RUSH: Richard in Philadelphia, great to have you, sir, on the Rush Limbaugh program. Hi.
CALLER: Hi. Welcome. I'm a critical care and pulmonary physician outside of Philadelphia.
RUSH: What is a critical care physician?
CALLER: I take care of patients who are in the intensive care unit on mechanical ventilators after surgery. Sick patients.
RUSH: I see. Okay, thank you.
CALLER: They come in with heart failure, pulmonary failure. Anyway the patients... I work in the city hospital. They have a wide range of insurances to no insurance to the best, and everybody gets what they need. If they need a pacemaker, they get it. They need a consult for any physician dialysis, they get it. There's no questions asked, and no consultant has ever refused a consult. The day that some --
RUSH: May I stop you there for a second?
RUSH: Don't lose your train of thought.
RUSH: But you've reminded me. We never do hear these horror stories in this country of people who need the things you just described, being denied them. We never do hear that. We hear it from Canada. We hear it from Great Britain, but you're right.
CALLER: It doesn't happens. It doesn't happen.
RUSH: Everybody listening to you is wondering, "Well, you just made it sound like whether they can pay for it or not, they get it."
CALLER: They get it. The "pay for it" is after the fact. They get what they need. I've had uninsured patients who got defibrillators at $25,000 a pop, but nobody batted an eye. They needed it, they got it, there were no questions asked. The day a government bureaucrat tells me that I can't put a lifesaving pacemaker in a 95-year-old lady who's otherwise vital, is the day that I retire. I'm 54 years old.
CALLER: I'm at the end of the line. I'm actually looking at this more as a consumer of medical care than a provider anymore. My wife is a primary care physician and she takes all the insurances, half of which don't show up for appointments. Most of the patients are the ones who are getting free care, because there's no sense of responsibility anymore.
RUSH: Yeah, that's a whole 'nother aspect.
CALLER: Yeah. And one other thing, if I may. The AMA. I am only drawing the AMA a few times and that's to get malpractice insurance. I have never been a member of the AMA otherwise and they've really embarrassed themselves today, going for this proposal.
RUSH: I'll tell you, I am so glad you called, because you just said something that we all know but we never voice or even realize. Be it the emergency room or wherever -- and you're talking about intensive care. You're talking about people admitted to the hospital.
CALLER: Oh, yeah.
RUSH: What we do hear in this country are stories about how people do get turned away if they can't prove they can pay.
CALLER: No way. I mean, people --
RUSH: It's not true because we don't hear it. We do not have these stories of people dying because they didn't get this or that. We do hear these stories from countries that have socialized and government-run health care systems.
CALLER: I've gone up against insurance companies. Can I have a quick story?
CALLER: A patient of mine was going to go home on a tracheostomy collar with a hole in her neck and a lot of equipment after being saved after three months. The local independent insurance agent here would not cover the ambulance ride home. She lived on the third floor. So I actually called the insurance company up and I said that I will report them to the local news agency because what pictures they would get from a patient sitting on the lawn because they were refused an ambulance ride home by the insurance company.
CALLER: That got them to shake their rear end and get the ambulance. If I call a government bureaucrat they would say, "Press number nine and leave a message."
RUSH: (laughs) Exactly right. Exactly. Illustrating how the private sector handles this stuff. Caregivers are caregivers.
CALLER: I'm a patient advocate, and I always have been, and so have my partners and the people with which I work. We're upstanding. There's bad apples in every group, but doctors are...
RUSH: So you have people from all various economic circumstances in your hospital?
CALLER: Oh, Rush, absolutely. And you do the best you can, and you communicate with the families, and, you know, when this comes along, I'm hanging it up. I try to retire the best I can. So can my wife.
RUSH: Well, let me ask you this. You said you collect after they go.
RUSH: They pay after they leave.
RUSH: We do hear about people who get care -- and I've heard this. I had a friend of mine repossessed the cars of people who welched on their hospital bills. But the hospitals make deals with them right? Do what you can to recover the costs.
CALLER: Yeah, absolutely. And there are plenty of patients that give false information, false cards, false numbers and you don't get paid. You try your best, but we have so much write-offs in uncollected bills. But I sought to pay any malpractice and my staff and the other doctors. I haven't really truly gotten a raise in 20 years, if you go against inflation because I don't have a lot of procedures and I just do medical bedside clinical care. But I don't have much. I have one procedure that I don't do very much. It's a bronchoscopy, but that's it.
RUSH: So you do it because you love it.
CALLER: Yeah, I mean, there's plenty of days you go home and you say, "I hate this but," you know, the few patients that come by -- especially after they die, because I take care of some sick patients -- and they thank you for trying your best and making my husband's last day's memorable or comfortable. I get a lot of satisfaction out of that.
RUSH: Are you serious when you tell us that if this plan, as you understand it is implemented, you're out?
CALLER: The day that I am forced to not provide patient care that I and my colleagues deem critical, and some government, high school dropout is going to tell me, "No you can't have that. Granny's too old." That's your Hippocratic oath, isn't it?
RUSH: Most certainly is.
RUSH: Tell me. In your sphere of friends and colleagues who are also in your business, is the sentiment common that you just expressed?
CALLER: Well, certain doctors I work with are full-bore behind Obama, you know. I call a lot of them "the bow ties," because they don't get out of the lab and they're churning out their papers.
CALLER: But they don't work on the front lines like a lot of us who get calls at three or four in the morning.
RUSH: (laughs) The bow ties.
CALLER: Yeah, that's what I call them.
RUSH: Because they don't get out of the lab.
RUSH: They're churning out their papers but they don't work on the front lines.
CALLER: You know, they want us to see a few patients -- they have to see a few patients -- over time because they have to fulfill their obligation to the medical school. But other times they can't wait to get back to the lab so they can churn out more documents to get more funding from NIH.
RUSH: I was playing golf yesterday with a guy who was telling me about his family. I knew him just from previous golf tournaments. He's not a close friend, but he told me he was very proud of his daughter who was going to go to medical school. She wants to become a golf surgeon and because it was golf, I did not say, "Are you sure she wants to do that given what's coming to health care?" but what would you tell somebody who wanted to be a heart surgeon?
CALLER: Well, I have two kids and they're grown up and they're in their twenties and graduated and my wife and I never encouraged them to be doctors but we never discouraged them, either. We let them see what the real world is and they listened to us a dinner, our complaints but also our sense of satisfaction of doing the right thing for people. I mean it.
RUSH: You do your best.
RUSH: -- and you work around the obstacles that people put in front of you. Richard, great call. Thank you so much.