Enjoy the interview with DPMA Member Dr. Richard Reece!

By Leslie Johnston,  Membership Director, Doctor Patient Medical Association

July 27, 2012 - Reading Dr. Richard Reece’s latest book, The Health Reform Maze: A Blueprint for Physician Practices, was an encounter with common sense.

Donald J. Palmisano, MD, JD, FACS,  former president of American Medical Association,  said of the book, “It‘s a must read collection of essays that gives the good, the bad, and the ugly of the new healthcare law, PPACA”

Dr. Reece has written 2350 blogs, 1500 tweets,  and 11 books on freedom in medicine. You can read his blogs at medinnovationblog.blogspot.com.

Dr. Reece is a renowned physician author. He has written a myriad of articles spanning the vast terrain of medicine. His topics cover everything from, “Why Doctors Don’t Like Electronic Health Records,” to “Common Medicare Scams.”

Dr. Reece is a retired pathologist but continues to invest in patients through his writings and speaking engagements. He resides today with his lovely wife of 50 years in Connecticut. We are fortunate and happy to engage him today on preserving liberty for doctors and patients in health care.

Enjoy this interview with DPMA Member Dr. Richard Reece!

Dr. Richard Reece on freedom in medicine, authenticity in health care policy, and why it is important to preserve our health care liberties.

Q: What are you “for” and”against”?

A: I am “for” health reform, with better outcomes and lower costs.

I am “for” universal tax credits for individuals and corporate employees. 

I am “for” national marketing and choice of employee health benefit plans now enjoyed by government employees.

I am “for” marketing of plans across state lines. I am “for” widespread implementation of health savings accounts linked to high deductible plans.

I am “for” direct-cash and concierge practices.  I am “for” moving the age of Medicare eligibility to 67, means testing for Medicare, Medicare vouchers, Medicaid block grants for the states – whatever it takes to preserve, save, and sustain these vital programs for future generations.

I am “against” Obamacare.  It should be repealed and replaced as unworkable and prohibitively expensive.  It is full of good intentions, but as Samuel Johanson (1707-1784) observed, "The road to hell is paved with good intentions." And I would add, "unforeseen and adverse conequences."

I do not regard “Obamacare” as a pejorative, partisan, or dismissive term.  The President himself embraces the term because, he says, it shows he “cares." Besides, “Obamacare” embodies his governing philosophy, which is “trickle-down government.”

Q:   What does “freedom” in medicine mean to you?

A:  “Freedom” means being able to choose your own doctor and to have your doctor choose what is best for you. These choices should be personal, patient-centered, commonsensical, and cost-effective.

The coming election is about choosing between: one, individual freedoms, choice and enterprise, and two, collectivism, government control, and economic security. It is not, in my opinion, about “social justice.” That comes when the economic prosperity tide lifts  all boats.

Q:  You call the President’s Health Care Bill a “Raw Deal” for doctors. Why?

A:  It’s a “raw deal” because over the course of 10 years, it cuts doctors’ income to the level of Medicaid (now 56% of private pay), allows an unelected payment commission board to set doctor pay, controls what doctors can order for patients and what government will pay, and bases reimbursement on “value based evidence” of patient outcomes rather than on doctor-patient based decisions and interactions.  It is about remote bureaucrats and managers making decisions rather than doctors and patients at the point of care.

Q:  What does “authenticity” mean, and how does that play in the pieces you write for your blog and the media?

A: My dictionary defines, “authenticity” as the truth or reality.  Frankly, I do not think government experts know what constitutes truth or reality on the ground in doctors’ offices or hospital corridors.   These experts advocate data-dictated care.   They see data as a Holy Grail. They are fond of smugly saying, “In God we trust, all others use data.”  The health system would be better served if these experts spent more time in doctors’ offices, listening and observing and less time in front of their computers, crunching numbers.

Q: Are there any surprises regarding the responses you receive on your blog posts and writing?

A:  No, people stand where they sit, and they rarely change their mindsets or political positions.

Those on the left think of government as custodian and protector against private abuses. They believe physicians make decisions in their own self-interests rather than in in the patients’ best interests. Further, they do not believe patients are sufficiently intelligent or informed enough to make health care decisions.   They believe health care ought to be a “right” and “free” entitlement.  As Margaret Thatcher observed, “The only problem with socialism is sooner or later you run out of other peoples' money.” Obamacare may not be socialism. But it is left-center  stab at it in a right center country.

Those of the right think medical professionals should be trusted to do what they spent 12 to 15 years learning to do, and health consumers are smart people, perfectly capable of making health decisions in their own best interests, in concert with their doctors.

Q: How do you see PPACA directly impacting the personal liberties of physicians and patients?

A:  The PPACA impacts physicians by compelling them to comply with federal regulations, to prescribe electronically, to install electronic health records, to accept lower federal reimbursement for Medicaid and Medicare patients.  It impacts patients by making them enroll in government-approved plans, by limiting the procedures and tests they can receive,   potentially by rationing care, and raising premiums and taxes. . 

Q:  If you had a crystal ball, and the President’s Health Care Bill is not overturned-what are the most significant changes you foresee in health care over the next ten years?

A:  I do not have a crystal ball, although it is sometimes said of pathologists that they know everything but it is too late.   For doctors, I foresee a steady decline of private practice, particularly of solo and small groups, an explosion of regulations, an increase in the load of Medicare and Medicaid patients, and a herding of doctors into salaried employment in consolidated and integrated health systems with enough electronic and administrative infrastructures to deal with federal regulations.  For patients, I foresee increased premiums, limiting of choice to government-endorsed health plans, long waiting lines to see a doctor, more care in community health plans and safety net institutions, and restricted access to high tech care by specialists.

Q;   Does it take a measure of personal courage to publish your views on health care?

A:  No, I am an independent thinker, beholden to no one.  I am of an age where I say what I think, based on what I observe and on the historical record.

Q: Who or what inspires you as you write about health care?

A:   I believe in the American ideals of individualism, free enterprise, hard work, and choice. I believe these ideals apply to medicine as well as the economy as a whole.

Q: Why did you join the DPMA?

A: to preserve and to articulate those ideals.

Q:  One last question.  Why is the PPACA so controversial and confusing?

A:  That’s easy. 
 It is controversial because it is the most comprehensive piece of social legislation ever attempted.  It covers the whole health care waterfront:  coverage, quality and efficiency, prevention and wellness,,the health care workforce, fraud and abuse, long term care, biopharmaceuticals,  medical devices, neglect of the poor and elderly. 

It is controversial because it calls  for an expenditure of roughly  $2 trillion over  the next 12 years with new  taxes of over $500 billion.  It is controversial because it affects every American.  Yet it passed  without a single Republican vote. That has never happened in the history of the Republic.  That poisoned the political process.  

It is controversial  on the physician side of the equation because it calls for  flat or declining reimbursement, growing regulatory and administrative paperwork, no relief from malpractice costs,  forced implementation of expensive information technologies,  no tort reform, no relief from medical education debts, and health reform’s adverse consequences.

 It is confusing no one understands its high costs and adverse effects,   These are buried in a 2700 page bill written in federal jargon which no one has read or understood in its entirety. As Jonathan Oberlander remarked in a December 9, 2010, New England Journal of Medicine article, “The law is not a single program. It  is a collection of mandates, public insurance expansions, and regulations that affect different groups of Americans in different ways at different times.” It is a toxic health care cocktail  concocted by politicians far removed from the clinical scene.

As Nancy Pelosi famously said, “We’ll  have to pass it to see what’s in it.”  We are just beginning to see what’s in it, and we do not like what we see.

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