpractice reforms were enacted, can be dismissed even before checking the validating historical record. If an insurance company, or group of insurance companies, conspired to do such a thing, their profit margins would be high for only a very short amount of time, as their actions would create ample incentives for new insurance company startups, or for existing outside companies, to enter the market in order to take market share from the 'excessively profiting' companies. Incidentally, this same sort of reasoning will show why there can be no such thing as price gouging, or monopolizing.

In conclusion, I wouldn't want to leave out the highlight of the trip, which was meeting Rep. Ron Paul, MD, (R-TX), the utmost defender of liberty in all of Congress, an unabashed libertarian, and whom I didn't even know was also a doctor until just now.

We were walking the halls of Congress and we passed by his office and I thought, "Wow, Ron Paul's office, I wonder if he's in." So, later on we went back and asked his staff if we could steal just a minute or so of his time to meet him and maybe get a quick picture. It turned out he was in and he came out and shook our hands and posed for some quick pics:

I mentioned to him I had run across and appreciated his accurate root diagnosis of the campaign finance reform debacle and had even found a prominent space (required reading) for it on my blog.

As we were leaving, I told him I was very glad to meet him as he was the only politician I knew who actually worked to shrink their own power.

His response?

"Damn right."

Senate Defeats Effort to Limit Medical Malpractice Awards

5/9/06 LA Times

In a Dentist Shortage, British Do It Themselves

5/7/06 New York Times

Congressman Paul's Legislative Strategy? He'd Rather Say Not.

7/9/06 Washington Post

Some more pics:

Dr. Joseph Kuchinski, Vice Chair of the AOA Council The Nevada Student DO delegation, including Touro U On Federal Health Programs. Dr. Kuchinski ate lunch Student Body President Nik Kubista on the far right and with us and gave us great advice and insights, Touro U SOMA president Sara Garcia on the far left. We

plus he's just a fun guy. :) are in NV Senator Ensign's office.

The Touro Nevada SOMA delegation at the Watergate hotel for a SOMA dinner;

yes, it's that Watergate hotel. :) We all attended 'DO Day on the Hill' too.

Added 5/28/06

The pictures from a constituents breakfast with Senators Ensign and Reid came in. They weren't digital, but I took pictures of the pictures with my camera, lol: