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Bill Kalmar

Quality Insider

Is There A Doctor In The House?

Health care, a tough "bill" to swallow

Published: Friday, August 7, 2009 - 15:16

T

hose of us who were fortunate enough to avoid the swine flu or so-called pandemic several months ago, may have another opportunity this autumn. Reports are that another strain of the dreaded flu will emerge and the drums of fear and persuasion are already beating—fear that thousands of people may die and persuasion that everyone should take advantage of the vaccine being prepared and sign up for the inoculations. But here’s the rub:  If you don’t become ill from the swine flu, you no doubt will get sick just reading and trying to understand the proposed National Health Care Bill. However, don’t worry about reading it in its entirety, because neither President Obama nor Congressman John Conyers have read it or understand it. In fact, Conyers stated it eloquently during a recent luncheon speech at the National Press Club when he said, “What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?”

I'm all for improving the quality and the availability of health care. But the government wants us to wholeheartedly support legislation but, when, apparently, no one has taken the time to absorb its content. Some of the provisions though in the plan have seen the light of day and frankly, after reading just a few, I have already taken ill. Here are just a few tidbits that have given me intestinal discomfort.

Keep in mind these are interpretations from those who claim to have staggered through the thousand plus pages.  Some call these claims untrue and propaganda, but without a definitive answer to the myriad of questions being posed by concerned Americans, who is to say these concerns are unwarranted? If neither you nor  I, nor many of our representatives, have read through and understood the 1,000-page document, how do we know what is true and what isn't? Here we go:  

  • Illegal aliens will be eligible for health care. We are a generous and caring nation but somehow I don’t want my tax dollars paying for people who have never paid into the system.
  • The controversial organization Association of Community Organizations for Reform Now (ACORN) will be paid for referring the uninsured to the new national health care plan. Just what we need—a finder’s fee for bringing in your “tired, your poor, your sick and your injured.” The AARP is supporting this legislation too. One can only wonder what special incentives that organization is receiving for doing so. Am I a skeptic? You bet.
  • Medical schools will be given additional funding and attention for instituting more widespread affirmative action goals.
  • Doctors’ services will be monitored closely so that second opinions and additional tests will be discouraged. It's almost like rationing out services—the government will decide what treatments one receives.
  • And the coup de grace. According to some interpretations of the bill, senior citizens will be required to attend End of Life Conferences. I wonder what constitutes a passing grade at these macabre events? Sounds like a new career move for Jack Kevorkian!

 

There seems to be a consensus from the medical profession that changes in health care are needed but the proposal that is on the table is untenable, confusing, and makes a mockery of all the good that is going on currently in health care in this country. Let me give you just one example:

Over a year ago, I was diagnosed with prostate cancer. My PSA had risen by a point and my doctor suggested a biopsy. I had three biopsies and the cancer was confirmed. Since this is a life-changing event, I decided for another series of biopsies from Henry Ford Hospital in Detroit. There, the physicians performed 12 biopsies, which again confirmed the original diagnosis. Over the course of the next four months, I contacted numerous physicians and hospitals to discuss my options, finally opting for robotic surgery at Henry Ford Hospital. The operation was a success and I am cancer free.

Now here is my point: I had the luxury of being able to have additional testing and the ability to discuss the situation with a series of professionals in the field. I wonder if under the proposed health care legislation I would have that option. I don't think so.

Secondly, while preparing for and undergoing this procedure I met people from Japan, London, China, Portugal, and of course Canada (socialized medicine as you know) who came to Henry Ford Hospital because they discovered through exhaustive research that the best program for this type of surgery was headquartered here. If our system of health care is so flawed, as we are led to believe, why are people coming from all over the world to be treated?

So there you have it. Our system may have some glitches and may need some revamping but the proposal currently on the table needs resuscitation. Moreover, there may not be enough defibrillators or people of sound mind and judgment available to do just that.

Perhaps my comments will run contrary to what some of you want and expect from a health care bill, but let’s do this:  before our astute politicians vote this into existence, how about we all take the time to read it thoroughly (even John Conyers and the President) and lay out all the provisions so that we can understand it. Changes, of course, will have to be made because as it is now, a majority of Americans have rejected it.

Let’s hope that after all is said and done and when those critical words, “Is there a doctor in the house?” are uttered, they won’t be met by silence.

Some will conclude that I have acted “stupidly” in my rendition of the bill, but if it gets me an invitation to the White House for a beer, so be it.  On the other hand, if an invite arrives, I hope it doesn’t conflict with my End of Life Conference!

Discuss

About The Author

Bill Kalmar’s picture

Bill Kalmar

William J. Kalmar has extensive business experience, including service with a Fortune 500 bank and the Michigan Quality Council, of which he served as director from 1993 through 2003. He served on the Board of Overseers of the Baldrige Performance Excellence Program and has been a Baldrige examiner. He was also named quality professional of the year by the ASQ Detroit chapter. Now semi-retired, Kalmar does freelance writing for several publications. He is a member of the USA Today Vacation Panel, a mystery shopper for several companies, and a frequent presenter and lecturer.

Comments

Let's follow some Quality Principles, Bill...

So Bill Kalmar has a background in Quality. Interesting - one of the things Quality practitioners should always aspire to is getting accurate facts and data rather than reacting to stories.

Let's look at his list of concerns:
" * Illegal aliens will be eligible for health care. "
Not true - this has been categorically denied by all those involved in writing the bills currently before the House and the Senate.

" * The controversial organization Association of Community Organizations for Reform Now (ACORN) will be paid for referring the uninsured to the new national health care plan. Just what we need—a finder’s fee for bringing in your “tired, your poor, your sick and your injured.” The AARP is supporting this legislation too. One can only wonder what special incentives that organization is receiving for doing so. Am I a skeptic? You bet."
ACORN is hardly a 'controversial' organization outside of the far Right of the Republican Party; nor is the AARP. Don't know whether this claim is true or not - somehow I doubt it. But the whole idea of expanding coverage to ALL the population is that the tired the poor and the sick will get treatment, Bill. Or is that just plain unamerican? Presumably you think they should just be left at the side of the road to quietly expire and not get in the way of those who can afford to buy healthcare.

" * Medical schools will be given additional funding and attention for instituting more widespread affirmative action goals."
Only someone who denies the truth of ongoing present inequalities can consider that this would be a bad thing if it is true - just because we have President Obama in the White House doesn't mean that equal opportunity has been achieve nation-wide.

" * Doctors’ services will be monitored closely so that second opinions and additional tests will be discouraged."
This touches on the excess issue. So according to Bill, he had no less than 15 biopsies to confirm his prostate cancer... this seems somewhat excessive, to say the least. This sort of repetition of unnecessary procedures is part of the reason why the USA spends more than twice as much on health care per capita than any other developed nation. He then hung around for four months discussing his options with everyone he could get to talk to him. Sounds more like a case of not wanting to believe the truth and trying to buy a different answer. In the end a course of action was undertaken which could have been chosen after the first biopsy. I hope Bill considers all the extra money was well spent on HIS health care, but basically those extra tests should have been discouraged - they didn't change anything, nor were they likely to. A biopsy rarely produces a false positive in these cases.

" * And the coup de grace. According to some interpretations of the bill, senior citizens will be required to attend End of Life Conferences. I wonder what constitutes a passing grade at these macabre events? Sounds like a new career move for Jack Kevorkian!"
The proposals according to Palin and Limbaugh, not according to the wording in the draft Bills. The proposal is to make funding available for such discussions; they will not be mandatory. If Bill did better research he could have found that the Dana Farber Cancer Institute routinely has these conferences with its patients, and in consequence of establishing the patient's wishes they provide better end-of-life care at a far lower cost than hospitals which do not undertake this activity. What's wrong with that? It is common practice in other parts of the world and has nothing to do with Dr. Kevorkian, nor, as another commentator has pointed out, is it a test. There is no 'passing grade'.

This article says nothing about the real issue - the 15% of the population who have no health insurance and the additional 10% to 15% who have inadequate insurance. If the system is so great, Bill, how come that on just about every measure of public health the USA comes in way behind countries like France, Germany, the UK and Canada? And how come medical bills provide the highest cause of personal bankruptcy?

You may also be interested to know that 'medical tourism' is pretty big in the UK as well as here - and if he hasn't been reading the papers recently he has probably also missed the fact that medical tourism from the US to other countries where health care is affordable is also pretty big business these days.

Facts are so unfortunate when they get in the way of prejudice.

Rod Goult

Response to Mr. Goult

Mr. Goult,

While I appreciate that you took the time to respond to each of Mr. Kalmar's points, taking issue with his getting multiple medical opionions was an unnecessary and personal attack. In fact, for various reasons, treatment options related to cancer can be, and frequently are, in error.

Case in point, if Lance Armstrong had listened to the first cancer doctor he went to he would be dead.

Dirk Dusharme
Editor in Chief
Quality Digest

Quality people asleep at the wheel

When the opportunity to shine emerged, the quality folks were ALL out to lunch or asleep at the wheel. What is wrong with you people? You all are aware that a law (legislation) or regulatory requirement is not a problem solving tool, yet you sit idle while and let this administration do just that.
Where are the problem statements?
Where is the root cause analysis?
Where are the validated countermeasures?

You know PLAN DO CHECK ACT the stuff we quality folks talk about all the time.
For congress to just toss out a 1000 page plus bill and say " this is the countermeasure for all our health care systems ills" is the most ludicrous statement ever made among mankind. This is the highest pentical of stupidity. Quality logic tells us in our very bones that this will result in complete failure.
We have all seen this type of shot gun approach before and most of us were around to clean up the mess. Without applying good problem solving techniques and getting to the root causes of health care, there is litterally no way a piece of legislation will solve anything.
You folks should be screaming the loudest at the governemt, reminding that their chosen course of action is incorrect in every way.
Come on Quality folks remind this lawyers in Washington there their attempt to problem solve through legislation will not work. Focus them on the methods of PDCA whcih do work. This is the prime opportunity to to shine, guide the governemtn in the proper techinque for problem solving, show them six sigma, help them help us improve. Don' just accept their lawyer based, failed problem solving techinque

Why is this article in Quality Digest?

This is an editorial. A political editorial does not belong in this magazine. It has no bearing on quality professionals or quality practice. By allowing it to run, I must assume the publishers have a desire to see the health care bill defeated. This is not the forum for such desires. It is very disappointing, not because I agree or disagree with the author, but because QD found it appropriate to publish. Come on, QD, focus and get on point.

Healrth Care

How nice that you have the 'Cadillac' of health care that will afford you the possibility of how many biopsies?
And who paid for these?
Do you actually think that this type of care, these choices, are available to everyone?

You are part of the reason the changes need to be made.

If you have questions, read the bill yourself instead of relying on the Becks, Hannitys or Limbaughs of punditry that tell you what to think. You're full of ideas, too bad they're not yours or original. Each one of your talking points has been reputed by numerous, independent organizations that are reviewing healthcare.

And the people from "Japan, London, China, Portugal, and of course Canada (socialized medicine as you know) who came to Henry Ford Hospital because they discovered through exhaustive research that the best program for this type of surgery was headquartered here." didn't come for our health care system, they came for the technology that was paid for on the backs of the rest of us who have to shell out $400 a month for one maintenance medication to control cancer after having spent thousands on surgery, chemo and radiation.

It sounds like your 'American way' means 'those who can afford the coverage'.

"A majority of Americans have rejected it" (the health care proposal) is also a crock. For one, there is no single bill being discussed and secondly, unless you've done the study, where are your numbers, or are you allowed rash generalizations because your a 'columnist'?

Thankfully, I won't have to suffer with your uninformed and partisan opinions. I can just cancel my subscription.

Now explain how this relates to the quality industry.

Health Care

Insurance is already determining what health care we receive. Could you have treated your cancer the way you did if you were uninsured? I don't know if the government will be better or worse but "oversight" has become the name of health care culture. On a more personal note, my new employer based health insurance determined that I was taking more of a drug than they thought was reasonable. I had been taking the drug for 20 years with no ill effects. Now I must take 3 pills a day instead of 4 (after numerous appeals-they thought 2 tablets was enough). This was in spite of blood tests for the drug that were in a normal range. Now, I suffer every morning and must use a strong inhaled medicine to clear my lungs due to the reduced medication. That is how our current system has "improved" my health.

Let there be one condition

Let there be one condition on the passage of Universal Health Care: Those politicians who came up with it are required to have it, and only it, for the rest of their lives.

Health care reform

An "End of Life Conference" is exactly that; a conference. There is no test, and you can still make the choices you have always been able to make. There is no pulling the plug on Grandma as the health industry would have you believe.

I agree that having all those tests and conferences was a "luxury". You must be a very wealthy man to be able to pay for all those tests. What did the additional 12 biopsies do? Nothing but line the pockets of the health industry and lighten your pockets, but evidently you are a very wealthy person. Most of us can't afford that. Having one biopsy is a financial strain.

There is no doubt that the US has the best medicine that money can buy, if you can afford it.

End of Life Conference overstated

I've often enjoyed the author's frequently cantankerous but usually well-aimed jabs. The AARP, an organization to which Mr. Kalmar is certainly entitled to be a member, has debunked the reported mandatory End of Life conference as an obfuscation and scare tactic. While I don't always agree with them either, the AARP has gone the extra mile of meeting with the President to get clarification of these questions and express concerns of their membership where needed. As quality professionals, our culture is to be cautious about broadcasting assertions without objective evidence -- even if the point is to show that an area of public policy appears to be unnecessarily murky. There seems to be adequate innuendo available without additional logs on the fire.
http://www.aarp.org/aarp/presscenter/pressrelease/articles/health_care_d...