I got an email about a doctor in Indiana who read the entire health care reform bill from the House Committee on Energy and Commerce and sent a long and detailed letter to Senator Evan Bayh in which the doctor stated his concerns and objections to the health care reform bill.
I investigated to verify that the doctor and the letter were genuine. I contacted the doctor and he sent me the letter that he had sent to Senator Evan Bayh. Later, I interviewed the doctor and posted the interviews on YouTube® and linked them to my website.
Here, without any other comment from me, is the doctor’s letter to Senator Bayh.
My source for HR3200 is from the energycommerce website. The link is http://energycommerce.house.gov/Press_111/20090714/aahca.pdf.
Dear Senator Bayh,
As a practicing physician, I have major concerns with the
health care bill (HR 3200) before Congress. I spent the
last week reading this bill, which at over 1000 pages is
quite difficult to get through. Have you read it? I’m
shocked by the brazenness of the government’s intrusion into
the patient-physician relationship. I’m especially
concerned about the creation of a central committee to
decide medical coverage decisions.
Every physician and nurse I work with agrees that we need
to fix our health care system. Our President’s statement
last week in his health care press conference that
physicians are likely to make a patient care decision based
on reimbursement rather than a patient’s best interest is
not helpful in moving this discussion forward.
As an anesthesiologist I’m responsible for life and death
decisions on a daily basis. I always have my patient’s
best interests at heart and I’m sure my physician colleagues
around the country do as well.
I ask you respectfully and as a patriotic American to look
at the following troubling sections I’ve read in the bill.
How can the following be in the best interests of the
country and our fellow citizens? Capitalized words within
quoted text are my emphasis.
SECTION 123 HEALTH CARE ADVISORY COMMITTEE
“A committee composed of 18 President-appointed individuals
and 8 Federal employees (26 non-elected citizens) to consist
of providers, consumer representatives, employers, labor,
health insurance issuers, experts in health care financing
and delivery, experts in racial and ethnic disparities,
experts in care for those with disabilities, representatives
of relevant governmental agencies and AT LEAST ONE
practicing physician OR
other health professional and an expert on children’s
This group will set coverage for the country…and other
than the surgeon general, a physician is not even guaranteed
to be on the committee. Is our country ready to let 25 or
more non-elected, non-physicians make these decisions? This
is a direct intrusion into patient care and I for one do not
want a community organizer to have input on what type of
care my patients can receive.
SECTION 141 HEALTH CARE COMMISSIONER
The health care advisory committee will report to the
Health Care Commissioner, another non-elected Presidential
appointee who will make the final decisions for the nation’s
SECTION 246 SUBSIDIES FOR UNDOCUMENTED ALIENS
“Nothing in this subtitle shall allow Federal payments for
affordability credits on behalf of individuals who are not
lawfully present in the United States.”
This states that taxpayer subsidies will not be given to
illegal aliens to obtain coverage but says nothing about
preventing them from obtaining healthcare in the US. Under
current law NO patient, illegal or otherwise can be turned
away from an ER if urgent care is needed. Section 152 states
that “all health care and related services including
insurance coverage and public health activities covered by
this Act shall be provided without regard to personal
characteristics.” Will the current law be changed thereby
withholding care from a vulnerable group of individuals?
Language translation and linguistic appropriate services is
This seems to apply to undocumented individuals as well.
The government will use community organizations to sign up
eligible citizens for health plans. Do you support using
an indicted organization like ACORN to do this?
SECTION 225 PROVIDER PARTICIPATION
This section states that Physician salaries will be
dictated on an annual basis. How can you support taking
over the livelihood of all physicians and dictating the
terms? This is pure socialism and to call it anything else
SECTION 131 REQUIRING FAIR MARKETING PRACTICES BY HEALTH
This section gives the government veto power over
advertising by private companies. Again this is an example
of socialism where the government decides what the public is
allowed to be told. How can you support this?
SECTION 312. EMPLOYER RESPONSIBILITY TO CONTRIBUTE TOWARDS
EMPLOYEE AND DEPENDENT COVERAGE.
This Bill mandates employer-paid coverage for part-time
employees and families which will be a huge burden for small
businesses. Overall, the compliance regulations and
associated costs for physicians, employers and insurance
providers is enormous. Also, random audits are authorized
with the full cost of the audit to be paid by the person or
entity being audited. Do you support random, costly
intrusions into physician’s offices?
SECTION 431 DISCLOSURES TO CARRY OUT SUBSIDIES
The Health care commissioner and others in government will
have full access to your tax returns. On Pages 58 and
195 Government will have real-time access to individuals
finances & a National ID Healthcard will be
issued. Officers & employees of HC Administration
will have access to ALL Americans finances /personal
returns. Quite an intrusion of privacy.
Under Medicare, every prescribed drug, device or medical
supply has to be disclosed to the government or a penalty of
$10,000 to $100,000 applies. Just think of the cost of
complying with this rule.
The health commissioner will approve expansion of physician
residency training positions with preference being given to
primary care and disadvantaged applicants. Do you want the
best and brightest to be our future doctors or those
selected by the government? This section also suggests that
specialty positions will not be expanded. This will lead
to a diminishing specialist base and a loss in quality
care. The obvious intention is to limit specialist care
and I think the country needs to be aware of this.
SECTION 155 SEVERABILITY.
“If any provision of this Act, or any application of such
provision to any person or circumstance, is held to be
unconstitutional, the remainder of the provisions of this
Act and the application of the provision to any other person
or circumstance shall not be affected.”
Why put this in? Do you think the bill is so radical that
you are trying to block the Supreme Court from striking it
SECTION 1233 ADVANCE CARE PLANNING CONSULTATION (pages
Page 425 Lines 22-25, 426 Lines 1-3: Government provides approved
list of end of life resources. Government MANDATES program for orders for end of life every 5 years. The Government decides it should be involved in end of life care.
Page 428 Lines 17-25: Additional advanced care planning consultations
will be used frequently as patients health deteriorates.
Page 429 Lines 1-3: “advanced care consultation” may
include an ORDER for end of life plans.
Page 429 Lines 13-25: The Government will specify which Doctors or other individuals can write an end of life order.
Page 431-2 The Government mandates that “quality measures on end of life care” be measured and reported.
While advanced planning is always a good thing, this decision is best made with the physician, patient and family. The majority of health care dollars are spent in the last year of a citizen’s life. Mandating government intrusion and reporting of end of life care brings up the question of rationing. This section is quite vague on listing protections for seniors. Can you reassure me Senator that rationing is not the goal of this section of the bill?
Other troubling sections I discovered:
Pages 65-66 Section 164: Describes a subsidized plan for retirees
and their families in unions & community
organizations. Why the special treatment?
Page 84 Section 203 HC bill: Government mandates ALL benefit
packages for private care plans in the Exchange.
Page 85 Line 7 HC Bill: Specifications of Benefit
Levels for Plans = The Government will ration your Healthcare!
Page 85 Line 7 HC Bill: Specifications of Benefit Levels
for Plans. AARP members – Will your Health care be
Page 102 Lines 12-18 HC Bill: Medicaid Eligible
Individuals will be automatically enrolled in Medicaid. No choice.
Page 121 lines 11-17: Doctor or provider payment will be at medicare rates under the public option. Medicare pays well under market rates and many physicians currently subsidize or cost-shift from private patients to provide care to seniors. If medicare rates are mandated, access to care will suffer. Do you support paying physicians at medicare rates under the public option Senator?
Page 124 lines 24-25 HC: No company can sue the government on price
fixing. No “judicial review” against Govt Monopoly.
Page 203 Line 13-15 HC: “The tax imposed under this
section shall not be treated as tax” Why the deception?
Page 265 Section 1131: Government mandates & controls
productivity for private HC industries.
Page 268 Section 1141: Government regulates rental &
purchase of power driven wheelchairs.
Page 272 Section 1145: TREATMENT OF CERTAIN CANCER HOSPITALS
Cancer treatments are expensive and represent the latest in research, technology and understandably cost a lot of money. This section, like others is vague in details. Senator, how will rationing of the latest advances be avoided?
Page 280 Section 1151: The Government will penalize hospitals for
whatever Government deems preventable re-admissions. A good medical
outcome is never guaranteed! This is a crazy rule and may actually increase costs as hospitals and doctors will be hesitant to release sick patients!
Page 316-317: PROHIBITION on doctor ownership/investment. Failure to disclose ownership is a 10,000 dollar fine for each occurrence.
Government again dictating to Doctors what/how much they can own!
Page 317-318 lines 21-25, 1-3: PROHIBITION on expansion
Government is mandating hospitals or surgery centers cannot expand. Hospitals have an opportunity to apply for exception BUT community input is required. Will ACORN have a say in this?
Page 335 L 16-25 Pg 336-339: Government mandates establishment
of outcome based measures.
This is another way to justify rationing care. Every physician learns early in their training that each patient is unique and that a mandate for care will work for some but not for others. Learning to accept uncertainty is part of what makes our profession special and different. Rigid care mandates will result in decreased quality of care. This type of mandate also implies that physicians don’t have the best interests of their patients in mind which is nonsense. In other single-payer systems outcome based measures are ROUTINELY used to ration care. In the UK, a patient with macular degeneration must become blind in one eye before treatment is offered to the other eye!
Page 354-355 Sec 1177: Government may RESTRICT enrollment of
Special needs people to certain times and will review special needs plans and make recommendations “as the secretary of HHS deems appropriate.”
Something the public needs to know.
Page 379 Sec 1191: Govt creates more bureaucracy –
Tele-health Advisory Committee.
Page 469: Community Based Home Medical Services = Non
Should we expect ACORN nursing homes in the future?
Page 472 Lines 14-17: PAYMENT TO COMMUNITY-BASED
ORIGINATION. One monthly payment to a community-based
organization. Like ACORN?
Page 489 Sec 1308: The Government will cover Marriage &
Why should this be a mandate that all taxpayers pay for?
Page 494-498: Government will cover Mental Health Services
including defining, creating, rationing those services.
As for the dangers, costs, and failure of electronic
communication upon which this bill is dependent on, the
following article must be studied:
The computerization of Britain’s National Health Service
has been an expensive fiasco. Why does Obama want to emulate
It is also apparent that the Congress will not require
themselves to use the public plan as required for most
Americans. Why the double standard?
Will abortion services be covered with taxpayer money?
Why is there no mention in HR3200 of malpractice reform? Many studies show that defensive medicine is a major contributor to the cost of medical care in our country.
Senator, I guarantee that I personally will do everything
possible to inform patients and my fellow physicians about
the dangers of this legislation. Our country was not founded on
the socialist principles that make up this bill. There are
many other ideas and policies that could be adopted that
will not destroy the good aspects of our current health
system and cover those who currently are without coverage.
I implore you to use a nonpartisan mind to consider these
other options. If you vote for a bill that destroys private
medicine and the doctor-patient relationship, I will do
everything in my power to make sure you and other supporters
of this flawed bill lose your job in the next election.
Stephen E Fraser MD