Health care reform threatens anesthesiology, patients


While doctors aren’t the only source of information we should use when considering health care reform, they are on the front lines of providing care, and so their insights are valuable.

Recently, Ronald Dworkin contributed An Anesthesiologist’s Take on Health-Care Reform to the Wall Street Journal. He makes some good observations on doctors in general, and on the special nature of anesthesiology.

Dr. Dworkin warns of a mistake liberals always make: that they can raise tax rates, and people will still earn as much as they did. With the higher tax rates, it’s hoped that revenue to the government soars.

Dworkin explains that “today’s upper-middle class professionals are very sensitive to marginal tax rates. To preserve ‘lifestyle’ and ‘quality time,’ they will work less.” So the higher tax revenues may not materialize. They’ll be working less, it should be noted, at the same time that demand for medical care may soar.

A problem with Medicare is its low reimbursement rate to doctors, often less than the cost of providing services. Dworkin also explains, referring to anesthesiology: “In no medical specialty is the spread between the Medicare rates and private insurance rates greater. … According to one of the health-care bills in Congress, H.R. 3200, the public option would reduce reimbursement for anesthesia by over 50%.”

Dworkin warns that these low reimbursement rates will cause anesthesiologists to leave the field, leading to reduced care and more deaths. Obstetrics, he says, will be impacted first: “At the very least, pregnant women will be waiting a lot longer for epidurals. But more pain on the labor floor is only the beginning. If hospitals delay the administration of anesthesia because Congress skimped, needless deaths will certainly result.”

Some of the comments left to this article are informative. One: “Just another greedy doctor trying to scare people like some kind of clumsy Glenn Beck. The doc is afraid that the gilded age of over-sized paychecks is coming to an end. The truth is, you really do not need a new Mercedes Benz every year.” One person replied “I’ll take a smart, greedy doctor over a dumb, altruistic one any day.”

Another person reminded us that “Mr. Obama’s wife earned more than many doctors working as vp of community relations for a Chicago hospital.”

Mrs. Obama’s job, which paid over $300,000, may be one reason why health care costs are so high. Evidently it wasn’t all that important of a job, as in January the Chicago Daily Observer reported a story with the headline Michelle Obama’s job eliminated.


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