The perils of government-run health care

By Dr. Eric. G. Morton

There has been much discussion about whether government-run health care in the U.S. is going to be of benefit to patients. My opinion is that a government-run system will be nothing but a disaster.

A few years ago when digital mammography came into vogue, General Electric, the manufacturer of the machines, approached two U.S. senators about having Medicare cover the service. GE successfully lobbied these two senators, and a rider in a bill was approved by Congress to mandate that Medicare pay for digital mammography. Digital mammography soon became the standard. An additional reimbursement incentive was offered to hospitals and physicians for providing the service.

Digital mammography has a benefit to women older than 65, but there is little to no proven benefit to women that are premenopausal or under the Medicare age. The cost for a digital mammography machine is also much higher. It runs approximately $280,000, versus $80,000 for a typical film machine. Using digital mammography costs Medicare on the average of about $325 million a year.

There's a second example of government's folly in health care. As an obstetrician-gynecologist, we are constantly battling the threat and reality of preterm delivery. In the past we have used a non-FDA approved medication given as a once a week injection between 14 and 36 weeks of gestation. Medicaid, Medicare and insurance companies have refused to pay for this because they said it was an "off-label use." The average cost for the injection was about $10 and had a total cost for the entire pregnancy of about $250. Now a company has manufactured the same drug, which is now FDA approved. The projected cost for this new medication, even though it is exactly the same as the one previously used, is about $1,500 per injection, with a total cost per pregnancy between $30,000 and $35,000. This will soon be approved by Medicare, as well as Medicaid, and insurance companies will follow.

The simple fact is that the government did not have the foresight to allow reimbursements for the inexpensively manufactured medication previously used, and now this treatment will cost the system, including individual patients, much more. If the government would have listened to physicians' experiences, as well as the multiple scientific papers to support this experience, they could have approved this medication at a much lower cost, saving hundreds of thousands of dollars or more.

As government continues to squeeze hospital and physician reimbursements, the situation in the medical community will become dire. There is already a projected negative effect on physician recruitment to medical schools, and, in the near future, there will not be enough physicians to go around.

I encourage people to be aware of these things and make it known to their members in Congress that they do not support a government-run health care system.

Dr. Eric. G. Morton is a physician in Cape Girardeau.