Government inflexibility and Healthcare reform

At the peak of the national debate on healthcare reform a central fear of ordinary people and healthcare providers remain unaddressed and rarely discussed. Would bigger government role in healthcare make our government even more inflexible in correcting system failures that impact patient care?

I submit that the government’s past conduct in fixing existing issues is the barometer for things to come. Issues like the VA’s prior authorization for PCP visits in nursing homes (In some nursing home contracts the VA mandates that they pre-approve most, if not all, visits by the patients’ own PCP before they happen) that practically make veterans second class patients.

Another current unresolved issue is the DEA requirement that nursing home patients not receive medications ordered by doctors unless there is a hard script given to the nursing home, a process that has caused delays in patient care since its enforcement almost a year ago. All efforts by healthcare organizations such as the AMA and AMDA have been fruitless on this issue as no one in government wants to be the one responsible for changing the rules, even if it makes sense to do so.

We should pause and consider the root causes for this apparent trend of government inability to respond to concerns or to correct rules that are proven to endanger the well-being of patients.

Letters to government, including our representatives, are responded to with generic responses, and the big government systems remain unimpressed by the professionals' protest of government rules that hamper their effort to provide basic care for their patients.

Nursing home care is out of site and out of mind for most in healthcare and in government, but there is a growing movement to get attention to a variety of concerns that are the creation of the government's own, often obsolete, rules.

Going back to basics in trying to get the attention of our giant, unyielding, government, a petition was published 3 weeks and is so far signed by hundreds of doctors and other healthcare professionals protesting a specific government action in nursing homes. This petition was sent to many government officials in the executive and legislative branches and we await their response.

Link: http://www.gopetition.com/online/32305.html

McCain! You're killing me!

I happen to be in the unenviable position of thinking that Senator McCain is the best choice for president of the United States at this juncture. He is probably not going to be president, however, due to, in no Small part, to his own efforts. Everybody know that he needs to pander to the extreme right in order to pass the hurdle of the Republican primary, but he is taking it so far that he is becoming unelectable even in the eyes of right wing Republicans. He looks like he badly needs the presidency, rather than wanting to be president.
His advisers seem oblivious to the fact that both Republicans and Democrats all want an end to the Iraq war in their life time, and so when he the Senator comes across as pro-war no matter what it hurts his electability with both party electorates. Even for supporters, like me, it is becoming worrisome when McCain doesn't distinguish himself from president Bush when it comes to Iraq. There is nothing wrong with qualifying the Senator's support for the war by declaring that he wants the US out of Iraq but he'll do it in a manner that protects US interests and the territorial integrity of Iraq. I personally hope that Mr. McCain doesn't really believe that having 500,000 troops in Iraq would solve the problem; if he does then maybe it's a good thing that he doesn't stand a chance at this point.
If I were the senator's advisor I would advise him to do the following:
-To come to peace with the possibility that he won't be the next president of the United States as it is detrimental to his cause to appear to want the presidency at all cost.
-Support the efforts in Iraq by saying that we he is not in support for immediate withdrawal from Iraq but he does not support turning Iraq into another de facto US territory and is in favor of calculated withdrawal with continued support for our allies in Iraq post withdrawal.
-To continue his anti-torture stance but clearly state that the United States can never guarantee 100% security for its citizens even with torture. The United States, more than ever, needs to make a stance against the forces of hatred and blind revenge within and without. The best chance the US has against terrorism is when it stands for its ideals and principles without giving in to the temptation to hate back and take revenge.
-Declare that the US economic recovery is dependent on US efforts to support peace in the world and mutual peaceful coexistence.
-Talk about how Democratic candidates, if elected, are likely to adopt an aggressive posture in Iraq in order to demonstrate their toughness against terrorism, and that Senator McCain is the best candidate, as a war hero, to make the right decisions in Iraq without worrying about being called a coward if he pulls out of Iraq.
I hope Senator McCain would heed the advice and go on to be the next president of the United States.

Jabbar Fazeli, MD
Author, Iraq Decoded