An Open Letter to my fellow medical professionals about California's Proposition 45 and the primary obligation we have to protect the well being of our patients.
Like generations of doctors before us, when each of us graduated from medical school, we were asked to raise our hand and recite the Hippocratic Oath. This was a defining moment in many of our lives. Reciting the words carried great weight and purpose: "I will apply all measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice."
It is through the prism of these words that I watch you appearing in advertisements against Proposition 45 and react in horror. Dr. Amy Nguyen Howell, Dr. Marshall Morgan, and Dr. John Maa, I believe you are betraying your Hippocratic Oaths, and Registered Nurse Candace Campbell, I believe you are betraying the Nightingale Pledge. In fact, in your roles advocating against Prop 45, you are spreading lies designed to mislead and scare the public -- our patients -- in order to protect the insurance industry. It is unconscionable.
The facts are that since 2002, health insurance premiums have increased 185%, while wages for the bottom 70% of our state have remained stagnant. During this same time, California health insurers have issued over 45.7 million denials of treatment, while making record profits which have translated into record cash reserves in the billions.
So let's take a real look at your arguments:
In advertisements paid for by the health insurance industry, you claim that we should keep the new "independent commission" and that special interests are sponsoring Proposition 45 to give "one politician" new power over our health care -- including what treatment options our health insurance covers.
First off, there is absolutely no conflict between this new "independent commission" -- Covered California -- and Prop 45. The Affordable Care Act (Obamacare) was written to accommodate just this sort of rate regulation, and 35 other states already have some version of it.
Covered California is actually run by purely political appointees, some of who have a long cozy history with the private insurance industry. Unlike the State Insurance Commissioner, who is publicly elected to serve as the ultimate consumer protector, the citizens of California have no say in who is appointed to this "independent commission" whereas the Insurance Commissioner is publicly accountable and can be voted out of office.
As for giving the Insurance Commissioner new power over treatment options, this is false on so many levels. First and foremost, it is the private health insurance industry and their administrators, many of who have never cared for a patient, who are denying care, while telling doctors what treatment and drugs they can provide. Our Insurance Commissioner does not do this now and Prop 45 will not give him the authority to do so in the future.
In fact, Prop 45 would simply apply the same regulatory framework to health insurance which has proven so successful regulating auto, home, and medical malpractice insurance in California. Auto insurance rates have actually decreased in the 26 years since Prop 103, saving Californians billions of dollars in premiums. In 2012, our state Insurance Commissioner actually saved doctors like yourselves over $44 million in excessive malpractice premiums using the very same system proposed in Prop 45.
With regard to special interests funding Prop 45, it is actually Big Insurance -- Kaiser Permanente, Well Point, and Blue Shield -- that is spending $37 million of our patients' premium dollars to try and kill Prop 45.
For every dollar that is spent on this campaign trying to protect patients against excessive, unreasonable health insurance rate increases, Big Insurance is spending almost 40 times as much to protect their lucrative status quo.
So, I urge you to stop spreading these lies. I challenge each of you to publicly debate the facts in person. Our patients are suffering mentally and physically from outrageous rate increases, and as the Hippocratic Oath makes clear, we must "keep them from harm and injustice." I call on you to renounce your opposition to Prop 45 and remember the promise you once made to all of your future patients.