Despite health-care reform, system remains broken

By Joseph Birnbaum
Times Herald-Record (Middletown, N.Y.), Aug. 1, 2010

I was impressed with Dr. Teitelbaum's expressed concerns ("CEO wants fix for health-care system," TH-R, July 26) regarding the new health reform law being touted by Rep. Hall and the current administration.

Teitelbaum has created and manages a large, uniquely organized, equipped and housed group of health-care providers. He, better than most, understands that while this legislation was the first stumbling step in the right direction, it cannot and does not address the crumbling and chaotic health-care system we alone, among all the industrialized nations of the world, must live with.

Teitelbaum notes quite correctly that the attempt to provide cost-effective, accessible, quality health care for 32 million more Americans (while leaving millions more under- or uninsured) can't be paid for as predicated by the administration.

Despite the valuable controls being put in place to prevent the insurance companies from denying and limiting needed care, the fact remains that Big Insurance and Big Pharma (the medical/industrial complex) are still in firm control of our health-care system and will still be able to spend 25-35 percent (or more) of your health-care dollars on management, marketing and huge administrative salaries.

The insurance industry is attempting to develop loopholes in the badly worded new legislation mandating that they spend 80 percent of your premium dollar on providing health care. They seek to include their insurance brokerage fees and a host of non-medical care expenses as part of that 80 percent mandate.

Those of us who are providers of health care and who have been urging an improved Medicare for all (, which would eliminate multiple third-party payers and would spend only 6-8 percent of your health-care dollar on managing the delivery of care, were let down when this legislation was passed.

We agreed with President Obama and many of the legislators who initially recognized that single-payer universal health care for all was the best and most workable solution. We watched in despair as the president and many in his party abandoned this concept in order to pass the current watered-down health-care reform bill. This legislation keeps us in thrall to the bottom lines of the insurance and drug industries and does not honestly address the broken elements in our current delivery system.

The 17,000 members of Physicians for a National Health Plan will continue to press for an improved Medicare for all, and now that we have health reform legislation that can be repaired and redirected to achieve this end, our mission might be nearer fruition.

Joseph Birnbaum, O.D., lives in Monroe, N.Y.