All Medicines Are Poison!

The N Y Times: Many Health Plans, Many Hours Spent Haggling.

2011-10-29T08:56:00.000-07:00

This article should be a "must read" for everyone. It compares the many health plans in the U.S. to the single payer Canadian health care system.
I practiced family medicine for almost fifty years and I can state that every word in this article is true. Our health care system is too expensive and wasteful. Too much health care money goes to the for-profit insurance industry. Too much time is wasted deciding whether or not a necessary test, procedure or treatment will be paid for. The doctor's office and treatment facilities drown in unnecessary paperwork, as are services such as laboratories and and other necessary providers.
The 18000+ Physicians for a National Health Program (PNHP) and a majority of nurses believe that the only answer
is a single payer system. But our federal legislatures will not let that happen. Money talks!
Melvin H Kirschner BA BS MPH MD
Dr. K's book "All Medicines Are Poison!" discusses many of the shortcomings of the U.S. health care system.
www.allmedicinesarepoison.com

Dr. Reynolds. More than a mentor...

2011-10-29T08:52:00.000-07:00

I first met Dr. Reynolds when I was in medical school. He practiced general medicine and in the addition to honing our diagnostic skills, he made the patient/doctor relationship a very important part of our training. Our first two years of training was at the classrooms of the University of Southern California's campus. Our second two years were spent on the vast Los Angeles County Hospital wards.
Although we were exposed to many specialties and many specialists at the hospital, our "home room teacher" was Dr. Reynolds. It was he who molded everything that we learned into a pattern that represented the comprehensive medical care expected of the family doctor. After I completed training and went into practice, it was not unusual to see doctor Reynolds at continuing educational functions.
Years after I became a practicing family physician, one of my patients presented with mysterious symptoms. I hospitalized her and was unable to determine the cause of her illness. None of my consultants could offer a cause or recommend a treatment.
I called my old professor Dr. Reynolds. He remembered me and offered to come and see my patient. After examining my patient he was also complexed by the symptoms. He noted that the mysterious illness was being reported in the international literature. Shortly thereafter, the international medical literature reported the cause of the mysterious illness and proposed a treatment, but no cure.
After 50 years of family practice, I'm retired and writing essays and books about medicine. Dr. Reynolds is long gone but still remembered. I'm proud to say that he was my mentor.

Why do so many people in this Country have inadequate health coverage or none at all?

2011-10-29T08:47:00.001-07:00

As health arena worker and a family physician for over 60 years, I was always concerned about the fact that so many people in this Country have inadequate health coverage or none at all.

It certainly influenced how I practiced medicine. I saw to it that everyone who enter my medical office door received the treatment that the needed or was sent to an appropriate facility where they could receive it. If necessary, I would take care of their immediate needs until they could get a to free clinic or a hospital. When they were unable to pay my fee, I cancelled it. Never-the-less, I always made a very comfortable living. I believe that many of my colleagues practiced the way I did.

As a doctor, i've always been treated with great respect. I realize that I was fortunate to receive an excellent education and degrees at the five highly regarded universities that I attended. It was hard work and dedication, but worth it. I'm proud of my Country that made it possible for a poor boy from a poor family to do this and I consider what I did as a medical doctor to be pay back. Now that I'm retired from active practice, I continue to be involved in the medical arena whenever I can be of value.

I sincerely believe that at least 95% of our society are good people who wish the best for our fellow humans. Unfortunately I'm convinced that greedy, self centered people own this Country. I'm now 85 years old. I won't be alive to see our people take our Country back, but I hope that it will happen soon.

Melvin H Kirschner, BA BS MPH MD
Author of: All Medicines Are Poison!

Over use of the Emergency rooms

2011-09-19T23:38:00.000-07:00

There’s a simple truth here. People who get sick and show up at emergency rooms will get care whether they have insurance or not — and they should. Under a law signed by President Ronald Reagan — the Emergency Medical Treatment and Active Labor Act of 1986 — nearly every hospital is required to offer treatment to those in urgent need of help. The law stops private hospitals from “dumping” (the term of art in the medical profession) patients onto public hospitals.
Excerpt from June 1 2011 Washington Post

Melvin H Kirschner BA BS MPH MD
Dr. Kirschner's book "All Medicines Are Poison!" discusses the health care inequities in the U. S. and offers some solutions.

The death of Dr. Kevorkian

2011-09-19T23:37:00.001-07:00

As a member of several end-of-life committees in California, I debated Dr. Kevorkian on national radio. My view is that a person has a right to die if they are suffering or are in an irreversible coma and being kept alive by artificial means. This decision and action must not be the doctor's choice. Several states now permit the doctor to provide the means but they must not perform the actual death.

Melvin H Kirschner BA BS MPH MD
Dr. Kirschner's book "All Medicines Are Poison!" discusses the health care inequities in the U. S. and offers some solutions.

To the L A Times Health Section:

2011-09-19T23:36:00.001-07:00

The May 9 Health Section article "Doctor takes risk with drug trial tampering" discusses the most vital aspect of medical science research. That aspect is absolute honesty. The most important element of medical research is the "double blind" study. Double blind requires that neither the doctors or the patients are aware of who is getting a placebo or who is getting the actual medicine. A breach of that procedure invalidates the study.
I'm certain that there are medicines on the market today where faulted or inaccurate studies have qualified them as a useful medicine, Indeed, many medicines, previously approved by the Food and Drug Administration, have been removed from the marketplace because they are less effective or more dangerous than the studies demonstrated.
Conclusion: the studies were inaccurate or inadequate. But I suspect that some of them have been tampered with.

Melvin H Kirschner BA BS MPH MD
Dr. Kirschner's book "All Medicines Are Poison!" discusses the health care inequities in the U. S. and offers some solutions

'Dr. Death' was just a sideshow.

2011-09-19T23:35:00.001-07:00

In this Times article, Bette Rollin, a board member of the Death With Dignity Nation Center, states that the recently deceased Dr. Kevorkian failed to understand what the death with dignity movement is all about.
I debated Dr. Kevorkian shortly before he was sent to prison because he killed a paralyzed patient by administering a legal dose of medicine. At that time Oregon and Washington had already passed laws permitting a doctor to prescribe a lethal medicine dose, but they were not permitted to administer it. California was passing laws that permitted physicians to withhold or withdraw life supporting measures for patients who were comatose because of irreversible brain damage.
California never past a law that permitted physician assisted suicide, but no matter how carefully the doctor prescribes, there is always a risk of overdose. All medicines are poison! If the patient takes too much medicine, there may be serious side effects and even death.
I recall two severely depressed patients who killed themselves by ingesting a huge over dose of reactively safe medicines that I had prescribed. Obviously these two patients had saved medicines for this purpose. The police found several, long expired, empty prescription bottles adjacent to the deceased patients. But it doesn't require pills to committee suicide. One of my patients jumped out of a third story window to his death, after a heated argument with his wife.
A doctor cannot always prevent a patient's death, but we are not Kevorkians.

Melvin H Kirschner BA BS MPH MD
Dr. Kirschner's book "All Medicines Are Poison!" discusses the health care inequities in the U. S. and offers some solutions.

N Y Times Business Section: Can Johnson & Johnson Get Its Act Together?

2011-09-19T19:43:00.002-07:00

As a young doctor 50 years ago, I was convinced that brand name medicines were significantly more reliable and safer than their generic equivalents. As the years went by, I realized that generic drugs provided the same medical benefits at a significantly lower price. However, I still believed that brand name drugs assured higher production standards and quality. The N Y Times article clearly indicated that is not always true. Prescribing "off brand" medicines certainly saves the patient money. But a better solution is suggesting no medicine when none are necessary. All medicines have side effects.

All medicines ARE poison!

2011-09-19T19:43:00.000-07:00

From the time we were small children, my sisters and I knew that medicines were poison. My mother would not let us open the medicine chest in the bathroom. If we scratched our skin she would immediately apply iodine or Mercurochrome to the wound to prevent us from getting "lock jaw", the layperson's name for tetanus. Iodine was so poisonous that it even had skull and crossbones embossed on the front of its square bottle. And it burned ferociously when applied to the wound. We preferred Mercurochrome. It didn't burn when applied and it had a pretty red color. We weren't aware that it was just as poisonous as Iodine. My mother put the Iodine bottle on top of the refrigerator to insure that we couldn't reach it.
Years later, when I became a medical doctor, I prescribed medicines even though I knew that all medicines are poison. But I only prescribed medicine when I believed that the risks of the illness were worse than the potential side-effects and risks of the medication.
I supported this principle during many of my lectures, letters to the editors, radio and TV appearances and articles. This eventually lead to the publication of my book "All Medicines Are Poison!" which actually is a discussion of the sorry state of the health care arena in the U. S.

Why prescription drugs should not be advertised to the public.

2011-09-19T19:41:00.000-07:00

Soon after I became a physician it became obvious that the pharmaceutical industry clearly reported the benefit of their medicines, but had a tendency to downplay or forget their risks and side effects. There was no advertising to the public permitted in those days. The drug representatives tended to minimize any known side effects or hazards. Adverse information regarding the product was buried in tiny print somewhere in the product brochure or not mentioned altogether. Advertising only appeared in the medical journals.
In recent years, advertisements in the public media became common. Patients who are completely uneducated regarding the risks and hazards of taking medicines often demand a medicine when none is needed and may be inappropriate.

Healthcare coverage in the U.S. Why do so many people in this Country have inadequate health coverage or none at all?

2011-09-19T19:34:00.001-07:00

As a health arena worker and a family physician for over 60 years, I was always concerned about the fact that so many people in this Country have inadequate health care coverage or none at all. It certainly influenced how I practiced medicine. I saw to it that everyone who enter my medical office door received the treatment that they needed or was sent to an appropriate facility where they could receive it. If necessary, I would take care of their immediate needs until they could get a to free clinic or a hospital. When they were unable to pay my fee, I reduced it or canceled it. Never-the-less, I always made a very comfortable living. I believe that many of my colleagues practiced the way I did.
As a doctor, I've always been treated with great respect. I realize that I was fortunate to receive an excellent education and degrees at the five highly regarded universities that I attended. It was hard work and dedication, but worth it. I'm proud of my Country that made it possible for a poor boy from a poor family to do this and I consider what I did as a medical doctor to be pay back. Now that I'm retired from active practice, I continue to be involved in the medical arena whenever I can be of value.
I sincerely believe that at least 95% of our society are good people who wish the best for our fellow humans. Unfortunately I'm also convinced that greedy, self centered people own this Country. I'm now 85 years old. I won't be alive to see our people take our Country back, but I hope that it will happen soon.

Opinion response in the New York Times

2011-04-17T09:58:00.000-07:00

Gail Collins has written several articles about women's health in the New York Times. I commented in response to her article "The Women’s Health Initiative and the Body Politic" explaining that as a practicing Physician, I saw many drugs, previously regarded as useful, removed from the marketplace. Read my response in full here: Women's Health, Who to Believe?

Does Darvon spell Death?

2010-11-28T15:45:00.000-08:00

I've used Darvon as a pain relief medication for my patients ever since it first came out. It has been reported in various news media Darvon and Darvocet have just been removed from the market in November 2010. Little did I expect that a product in use since 1957 would be pulled from the market at such a late date. It has come to light that it has serious side effects including: heart attack, irregular heart rate, & interruption of heart's electrical impulses. I wonder how many of my own patients have been negatively effected by this drug based on the limited information I have had about it until now. As it turns out, it is frighteningly easy to overdose yourself on this medicine

All medicines are Poison, including Darvon. I have always considered that the benefit of its use outweighed its risks and this was backed up by the FDA's own findings. Now we find that the reverse is true and the inherent dangers have caused it to be removed from the market at the FDA's own behest. I will now have to use other drugs that are not reported to have similar consequences, yet relive the discomfort my patients suffer from. Please consult your medical professional about the continued use of this or any medicine before changing dosage on your own.

Melvin H Kirschner, MPH, MD, Family Practice.
Dr. Kirschner recently published a book entitled “All Medicines Are Poison!” It discusses the sorry state of this Country’s health system and suggests how it could be repaired. Buy it here.

Promoting Single Payer health care in California

2010-11-05T16:15:00.000-07:00

In California, single payer health care to cover all Californians is being promoted.   The bill was known as SB 840 (Kuehl). It was passed twice by the legislature and vetoed both times by the Governor with the help of the for-profit health insurance industry.
     Ninety-five percent of California nurses want single payer to pass. As a 50 year member of the CMA and a member of Physicians for a National Health Program, I have promoted “single payer” since it was first discussed, as do most of my colleagues.
     When I was a young physician, most medical insurance was “not-for-profit” and the patient and I were rarely questioned about the necessity or value of my services. Now, I often have my fees reduced or totally denied. Each insurance company has a different set of rules and they keep changing. A single payer will have one set of rules and one payment schedule.
     More than half of my colleagues and I would prefer a single payer system. There will be one set of rules, one insurer to bill and every patient will be covered.

Melvin H Kirschner, MPH, MD, Family Practice.
Dr. Kirschner recently published a book entitled “All Medicines Are Poison!” It discusses the sorry state of this Country’s health system and suggests how it could be repaired. Buy it here.

Single Payer health care for all of WHO?

2010-11-03T10:17:00.000-07:00

The recent passage of the Federal health care bill is not the wonderful improvement of the country’s health care system that it’s portrayed to be. It’s a tiny concession by the healthcare insurance and pharmaceutical industries. The legislation that was just passed by a thin margin may yet be overturned. Many Senate and Congress members have received “reelection funds” from these industries. Even if recession fails, these small gains will take years to implement.
In contrast to the just passed federal health care bill, the California legislators have passed a single-payer bill three times in recent years. Governor Schwarzenegger vetoed the bill twice. Californians are waiting for the next governor, Mr. Brown, to finally be sign it. California has term limits. That is likely why the industries affected, were unable to prevent its passage. (Thank goodness for term limits.)
The reason California was able to pass the bill three times is the large, very vocal, population in favor of single payer health care. Every major population center in California is represented by chapters of “Health Care for All” (HCA). This organization is the voice of Californians, many of who have been in favor of single payer for years.
The California Physicians Alliance for single payer health care (CaPA) is the voice of more than half of the physicians practicing in California. It’s now a chapter of Physicians for a Nation Health Program (PNHP).
Ninety-five percent of California’s registered nurses are in favor of single-payer health care. Many other health care professionals have added their voices to the drum beat.
People without health care insurance are inundating California’s emergency rooms. Many of these people cannot afford to go to a doctor. Statistics have shown that emergency rooms are the most expensive way to obtain routine medical care. Early, routine medical care minimizes the possibility of an illness progressing to a more serious stage that may require complex treatment or hospitalization.
In our country, many thousands of deaths occur year because of lack of access to medical care. The best and least expensive solution to this dilemma is a single payer health care system.

Probems with medicines and other treatments

2010-05-08T14:15:00.000-07:00

May 8 2010

The number of articles in the news media that report problems and withdrawal of medicines has become so frequent that I can hardly keep up. When I wrote my book "All Medicines Are Poison!" there was only an occasional discussion of these issues by the news media. Much of the medical and health care problems were conclusions drawn from my own and my colleagues' experiences. The book was developed from my own experiences and observations. I not only care for my patients, I cared about them. It became obvious to me that some of the treatments and prescriptions I recommended, caused no benefit at all or created more harm than good. My letters to the editor, interviews and lectures pointed that out.
MHK

Last hours of 2009

2009-12-31T17:49:00.000-08:00

47 million still without health care coverage.
Still at war!
Country still torn by discontent.
Happy New Year for all.

AllMedicinesArePoison, the press is noticing.

2009-12-08T00:34:00.000-08:00

I've already given several lectures regarding the book.So far, I've been interviewed on 7 radio stations in the US and Canada.I may be on the Rachel Raye show early next year. Dr. Harriet Hill has published a detailed review and critic of the book.
I wrote this book because of the sad state of the health care industry in this Country. I believe that my 60 years serving our health care system has provided me with the knowledge of what's broken and how it can be fixed. The alternative medicine advocates are right when they state that all medicines are poison, but those poisons have life-saving usefulness when prescribed by doctors. Doctors are trained to weigh the risks versus the values.
But Medicines are only one part of the health care system. The book discusses many other elements of our health care system. These elements include hospitals, drug research, manufacturing and advertising, insurance coverage, government oversight, the under-insured or uninsured population and why medical care in the U. S. is twice as expensive here, than it is in the rest of the industrialized world.
You don't have to agree, but you should be aware of the issues.

MHK, MPH, MD

The Website for my new book is now available.

2009-12-08T00:20:00.000-08:00

My book "All Medicines Are Poison!" is now available on my website, www.allmedicinesarepoison.com.

Please visit and click on the "order" button to get it in your choice of paperback or hardbound.

2009-06-27T17:45:00.000-07:00

To N.Y. Times: The death of Michael Jackson.

I'm certain that everyone who reads my letter to the N. Y. Times already knows about Michael Jackson's death. I don't mention it in the letter to the Times, but I believe I know why he died. I've written a book, soon to be available, entitled "All Medicines Are Poison." Although the book discusses many aspects of the American health care system, the main theme is that doctors must proceed with every prescription they write after evaluating the risks. Benefits must outweigh risks.
I knew some members of the Jackson family and share their grief. A 50 year old man is a little more than middle aged. He should experience a full life. Michael had much to offer--it will never be seen.

The death of Michael Jackson had special meaning to me, not only because the world prematurely lost a great talent, but also because I knew members of his family. As a physician, I attended his grandmother until she expired. I also took care of several members of the family including his mother. She is a lovely woman and I sense her grief because of Michael’s death. I never attended Michael, but I met him once when I had hospitalized his grandmother. We had him wear a scrub suit, mask and surgical hat so that he could visit his grandmother without being recognized by his many admirers.
At this point the doctors at UCLA are unsure of what caused Michael’s death; apparently the autopsy was unrevealing. Perhaps the toxicology studies will give us an answer; he had been taking medicines and all medicines are poison. A doctor must weigh the benefits to be achieved, versus the potential risks before prescribing anything. I was fortunate to watch a TV interview of Dr. Deepak Chopra, who knew Michael well. He and I disagree on some aspects of practicing medicine, but I respect his viewpoints and I believe that he and I would agree on the cause of Michael’s death. I’m sure that he would also agree that a doctor should not only take care of patients, but also care about them.

Dr. Kirschner is a retired family physician. He continues to volunteer in community-based health related programs and is active on several biomedical ethics committees.

Melvin H Kirschner, MPH, MD

Private Health Plan vs. Public Option

2009-06-25T18:11:00.000-07:00

People who write OP-ED pieces and present opinions on radio and TV, are certainly entitled to their opinions, but too often what they say is not the whole truth. As a senior who has Medicare coverage and has needed to use it many times in the last few years, I could not afford those illnesses without it. As a family doctor for 47 years how much sicker and more expensive to care for, than any other group. The benefits of Medicare are that no 65 or older is rejected and everyone gets the same coverage. Our entire population needs than type of coverage.

The authors of the N.Y. Times 6/25 OP-ED “The Only Public Health We Need,” speak out of both sides of their mouths. On the one hand, they favor giving “private insurers the incentive to provide cheaper, better care.“ On the other hand they advocate “a public plan that will impose a stern and lasting discipline on our insurance market.“
The private health insurance companies know that they cannot compete with a public option and still be profitable. A pubic plan will put them out of business. How many seniors select a private primary health plan over the single payer Medicare?
The people who require the most health care, are already covered by Medicare. If every resident of this Country had Medicare coverage, they would be less of a financial burden than what our government spends on Medicare for our seniors only,

Melvin H Kirschner, MPH, MD

TIMES POLL

2009-06-21T19:55:00.000-07:00

I wrote this piece to illustrate what the majority of our citizens want, but will not get. Money talks, and politicians are willing to listen even when it's not in the best interest of their constituancy. Not what our founding fathers intended when they created this Country.

The N Y Times printed an article entitled, “Poll Finds Wide Support for Idea Of Government-Run Health Plan.” The poll was conducted with 895 randomly selected adults throughout the United States. The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance. A government-run insurance plan to compete with private insurers was favored. When asked which party was more likely to improve health care 57% of Democrats and one in four Republicans, said the Democrats would do better.
It’s obvious that the majority of the citizens of our Country want the single-payer or pubic option health coverage. This is a “Country of, by and for the people.” So why are we not getting our way? The answer is obvious. The health insurance and pharmaceutical industries give a lot of money to the legislators' re-election coffers. It’s time to start throwing those people out office or limiting them to two terms. We did that to the presidency, and it worked!

Melvin H Kirschner, MPH, MD

Hidden agendas regarding health care

2009-06-18T21:20:00.000-07:00

Health Care America, the hidden agenda. I Wrote this Op/Ed peice in order to call attention to the fact that most people who favor single payer without an unspoken agenda are those who have no hidden hidden agenda. For most others it's profits ahead of health care. This is not how it should be. Yes, there are those who will cheat and game the system, but they are doing that now and always will. I'm delighted with the fact that most patients now want single payer, but over 50% of doctors now favor it. Read my reaction to the AMA's stance in an earlier letter. Their members (including me) represent only 25% of practicing doctors and the numbers are dropping.
From:	mhkirschnermd@aol.com
To:	letters@nytimes/opedsubmit.com
Date:	Thu, Jun 18, 2009 9:19 pm

To N Y Times Op/Ed
Over 50% of the population and caregivers of the United States are in favor of single-payer health care. They have no hidden agendas. They are aware that Medicare, a single-payer system for the seniors age 65 and older, has been successful. The senior population is the sickest segment of our population and requires the most care. Since the creation of the Medicare program our seniors are in better health and living longer.
It’s clearly evident that all those who oppose the single payer system, or even a public health care option, have a hidden agenda. This may be reduced profit and executive salaries for the for-profit private health insurance companies who are well aware that they can’t compete with a public health care option. They keep inventing and loudly publicizing reasons why single-payer is a bad choice. They point out long delays for care in Counties that have health care for all. This is only true for elective procedures and things of the kind. Urgent or emergent illnesses are treated promptly and the patient isn’t facing bankruptcy because of what it cost.
The private, for-profit insurers frighten patients by claiming that a public plan would not cover many procedures and treatments. They are careful not to mention private plan practices such as rescission, retroactive denials, the multiple differences in rules and coverage from pla
n to plan, plus the limitation of hospitals, doctors and other providers who will accept the plan as the payer. Medicare has one set of rules, almost everyone is eligible for coverage, most providers accept Medicare fees and no one is permitted to charge more than Medicare allows.
Those who oppose single-payer complain that single payer will cost trillions of dollars, especially if everyone is covered. The seniors are the sickest and most expensive patients in our Country. If the entire under age 65 people in our Country were covered, the cost of their care would probably not equal what we are spending for the seniors alone.
Taking all of these so-called facts into account, it becomes obvious which group has a hidden agenda that causes them to say almost anything to prevent a single payer or public health care option. It’s Profits ahead of health.
Melvin H Kirschner, MPH, MD

Dr. Kirschner is a retired Family physician. He still volunteers for numerous health related community programs and several biomedical ethics committees.

Re: Conyers Bill

2009-06-17T12:20:00.000-07:00

I wrotes these letters to my local Congressmen because although Waxman is still indecisive, Sherman is a no. The incident at Sherman's Van Nuys office was the rude denial by the head of the staff to be interviewed regarding Mr. Sherman's position regarding health care for all. My letter to the Washington brought an apologetic phone call from the head of the Washington office telling me that is not their policy and it won't again. I haven't heard from Waxman and don't expect to.

June15, 2009

Dear Mr. Sherman:

I recently got a phone call from your Washington office, apologizing for the way my companions and I were treated at your Van Nuys office. I was assured that such behavior would not occur again. Now a major issue faces our Country.
I've been in practice as a family physician for 47 years. That's longer than Medicare has been around. As you know, Medicare is a single-payer system that has served patients and the health care system well. On the other hand, the private health insurance companies put their desire to earn maximum profits, ahead of patient care.
There are 46 million people in the U. S. without health insurance. Mr. Conyers health care bill is a logical solution to this problem and more than half of our people, including doctors, agree with this fact.
I realize that, at this time, you don't support single-payer, but I hope that you will support the pubic-option alternative. Senator Baucus said that it was “off the table.” Now he’s having second thoughts. Please don’t let vested interests buy Congress. Your loyalty must be in the best interest of patients as it always has been in the past.

June14, 2009

Dear Mr. Waxman:

Several years ago your office staff called me for advice on medical issues you were working on. I was delighted and flattered that your Washington office staff had decided that my opinion was valuable. Now a major issue faces our Country. I've been in practice as a family physician for 47 years. That's longer than Medicare has been around. As you know, Medicare is a single payer system that has served patients and the health care system well. On the other hand, the private health insurance companies put their desire to earn maximum profits, ahead of patient care.
There are 46 million people in the U. S. without health insurance. Mr. Conyers health care bill is a logical solution to this problem and more than half of our people, including doctors, agree with this fact. Don't let the vested interests buy Congress. Your loyalty must be in the best interest of patients as it always has been in the past.

2009-06-17T12:01:00.000-07:00

Re: New York Times article, “Doctor’s Group Opposes Public Health Insurance Plan.”
As a family physician and member of the American Medical Association for nearly fifty years I was angry and offended by this report that the AMA opposes a public health insurance plan. The association stated that health services “should be provided through private markets, as they are currently.”
The association also said it: “does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health coverage and lower costs.”
I couldn’t disagree more. I don’t believe that I’m the only member of the AMA who feels that way. Medicare has always been good for my senior patients. Many of them would have had no health insurance if there were no Medicare, so as a doctor, I’ve also benefited from this government program.
The president of the AMA opposed, “government control of health care decisions or mandatory physician participation in any insurance plan.” Does the AMA think that 47 million Americans without health insurance is a better plan? I remind her that the private health insurance industry controls decision now, by refusing to pay for many tests, procedures and prior existing conditions.
I guess it’s time for me to resign from the AMA.

2009-06-17T11:56:00.000-07:00

June14, 2009

Dear Mr. Waxman:

Several years ago your office staff called me for advice on medical issues you were working on. I was delighted and flattered that your Washington office staff had decided that my opinion was valuable. Now a major issue faces our Country. I've been in practice as a family physician for 47 years. That's longer than Medicare has been around. As you know, Medicare is a single payer system that has served patients and the health care system well. On the other hand, the private health insurance companies put their desire to earn maximum profits, ahead of patient care.
There are 46 million people in the U. S. without health insurance. Mr. Conyers health care bill is a logical solution to this problem and more than half of our people, including doctors, agree with this fact. Don't let the vested interests buy Congress. Your loyalty must be in the best interest of patients as it always has been in the past.

Melvin H Kirschner, MPH, MD

The Cost Of Health Care

2009-06-14T11:49:00.000-07:00

I responded to the Times editorial, not because it criticized doctors, but because I agree to some extent. Many of my colleagues do most tests and more referrals than are actually necessary. This practice started years ago, when the malpractice lawyers were doctors for the least of reasons. In those days the malpractice insurance carriers and doctors would rather settle out of court than go through the expensive, time consuming court case. This often happened even though many court cases would have found that the doctor did no harm. Malpractice suits have not "practically disappeared." I don't fault doctors who overutilize for fear of being sued. I do believe that doctors should not do procedures and tests just to enrich themselves.

The June 14 Times editorial “Doctors and the Cost of Care” cites “evidence that many doctors do a lot more than is medically useful,” but “no doubt a vast majority of doctors strive to do the best for their patients.”
As a family doctor who practiced for 47 years, I reluctantly agree with the Times’ analysis. However, the Times report that “malpractice suits have practically disappeared” is somewhat of an overstatement. For most doctors, the memory lingers on.
I prefer not to point a finger at my fellow physicians, but I do agree, “Medicare should be able to coax or push physicians to behave more prudently”

Melvin H Kirschner, MPH, MD

Response to AMA stand re public option

2009-06-14T07:00:00.000-07:00

Eight letters were published in the LA Times in response to the AMA president's statement about health care insurance. They were all in favor of single payer or public option. Senator Baucus is wavering, but still hasn't announced that public option is back "on the table." Meanwhile the private health insurance industry is using the power of money to prevent that from happening. They are also loading the news media, radio and television with mis-information.

To the Editor:
I was pleased to see the multiplicity of letters in response to the LA Times article regarding health insurance. Every letter was against the for-profit health insurance industry. As a family doctor I made a good living, but my patient’s health and welfare always came first. I was pleased that Medicare made it possible for the people over age 65 to receive good medical care without putting them in the poorhouse. This country really needs a single payer health plan, but for now I would settle for the public option. So why is that “off the table.” It’s off the table because the for-profit health insurers know it would mean the beginning of their end. The legislators, who all have good public health insurance, took the public option off the table because the insurance companies would stop contributing to their reelection funds.
Melvin H Kirschner MPH, MD

AMA letter to NY Times

2009-06-13T12:13:00.000-07:00

NY Times AMA article and letters.

The day before I wrote this letter to the Times Editor, there was an outburst of letters disagreeing with a NY Times article that quoted the AMA president. She implied that most doctors favored the private health insurers over a government program. That is not true; three quarters of medical doctors do not belong to the AMA and more than half favor prefer a Medicare style plan. Not one doctor's letter agreed with what the AMA president said.

As a family physician and member of the American Medical Association for nearly fifty years, I agree that every American deserves affordable, high-quality care. In a letter to the Times, Nancy Nielsen, the AMA president said, “a government-run health care plan is certainly not the only option on the table.” Seems she didn’t she know Senator Baucus declared that a public-option is “off the table.”
Medicare, a government funded health plan, has always been good for my senior patients. Many of them would have had no health insurance if there were no Medicare. Doctors also benefited from this government program.
The real objection is that private health insurers cannot compete with a public option and keep their patients.

Melvin H Kirschner, MPH, MD

American Medical Association

2009-06-11T21:13:00.000-07:00

I wrote this letter because the AMA did not represent my viewpoint nor that of many of my fellow physicians. The AMA represents only 1/4 of the doctors in the U.S. Now it will have one less member. I would think that the officers would take a poll of its' members before making statements such as quoted in the news article. There are other untruths in the Times article that I didn't memtion in the interest of brevity. If you read my blogs and letters to the editors, you will understand how angry I am!

www.nytimes.com/2009/06/11/us/politics/11health.html

Re: New York Times article, “Doctor’s Group Opposes Public Health Insurance Plan.”
As a family physician and member of the American Medical Association for nearly fifty years I was angry and offended by this report that the AMA opposes a public health insurance plan. The association stated that health services “should be provided through private markets, as they are currently.”
The association also said it: “does not believe that creating a public health insurance option for non-disabled individuals under age 65 is the best way to expand health coverage and lower costs.”
I couldn’t disagree more. I don’t believe that I’m the only member of the AMA who feels that way. Medicare has always been good for my senior patients. Many of them would have had no health insurance if there were no Medicare, so as a doctor, I’ve also benefited from this government program.
The president of the AMA opposed, “government control of health care decisions or mandatory physician participation in any insurance plan.” Does the AMA think that 47 million Americans without health insurance is a better plan? I remind her that the private health insurance industry controls decision now, by refusing to pay for many tests, procedures and prior existing conditions.
I guess it’s time for me to resign from the AMA.

Melvin H Kirschner, MPH, MD

Paying for Unibversal Health Coverage

2009-06-07T11:59:00.000-07:00

We are the only industralized nation in the world without universal health care.
If we beat the drums long enough and loud enough, maybe the legislators will vote for what we need.

Re “Paying for Universal Health Coverage” June 7 editorial:
It’s obvious that if everyone who now has private health care insurance were to switch to Medicare for all, the absence of private insurers profits, and Medicare’s single set of rules, would result in less cost to care for that group than is spent now. These savings may be enough to pay for coverage of the 47 million people who now have no health care coverage.
That scenario would result in a single payer system; one set of rules, one payment standard and one place to summit bills for service. Obviously the private, for-profit insurance companies don’t want that to happen, because it would leave them only with patients who want coverage beyond what Medicare for All would pay for.
For-profit health care insurers and their proponents will say anything to prevent adoption of single payer for all. They will give large sums of money to the reelection campaign of any legislator who is willing to vote in favor of the private insurance option.

Melvin H Kirschner, MPH, MD

Kennedy Health Care Bill

2009-06-06T11:37:00.000-07:00

The Kennedy Bil is not single payer; it's a public/private option bill. The for-profit private health insurance companies hate that almost as much as they hate single payer. The private insurance companies realize that their insured people will gradually move to single payer until the only thing they will be able to sell is insurance for those people who want coverage beyond what single payer covers. They'll fight tooth and nail, but honesty is not an option.

KENNEDY HEALTH CARE BILL

New York Times, June 6: “Sweeping Health Plan Is Drafted by Kennedy”

The Kennedy bill known as the American Health Choices Act, is to the left of the bill being considered by Senator Baucus’ committee. Baucus said that the two bills would be merged before going to the Senate floor.
The new government-sponsored plan would compete directly with private insurers. Mr. Obama says it is needed to “keep insurance companies honest.”
More than half of the American citizens and care providers such as doctors and nurses would prefer a single payer system, but Baucus has declared that single payer consideration is “off the table.”
Supporters of private health insurers claim that a single payer system, or even a public/private option would not work. Medicare is single payer and it works. So is their statement honest?

Melvin H Kirschner, MPH, MD

Keeping insurance companies honest

2009-06-05T18:46:00.000-07:00

Today was a busy day. I wrote three letters about health care, to the editors today. In the days before the health plan option debate, I probably wrote one letter to the editor a week. The issue is evident. If a government health care option passes, not only would all of the uninsured people (46 million of them) join it, a lot of the privately insured people would choose to switch to it. The private insurers would only attract people who want more extensive coverage than the public choice provides. The insurers would probably continue their "prior condition denial practices," so those patients would have no choice but to join the public health care option. It hasn't a retroactive denial rule.

New York Times June 5th OP-Ed “Keeping Them Honest” gives us two pieces of advice:
1) Don’t trust the insurance industry.
2) Don’t trust the insurance industry.
The issue is, will there be new regulation that allows any American to choose a public plan as an alternative to private insurance. President Obama believes that this would give Americans “a better range of choices, make the health care market more competitive, and keep the insurance companies honest.”
The health insurance companies are promising to deliver major cost savings so that patients will not choose the pubic option. Fifteen years ago they made the same promise, but it never happened. They will do everything in their power to prevent public choice health legislation.
They could bribe the legislators with “campaign money.” That usually works!

Melvin H Kirschner, MPH, MD

PHARMACY STORE CLINICS

2009-06-05T17:36:00.000-07:00

I wrote this letter to the editor not because I consider nurse practitioners in financial competition with me, but because I am concerned about patient safety. I have a high regard for nurse practitioners, but they have limits. Doctors have limits; that's why there are so many specialists. It's not about money, I refer patients to specialists frequently. I tell the patients that specialists know everything about nothing and generalists know nothing about everything. I'm concerned that nurses may know a little about something and maybe a little about many things; but does she know when to do nothing or what to refer to a doctor. And what backup does she have if the patient has a reaction? Maybe she sends them to the nearest emergency room. It rarely happens, and that's what I would do.

The June 5th L. A. Times Business Section story, “Walgreen, CVS add to clinic services,” worries me as a physician. There are some excellent, well-trained nurse practitioners, who are capable of diagnosing and treating specific problems, but are they capable of handling an unexpected side reaction? Are they equipped to do necessary diagnostic tests when the etiology of the illness is unclear. The article admits that there is usually not a doctor on the premises when the nurse holds clinic.
I agree with Dr. James Milam who the article quotes. He says, “When my nurse gives an injection, I am here.” The patient needs a regular doctor who has their history, family history and allergy history.
A Wal-Mart spokeswoman commented that the company is “always looking for ways to better serve our customers.” Does she mean better services, or more profits.

Melvin H Kirschner, MPH, MD

2009-06-05T16:27:00.000-07:00

REPUBLICANS COMPLAIN ABOUT PLAN FOR INSURANCE

I wrote this letter in response to the noise our legislators are making about the proposed universal health care plan. They have already announced that single-payer is "off the table." It's likely that eventually a public health insurance option operating along side of the private plans will be adopted. It's not what we really need, but it's a step forward. If such a plan is passed, I believe that private health insurance will gradually experience a loss of most of its' business to the governmental plan. This would eventually create the single payer system that we'd like to have now, but it will take time and work. Just keep the faith.

The New York Times 6/5 National section article “Republicans Complain About Plan For Insurance” described their disagreement with the size, shape and cost of the emerging health care proposal.
Creation of a new government health insurance plan remains the most contentious issue in the debate. Opponents of a public plan are concerned that it would be unfair competition with the private plans and would make health care insurance much more expensive.
The truth is that 46 million people have no insurance, many because they can’t afford it. A universal health care insurance plan would cover everyone. President Obama favors “a public health insurance option operating alongside private plans.” The nay-sayers realized that private insurance providers could not compete with a public plan and still be profitable. Soon we would have a single payer health care system with everyone covered by government insurance.
The most expensive patients to care for are age 65 and over, They are already covered by Medicare. The public option would cover everyone else for no more than private insurance covers only a part of that population now.
Over 50% off our population want universal, single payer health insurance. They probably will not get it. After all, they are not putting huge amounts of money in their legislator’s reelection coffers.

Melvin H Kirschner, MPH, MD

2009-06-04T13:58:00.000-07:00

LETTER TO THE EDITOR IN RESPONSE TO THE TIMES ARTICLE

This letter illustrates why private, for-profit health care insurance should not be part of a universal health care system. A universal Medicare system provides care for everyone equally, under one set of rules. If a patient wants more coverage than the Medicare system provides, they may choose to purchase a supplementary plan from a private insurer. The backers of a combined system realize that private insurers cannot compete with a "Medicare for all" system and still advertise and make profits. Even though more than 50% of Americans want universal single payer, the private insurers will make every effort to scuttle it. Their only option is to buy off the legislators, and so far they seem to be successful at doing just that.

MEDICAL BILLS

The L.A. Times May 4th Business Section Article “Medical bills tied to more bankruptcies,” cited a study showing that “healthcare costs play a role in 62% of bankruptcies.”
To solve this problem, Senators Kennedy (D. Mass) and Baucus (D. Montana) are leading efforts to develop universal heath care legislation. Mr. Kennedy advocates a single payer, government funded system. Baucus advocates a combined health care program where the private, for profit insurance companies also have a role.
The study cited, showed that “private insurers have failed to protect consumers from financial ruin in the event of a medical crisis.”
There is no doubt that we need universal health care coverage; but the private insurers have already demonstrated that they don’t protect people from financial ruin due to medically related expenses.
We need universal, single-payer health care, such as Medicare. Everyone will have coverage and nobody will suffer bankruptcy due to medical bills. It will not cost more than is spent per patient now, because the most expensive group of patients are seniors over age 65, and they’re already covered by Medicare.

Melvin H Kirschner, MPH, MD

Gaps in Health Insurance

2009-06-03T20:29:00.000-07:00

The excellent June 3th editorial in the Daily News had a couple of "gaps in details." I detailed the points they made and added a couple of of my own. We all have a tendency to call the health care we need "universal care." That's true but misleading. The for-profit insurance/Medicare plan is universal; but it's not single-payer, which is actually what we need. The patients over age 65 now covered by Medicare are our sickest population and the most likely to use health care services. The rest of our population as a whole require much less care. Medicare-for-all will do two things that will reduce costs; yet cover everyone. An illness prevention program will be available to all; the under age 65 people will cost less than the sicker seniors. Seniors are at much greater risk of hospitalization, end-stage illness and death. Do the math!
Next time you mention universal health care for all, be sure that you use the expression "single payer."

Americans pay for gaps in insurance

The excellent June 3rd Daily News editorial, “Americans pay for gaps in insurance,” almost says it all. However, as a family physician I’m compelled to submit a short resume with a couple of personal observations.
I agree that insured Americans subsidize care for the uninsured. I’m well aware that “emergency room care remains one of the most expensive and least efficient ways to treat routine illness.” Everyone who walks into an emergency room must be evaluated and receive care, unless they can be safely sent home or transferred to a public facility.
A report by Families USA advocates universal health care. Congress has been considering “making sure Americans have a choice of doctors and health plans through a mix of affordable private and public offerings.”
That process will result in universal health care, but not what we really need. Medicare is a single-payer plan. Every Medicare senior is covered for life. There is one set of rules. No “pre-existing” condition can disqualify them for coverage. The for-profit health insurance companies each have different rules about what they will or will not cover, or which doctor or hospital the patient may go to. This nightmare increases confusion and expenses for doctors and the cost of taking care of patients.
We need a “universal, single-payer” system—Medicare for everyone. Everyone will have coverage at a cost less than the “For-profit/Medicare choice plan. And without the 46 million people now not covered at all, we will be a healthier country.

Melvin H Kirschner, MPH, MD

Tobacco

2009-06-03T11:16:00.000-07:00

TOBACCO LEGISLATION

I've seen many of my patients suffer and die because they couldn't stop using tobacco. In my soon to be published book, "All Medicines Are Poison," I tell some of these stories. I was glad to hear the tobacco regulation was going to be under FDA control. But when I read that the tobacco industry had a hand in crafting this law, I realized that the FDA would be unable to do much of value to control the use of tobacco and its dangers. Americans will continue to suffer and die until effective legislation is passed, free of the tobacco industry's influence.

LA Times June 3th article “Blowing smoke with legislation” sure corrected my opinion that putting tobacco under FDA supervision is a good thing.
The article indicates that the Philip Morris Company helped in the crafting of the legislation. The author is a Boston University professor who specializes in tobacco policy analysis. If what he reports is true, and I believe it is, this legislation has actually given no genuine ways to make tobacco smoking safer.
I practiced as a family doctor for 47 years and can validate the many deaths and much illness that can be attributed to tobacco. It’s very addictive and most of my patients could not stop using it even though they were well aware of the damage it was causing to their lungs and other organs.
We need legislation that does not include the tobacco industry’s input. There are plenty of doctors and other experts who can attest to the extreme danger of using this substance.

Melvin H Kirschner, MPH, MD

2009-06-03T09:42:00.000-07:00

“Obama Urges Quick Action By Senators On Insurance.”

I wrote this response to the NY Times report because there are many ways that the for-profit insurers to try to scuttle a public plan for all. Their biggest argument is cost. Medicare already covers the sickest, most frequent users of the medical care system, the seniors. Not only will the people under 65 cost less to cover, they will all have coverage and preventive medical care. One set of rules will reduce the time and effort doctors' offices spend for billing, They will be well aware of what the single payer will or will not cover. The private insurance coverage is a hodgepodge of different rules and coverages. We are the only industrialized country in the world that doesn't have single payer health care and we are listed 37th in the health outcomes of our population.

N Y Times June 3 reports that “Obama Urges Quick Action By Senators On Insurance.”
In recent weeks I’ve been discouraged by the trend that universal health care proposals have taken. My sense was that the for-profit health care insurance companies were going to succeed with their plan to scuttle any government healthcare plan similar to Medicare that would cover patients under 65.
The private health insurance companies realize that not only the 46 million uninsured would be covered, but many people now covered by private health insurance would also switch to the public plan.
They paint a Medicare plan for under 65 year olds as a slow and inadequate provider that will be shunned by most doctors and make it easy for unscrupulous people to over utilize the system. As a physician who has been in practice since Medicare started, I realize that the scammers, with and without insurance, have always been there and will continue to be there whatever plan we finally adopt. Sadly, there are also a few doctors who scam the system, but most doctors try to provide services that are best for their patients.
The for-profit health insurance companies promise to change their ways, such as retroactive denials, rejection for a history of prior illnesses, etc. Those patients will be dumped into the public system.
What we need is a single payer, with one set of rules and coverage for all of us. Anyone who wants more coverage can buy it from the private providers.

Melvin H Kirschner, MPH, MD

2009-05-31T11:48:00.000-07:00

DEMOCRATS SPEARHEADING HEALTH BILL ARE SPLIT

I wrote this letter to the editor because I'm frustrated by how our legislators favor those who fill their financial coffers. It's clearly evident to me that this Country needs a single-payer health care system. There are 45 to 47 million people in the U.S. who have no health insurance. If everyone was covered we would have a healthier nation. Even though we may have the most advanced medical system in the world, we are ranked 37th in the world for health outcomes. Nay-sayers complain that a single-payer system would "break the bank." It would not! What would break the bank is providing for-profit healthcare insurance for everybody in the Country. The tax credits and funds to provide this service would be overwhelming. The nay-sayers call single-payer socialized medicine. It is not! The same private health care system that we have now would continue to provide the care. In a socialized system, all of the hospitals and all of the caregivers would be on a fixed salary paid by the government. The Veterans Administration's medical care system is socialized medicine, yet it serves our veterans well.

LETTER TO THE EDITOR
N. Y. Times May 30 article: “2 Democrats Spearheading Health Bill Are Split,” compares Senator Kennedy’s preference for a national health plan that looks like Medicare to Senator Baucus’ choice of a bipartisan bill that would include the private, for-profit, health insurance companies.
Senior Republican, Charles Grassley of Iowa, opposes a new government program and declares “we cannot afford the public health plan we have already.” (Medicare)
As a senior, and a physician with 47 years of family practice experience, I’m well aware of why Medicare spends so much. The seniors are the sickest and require the most medical care as a group. Patients too young to qualify for Medicare coverage, use doctors, hospitals and other medical services in far less volume and frequency than the seniors do.
It doesn’t take a mathematician to figure out that a single-payer health care system would cost less or, at worst, no more than a system that included the private, for-profit insurance companies.
Over half of our people and healthcare providers are in favor of single–payer, but the pharmaceutical industry and the for-profit insurance companies have bought our legislators with campaign money and other financial benefits.
No wonder the single-payer plan is “off the table.”

Melvin H Kirschner MPH MD

2009-05-29T14:41:00.000-07:00

WHAT IS THE FUTURE OF MEDICAL INSURANCE IN THE U.S.?

Dr. Gawande is a surgeon with an impressive educational background. He also is a prolific author. His long article in the New Yorker goes into great detail, but is well worth reading. I may have misinterpreted his conclusions, but the article is worth reading.

MEDICINE'S COST CONUNDRUM

Dr, Gawande’s June 1 article in the New Yorker, “The Cost Conundrum” views the reasons the cost of medical care in the U. S. varies so much even though the outcomes are relatively similar. As a family physician I agree with most of what he says. I sense that a system based on the socialized medicine model is what he prefers.
Socialized medicine would be administered and paid for by the government. There would be a fixed set of rules and standards for providers. The doctors would be on fixed salaries and essentially working for the government. The government would pay for other services as Medicare does now.
Many countries already have such a system, but I don’t believe that the people of the U. S. are ready for socialized medicine. All for-profit health care insurance companies are opposed to it, as are many providers. However, I believe that our people are ready to accept single-payer. A government funded single-payer system would have one set of rules to follow and one schedule of payments, but providers would not be government employees and not be on a fixed salary.
A single-payer system would be a health insurance program that would cover health care for every resident of our country. The for-profit insurance companies now leave 45 to 47 million people without health care coverage. In order to survive, the private for-profit insurance industry would have to provide coverage that the national single-payer did not include. There is no question that their covered population and income would drop precipitously

Many who do not want a single-payer, label it “socialized medicine.” As I described it above, socialized medicine is more than single-payer, it’s single provider.
I don’t believe that our country is ready for that.

Melvin H Kirschner, MPH, MD

2009-05-29T09:05:00.000-07:00

I COULDN'T RESIST WRITING THIS LETTER
It's seldom that I see two stories about health insurance rescisions in the same paper, let alone the same section. I was at a meeting about single payer last night. Everyone in the room indicated that they favored a single payer health care system--not only in California, but in the entire nation. Our people are tired of the games that the private, for-profit health care insurance companies play. The fire department, the police department, the Veterans Administration are all single-payer agencies. Would you have them all privatized, for profit and available only to people who can afford to buy their services? I doubt it. Unlike these agencies, the single payer health care system would continue to pay for the doctor, dentist, hospital or other private, for profit services that the patient uses now. The government would be the funding agency as health insurance is now. The difference is that there would be one set of rules and one payer instead of the hundreds of plans we have now. If anybody wants coverage that the single payer doesn't offer, thay could purchase additional coverage from one of the private insuranse companies.

TWO STORIES ABOUT HEALTH CARE RECISSIONS

The May 29 Business Section of the L. A. Times printed two stories regarding rescissions of payments by health care insurers.

One article reported that Blue Shield successfully rescinded coverage and payments for services billed, because the patient “failed to disclose preexisting conditions, including hypertension.”
The other article, in the same Times Business Section, reported that Health Net “agreed to pay California hospitals at least $1.95 million for care delivered to patients whom the insurer later dropped.”
These two stories are good examples of why we should have single payer medical care coverage in California. A single payer insurance program would insure every California resident regardless of prior existing medical history. S, B. 840 was such a bill, but was vetoed by Governor Schwarzenegger twice. It had one set of rules. All California residents would be covered. All doctors, dentists, hospitals, laboratories and other medical care providers would be paid for their services as long as they followed those rules.
That bill is back as S.B. 810 (Leno), with the prospects that the next governor will pass it. The insurance companies are fighting it vigorously. They realize that single payer will be less expensive than their insurance and hugely cut their patient base and their outrageous profits.
If it passes, California will be the first in the nation. It could lead to passage of a national single payer health care program such as S, B, 676 (Conyers).
Melvin H Kirschner, MPH, MD

DYSFUNTIONAL HEATHCARE SYSTEM

2009-05-27T11:37:00.000-07:00

Candian vs. U.S. Health Care

The L. A. Times May 27 Business section: “Canada’s healthcare saved her. Ours won’t touch her.” relates a poignant example of how dysfunctional the U. S. healthcare system is.
The article discusses the plight of a Canadian woman who was in a car accident in Nova Scotia. She suffered a brain injury and thirteen broken bones. She spent three months in a Halifax hospital. The Canadian government paid the entire bill.
She recovered from that accident, married an American and now lives in San Diego County. She applied for healthcare insurance, but was rejected by two major health insurance companies. The decision was based on her 2007 hospitalization, even though she has recovered.
The lesson to be learned is that our healthcare insurers put profit ahead of patient needs. This country needs a single-payer health care system, similar to the Canadian system, but the private insurers are lobbying aggressively to prevent that from happening.
Most Americans, including nurses and doctors, want a single-payer healthcare system, but our legislators declare that the issue is “off the table.” They are supposed to be legislating in the best interests of the public, but the for-profit health insurance industry puts lots of money in their coffers, and money talks.

Melvin H Kirschner, MPH, MD

2009-05-27T10:40:00.000-07:00

As a family physician in the San Fernando Valley for 47 years I've watched the health care system mutate from a mostly not-for-profit patient service, to a monster that maximizes profits and minimizes patient care. The L.A. Times article validates that statement.
Our people, including a majority of doctors and a large majority of nurses have concluded that we must have a single payer health-care system, with a single set of rules for everyone. This will not be socialized medicine and it will not cost more than the private, for-profit insurance system that we now have. What we have now leaves 47 million people without health insurance coverage and millions more with inadequate coverage.
The government funded system would be a form of Medicare. It would be not-for-profit, paid for by taxes, have one set of rules and use the health providers that we now use. If anyone wants coverage beyond what the Medicare-for-All provides, they would be free to buy additional insurance elsewhere. But the Medicare system would cover all essential needs as it does now for seniors.
I'm convinced that the Medicare-for-All would cost no more than the patchwork of private for-profit insurance companies spend now for only a portion of our population. Medicare-for-All would probably cost less.
Melvin H Kirschner, MPH, MD

DYSFUNCTIONAL U. S. HEALTH INSURANCE SYSTEM

2009-05-27T10:38:00.000-07:00

The L. A. Times May 27 Business section: “Canada’s healthcare saved her. Ours won’t touch her.” relates a poignant example of how dysfunctional the U. S. healthcare system is.
The article discusses the plight of a Canadian woman who was in a car accident in Nova Scotia. She suffered a brain injury and thirteen broken bones. She spent three months in a Halifax hospital. The Canadian government paid the entire bill.
She recovered from that accident, married an American and now lives in San Diego County. She applied for healthcare insurance, but was rejected by two major health insurance companies. The decision was based on her 2007 hospitalization, even though she has recovered.
The lesson to be learned is that our healthcare insurers put profit ahead of patient needs. This country needs a single-payer health care system, similar to the Canadian system, but the private insurers are lobbying aggressively to prevent that from happening.
Most Americans, including nurses and doctors, want a single-payer healthcare system, but our legislators declare that the issue is “off the table.” They are supposed to be legislating in the best interests of the public, but the for-profit health insurance industry puts lots of money in their coffers, and money talks.

Melvin H Kirschner, MPH, MD

2009-05-27T10:27:00.000-07:00

Dysfunctional U. S. healthcare syste

2009-05-27T10:23:00.000-07:00

The L. A. Times May 27 Business section: “Canada’s healthcare saved her. Ours won’t touch her.” relates a poignant example of how dysfunctional the U. S. healthcare insurance system is.
The article discusses the plight of a Canadian woman who was in a car accident in Nova Scotia. She suffered a brain injury and thirteen broken bones. She spent three months in a Halifax hospital. The Canadian government paid the entire bill.
She recovered from that accident, married an American and now lives in San Diego County. She applied for healthcare insurance, but was rejected by two major health insurance companies. The decision was based on her 2007 hospitalization, even though she has recovered.
The lesson to be learned is that our healthcare insurers put profit ahead of patient needs. This country needs a single-payer health care system, similar to the Canadian system, but the private insurers are lobbying aggressively to prevent that from happening.
Most Americans, including nurses and doctors, want a single-payer healthcare system, but our legislators declare that the issue is “off the table.” They are supposed to be legislating in the best interests of the public, but the for-profit health insurance industry puts lots of money in their coffers, and money talks.

Melvin H Kirschner, MPH, MD

Blue Double Cross

2009-05-22T11:20:00.000-07:00

I read Paul Krugman's May 22 column in the N. Y. Times and entirely agree with his view of the for-profit health care insurance companies. In the 47 years that I've been a family physician, I've seen these insurance companies evolve from not-for-profit patient orientated providers to the rapacious gang they are today. As a young doctor, I could rely on the insurance providers to see to it that my insured patient's medical necessities were promptly covered within the clearly descibed limits of their policy.
There were many people who had no health care insurance. The government partially reduced the size of the uninsured population by legislating single-payer plans for the indigent and those people age 65 and over, (Medicaid and Medicare.) Those programs exist today and cover almost one third of our population. They limit the amount they pay for services, but the guidelines clearly state what is covered and the remuneration for each service.
The Medicaid and Medicare programs are not "socialized medicine," as the opponants to single-payer lead the public to believe. They do not directly employ care-givers and other providers, or own the hospitals or laboratories. The Veteran's Administration program is an example of a government owned single-payer system. Everyone working for them is on a fixed salary and the hospitals and clinics belong to the government. Yet it's considered one of the best health-care providers in the Country.
The private for-profit health insurance companies are actually more expensive than the government plans, because of their need to make profits. Insurance company profits do not pay for patient care. The patch work nature of the industry also costs the patient-care providers more time and money.
My letter to the Times is a brief response to Krugman' excellent column.
Melvin H Kirschner, MPH, MD, Family physician

To the N. Y. Times:

As a family physician for 47 years, I totally agree with Paul Krugman’s May 22 column “Blue Double Cross. Healthcare insurers are “more bureaucratic than any government agency. They deny choice of doctor, and sometimes refuse to pay for care.”
My experience with the government programs, Medicare and Medicaid, is that the reimbursement for services are low, but there is one uniform set of rules to follow.
Each healthcare insurer has a different set of rules. The reimbursement for services varies widely and the doctor sometimes doesn’t know where to send the patient for laboratory or other tests. Furthermore, the physician often doesn’t know whether the prescriptions they write will be covered.
As Mr. Krugman reports, “Insurance companies are still bad for your health.”

Melvin H Kirschner, MPH, MD

2009-05-16T16:56:00.000-07:00

I wrote this letter because I was incensed by Senator Max Baucus' total disregard of the people's role, their testimony and their best interests. We need term limits, publically funded election campaigns and no lobbying money permitted. That is the only way that the true voice of the public can be heard.

2009-05-16T16:53:00.000-07:00

I read the NY Times 5/16 article “HEALTH PLANS WOULD ADD TO CONTROLS ON INSURES” with some disbelief and much disgust.

The reason politicians have not resolved the “explosive question of whether to create a public insurance program, to compete with private insurers,” is because that would cut off a substantial portion of their re-election money.
A public health insurance plan would surely scuttle the private for profit health care insurance industry. Except for supplementary policies, what percent of Medicare eligible seniors buy private insurance as their primary policy?
It’s interesting that no advocates of a single payer system were allowed on the committee. In fact those who tried were arrested, including three physicians.
Ours is not a country “of the people, by the people and for the people.” Our legislators sell themselves to the highest bidder. Until we get legislative term limits and restriction against accepting lobbying money, the pubic will never have true representation.

Melvin H Kirschner, MPH, MD

Letter to NY Times re health care for all.

2009-05-14T09:08:00.000-07:00

I was reading an article in the NY Times this morning, and became offended by the lack of truth in what the Republicans said about the health care for all proposal. According to the paper, Mr. Frank I. Luntz. an expert on the language of politics and an adviser to the Republican party had criticized the Democrat's health care for all plan. Here is the letter I wrote to the Times:

The N.Y. Times 5/14 article “Democrats To Develop Plan to Sell Health Care” should have been titled “Republicans Develop Plan to Scuttle Health Care for All.” The Republican message is that “the Democrats want to put Washington politicians in charge of your health care” and that their plan would “deny people treatments they need and make them wait to get the treatments they are allowed to receive.”
The first statement is simply untrue and the second describes what happens now in our current for profit health care insurance system. The proposed Democratic health care system would cover everyone—health care for all. A patient would be able to choose any plan they want. The big “for profit” health care insurance companies realize that they would lose patients and profits in such a system. They have bought our legislators so that they will oppose the Democrat plan.

I wrote this letter to make the point that under the current for profit health care system, all of the issues around not getting proper and timely care already exist. Mr. Luntz and advised the Republicans to make statements that would imply that these issues don't occur under the current system, and would only happen once the Democrat's plan was enacted. As a biomedical ethicist and a physician, I feel it continues to be my duty to clear the rhetoric from the situation rather than add more to it. To that end, I'm going to an ethics meeting tonight! More as this continues to develop...

Welcome to my Healthcare Blog

2009-05-11T21:08:00.000-07:00

Hello. I am Dr. Melvin H. Kirschner, MPH, MD. Welcome to my new web log.

I have been a family physician for 47 years, and prior to that worked in the public health arena as a Public Health Inspector for several California State health departments. This blog will discuss issues related to the health care system in the US. It is my hope that you will come to value my comments and opinions, and share your views and experiences with me.

It is also with great pride that I announce the launch of my new book, which this blog takes it's title from. "All Medicines are Poison!", due to be published during the Summer of 2009. I will be posting more information about when and where it will be available as it nears distribution.