The President’s Doctor of 22 Years Disses Obamacare

Dr. David Scheiner, President Obama’s internist of 22 years, has a mixed practice of adults from local housing projects on up to some very famous patients. He issued the 276-word statement last year vouching for Obama’s “excellent health.” While he still supports the President, David Whelan’s Forbes article Obama’s Doctor Knocks ObamaCare allows that:

[Scheiner] worries about whether the health care legislation currently making its way through Congress will actually do any good, particularly for doctors like himself who practice general medicine. “I’m not sure [Obama] really understands what we face in primary care.”

…Looking at Obama’s team of health advisors, Scheiner doesn’t see anyone who’s actually in the trenches. “I have a suspicion they pick people from the top echelon of medicine, people who write about it but haven’t been struggling in it,” he says.

Scheiner is critical of Obama’s pick for Health and Human Services secretary–Kansas Gov. Kathleen Sebelius, who used to work as the chief lobbyist for her state’s trial lawyers association.

Odd that President Obama would choose to throw Howard Dean under the bus and not give him the HHS appointment. It also seems SoS Clinton is not being consulted here. With her earlier efforts and deep dedication to this issue and her latest proposals, I’m sure she has much insight to offer.

“He doesn’t see all the pain, it’s so tragic out here,” [Scheiner] says. “Obama’s wonderful, but on this one I’m not sure if he’s getting the right input.”

But this is typically the issue. “Experts” are assigned to fix the problem without a clear understanding of what it is. Scheiner recommends

…”Medicare for all,” a single-payer system where the government would cover everyone and pay for it by cutting out waste in the system. “A neurosurgeon gets paid $20,000 for cutting into the neck of my patient. Have him get paid $1 million a year instead of $2 million or $3 million. He won’t starve.”

Scheiner thinks that Obama’s “public plan” reform doesn’t go far enough. He supports the idea of that option for people who don’t like or can’t afford their HMO. But he worries that it will be watered down or not happen at all. “It’s nonsense that the private insurance companies need to be protected,” he says. “Why? Because they’ve done such a good job?”

He thinks that Americans have been scared into believing that they will lose the coverage they already have if a public plan is created. And he worries that nobody cares about the 50 million uninsured. “I have people who have lost their jobs and come to me and I give them drug samples,” he says.

Scheiner says he thinks that Obama probably sees the virtues of a single-payer system but has decided it would be politically impossible to create one.

Well, that’s where the dig your heels in and fight part comes in. As much as I want health care reform, once again I get the sense that we are rushing into something without having thought through the options properly. The President as already worried about re-election and wants to get his “agenda” passed as quickly as possible, but during this frightening economic time, it would seem that building a better floor under us would build confidence not only in our economy but in the President’s leadership abilities and might make his “impossible fight” a little more possible down the road.

Reid Cherlin, an assistant White House press secretary who covers health issues, wrote in an e-mailed statement, “The President has been clear that while a single-payer system may work in some countries, it makes the most sense for us to build on what works in the system we have and to fix what’s broken.

“He would certainly agree that there’s too much waste in the system–where families, businesses and governments pay too much for too little,” he added, “and that’s why he’s committed not just to expanding coverage but to reforming the health system to provide high-quality care at a lower cost to more Americans.”

“I once briefly talked to him about malpractice, and he took the lawyers’ position,” [Scheiner] says.

Obama reiterated his opposition to caps on medical malpractice before the AMA this week.

Scheiner, like most others in his profession, thinks that it should be harder to sue doctors and that awards should be capped. He says that he and other doctors must order too many tests and imaging studies just to avoid being sued.

The article further states that Scheiner, a graduate of Princeton who got his start at Columbia University’s College of Physicians and Surgeons, had “watched his income decline over the years to what he calculated to be $22 an hour ($2,100 every two weeks after withholding for taxes, health insurance and malpractice insurance.)”

Scheiner thinks that any health reform should involve paying primary-care doctors better so they don’t have to rush through appointments to make ends meet. He says that the medical students he encounters are no longer even taught how to do a patient history and physical exam. Patients get imaging studies and lab work instead of actual work-ups. “It’s like in Star Trek where Bones had the thing he would wave up and down. They don’t even talk to patients,” he says.

In an interview with Reuters today, Senator John McCain commented:

Efforts to overhaul America’s costly healthcare system need to begin anew after the non-partisan Congressional Budget Office said a draft bill would cost $1 trillion and insure only 16 million of the 46 million uninsured people, McCain said.

“They just took a body blow,” he said of Obama’s Democrats. “Whether they recover from it or not, we will probably know in the next few days.”

McCain had some stark advice to Democrats writing the legislation: “I think that they should start over.”

Further a PEW research study published on June 18th had this to say:

As health care reform legislation moves forward in Washington, the political environment is somewhat different than the last time a major overhaul of the health care system was attempted sixteen years ago. In early 1993 the sense of a health care crisis was far more widespread than it is today – a 55% majority in 1993 said they felt the health care system needed to be “completely rebuilt” compared with 41% today. Health care costs were also a broader problem in 1993 – 63% of Americans said paying for the cost of a major illness was a “major problem” for them, compared with 48% currently.

The issue of limiting overall health care spending is also more prominent in 2009 than it was in 1993. Somewhat fewer today say the country spends “too little” on health care, and a larger share believe that limiting the overall growth in health care costs is a higher priority than expanding coverage. But overall, public support for guaranteed access to medical care for all Americans remains widespread.

I find this rather odd, with health care costs spiraling out of control and so many Americans without coverage. Here is an overview of the study’s findings: I encourage you to read the entire article here.

On health care spending:
Relatively few Americans believe the country as a whole is spending the right amount on health care at this point, but there is no consensus on what the problem is. Just as many Americans say we are spending too much on health care (38%) as too little (40%).

Most Back Overhaul; Fewer Than in 1993 See Crisis
Most Americans believe that the nation’s health care system is in need of substantial changes. Four-in-ten (41%) say the health care system needs to be completely rebuilt, while 30% think it needs fundamental changes. About one-in-four (24%) believe that the health care system works pretty well and needs only minor changes.

Health Reform Priorities
Most Americans favor ensuring health coverage to all Americans, and most also say it is very important to limit the overall annual increase in health care costs. Neither of these objectives, however, receives as overwhelming support as they did in early 1993. When Americans are asked to prioritize between these two goals, most continue to say that expanding health insurance to all is the more important goal. But the share who rate costs as the more important concern is nearly double what it was in 1993.

The public’s overall support for expanding health insurance to cover all Americans remains widespread, though more sharply partisan than in 1993.

And Fewer See Cost of Care as Major Problem than was thecase in 1993.

Any health care reform is going to be a huge fight. Both sides are already digging in their heels and I sincerely hope anyone with a reasonable proposal to bring to the table will be heard. It would be disastrous for this administration to push through health care reform in much the same way they did the Stimulus package earlier this year.

I appreciate Dr Scheiner’s comments as I understand how painful it is when those who are actually going to be on the receiving end of the government’s overhaul are not getting enough consultation on the matter. He’s offering a physician’s point of view. I’d certainly like to hear from others “on the ground.”

Where do you fall in the debate on this one? Your insights would be greatly appreciated.