Health care needs reform

I am a physician, a pediatrician, who has run a small private practice for 32 years. I am confronted by the deteriorating health care system as a provider, an employer and a consumer.

As a physician, I am confronted by ever-increasing inefficiency created by insurance companies with their prior approvals, pre-authorizations and denials of care that many times are capricious. I have to employ additional staff to handle these bureaucratic chores and spend time myself listening to automated telephone menus to get my patients the care and medication they need – time that could be used seeing children in need.

The overhead insurance companies report includes administrative costs, executive salaries and investor profits. It is quite high, but it is only part of the excess overhead that the current system requires.

I am constantly aware that my patients are getting less and less coverage for higher premiums. They are paying for more of their care out-of-pocket. And more and more of my patients can’t afford health insurance at all.

As an employer, I am staggered by the premiums we pay for employees’ insurance (12 employees and we pay $90,000 a year – and that does not include coverage for their dependents). Why must employers be the camel upon which the burden of health care is heaped?

As consumers, my wife and I were faced with a 50 percent increase in our premium for the current year and were forced to take a substantial reduction in coverage to be able to afford it at all.

On the basis of public health statistics, we do not have the best health care system in the world. Far from it. The number of uninsured people, especially children, is a disgrace. We must not buy the scare tactics of the insurance industry. Mandating that everyone have insurance but they must purchase it from for-profit insurance companies will only make things worse – more complicated, more inefficient and more inexpensive.

Real reform must take Wall Street out of the revenue stream. We must have a public option. And it should rightly be seen as the first step to a single-payer system. The health care system is so big and so complex that it cannot be changed overnight or by one act of Congress. But we desperately need to take that first step.

Dr. George T. Sproul

Staunton