Dear Obama - reflections on the obama infomercial

Dear Mr Obama,

I have some questions and comments that I didn't really see answered in your infomercial.

Can you please tell me how paying for student loans for primacy care doctors translates into patients using primary care rather than emergency medicine? It does not! It doesn't make sense to compensate doctors in order to influence patient behavior. You stated that you believe that primary care is where health care reform needs to occur, many people agree, but you aren't creating a reason for a change to primary care!

What does choosing or keeping a doctor or choosing or keeping a health care plan have to do with doctors and patients making choices in the patient care? Absolutely nothing. The reason you didn't answer this question was because you don't want to tell people what you're going to be cutting from patient care and the cost trimming measures you will be taking in order to provide "quality care" for all people. The way medical care works is itis a scarce commodity that costs money. There is only so much to go around. Quality care for all people will actually be minimal care for many people.

I understand that having pre-existing conditions provisions sucks, BUT it is a way for health insurance to actually make money and protect themselves from loss. Since the only purpose of the health insurance company is to make money, it makes sense for them to exclude pre-existing conditions. They should have the ability to protect themselves from loss.

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Medical care had become more expensive because people are increasingly less healthy. Many children are entering high school being obese, not exercising and eating crap food, and living with Type 2 diabetes and many other health conditions because of their poor health habits (see Wall-E for examples into the future or Michael Moore for a current example). The way to change this is through personal effort, how are you going to influence people to become more healthy on their own so we do not have to care for them in the medical system?

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More Thoughts of Health Care Reform

PHRMA has recently agree to cover half of the medication costs while Medicare Part D patients are in the doughnut hole period, the coverage gap where patients pay 100% of the drug costs between $2700 and $6154. So this means that PHRMA will actually reimburse the government for half of the cost of the brand name medications which patients take during the doughnut hole period. So why is PHRMA being so generous? PHRMA is interested in keeping patients on high cost brand name medications and will take only a small loss on this pay out, whereas they would lose the entire amount of the patient if they changed therapy to a cheaper therapeutic alternative which may come in a generic form. PHRMA is looking out for the interests of pharmaceutical companies, which have every right to make

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and sell innovative and expensive medication treatments and we should not interfere with that right. However if we are concerned with costs we may have interests that are better met by using alternative therapies.

The doughnut hole is the section where the Medicare Part D plans recoup some of their money spent on covering elderly patients and has patients become responsible for their costs. However, even in cases where patients are taking many medications, the doughnut hole is not necessarily something that patients must reach. If appropriate medication management is performed, patients can reduce their costs for medications as well as cost of medical care for society. Pharmacists are well trained and qualified to recommend changes to medication therapy to patients and doctors in order to reduce medications and lower medication costs through altered therapies. By reimbursing pharmacists for this process and encouraging patients, Medicare Part D or not, we would reduce costs of medical care across the board.

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Healthcare reform thoughts

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How can we reform health care? I know that many ideas have been presented; however, many of them only shift the burden of health care costs from one group of people to another. That is not in the interest of everyone nor is it reducing the cost of health care. We could let all the people who cannot live without health care die off and reduce our costs, but that is not really a good solution for those who would have to die. Yet it brings forth an interesting point… some people are born premature die young and have lifelong medical conditions, is that a situation we, as a civilized society should support? Wouldn’t it be better to support allowing these children to not have to live a life in pain and allow them to die early? Are we playing the role of God by trying to force tiny infants to try to survive in a world they are not able to handle by attaching them up to electronic life support? The question of mortality has been recently in my mind and I think that currently I probably am not healthy enough to survive without all the amenities that the developed world offers, such as cars, health care, air conditioning, and supermarkets. I couldn't survive outside in 90 degree weather with 80% humidity trying to chase and hunt some food. My asthma would act up and I'd be left hungry and chewing on some grass. So I am happy that I do have these luxuries, but how much is too much when it comes to medical care? When are the parents thinking more of their desires for a child than of the suffering of the child growing up in conditions that it cannot handle?

This is of course brought to you by someone who desperately wants a "world's greatest not a dad" T-shirt.

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