I found this letter through a link on Reddit and thought it worth reposting:

Amongst the four docs in our practice, we all want to see health care reform. The current system is broken and will only get worse. We are very disappointed, even angered, at the ridiculous debates that have been had these last few months which have been about everything but the actual reform. All the scare tactics, lies, misinformation I had hoped maybe only "fringe" individuals would believe. Instead the elderly were preyed upon, veterans, other vulnerable people. Sickening.

We want simple cuts in cost, not in service. No docs want to see socialized medicine ala England, Canada, etc. No one is proposing that either, though the far right would have us believe so. The four of us are in favor of a government health option to compete with the private sector. We don't understand why educated people would believe that this plan would ration care, deny benefits to elderly, hasten end of life.

We already have health care rationing - in the private sector. Aetna, Blues, United Health Care, Health Net, etc., we have to fight them on denials for cancer care every day and don't always win. The current government plans (Medicare, Medicaid) are actually the easiest to deal with and pay the best. We don't need prior authorizations, there are no appeals to arbitration boards to get a PET scan, MRI, expensive chemo. If you have a blue cross PPO however, it can take up to 3 months and 3 appeals to get a PET scan approved. The privates are rationing....to make money for the shareholders and fat cat CEOs at the expense of all of us.

If the government wanted to do all these terrible things that people are spreading to scare others, they could have done already for years - via Medicare. They never did - instead it continues to be the best coverage out there.

Even those with "good insurance" are mostly under insured if they have a cancer diagnosis. Deductibles and co-pays are thought to be minimal when people think about an rx for an antibiotic, but they never dream that if they have cancer and are on chemo that costs $10,000 to $20,000 per MONTH, that even their 20% co-pay is unaffordable. Then the patient goes without the chemo that is "covered" by their blue cross PPO. That scenario happens every week in our office - but never with Medicare.

The drug costs must come down to work - they are way too expensive. We had to take out a $500,000 loan recently to stay solvent after purchasing these drugs and getting denials by PPOs that look for reasons to cancel someone's coverage - one recent patient the PPO decided they thought that his cancer was a pre-existing condition after all. This was decided out of the blue 6 months into chemo that he was responding to. Now he is in appeals, but not getting any care for 2 months, and we are out $100,000 in the red on his treatment. The drug companies continue to make billions and have CEOs with unbelievable compensation. That is the current state of Private Sector oncology healthcare. By the way, that patient's cancer was NOT pre-existing, but the insurance doesn't care what I have to say - he has no coverage in sight.

So while we're dealing with the consequences of these tragedies for real people and their families, idiots from coast to coast are arguing about stupid death squads, socialism, and so disrespecting our President that his very citizenship and "American-ism" is called into question. We are dumbfounded by this. Whether one disagrees with Obama or not, he hasn't really given us any surprises. As far as I can tell, everything he has done he said he would do on the campaign trail - and the people elected him. So why the shock? Why blame him? The people are responsible. I wish Republicans would come up with viable counteroptions and alternatives instead of just trying to kill reform.

If we had a theoretical Medicare-like plan option for people of any age, oncology care would be so much more complete - un-rationed. With that increase in service, the only way to cut cost is to do exactly that - cut the horrendous drug costs, supply costs, etc. The drug company lobby is so massive to fight this because they want to make their billions. In the last 10 years, doctors have taken numerous percentage cuts for our services. The private HMOs are so bad for this, that for oncology those patients are only covered to discuss one or two problems/concerns per visit. Any further complex office visit must be done another day, or split into 3 visits over 3 days. They won't cover complex follow-up visits on any occasion - can you imagine finding that out after you're diagnosed with cancer?? Again, the private sector at work. The drug companies and the insurers must take big cuts now too if we are to make any reform possible here. This is the key and a government option might help if they are not willing to concede billions up front.

I'm personally afraid this is going to end in some watered down compromise that says it accomplishes reform, but doesn't really change things all that much.

You asked - so there you have it. Feel free to forward to whomever.

Derek Helton, M.D.