Government relations session tackles healthcare debate

April 18 - Washington, DC - The topic of healthcare continues to garner much debate on Capitol Hill. Former congressman and practicing physician Sen. Tom A. Coburn, MD (R-OK) kicked off the Government Relations General Session at the American Society of Cataract and Refractive Surgery meeting.

He served 3 terms in the House of Representatives, starting in 1994, and worked closely with ASCRS and the medical community on issues that affect physicians and their patients, such as the Patient's Bill of Rights. As a senator, he will play a role in the upcoming Medicare, Medicaid, and liability reform debates.

"The key is we have to open up the ethics process so that we can have common sense that allows you to continue to be involved and to participate in politics," he said. "We need more doctors in the U.S. Senate.

"We spend 40% more than any other country in the world on healthcare and yet we're not healthy," Dr. Coburn said. "Can't we do it better?"

He outlined five suggestions where change is necessary.

1. Emphasis on prevention. "We now know that children who are fed foods sweetened with high-fructose corn syrup during their formative years up to age 9 double their lifetime risk of diabetes," he said. Why isn't something being done? Because there is no leadership on prevention in this country in healthcare, he said.

2. Liability reform. "In 2001, we as physicians ordered $130 billion worth of tests we knew our patients didn't need, but we knew we needed to protect ourselves," he said.

3. We have not have a competitive pharmaceutical industry. "How is it that none of the pharmaceutical industries wants to have an increased market share in things like anxiety/antidepression drugs or antihypertension medications. Why would they price all within pennies of one another? We as American consumers subsidize the rest of the world's pharmaceuticals," he said.

4. Best practices. "If we're really going to have a competitive market, the consumer ought to know how you're rated in terms of outcomes," he said.

5. Individual responsibility put back into healthcare. "We've moved toward health savings accounts, but we're not moving far enough or fast enough," he said.

"We're never going to solve these problems unless physicians become politically active," he concluded.

Dr. Coburn set the stage for a discussion by "The McLaughlin Group," one of the highest-rated public affairs programs on television. Members of "The McLaughlin Group" included host and moderator John McLaughlin, PhD, and panelists Tony Blankley, The Washington Times; Pat Buchanan, co-host Buchanan & Press, MSNBC; Eleanor Clift, Newsweek Magazine; and Lawrence O'Donnell, MSNBC.

The group focused on many issues of the day, including healthcare and Social Security.

"Whether you agree or disagree with President Bush, he is a leader. Taking on Social Security shows leadership," Buchanan said. "I'm one of those who believes Social Security and Medicare are like 'Thelma and Louise' and they are heading for the cliff."

Social Security was not mean to be an investment program, Clift said.

"It's a social insurance program designed to replace the intergenerational pact where families took care of their aging relatives," she said. "If you took care of your mother and father and your spouse's mother and father, would you somehow then expect to get a pot of money at the end of it? No.

"This is to take the place of what families used to do in a very mobile society," Clift added. "It's been hugely successful."

Touching on the issue of Medicare, Blankley said that between now and 2075 Medicare will have $61 trillion of unfunded liability.

"The demand for healthcare goes up about 3% faster per annum that the gross domestic product goes up," he said.

"The formula of socialized national coverage has already been tried in Europe and has failed and we're moving toward that direction here," Blankley said.

Healthcare as it turns out is a luxury, according to O'Donnell.

"People talk about it as this basic necessity like food. It isn't," O'Donnell explained. "We have known as we have become richer that it's a much bigger commander that this. All we're really talking about is what's the name at the top of the form? Is it the U.S. government? Is it Aetna? What is it?

"This pariticular subject does bring out the socialist in me. The only thing I would do in the healthcare arena is delete the words 'over 65' in the Medicare structure," O'Donnell said. "We're all just going to be debating about the name of the form, how long is the wait, and how much does it cost? It's the same everywhere."

The group also touched on issues regarding immigration and speculated on potential front-runners for the next presidential election.