Monday, August 10, 2015

A Review of Big Medicine: The Cost of Corporate Control and How Doctors and Patients Working Together Can Rebuild a Better System, by Elaina George, MD, Alethos Press, St. Paul, Minnesota, and ebooks at and Hardcover version printed by Bethany Press International, Bloomington, Minnesota.

Now and then comes a book on how a practicing physician really feels about ObamaCare. This is that book.

For good writing it is a good practice to follow this rule, “If you have a nail to hit, hit it on the head.” Elaina George, MD, an Ear, Nose, and Throat Surgeon, from Atlanta who has been in private solo practice for 17 years, hits several nails on the head in 27 chapters and 134 pages. She describes her honest reaction to reflections on ObamaCare from the viewpoint of the MD at bedside. The purpose of her book is to transmit and justify this reaction, which is generally negative, to patients.

Readable writing is also a product of good editing. In this book , Dave Racer, an author and publisher in his own right, has done a superb job reducing this Doctor George's blogs and thoughts into a coherent book.

Doctor George, is a graduate of Princeton, the Mt. Sinai School of Medicine in New York City, and completed her residency at the Eye, Ear, and Nose Hospital in Manhattan. She says corporate and government control of medicine comes at financial and human costs, but can be remedied by doctors and patients working together.

As I read her book, written by a surgeon, I thought of the words of the poet Emily Dickinson (1830-1886),

Surgeons must be careful
When they take the knife,
Under their fine incisions,
Stirs the Culprit - Life!”

In this case, Life! is the life of the American healthcare system, private practitioners and patients, caught under the regulatory heel of the health law and ensnarled in the web of consolidated corporate entities – the huge insurers, pharmaceutical firms, and hospital chains – and government bureaucrats who carry out and enforce the law.

There is tremendous unease among doctors and patients about ObamaCare and the big medicine it produces. In a Physicians Foundation survey of 650,000 physicians, to which 20,000 responded, 46% of physicians gave ObamaCare a D or F grade. In over 1,000 national polls conducted since ObamaCare passed in 2010, the public has opposed the health law in over 95% of polls, usually by double digit margins.

You get an inkling of these reasons why this unease exists from some the chapter titles in Dr. George’s book: “ObamaCare: Trojan Horse for Socialized Medicine,” “Crony Capitalism Can Be Hazardous to Your Health,” “The Administration’s Answer to High Healthcare Costs...Rationing,” “Cookbook Medicine: The Future of Health Care in the United States,” “Six Ways Your Health Insurers Make It Harder to Take Care of You,” and “A Practicing Physicians Prescription for a Health Care Fix.”

Among Dr. George’s “Prescriptions” are these:

• Change the tax code to allow private physicians to pay off bad debt.

• Change medical malpractice law through tort reform.

• Allow Medicare and Medicaid patients access to cheaper drugs from other countries.

• Refuse to mandate, as matter of licensure, that physicians must accept Medicare, Medicaid, and ObamaCare health plans.

Dr. George does not advocate for outright repeal of ObamaCare, although she strongly points to it as a main hindrance to a restored healthcare system. She clearly wants “Big Medicine” to leave doctors and patients alone to do the right thing instead of the left thing.

By and large, this is not a political book. It is a comprehensive litany of why ObamaCare’s good intentions, to cover costs of the poor and uninsured, comes at the cost to the middle class, patients, doctors, and the nation as a whole. ObamaCare, in short, is an obamanation (my pun, not Doctor George’s).

You cannot fool or please all of the people or all of the doctors all of the time.

By George, this is a fine book. I recommend it. But it will be difficult for most readers to digest in its entirety, for the law affects different groups of Americans in different ways, at different times.

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