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Open letter to Gov. Haslam: Don’t abandon the vulnerable

By Diana Reed, M.D.

The following letter was sent to Gov. Bill Haslam of Tennessee on May 10.

Dear Governor Haslam:

I am a concerned citizen, a retired disabled doctor, a Tennessee resident and a woman who has devoted her life to health care as a neurologist in Columbia and at Vanderbilt before a work related injury left me disabled and uninsured.

What a slap in the face! Eventually I was able to get on Medicare and my husband who had a heart attack in 2005 was also uninsurable until the Preexisting Condition Insurance Plan became available. When that program ends, if you do not participate in the Medicaid expansion or the health exchanges, he may end up uninsured again, and if he has an illness or injury, we may end up in bankruptcy for a second time due to medical bills.

My husband’s best friend just died in January because he stayed home during his heart attack, rather than burden his family with medical bills he couldn’t afford because although he worked full time, he had no health insurance. The last three weeks of his life spent in Intensive Care Unit, cost his children what little inheritance they would have received from his estate.
 
Since my career in medicine was cut short, I wrote a book, “The Other End of the Stethoscope The Physicians’ Perspective on the Health Care Crisis.” The book explains why we are losing so many physicians in practice today, and how the health care crisis affects physician’s morale and bottom line. It explains where the money really goes as we spend twice as much as other countries and leave 46 million out, and why we rank 37th in over all health quality.

With the recent release of information on hospital charges, it is interesting to note that hospitals, like doctors almost never get paid what they charge, and due to antitrust laws, are not able to compare or discuss charges with their colleagues in similar practice situations or regions.

It really doesn’t matter what any of them charge, and of the uninsured, very few will pay anything toward their hospital bills. CMS and private insurers dictate what they will pay, and the only choice hospitals and doctors have is whether to be a provider.

As a physician, I had hundreds of thousands in unpaid accounts receivable that were never collected, yet, unlike hospitals I was not allowed to deduct that from my taxable income. I did provide health insurance to my three employees, but after they had some health issues, my rates tripled, along with the medical malpractice insurance.

With no control over my income or overhead, private practice in Tennessee became unsustainable and I, like most doctors today, was forced out of small business and into employment. The three jobs of my office manager, receptionist and nurse I supported were lost, along with my independence and love of medicine.
 
If someone collapsed on your doorstep, would you let them die there because they have no health insurance? Because as governor, that is exactly what you are doing. The poor and disabled, the most vulnerable of the people you represent, are being let down by the policies you espouse.

Contrary to what you might believe, it is tough out there, and hard working people are suffering while you seem to be most concerned with protecting the richest Tennesseans and their pocketbooks.

You seem to believe that the poor will make wasted trips to their doctors and drive up costs if they don’t have skin in the game by paying co-pays and deductibles they can’t afford, by definition of being poor. Isn’t their life skin enough?

The real cost savings will come when the poor can get to primary care, preventative health screening, medications for high blood pressure and diabetes, mental health care and health education rather than showing up in the ER with end stage catastrophic and chronic conditions that leave them disabled or dead, and costing us all much more in the long run.

Economically, the PPACA and the Medicaid expansion are a win-win for Tennessee, and I urge you to reconsider your political posturing and work to the benefit of all Tennesseans. You and your Republican colleagues are not hurting President Obama, whose agenda and health care plan was overwhelmingly approved as evidenced in the last election. You are not helping to make America strong, you are really hurting the Republican party and it will show in the next elections. People are sick of obstructionism.

Mainstream Americans are not a selfish, money-worshipping group that have no compassion for the poor or disabled. They know that we are all one people on one earth; that the Bible tells us we must help our brothers, especially the least of us, if we are to live by God’s word and we will all benefit. You need to come out of your ivory tower, and see how the majority of people in Tennessee are struggling, starving, and dying.
 
I would like to meet with you face to face, if possible, to discuss the health care crisis further, and as a Tennessee Volunteer, I would be happy to work with you toward a goal of compassionate care for all Tennesseans. Thank you for your consideration.

Dr. Diana Reed resides in Spring Hill, Tenn.