Doctor in the House: an interview with author Congressman Michael Burgess, M.D.

When Dr. Michael Burgess gave up delivering babies in favor of kissing them, most physicians thought he was crazy.

After reliving the September 11th World Trade Center nightmare in his head for weeks, the successful obstetrician decided to run for Congress in his Republican district of North Texas against the well-funded and well-named son of then Majority Leader Dick Armey.

Not only did Burgess win, but he has quickly become the thought leader of American medicine in the United States Congress.

In his new best-selling book, Congressman Dr. Burgess retells the story of his first years in the House of Representatives where another nightmare unfolded: the Democratic creation of Obamacare.

His work is entitled Doctor In The House and it contains the prescription necessary to heal the ills of American health care.

In this blog we engage in a spirited discussion with Dr. Burgess. Let us know what you think.

Is Obamacare unconstitutional?

Is Obamacare unconstitutional?  That's the question we address today on docdano.com.  Darren Whitehurst and Dan Finch from the Texas Medical Association join us today to discuss the Virginia federal judge ruling that the health reform bill is unconstitutional.  What does it mean?  And what effect is it going to have on the upcoming session of Congress?

So what is an accountable care organization?

Mortgage meltdown or medicine meltdown?

As we enter the final phases of the election cycle you can get a good idea of the spoils of big government just by looking at the rhetoric in the campaign.

Clearly, one issue is dominating the election this fall: the economy, and more specifically the lack of jobs.

So I would like to pose a few questions and ideas on just how government actually performs in creating economic growth and in kick starting job growth. I don't necessarily have the answers, but I'm real good at asking questions.

Did government assisted mortgages help the economy? Certainly by artificially lowering mortgage rates and the creation of investor owned, government back sub-prime mortgage equities, the federal system of assistance in home buying has become the norm.

But given the meltdown in the mortgage industry, did we do a service to Americans by putting people in homes they couldn't afford? Flipping houses became the source for a evening cable television show and the folly of many particularly young home buyers.

As liquidity in the mortgage market disappeared so did the dreams and savings of many Americans -- including those that had invested in the "government" back equities of Fannie Mae and Freddie Mac.

Is government funded healthcare going to be beneficial for our country in the long term? Just like mortgages, are we going to put our country into a health system they can't afford?

Out current federal health legislation creates "coverage" for 85% of our citizens, but does nothing to promote access to care or an improvement in health care choices.

The latter is particularly concerning.

Regardless of the life style choices one makes, there is a guarantee of coverage. There certainly needed to be an improvement in health care services for the uninsured, and there needed to be some limitations on the growth in spending, but wouldn't it have been better to put incentives on the user?

The real question becomes: will we be facing a health care meltdown just like the mortgage industry? As the requirements for health care services rise, there being no limitations on cost, and no impediments to limiting health care decisions, can the system continue to function?

The biggest concern here is whether physicians and other health care industry providers (pharmaceutical companies, insurance companies, hospitals) can continue to function in an economic environment of continued declining reimbursement for services.

This is especially true given the proposed 23%+ cut in Medicare rates next month with more to follow in January.

Will there be a decline in health care liquidity?

Physicians and other health care providers may find themselves in a situation much like the mortgage industry: servicing consumers with health care services they and the government really can't afford.

I guess the real question is will there be a foreclosure on your new sub-prime health coverage?



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Perry-Palin in 2012? Hillary Clinton in 2012?

As we enter the final weekend of this political season I thought I would take a few moments to suggest some possible scenarios for 2012 that will begin as soon as the last ballot is cast on Tuesday.

Here are some thoughts:

Perry-Palin 2012? Could this be the next Republican dream team? Before I get the laugh lines and hate mail let me make my point.

Both of these individuals have been or are Governors from large states with many similarities. Texas and Alaska have faired much better than their counterparts in the latest recession, have enjoyed a relatively friendly tax environment, have benefited from the increase in energy demand, and, lets face it, represent geographically about a third of the United States.

But more importantly both Rick and Sarah correctly identified early on the upswing of the Tea Party movement and latched on. I think this "movement", I don't really think it qualifies as a Party yet, has surprised almost everyone's expectations about its growth and popularity. I'm not sure where it will end up, but these two mavericks have been riding the wave into this election season.

Both have also been able to run as "non-incumbents". This has been easy for Palin (read: jobless), but despite the anti-incumbent rage sweeping the country, Perry has been able to be the outsider in the current Texas governor's race. He has successfully painted his opponent as being part of the "problem" by using his mediocre performance as Houston mayor as the whipping post.

Will I vote for this team? Not sure, but it will make for an interesting discussion as we move into next year and both are not running for President. Right.

Now think about this: Hillary Clinton the Democratic nominee? I know this sounds far fetched.

But think about it for a moment. Assuming President Obama is defeated in his bid for reelection, Hillary would face the risk of a four to eight year stint of being on the outside of a Republican administration. (And she would likely be too old to run at the end of an Obama second term.)

So what would happen (assuming the Democrats get trounced in the Congressional elections) if Clinton resigns her post as Secretary of State, moves back home, and now jobless -- turns into the Palin-type evangelist of change and returns to the Democratic principles that she campaigned on (and remember, almost won).

She could certainly make the argument that the wrong choice was made in selecting Obama and he has moved way outside the mandate for American that swept the D's into power.

If she could somehow manage to recreate the mid-term rehabilitated mode of her husband Bill during his first term (move slightly to the center, fiscal responsibility, make the country's problems those of the Republicans), she might offer hope to the Democratic Party.

Particularly if there isn't a valid Republican nominee (read #1).

Plus, what an exciting political season. We haven't had a sitting President with a primary challenge in a long time.

I know everyone just can't wait to start this circus all over again.


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Location:AA Flight 2324: somewhere over Illinois

Obamacare - You want fries with that?

A recent article in the Wall Street Journal and the followup editorial concerning McDonald's decision to consider ending health care coverage for its work force has sparked controversy.

But it is a very compelling message.

Obamacare, or more correctly, the new federal health legislation passed in the spring by the Democratic Congress, promised to "keep your current health coverage intact."

But as the law goes into effect, it is confirming what we pundits have been screaming from the beginning: it will impact everyone in America.

Read: everyone. From the uninsured (which hopefully will see expanded coverage but still be challenged with with limited access) to tax payers to small business and yes, to physicians, everyone will see an impact.

And it will vary from the potential double digit increases on private indemnity insurance for those 25 year old new entrepreneurs to the seemingly bizarre requirement that small business owners will now have to issue thousands of additional 1099 forms to virtually every vendor they purchase products or services from.

So for McDonald's to be considering eliminating health care coverage may not come as a surprise. Now before my faithful readers start sending me emails about "how these were minimum benefit plans" and "these workers deserve better care," let me preempt you.

McDonald's offers ground level employment for thousands of young people -- and many part time workers. So for them to be offering any health care benefits to begin with was extraordinary.

And now to have them being forced to either enrich the plan with added benefits and cost, or abandon their current entry level health benefit structure is an example of how they too will be impacted by the legislation.

But for all the bad that has been said about the federal health regulations, the most chilling concern that I have is that at the end of the day despite the super-sized money and new statues that have been created -- we may not see an improvement in the access and quality of care.

There is no value meal here.

My interview with Dr. Michael Burgess, Congressman from Texas, on some provisions of the new federal health plan