Review: What Have I Said Recently ?

Stanley Feld M.D.,FACP,MACE

I have been distracted from my main theme, the ideal Medical Saving Account as the vehicle needed to repair the healthcare system. I have been building the case for this system of self responsibility as the mechanism to repair the best medical care system in the world. The theme is patients’ must control their healthcare dollar to repair the healthcare system.

We must develop a system of incentives where provider prices are transparent and providers compete for the patient’s healthcare dollar. We must create a system where providers (hospitals, physicians, and other healthcare providers) are forced to become efficient to compete for the patient’s healthcare dollar on quality of care and cost of care. The result will be that healthcare costs will decrease and the quality of care will increase. This is the meaning of consumer driven healthcare.

The last few weeks have been spent on the “Dirty Coal Plants” TXU is proposing for Texas. These “Dirty Coal Plants” are being proposed all over the country because of the abundance of cheap dirty strip mined coal. Presently $34 billion dollars are wasted healthcare costs to treat illnesses resulting from the present levels of pollution. The healthcare costs resulting from the proposed “Dirty Coal Plants” in Texas and around the country could easily double and perhaps triple.

The point is that Dirty Coal Plants polluting the environment result in large avoidable costs to the healthcare system. These costs can not be controlled by the patient exercising patient responsibility.

Patients will be afflicted with unavoidable environmentally caused diseases once these Dirty Coal Plants are built and operational. The Dirty Coal Plants will be operational for the next fifty years. The illnesses and costs of medical care for these illnesses could be avoided if we do not pollute our environment.

One could look at building these Dirty Coal Plants as “man’s inhumanity to man in pursuit of the mighty dollar.” I have been amazed by how many people believe that the EPA standards are the state of the art, that the present EPA rules will protect us from pollution. If the levels were a concern the EPA would change the rules. Therefore, we do not have to become pollution experts. The EPA’s mission is to protect us from any environmental toxin that might be dangerous. We have delegated the EPA as our surrogate to protect us from pollutants that could harm us.

Unfortunately, this has proven not to be true. Two court judgments have gone against the EPA rules in recent months. The EPA has for some reason loosened standards of pollution since 2000. One should question why. Our advances in technology have given us the ability to decrease coal burning pollution markedly by building IGCC Coal Plants. Our advances in understanding the medical effects of pollution have demanded that we decrease our exposure to these pollutants.

I understand our need to reduce our dependence on foreign oil as an energy source. If the new Dirty Coal Plants result in an additional $68 billion burden to our healthcare system by avoidable disease healthcare costs, shouldn’t a prudent government be investing in creating incentives for renewable sources of clean energy such as wind and solar energy? At the same time shouldn’t we be investing in creating incentives for energy conservation? We could use the extra $68 billion saved to promote these efforts.

TXU claims there are other sources of pollution such as our automobiles. Shouldn’t we create incentives for automobile companies to decrease the pollution and increase conservation of fuel for our automobiles more than they have? Look at the impact of the Toyota Prius, without incentives. Toyota is not even an American company. Toyota has created a competitive advantage for their product. Other companies have been slow to follow with as efficient a product. In fact it seems they are trying to undermine the efficiency of the product.

America is a brilliantly creative marketing country. America has created many “hypes” in my lifetime. My first recollection was promoting cigarette sales even though the cigarette companies knew they were not good for us. I could not wait to be old enough to smoke a cigarette. Recently, it is flat screen high definition television. Congress has even taken time out from their busy work to set a deadline for digital HDTV.

Why can’t Congress create incentives for us to stop harming ourselves with environmental pollution? Perhaps there is not enough lobbying money in the effort.

Why can’t Congress get smart and use its creative energy to promote the health of our citizens, rather than bending to the vested interest pursuit of the almighty dollar resulting in more pollution and more medical costs to society.

It can only be done if the politicians, the government officials, and the government agencies are challenged by the citizens they are supposed to be serving. It is clear to me the evolution of the rules in our legal system and the institution of lobbying has removed citizen input for demanding what is in the citizens best interest.

The time has come to express ourselves. The citizens of Texas are trying to do that right now. However, we have a very refractory Governor Rick Perry and a very powerful corporation in TXU. TXU has not demonstrated any corporate community responsibility to date. I hope our legislative officials in Austin will be able to respond to the cries of the citizens and force this folly to stop!!