By Marion Mass, MD
Let’s talk charity. True charity is that which is given willingly and freely. Physicians are in the unique position to give such a valuable commodity, many do give of their time, but could the government make it easier for them? And if they did, would there be any beneficial side effects?
Since 1990, Medicaid spending, jointly run by federal and state governments, has increased roughly five times. Most state budgets have approximately 30-35% of their budget chewed up by this program designed to give medical care to the poor. Helpful charts can be found at: https://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/17/the-state-of-medicaid-in-charts/
Enter Dr. Alieta Eck, M.D. who founded the Zarephath Health Center in New Jersey with her physician husband, John Eck. Zarephath is a local free clinic serving 300-400 patients per month, and doing so at a fraction of the cost that it would take the same patients to receive care under the government plan.
Dr. Eck is also working to enact NJS94, a piece of state legislation, whereby physicians would be incentivized to donate their time caring for the poor and uninsured in non-government free clinics in exchange for the state providing medical malpractice protection within their private practices.
In Dr. Eck’s words:
What if we delivered care for the poor without any compensation? But not in our offices where we still have overhead, but in a non-government free clinic, funded by charitable donations? So all it costs us is our time?
Then, instead of spending our time billing bureaucrats, and feeding the coding industry, and trying to fill in 17 boxes to satisfy meaningful use nonsense, and otherwise wasting time, we simply looked these patients in the eye, assessed their needs, and went to a well stocked pharmacy to bring back exactly what they need. Instead of dealing with an EMR designed by those who do not care for patients, what if we just used a simple paper chart or very user-friendly EMR that served only our patients and stayed right within our clinic?
Now, imagine a little further. What if we could melt away much of the Medicaid bureaucracy, and relieve the taxpayers of that 1/3 of the average state budget? Instead of pretending to pay us for our work, what if the state would simply protect our PRIVATE practices for medical malpractice, so that the plaintiff would be suing the state instead of the physician who donates 4 hours per week in the non-government free clinic?
Think about it and imagine how our stature in the community would improve, how patients would be truly grateful for our volunteer service, and how those 4 hours would feel good, surrounded by volunteers in the community, with big hearts and smiling faces.
This is the essence of NJ S94 that we are working to pass in NJ. We are whittling away at the naysayers and those who are heavily invested in our current wasteful system. But we pray that 2016 is the year we break through and get the law passed. Go to NJAAPS.org to read the bill and the explanation of why it would be good.
I want to imagine even further: What if a brave physician, or a handful of them in each state, proposed to do the same thing, each in their respective states? Now we have created true medical charity, charity that is much more cost effective.
Bear with me, because we are about to talk about religion. I am NOT about to go all evangelists on you, and I promise I’ll bring the discussion back to NJS94.
At this time of year, we are GIFT obsessed, and all because of Christmas. Have been reading about people of many faiths who enjoy the celebration of the tree and gift giving. That is great; Christmas is joy that is meant to be shared. Let’s talk about who shares in the gift giving/receiving.
Think about Jesus from a pure historical perspective. He was a poor Jewish Boy, one whose inception raised some eyebrows… Mary was pregnant before she and Joseph married. Fifty years ago, this was frowned upon in our culture; think about 2000 years ago among truly orthodox Jews. Tough start. Who heard the story of the birth first? Shepherds, men whose blue-collar like profession likely excluded them from participating in religion. And the announcement was Broadway big: a host of angels (apparently they come out in groups rarely). So these poor probable pagans are moved to travel hundreds of extra miles to bear witness. And who else received the message? Wise men, learned astrologers from the Middle East. They came bearing expensive gifts and had an ….(wait for it) an Epiphany. A stark and sudden realization that something world-rocking had just happened. And it had.
So poor pagans, and Persian sages, and animals all converged at the birth scene of a Jewish child with questionable parentage. They didn’t know what would happen next, only that it would be something earth shattering. If only Paul Harvey were here to tell the rest of the story. Needless to say, many of us all are still bearing gifts in celebration. You needn’t be Christian to celebrate. Santa Claus is a wonderful symbol of the charitable spirit that was born in the desert of Bethlehem. And he lives forever.
What a gift to the underserved it would be to enact NJS94, and a gift to our children, saving them billions for their futures, and a gift to physicians, who could experience the pleasure of bestowing their craft, while having some of their malpractice burden. Will politicians take the high road and bestow such a gift? Or will they bow to powerful lobbies and burecrats, and to their own need to cultivate votes by keeping voters beholden to them and their bloated social programs?
The healthcare feeding chain is upside down. Patients are the bottom feeders, followed by doctors, then bureaucrats, then politicians, and finally the lobby money. Time to flip the chain. And if your politicians do not have an Epiphany, refuse to give the gift of the Magi, refuse to be a part of the universal joy of Christmas, they should suffer the consequences. Santa Clause, the spirit of charity can be gifted to the needy that walk among us. And if there be Grinches among our politicians, Grinches whose hearts remain too small, let’s gift ourselves and replace them with true public servants.
