Do you have the courage to take on the pharmaceutical companies, health insurance companies, medical device companies, your colleagues in the Senate?

Dear Senator Feinstein:
Thank you very much for responding to my email supporting health care reform.

For the record, I am a board certified medical psychologist and pain management specialist practicing in Los Angeles since 1972. I along with many of my colleagues (most on staff at Cedars Sinai, Brotman Medical Center, and Olympia Hospital) support health care reform.

More importantly we support insurance reform. It is admirable to pass legislation prohibiting insurance companies to deny coverage. However, that will not reduce the cost of care.

I have been practicing for 37 years and I believe the only cost cutting device is COMPETITION. If insurance companies had to compete with a public option, if providers had to compete for patients, the cost of health care would plummet.

Further, treating health care as a commodity like we do pork bellies and General Electric is flat out wrong. Corporations must make a profit. Health insurance companies make a profit from sick or injured people. There is somethng terribly and inherently wrong with this picture. Moreover, the profits by insurance companies are significantly increased by denying coverage or delaying treatment. These health insurance companies should be held accountable for the tens of thousands of people in the US who die each year for lack of coverage.

There are other changes that also need to take place to fix our broken health care system. Medicare rules MUST change. Using the CMS reimbursement as a base is fine, but the rule must allow for provider and patient to negotiate balances as opposed to forcing the provider to accept assignment. This will also result in cost containment because the patient will know prior to receiving health care what their out of pocket expense will be. Since providers will have to compete for patients, patients will benefit from this change in rules. The net effect of changing Medicare would be to put the health care decision making where it belongs; between provider and patient. Further, this change would put free enterprise back into medicine.

There must be changes in Tort law as well. Frivolous lawsuits should be disallowed with a mandate to the insurance companies to lower the premiums to providers.

The pharmaceutical and medical device companies also need reform. Two weeks ago we performed a neurostimulator implant surgery at our Los Angeles ambulatory surgery center. Our cost for the neurostimulator was $25,000. I would be willing to bet that the cost of manufacturing the device is less than $2500.

I can provide you with many examples and invoices from surgery equipment and supply vendors revealing the inflated and obscene charges from these companies. There is NO accountability and very little if any competition. These companies have been getting away with these outrageous charges since the early 1980's. Our elected representatives accept campaign contributions from all of these companies. I believe this is a major and significant reason why our health care system is broken.

As you well know, the drug companies are just as bad. Same drug, same manufacturer will sell for 10 times less in Canada or Mexico or any other country in the world than in the USA. The pharmaceutical and medical device companies drive the pricing in health care and it is time for you and your colleagues to STOP them. The only reason they get away with robbery is that we are the ONLY country in the industrialized world that does not have universal health care for their people.

You want to ensure access to health care to all of your constituents? You want to drive health care costs DOWN? You only need to look at the insurance industry, pharmaceutical industry, medical device industry and congress protecting them to make that happen. The solution is a lot simpler than you and your colleagues make it out to be.

Do you have the courage to take on the insurance companies? Pharmaceutical companies? Medical Device companies? You would make all Californians proud if you took them on.

I think it would be very beneficial for you to look at the New Zealand health care system. It is a combination of public and private health care that really works.

My colleagues and I are available to discuss any of these issues with you or your staff, and thank you for listening.

Howard Stanley Rubin, MP PhD
Chief Executive Officer
Museum Center Surgery Group, Inc.
Los Angeles, California
http://healthcarenow-doc.blogspot.com/