We recently spoke with Dr. Claudette Lajam, NYU Hospitals for Joint Diseases, Department of Orthopaedic Surgery, as well as Adult Reconstruction and Joint Replacement Assistant Professor of Orthopaedic Surgery, NYU Langone Medical Center. She does pediatric, assisted in the lauded robot knee-replacement procedure, affiliates with Cornell Medical and the Alpha Award Club, and hosts Sirius Radio, Monday evenings. These will do for a start.
Lajam was speaking on “The Myth of Choice” to the NY County Republican Women’s Club. We stayed afterwards to schmooze and exchange views on reproductive topics and related hot-button topics. “Choice” means more than pregnancy termination.
Not inconsequentially, Dr. Lajam -- pert, personable, honey-blonde wife and mother -- is sole female surgeon specialist in her practice field in the city. The hospital in which she plies her skills is No.1 in safety.
To get where she is, she had to stay focused, tough, mindful of her colleagues, ahead of thousands of would-be’s. Not, as anyone knows who has tried to wrest an appointment with an in-demand pro, a breeze.
Thoughtfully, Dr. Lajam referred to the fact that 26 August is the 95th anniversary of Women’s Suffrage, the 19th Amendment to the Constitution -- after a long, bloody fight by incredibly doughty women who suffered jail, torture, humiliation and public shamings.
“There’s more to Choice than genitalia,” asserted the ‘orthopod.’
Because the Feds are so involved in care, micromanaging medicine and its practitioners, all independent hospitals in Queens, she notes, are gone.
Every surgeon generates seven or more support staff: aides, accounting, intensivists, resupply, nurses, and the like. When you cut a hospital, you cut all ancillary staff that keeps it humming -- and patients in standard ameliorative care.
Medicine is Big Biz.
Why aren’t we more aware of the irritating negatives and foreclosing of real ‘choices’? “There’s no meme for these things,” responds Dr. Lajam. “The abortion meme is there, and gets a constant workout,” shutting out other valid concerns. That narrows what some seem to be able to envision.
“The leading cause of doctor visits in the U.S.,” Lajam continues, “is musculo-skeletal problems.” As a consequence of President Obama’s signature, deeply meddling Affordable Care Act, unneeded workers in those hospitals -- mostly women -- were excessed. They lost what had been good jobs, benefits, decent pay.
Replacement jobs for these workers were in the $10/hour area, the only ones available. Obama’s interminable recession meant that wages were stagnant, and those in such low-pay, low-reward jobs failed to escape their job dungeons, manacled by BHO’s recession. Which dragged on longer than any since WWII.
Crux: although she accepts “any and all insurance,” fully 20% of her patients can’t afford to see her, lacking insurance and cash to pay for services. Those with time could wait 4 or 5 hours in the free clinic. Working people don’t have that kind of time available.
Average doctor insurance, in her specialty, was $140,000 a year -- private practice. “That’s for a doctor without the whiff of a lawsuit.” If you get sued, the sky’s the limit. How many patients do you have to see to see Dollar One, after that stratospheric overhead?
One of the inconveniences of the ACA, Lajam notes, is the necessity to provide e-records for all, the requirement to supply Uncle Obama with invasive private records that were, until recently, the province of the doctor and patient. Our GP for the past decade, in line with our distrust of invasive government, took hand notes, and they remained in the physician’s private file, inaccessible to Big Bro surveillance.
But the ACA forces doctors to keep electronic records, and medical professionals must submit these to government. No records, no payments.
These ObamaCare oversight echelons don’t add one millisecond of better healthcare to overarchived and scrutinized patients by un-doctors earning their cushy DC ricebowls.
Also not choice.
Privacy is available, but at a huge premium, for out-of-network physicians. Few can afford this.
The upshot is that the majority, needing someone, lose the ability to pick their doctor. If you have any of what they call “modifiable factors,” like obesity or diabetes, smoking or drug habit, co-morbidities, irresponsible sexual habits (with or without prophylactics), instead of being scheduled to see a physician in 18 weeks, you’re waylaid, VA-style, months. Years.
Current quip: British healthcare is the best in the world, unless you’re sick.
Cancer is better vanquished if caught early, as was the case in the U.S. pre-ACA, than “managed” in later, advanced, stages, as in England or even Canada.
Hardly choice.
Lajam: Anything beyond the most elementary pediatric care is extra. Hospitals are bonused for discouraging revisits and long stays, rewarded for faster visits, quicker exams, less interaction. The primary losers? Patients.
Someone living alone who breaks their leg, without constant care and assists, “that person is dead. Dead.” They can’t walk; depend on others; inexorably decline. Especially the elderly, those former Governor Sarah Palin said are subject to infamous “death panels” that were vociferously denied by ACA proponents -- until they were acknowledged. Doctors entertain a menu of metadata, and if you are over the age, utility or wealth factors deemed salvageable, you’re given pills and expected to wrap it up. Step over to this grave. Thanks.
Also, little choice.
The doctor trying to schedule a patient with any modifiable factors pushes the patient to drop weight and smoking, cease whatever would be pushing them toward a high-ticket specialist. Then: wait.
Choice?
With huge deductibles, people choose not to go for a checkup unless it’s catastrophic. Can’t afford the cost of visits, if the care goes beyond ABC.
Enter liquid diets, pills, nostrums: trendoid fast fixes.
To see a patient for a simple knee problem, physicians must fill out a raft of electronically transmissible ACA forms on “meaningful use” -- a shopping list of 50 or 60 lifestyle factors to check or eliminate before patients can be helped.
This wastes time and resources before diagnosing something innocuous, delays treatment and recovery, loads red tape, and adds nothing for patients. It all irritates doctors, of course. Physicians are forced to take blood pressure and irrelevant redundancies that Lajam and the industry calls “noise” -- not cure nor therapeutics.
Weeks ago, Dr. Lajam consulted with Sen. Charles Schumer on these issues. She and her sponsoring hospital paid him $25,000 for an hour. He came 20 minutes late (but didn’t expect one-third less than the agreed price). The House and Senate had, happily, passed the Electronic Record Healthcare Fairness Act, which surgeons had lobbied hard for, eliminating the blizzard of avoidable ‘meaningful use’ questions, delay, cost- and cooling data and paperwork. After arriving $8,300 late, Schumer listened: state and city would save considerable bucks. He approved.
Signing off, Dr. Lajam concluded: “The city’s hard on people… New Yorkers are ‘everyday athletes.’”
We struggle, race to confabs, fight for parking, get dropped from must-see restaurants, tweet, swelter on snaking Shakespeare queues, and worry ourselves unwell. Hardly choice.
Read more: http://www.americanthinker.com/articles/2015/08/obamacares_true_cost.html#ixzz3k4HeWOnD
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