As the Senate Finance Committee completed its work on a bill that would greatly expand the government’s role in health care – requiring nearly everyone to buy insurance, and designing that insurance through subsidies and mandates – President Obama is trying to rally doctors to his side. At an event last week at the Rose Garden, phalanxed by doctors wearing their white coats (as well as some that White House staffers had handed out), Obama declared, “nobody has more credibility with the American people on this issue than you do.”
Yet one of the nation’s top surgeons, with credibility and acclaim the world over for the pioneering surgeries he has and his personal story of overcoming hardship, recently ripped the dominant health care legislation before Congress in a critique similar to that of conservatives and libertarians. Benjamin Carson, director of pediatric neurosurgery at the Johns Hopkins Medical Institutions in Baltimore, Md., and recipient of numerous awards including the Presidential Medal of Freedom, criticized in a recent interview the approach of the current bills for their mandate, creation of a “public option,” and lack of malpractice liability reform.
“My biggest problem is I feel it’s going in the wrong direction,” Carson told reporters at TV station WLOS in Asheville, N.C. (Video here.)“It’s giving us more government and less autonomy. And I think we should be going in exactly the opposite direction. We should be having more autonomy and less government. And that is the kind of thing that brings the prices down.”
Considered one of the best neurosurgeons in the world, Carson gained acclaim in the ’80s and ‘90s for his pioneering operations separating conjoined twins joined at the head and other procedures that have saved children from epilepsy and brain cancer. But Carson is also celebrated for his personal story of overcoming poverty and prejudice. An African-American, Carson grew up in a single-parent home Detroit ghetto, but his mother pushed him and his brother to achieve excellence. He is the author of the popular autobiography “Gifted Hands: The Ben Carson Story,” which was made into a TV movie this year with Cuba Gooding Jr. portraying Carson. And he does much philanthropic work through charities such as his “Carson Scholars” fund.
Over the past few years, Carson has been writing and speaking more about public policy, including health care reform. He has railed against excessive litigation, pointing out how much malpractice insurance and other forms of “defensive medicine” to protect against lawsuits add to medical costs. In the interview with WLOS, Carson insisted that tort reform must go “hand in hand” as part of any true health care reform.
“We have to bring a rational approach to medical litigation,” he said. “We’re the only nation in the world that really has this problem. Why is it that everybody else has been able to solve this problem but us? Simple. Special interest groups like the trial lawyers’ association. They don’t want a solution.”
Carson also blasted proposals backed by Obama and most Democrats that would create a government-backed “public option,” saying it would inevitably lead to a “single payer” system like that of Canada, in which the government as the sole insurer would end up calling all the shots for patients. He pointed to how the Canadian government itself crowded out private insurance. “What happened to the private insurance companies in Canada? Just like that, they were gone, because they couldn’t compete with it (the government). Now, why would it be any different here? That’s one of the things that disappoints me about the lack of honesty … We can’t really debate when there’s all this subterfuge.”
Carson said that despite the problems with American health care, Canada and European countries were not models to emulate in their health insurance financing systems. “All we have to do is go to other places and see what’s going on. See how long people have to wait. Very, very long waiting periods. Why do you think so many people from Canada come here when they have a problem? I know a young man in England who has a problem with his knee. He needs an operation, and the waiting list is so long. … These are the kind of things that people in this country are not used to. But more importantly, it’s something that we don’t have to get used to. We can fix this without going to that kind of system that causes those kinds of long waits.”
As his main “fix”, Carson proposes a system of patient empowerment in which “individuals and families can own their own insurance; it doesn’t have to be through their employer.” Not all of Carson’s ideas expressed in the interview were free-market, though. He did propose that the government set insurance rates, and cover patients’ catastrophic costs above $250,000.
Above all, Carson was adamant that there transparency and deliberation, rather than a rush to force through a health care bill that no one had read. In fact, he proposed bringing health care to a national vote of the American people “I would say we should have a national referendum on it. People should be able to vote. That would really work, because now, people would have to explain it. They would have to know what was in it. When we do these big sweeping national things and just sort of jam them through and nobody even knows what’s in it, that’s not democracy. At some point, someone has lost their ideal of what democracy is.”
Carson’s colleagues at Hopkins – ranked by U.S. News and World Report for 19 years as the nation’s best overall hospital and lauded for the millions it spends on charity care for the poor –have also voiced concerns about the direction that health care legislation is going. Citing the cuts to hospitals to pay for the goal of universal coverage – cuts of more than $150 billion in Medicare and Medicaid payments to hospitals, according to the Congressional Budget office “preliminary analysis” of the Max Baucus’ Senate Finance Committee bill – the Hopkins officials have been warning about severe stress on Hopkins and other hospitals that Hopkins and other hospitals would face.
At a Sept. 18 “town meeting” on the campus of the main hospital in Baltimore, Md., Johns Hopkins Institutions Director of Federal Relations Beth Felder was blunt about the cuts in reimbursements. “That is going to come out of hospitals and health systems,” she said. “I think that’s not a good thing for us.” Similarly, Johns Hopkins Medicine health system CEO Edward Miller told C-Span on Sept. 16 that cuts in the reimbursement rates for Medicare and Medicaid, “There are going to be less physicians that will care for these patients.”