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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883


Medicare best for patients

Dr. Robert Golden Special to The Spokesman-Review

In recent health care debates people proclaim they don’t want the government standing between them and their physician. Some have adamantly opposed a “single-payer” health plan while demanding, “Don’t touch my Medicare.” As a physician practicing in Spokane for the past 26 years, I would like to share my experiences.

I am a urologist, providing medical and surgical care to my patients with diseases of the urinary tract. Over 75 percent of my patients are on Medicare.

Medicare allows me the freedom to provide quality health care with the interests of my patients as first priority. Medicare is a single-payer, government-sponsored health insurance plan and yet imposes no restrictions or arbitrary rules between my patients and me. The health care decisions are only between my patients, their loved ones and me. Yes, there are guidelines for best practice, which I honor and embrace.

Americans support the Medicare system by paying into the program their entire working lives. At age 65, all citizens are eligible for this program and enjoy the security of knowing their health care is covered. Younger patients in special categories (end stage kidney disease, permanent physical or mental disabilities) are also covered by Medicare. I am appreciative Medicare is the force that allows people to come to my office for urologic care. Without coverage, they stay away, suffer with their usually treatable ailments, or die in pain. All American citizens deserve comprehensive health coverage and Medicare fulfills this right. My vote is “Medicare for all.”

In contrast, private insurance plans are heavy-handed and defiantly stand between patients and their health care providers. These plans ration care irrationally. Confirming coverage, obtaining prior approval for procedures, collecting money and billing these insurance companies over and over because of denials ranging in the 25 percent to 40 percent range are huge obstructions. Private “insurance” policies are cumbersome, denying and frustrating. Documented claims filed electronically with Medicare are quickly resolved.

Medicare eases my patients’ minds. Every week, I see patients without insurance, delaying treatment for fear of bankruptcy, emptying their savings, selling their houses, etc. These people are sometimes one illness away from complete financial disaster. No wonder they delay doctor visits and live with symptoms – sometimes too long – and their disease (cancer, infection obstruction) progresses to a point of uncontrollability or even mortality. I am not willing to accept this as democracy or compassion. This is wrong.

President Barack Obama and some members of Congress have earnestly tried to reform this mess we call our “health care system.” The president has consistently supported increased reimbursement to primary care physicians, while encouraging medical students to choose primary care as a specialty. He also advocates for absorption of student loans in exchange for primary care doctors practicing in underserved urban and rural areas.

That nearly 50 million citizens in our country are uninsured is a travesty and, frankly, embarrassing. Every year, more than $400 billion of private health insurance money (paid for by subscribers of the insurance company like you and me) go to profits, marketing, executives, buildings, etc. The president of United Health Care makes $102,000 an hour. Of the money flowing into for-profit private insurance, only 65 percent is used for actual health care services. This is in contrast to Medicare, where more than 95 percent is directly used to provide health services to our seniors.

These issues are complex – financially and ethically. Standing by and listening to the verbiage by the profit-seeking, fear-mongering insurance and pharmaceutical industries is no longer an option for me. What makes this country great is our willingness to sacrifice our excesses for the general greatness of the whole.

Personally, I became a medical doctor to serve with compassion and love – to relieve pain and suffering. At the end of the day, I do not ruminate about money. Rather, I hope I’ve contributed to my patients’ journey toward a greater understanding of the wonder and blessings of life.

The Canadian physician William Osler stated this simply, “We are here to add what we can to life, not to get what we can from life.”

Dr. Robert Golden is a urologist in Spokane.