Obama's Chicago doctor talks about Obama's plan

http://www.forbes.com/2009/06/18/obama-doctor-knocks-obamacare-business-healthcare-obamas-doctor_print.html

David Scheiner, an internist based in the Chicago neighborhood of Hyde
Park, has a diverse practice of lower-income adults from the nearby
housing projects mixed with famous patients like U.S. Sen. Carol
Mosely Braun, the late writer Studs Terkel and, most notably,
President Barack Obama.

Scheiner, 71, was Obama's doctor from 1987 until he entered the White
House; he vouched for the then-candidate's "excellent health" in a
letter last year. He's still an enthusiastic Obama supporter, but he
worries about whether the health care legislation currently making its
way through Congress will actually do any good, particularly for
doctors like himself who practice general medicine. "I'm not sure he
really understands what we face in primary care," Scheiner says.

Scheiner takes a few other shots too. Looking at Obama's team of
health advisors, Scheiner doesn't see anyone who's actually in the
trenches. "I have a suspicion they pick people from the top echelon of
medicine, people who write about it but haven't been struggling in
it," he says.

Scheiner is critical of Obama's pick for Health and Human Services
secretary--Kansas Gov. Kathleen Sebelius, who used to work as the
chief lobbyist for her state's trial lawyers association.

"He doesn't see all the pain, it's so tragic out here," he says.
"Obama's wonderful, but on this one I'm not sure if he's getting the
right input."

What should the president be focused on? Scheiner thinks that a good
health reform would be "Medicare for all," a single-payer system where
the government would cover everyone and pay for it by cutting out
waste in the system. "A neurosurgeon gets paid $20,000 for cutting
into the neck of my patient. Have him get paid $1 million a year
instead of $2 million or $3 million. He won't starve," Scheiner says.

Scheiner thinks that Obama's "public plan" reform doesn't go far
enough. He supports the idea of that option for people who don't like
or can't afford their HMO. But he worries that it will be watered down
or not happen at all. "It's nonsense that the private insurance
companies need to be protected," he says. "Why? Because they've done
such a good job?"

He thinks that Americans have been scared into believing that they
will lose the coverage they already have if a public plan is created.
And he worries that nobody cares about the 50 million uninsured. "I
have people who have lost their jobs and come to me and I give them
drug samples," he says.

Scheiner says he thinks that Obama probably sees the virtues of a
single-payer system but has decided it would be politically impossible
to create one.

Reid Cherlin, an assistant White House press secretary who covers
health issues, wrote in an e-mailed statement, "The President has been
clear that while a single-payer system may work in some countries, it
makes the most sense for us to build on what works in the system we
have and to fix what's broken.

"He would certainly agree that there's too much waste in the
system--where families, businesses and governments pay too much for
too little," he added, "and that's why he's committed not just to
expanding coverage but to reforming the health system to provide
high-quality care at a lower cost to more Americans."

Scheiner says he never thought it was appropriate to talk about health
policy with Obama, especially once he became a U.S. Senator. The one
exception was medical malpractice reform. "I once briefly talked to
him about malpractice, and he took the lawyers' position," he says.

Obama reiterated his opposition to caps on medical malpractice-related
damages when he addressed an audience of doctors earlier this week at
the American Medical Association's annual meeting. (See "Will Doctors
Buy Obamacare?")

Scheiner, like most others in his profession, thinks that it should be
harder to sue doctors and that awards should be capped. He says that
he and other doctors must order too many tests and imaging studies
just to avoid being sued.

Scheiner graduated from Princeton and then started at Columbia
University's College of Physicians and Surgeons 50 years ago. After
training in internal medicine in Chicago he joined a practice in Hyde
Park. His partner was Quentin Young, a doctor known for supporting
universal coverage and for briefly being the personal physician of
Martin Luther King Jr.

Before selling his practice, he watched his income decline over the
years to what he calculated to be $22 an hour ($2,100 every two weeks
after withholding for taxes, health insurance and malpractice
insurance.)

Scheiner thinks that any health reform should involve paying
primary-care doctors better so they don't have to rush through
appointments to make ends meet. He says that the medical students he
encounters are no longer even taught how to do a patient history and
physical exam. Patients get imaging studies and lab work instead of
actual work-ups. "It's like in Star Trek where Bones had the thing he
would wave up and down. They don't even talk to patients," he says.

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