By: Mary Mostert, Analyst, Banner of Liberty, (www.bannerofliberty.com)
September 1, 2001
In 1997 the American Nurses Association (ANA) was "particularly appalled to learn that one of the ways Clinton is planning to implement his $1.7 trillion budget and move towards a balanced budget is by gutting funding for the Nurse Education Act (NEA). Funding for FY '98 is proposed at $7.7 million -- down from $63 million for FY '97." (http://www.nursingworld.org/pressrel/1997/budget97.htm)
The nursing shortage is just the tip of the iceberg. The iceberg coming is a massive shortage of doctors caused by the Clinton insistence on training fewer specialists and the almost universal desire on the part of America's doctors to get out of the impossible situation they are in. The MAJORITY of America's doctors would like to get out of medicine as soon as possible.
I thought about that in the last few days as I helped out in a family emergency involving the birth of my 25th grandchild, Joseph. Joseph has six healthy, bright older brothers and sisters. All of his cousins are also alive and well and I thought about how fortunate we are to live in a time when that is possible as I stood in the middle of the infant intensive care unit with Joseph and his mother Sharilyn watching Joseph breath on a respirator at the Utah Valley Regional Medical Center . Although he is a full term, nine pound baby, for some reason his lungs did not properly inflate and to make sure he doesn't have a problem caused by a lack of oxygen later, he and his mother were both transferred from the small hospital where he was born to the regional medical center which has the needed modern equipment to give him a good start in life.
This is costing about $5,000 a day and, we all hope, the insurance is going to pay for most of it. If it doesn't, of course it's going to be a financial burden. Is Joseph worth that kind of money? We all think so.
As I stood in the middle of the ICU unit and looked around I thought about something my mother used to tell me. There were four of us, and all of us had lived to be grown, a remarkable accomplishment in my mother's day. Mother was the first woman in generations in her family who had raised all her children with none of them dying. Her own mother died during childbirth. . Her baby brother died a couple of days later and the funeral was held up so both could be put in the same coffin. Her father remarried and three of her six half-siblings died before age 2. One third of her grandmother's children died when Union soldiers commandeered the family home and drove her and her six children out on a cold day in February during the Civil War.
Because of modern medicine, so far ALL of my grandchildren, are alive. If they had been born 100 years ago, anywhere from eight to twelve of them would already be dead from things like diphtheria, whooping cough, measles, mumps, polio, or mysterious ailments like what Joseph is experiencing, etc. Two of my grandchildren had life-threatening problems. One, Catherine, had a ruptured appendix at age two and the other, April, had biliary atresia, a condition that attacks newborns in which variable lengths of the biliary tree going to the liver are blocked. Today, because of modern medicine, which included well trained and gifted surgeons, they are alive and healthy. As recently as twenty-five years ago, both would be dead.
Of course, the medical costs, which fortunately were paid by insurance, for both Catherine and April were astronomical. In April's case, it was about three-quarters of a million dollars. Is she worth it? We in the family think so.
And that brings me to another conversation in keeping family members informed. I talked to my son Guy who is an orthopedic surgeon. In the conversation he repeated a point that he's mentioned before: doctors in America today are all guilty, according to the bills passed by Congress and signed by President Clinton, every day in every way. No doctor can, under current law to "control" medical costs EVER be allowed to make an innocent or computer error. If a doctor, or a hospital, is charged with "fraud" and they fight the charge, the fine automatically is tripled. So, doctors and hospitals routinely pay what can only be called government extortion fines of thousands of dollars for clerical errors made by their staff and are refused payment for the work they have done..
The latest example he gave me involves the hospital in which he practices. A Medicare patient had pneumonia and the paperwork, which is horrendous, was sent off for payment for the patient's hospital and doctor care. Only, the person at the computer inadvertently used the wrong type of pneumonia in the report. These reports go to a huge center, which uses super computers and all the allowable medical data in its software. If I'm not mistaken, it is that Medicare payment center that Ross Perot made his fortune creating.
When the super-computer picked up the fact that the wrong pneumonia had been claimed, it tossed out the hospital's claim and the hospital received an automatic fine for a fraudulent return. Was the computer wrong? Well, technically no. Someone actually HAD claimed treatment for the wrong kind of pneumonia in the elderly patient. Had that changed the need for the patient to be hospitalized? It had not. But, according to the super computer that is beside the point. The claim used the wrong kind of pneumonia so the entire claim was kicked out and the hospital not only fined but payment for the patients stay denied.. If the hospital or the doctors challenge the center's charge, the fine is automatically tripled. It doesn't matter what the facts of the case are.
This is why so many small hospitals, who can't afford or can't get the trained personnel nor the super-computer nor the software that the federal government's entrapment center uses are in financial difficulty or closing down or are unable pay for enough nurses and other professional personnel. This is especially true in areas where there are a large number of elderly patients.
And, even if they manage to afford the trained personnel, much of the time they can't FIND the trained personnel, especially nurses and, increasingly, doctors trained in various medical specialties, surgical specialties. Suddenly nearly every news magazine is talking about the "nurse shortage." My son, Guy who served his residency in orthopedic surgery during the Clinton Administration, watched anxiously as the Clinton administration repeatedly moved to limit the number of specialists trained. It also limited the number of nurses trained.
Five years ago Guy was worrying about even FINDING a place to practice as an orthopedic surgeon. Today he is in a shrinking group of surgeons and looking for a new partner, which he can't find, while he is performing three times as many surgeries as the average orthopedic surgeon. That, of course, combined with untrained or no help with paperwork., he knows, going to invariably lead to a paperwork error at some future time that could cost him a minimum of a $10,000 fine and could, if repeated, cost him his license to practice.
The government has it set up so that every doctor in America is guilty every day, Guy says, of SOMETHING that could cost him either money, time or even his right to practice. The system is not to improve medical care. It is a blatant and admitted move by the government, which controls the system, to avoid payment by labeling minor errors as "fraud" attempts in which the doctor and hospital are not only not paid, but are fined for healing the patient. The result is not improved medical care for patients. The result of this punitive system is the looming medical crisis in which no young person in his or her right mind will go into nursing or medicine and be treated as slaves of the federal government and/or the insurance companies.
A national survey, prepared by the Federation of Nurses and Health Professionals, found that one in five nurses now practicing plans to leave the profession within five years because of unsatisfactory working conditions. The numbers of doctors leaving their profession early is even higher. On a regular basis my 41 year old over-worked, highly-trained and talented orthopedic surgeon son threatens to leave his profession and go back to being a carpenter, his job as a high school and college student, as soon as his massive loans for getting his medical training are paid.
In some areas, the situation is already a crisis. Guy didn't even bother to try to find a place to practice in California when he finished his residency four years ago. In fact, he was told by those trying to place him that the "HMOs have ruined California's medical system." In four short years the reluctance of physicians to even try to cope with California's oppressive system have caused an exodus of doctors out of the State. In January the Cupertino, California Courier reported that the president of the California Medical Association (CMA), anesthesiologist Marie Kuffner, who teaches at UCLA, finds an alarming number of students plan to leave the state after graduation:
"In an October state-of-medicine-in-California speech, Kuffner reports some of the reasons for the exodus of California doctors: Physicians are being left with millions of dollars in unpaid claims; large numbers of medical groups are going bankrupt; the average California physician earns 15 percent below the national average. In fact, data collected during 1994-1997 showed California physicians' incomes fell by at least 12 percent, while physician incomes in the rest of the country rose, and she says Californian physicians' incomes have dropped even more since then. An article in Modern Healthcare reports California physicians are 47th in physician reimbursement in the country. The ratio of doctors to patients is 214 doctors per 100,000, and doctors are typically seeing 30 to 35 patients a day. "(http://www.metroactive.com/papers/cupertino.courier/01.17.01/cover-0103.html)
California is the nation's leader in trends. Doctor bashing began in California. Then, throughout the Clinton Administration doctors and the medical profession have been bashed on a nationwide basis and the nation's media has accommodated the bashing with stories designed to denigrate doctors and hospital while pushing the Clinton socialized Health Care plan.
What lies ahead is alarming. What if the people working in the Utah Valley Regional Hospital infant intensive care unit were not there one day? All those babies, including little Joseph, would die. Some of the babies had been in the unit for three months - and still were not big enough to survive without their help. And that doesn't count the patients throughout the hospital - many of them in the adult intensive care unit.
In my opinion, this is not even a really hard problem to solve. First, it would help a lot if more patients would understand the problem and express more appreciation to their doctors. Often all they hear from patients are their complaints. This does not encourage stressed-out doctors to remain in medicine.
And, secondly, the public needs to tell Congress and the president, to reverse the Clinton attack on America's medical system and to stop trying to create socialized medicine in America. Other nations, which have already socialized their system, such as Britain, are trying to learn how to accept the inferior medicine it creates. The pending Patients Bill of Rights could be a first step in that direction, depending on which bill comes out of conference and goes to the president. Sen. Kennedy and the Democrats are still determined to increase federal control over medicine.
To comment: mmostert@bannerofliberty.com