Monday, May 22, 2006

Plans to Put OB/GYN’s in Those 1,500 Counties?

Dear President Bush,

Did I fall through the rabbit hole to some bizarre world where up is down and down is up? I hear you say you will handle and fix problems yet they remain. Two examples include the Border Patrol’s other than Mexican “catch and release” program and the “kind of the dual eligible problem” with the new Medicare prescription drug program. Despite promises to fix them, both issues remain virtually untouched.

Then I hear you share another statistic, one that likely isn’t even a major problem. To push your liability reform proposals you repeatedly slap people with the red herring of “1,500 counties have no OB/GYN doctor!” Why would I suggest it to be fictional problem? Because I live smack in the middle of 20 of such counties and know every county in America does not need their own OB/GYN. Some smaller hospitals are well served by family practitioners trained to deliver most babies. High risk mothers and infants are identified early and referred to the nearest OB/GYN for their prenatal care and delivery.

Despite having nearly 30% of the people in our area without health insurance, the system ensures access to care for pregnant women and their children. Area OB/GYN doctors rarely see any true drop ins, women with no prenatal care, prior to delivery. How might that change with the spate of legislation ensuring only true blooded American citizens get health care benefits?

Your crackerjack health economic team likely has a handle on that, so write me back and let me know their analysis. On second thought don’t. As I am already disoriented, it would not be helpful to have another “up is down, down is up” assessment of reality. I currently disagree with them on the impact of health savings accounts.

Rather than making the doctor patient relationship stronger for many patients, HSA’s will blow the relationship out of the water. My guess is many more than 1,500 doctors will retire to avoid the hassles of Bush medicine. Growing self pay accounts will put tremendous pressure on both individual physicians and safety net hospitals such than some will voluntarily quit, while others have to close their doors.

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