Dr. Steven Knope transcript, Part 2: ‘Health insurance is not synonymous with health care’

In my interview on Tuesday with Dr. Steven Knope, a concierge medicine pioneer, I asked what he thought about the movement in Washington to impose health care reforms.

His answer:

If you’re talking politics, let’s get it on the table: We’re talking about socialization of the entire country, whether that’s the auto industry, the banks, massive stimulus spending and omnibus bills and TARP. These guys are not playing by the rules, they’re certainly not following the Constitution of the United States. If they decide to put some of these fee-for-noncovered-services concierge practices in their sights, they could make life difficult for certain concierge doctors. It’s just going to depend on how tough these doctors are, how willing they are to fight as to whether or not the administration can get everybody in lockstep with this socialized medicine model. I’ll tell you that it will not happen in my practice. I have several constitutional lawyers in my practice who have already agreed to take this to the Supreme Court if necessary. I will personally never return to a hamster wheel practice again. I will leave the country before I do that. Trust me: I take care of people from Canada who fly to see me. I’ve taken care of people in the English system. My patients have had disasters while traveling in New Zealand. There is nothing — nothing — good about big government managing medicine. It just doesn’t work.

Health insurance is not synonymous  with health care. There’s nothing synonymous about it. If you look at this experiment in Massachusetts, which was very interesting, everybody in the state of Massachusetts has now been mandated to carry health insurance [MM: Although members of health care need sharing ministries have been exempted]. What they’ve rapidly found now is that there aren’t enough primary care doctors to actually see the patients. Now there’s a year and a half wait to see an internist. The ERs are still overflowing now with people who have insurance but don’t have a doctor.  (President Barack) Obama and (U.S. Rep. Nancy) Pelosi and all of these folks who think that you simply insure people and now everyone gets health care are sorely mistaken. This is no more well-conceived and thought out than was the stimulus bill that nobody read. At some point, intelligent people have to stand up on both sides of the aisle and say, ‘Look, I know what you want and I know the kind of utopian values you profess to have, but if the numbers don’t work, then why don’t you explain to me why you think this program is going to work? If Medicare and Medicaid are already scheduled for bankruptcy and we’re already insuring 30 million people on that program, then how are you going to insure and take care of 300 million?’ The numbers don’t work. It’s analogous, when I listen to this politically correct speak, it’s really analogous to dealing with one of your teenage children. ‘Daddy I want it now.’ You say, ‘Look, we live in a real world with a budget. You can’t get a BMW at age 16. It’s not going to happen.’ ‘But I deserve it. My friends have one.’ ‘I understand, but that’s not the reality. The numbers don’t work.’

I’m not hearing even liberal publications like the New York Times or the Washington Post or the Huffington Post for that matter come out and say, ‘Look, these are the numbers of the Obama health care plan and this is why it will work and this is what conservatives don’t understand about it.’ I don’t hear any substantive discussion like that where people are saying, ‘This is why it will work. Let me convince you. You don’t understand.’ It’s this moralistic, utopian, ‘It’s a right, it has to be there, write the check and we’ll figure out later how we get the money into the account.’ It’s just absolutely without any rational thought at all. Not that I’m passionate about this. (Laughs.)

You look at this, you see Boehner standing there, John Boehner, standing there on the floor of Congress, and he drops this 1,100-page stimulus package that he got 11 hours earlier and said, ‘Nobody in this entire Congress has read this bill and we have just spent over a trillion dollars with interest.’ Bam! The thing hits the floor. And if that were not enough then here we are 120 days into this saying, ‘Now we need to do the same thing in health care. We just need to rush this through.’ It’s absolutely irrational.

Concierge doctor on personal responsibility and giving back

hires-steven-knopeI had a great interview with Dr. Steven Knope yesterday. Dr. Knope, author of “Concierge Medicine: A New System to Get the Best Healthcare,” is one of the pioneers of the concierge medicine movement, a model in which patients pay what amount to retainer fees monthly or annually for certain guaranteed services from doctors as well as discounts on other services. 

I’ll post the whole piece up here once it’s published, but I just finished transcribing his answer to a question about  personal responsibility and giving back to the community that I thought was particularly interesting. Here it is:

The first part of my career, the first 10 years, I took care of people with emphysema who smoked. People who were diabetics who refused to lose 10 or 15 pounds. Sedentary. Everybody wanted a pill. Everybody was on an HMO. Everybody wanted someone to fix them and they virtually wanted to do nothing for themselves, as a general statement. I remember the first time this dawned on me that this was really kind of a self defeatist approach. I had a woman that I was seeing free of charge who had lost her insurance, that I was seeing at 3 o’clock in the morning for an exacerbation of emphysema, and she continued to smoke. I came in at 3 o’clock in the morning and I was exhausted. I had seen 40 patients the day before and was going to see 40 the next and I said, “Look, we have to have a come-to-Jesus talk here. If you want me to treat you free of charge when you’ve lost insurance and you want me to get up at 3 o’clock in the morning and be at your bedside, I think it’s perfectly reasonable for me to ask you to stop smoking, and if you don’t do that, then I’m going to ask you to waste another doctor’s time. I’m not helping you by promoting this kind of behavior. You’re not helping me. And, frankly, you’re just taking advantage of my good will.” Though that may horrify some doctors, the lady quit smoking and she stayed in my practice. I think that unless people have skin in the game, unless they’re paying for their care, unless they’re investing in their health, people don’t really value things that are free to them. Now when I hear about a World War II vet or a Navy Seal or somebody who is getting crappy medical care and they are these incredibly responsible individuals who helped us both enjoy these wonderful freedoms, those are the kind of people I really want to seek out and say, “What can I do for you? I owe you. I was never in the military. It should be my honor to take care of you and help you for your service.” I don’t think that fits in with traditional physician philosophies. It probably rubs a few people the wrong way. I just think I’m probably going to get better results this way as opposed to playing the victim role and the enabler role.

One point to make here is that concierge doctors often get a bad rap as being “elitist” because some annual contracts are expensive. Here’s a guy, though, whose practice is split evenly between paying patients and indigent/poor patients, some of whom are veterans who are not receiving the respect they deserve from our society.

I’ll post his comments on Congress’ and Obama’s health care “reform” proposals a little later.

Lashon Hara

I strongly recommend listening to Daniel Lancaster’s three sermons on Lashon Hara, or the evil tongue. The messianic teacher explains how Scripture looks at gossip and the roles it plays in our lives and communities. You can find the mp3s here.

Life Line, June 7, 2009

About 75 people, from 4 months old to 85 years old, showed up along War Memorial Drive in Peoria, Ill., from 1:30 to 3 p.m. Sunday, June 7, to pray for an end to abortion.

Life Line was organized by Bradley University freshman Alexandria Reynolds. Though it was intended to be youth-centric, plenty of older folks showed up, too, to lend their support.

For a first-time event, it went off very well. Alexandria and her friends had prepared hand-painted signs with instructions on the back, including ideas for prayer.

Participants stood along War Memorial Drive, also known as U.S. Route 150 — probably the busiest street in Peoria — holding signs with such messages as “Better Off Alive” and “Yay for Kids.” Reynolds emphasized the positive nature of the event, which came one week after the murder of abortion doctor George Tiller but had been in the planning stages for months. It was an opportunity to show the peaceful nature of the pro-life movement.

Most drivers honked and waved their support. Only a few made some, uh, negative hand gestures.

Links to news coverage are here and here.

Below are some photos I snapped:

Participants in Life Line line up along War Memorial Drive in Peoria, Ill., on June 7 to pray for an end to abortion.
Participants in Life Line line up along War Memorial Drive in Peoria, Ill., on June 7 to pray for an end to abortion.
Young pro-lifers show their support for the movement.
Young pro-lifers show their support for the movement.

Obama’s Muslim speech

My brief reaction to Barack Obama’s speech to Muslims in Cairo last week:

  • Fairly innocuous and fawning in most respects, with a lot of verbiage and little concrete material. In other words, typical political speech full, unfortunately, of politically correct language (“extremists” instead of “terrorists”).
  • Irritating in some respects. Each time he would bring up an issue, such as human rights, he would talk about what the U.S. has done rather than the problems that exist in Muslim nations. On the other hand, perhaps he was just getting the thought into their heads and then trying to say, “Hey, we’re doing our part, now you do yours.”
  • He promised to make a particular effort to help Muslims, especially Muslim students, to have economic success in the U.S. Why not all foreign students or all students of all religious backgrounds?

UPDATE:  As pointed out at jihadwatch.com, Obama also claimed for Islam a “tradition of tolerance” that doesn’t exist. That’s clear from the many Christians, Jews, Baha’is and others that Muslims  have persecuted, sometimes violently. Anytime they didn’t in a Muslim-run nation, it was only because a dhimmi tax was paid by the non-Muslims. This statement by Obama is either a result of ignorance or an attempt to whitewash Islamic history.

Good insights on the Israel content of the speech here.

Update from Jihad Watch

Robert Spencer at Jihad Watch updates the “Muslim country” situation. The White House has released the transcript of the interview. The pertinent section is this:

Now, the flip side is I think that the United States and the West generally, we have to educate ourselves more effectively on Islam. And one of the points I want to make is, is that if you actually took the number of Muslims [sic] Americans, we’d be one of the largest Muslim countries in the world. And so there’s got to be a better dialogue and a better understanding between the two peoples.

That’s still not accurate. Spencer thinks Obama may have gotten this idea from Congressman Keith Ellison, himself a Muslim.

Obama says U.S. ‘Muslim country’

Barack Obama has his share of gaffes: claiming that the U.S. Constitution was written 20 centuries ago, the Special Olympics gaffe, etc. 

Now, in another amazing blunder worthy of Vice President Joe Biden, Obama this week claimed that the U.S. could be seen as a Muslim country:

In an interview with Laura Haim on Canal Plus, a French television station, Mr. Obama noted that the United States also could be considered as “one of the largest Muslim countries in the world.”

While I generally don’t like to depend on Wikipedia for any facts, a fairly well-footnoted entry  ranks the U.S. as either 38th or 54th — depending on which figures you’re willing to accept — in raw numbers of people identifying themselves as Muslims. As far as percentage of population, Muslims are only 0.6 percent of U.S. population — not even coming close to cracking the top 60 listed. (See here.)

So in what sense is the U.S. “one of the largest Muslim countries in the world”? Because we’re a large country and we have a few million Muslims? Are we a Muslim country in the sense that many for years have been saying we’re a “Christian nation”? Every time a Christian makes that latter claim, the church-state separationists are up in arms.

Is he saying the values of the U.S., although he has spent his first months in office saying our values stink, are representative of or represent the values of Islam? Even if one accepts this claim in general terms, defining Islamic values as a continuum of Judaeo-Christian values, I believe that Obama’s declaration of June as LGBT Pride Month alone would rule that out.

Or is the statement a flat-out attempt to pander to Middle Eastern Muslims, with whom Obama will meet this week?

I’d like to hear a full explanation of why he thinks the U.S. should be considered “one of the largest Muslim countries in the world.”

More views:

Roger L. Simon’s thoughts here. Robert Spencer also comments on Jihad Watch.

Committing murder is not trusting in God

This from the WSJ.com health blog about the man accused of killing abortionist George Tiller:

Morris Wilson, a past member of the Kansas Unorganized Citizens Militia who has since renounced his ties to the group, told the WSJ that (Scott) Roeder had been a fellow member. He spoke strongly against abortion and “felt he needed to do something,” Wilson said.

There is a frustration that comes with being pro-life, frustration that very little seems to change as babies are slaughtered in the womb every day.

Murder is not the answer to that frustration.

If we believe in the sanctity of life, we also need to believe in the God who gives that life sanctity. And if we believe in that God, the God of the Bible, then we need to trust that He is working in the perfect way to bring this tragedy to an end. “For we know Him Who said, ‘Vengeance is Mine; I will repay.’ And again, ‘The Lord will judge His people'” (Hebrews 10:30).

He will judge us on how we address this situation. Do we murder, like our opponents do everyday in abortion clinics, or do we sacrifice and extend love through crisis pregnancy centers, adoption? Will we “visit orphans and widows in their affliction” (James 1:27)?

Justice will ultimately out. If we believe in God, we have to believe that. Our job is to keep at it in peaceful ways.

George Tiller’s life, as reprehensible as his actions were, was just as precious to God as everyone else’s life. Up to his very last breath, the possibility of repentance and salvation was there for Tiller. No one had the right to take his life without the due process of law. Unfortunately, the law does not at this time consider abortion to be murder. What Tiller did was legal. Our entire nation will be judged for that. And Scott Roeder will be judged for murder.

Douglas Wilson helps to put the George Tiller murder on Sunday into perspective:

Well, no, because the Supreme Court doesn’t have the authority to declare murder okay, and only ghastly human beings like Tiller think they do. When such men take the Supremes up on their invitation to any slaughter that has been given the legal okay, they are helping to create a society in which lawlessness reigns. They cooperate with those who frame mischief with a law. But once this lawlessness has taken root, the bright boys running everything start to discover that lawlessness has certain shortcomings as a social theory.