Physicians: Independent professional practitioners or employees controlled by health care’s big players?

By Edgar A. Lopez, M.D., F.A.C.S.
Louisville Medicine, Letters, June 2014 

In the New York Times issue of February 14, 2014, an article written by Elisabeth Rosenthal and titled, “Apprehensive, many doctors shift to jobs with salaries,” the following information caught my attention:

Today, accordingly to the AMA statistics, in the USA:

  • 60 percent of family doctors and pediatricians are employees 
  • 50 percent of general surgeons are employees
  • 25 percent of surgical specialists including ENT, ophthalmologists and others are employees

In 2007, 24 percent of cardiologists were employed; it jumped to 35 percent in 2012.

Local hospitals in the state of New Jersey bought, just recently, 22 private cardiology practices.

These statistics reflect the rapid demise of the concept of the private delivery of medical care that has fallen in this country into the tentacles of the private health insurance companies that continue to siphon off, in a macabre way, the tax money that is supposed to be used for health care. Instead the funding of private health care in the USA, the richest industrialized country in the world, is all about profiteering and the Wall Street dance of the stock market as it relates to escalating health care costs for everybody.

In the meantime, the Affordable Care Act has only brought more sophistication to the profiteering process of the private health insurance companies while still more than 45,000 citizens a year die because of lack of health insurance. Believe you me these victims are hard-working middle-class citizens; they are not the immigrants (documented or otherwise), they are not the veterans of war, they are not from the top 1 percent, they are not from below the poverty line, they are hard-working individuals, low-level executives and college graduates, adjunct professors, low-level employees of the same private health insurance companies, etc., who carry exorbitant deductibles in the newly baptized Platinum, Gold, Silver, Bronze plans that, in my opinion, rather than precious metals’ names, should be called “chatarra” (which in Spanish means: scrap metal).

The concept of incremental health care reform sponsored traditionally and continuously by serious institutions like the AMA and the American College of Surgeons is another clear manifestation of a non-viable, non-sustainable system for funding and delivery of health care. It just doesn’t work, and the price for the ones left behind the affordability wagon is: death, debt, despair and mental illness plaguing the streets.

When you have an acute catastrophic illness and you are, for whatever reason, underinsured or even worse uninsured (don’t know which one is worse) there is absolutely no time to wait for incremental shenanigans.

My dear colleagues, the only viable solution to save the private practice of medical care (funding and delivery) in this country, and at the same time serve Everybody In and Nobody Out, is a single-payer system based on the bill introduced in the U.S. Congress on repeated occasions through the years by Rep. John Conyers: H.R. 676. We can call it also: Improved-Expanded Medicare for All, from birth to death and without the participation of the private health insurance industry. That bill will save at least $400 billion a year, to begin with. H.R. 676 is properly explained on the Web. Just google H.R. 676 and read the bill. Everybody’s back is covered, including the low-level employees of the private health insurance companies.

I want to respectfully invite the current president of the GLMS [Greater Louisville Medical Society] and the president-elect to a public conversation including members of GLMS to discuss why H.R. 676 doesn’t have the support of certain medical organizations. It is not even discussed. You bring your team of experts and I will bring mine.

Logistics and details can be properly planned.

Dr. Edgar Lopez is a member of Physicians for a National Health Program (PNHP) and a founding member of the Kentucky chapter of PNHP.