Thursday, August 13, 2009

Dr. Michael Richman on Health Care

Dr. Michael Richman is Dennis Prager's doctor, at least for cardio-thoracic issues.  He has twice been a guest on Dennis' show, discussing cholesterol and other factors involved in heart disease.  In a recent conversation, the good doctor mentione that although he voted for Barack Obama, he now regrets that vote, because of what havoc Obamacare promises to wreak upon the American health care system.

Dennis interviews him in the last half of his second hour, August 4, 2009.

Following is a transcript, from the podcast available through Pragertopia --

Dennis Prager show, 8/4/09, hour 2

(Start: 13:40)

DP: Well talking about that health care bill issue, I mentioned something yesterday that on a human level fascinated me, and I just want to say a word about my own interest in this matter. I don't care about the politics of the people that I hire or work with in my private life. If you do a good job, I don't care if you're a liberal, if you're a conservative, if you're a Democrat or Republican. It doesn't matter to me. And it shouldn't matter. I mean, that's why I still buy Ben and Jerry's ice cream. I mean, these guys are crackpot lefties. But I like their ice cream.

See, the left does this. They won't buy from, you know, if they know somebody was – well look. Look at the way they try to put out of business anyone who gave any money to Proposition 8 in California. Anyone who things marriage ought to be between a man and a woman should be put out of business and go bankrupt. This is the left's view. But the right doesn't have that view. I don't know anybody who boycott's Ben and Jerry's ice cream, though there is no left-wing position they do not publically champion. I mean, I'm surprised they don't name their ice cream after bills. You know, the same-sex marriage chocolate ... I'm serious. That is how overtly political Ben and Jerry's is.

Well anyway, how does this apply to my next guest is, the doctor that I have brought to you that I have as m y own doctor and who I believe – I don't know if he saved my life, he may have – I wasn't in a life-threatening situation, thank God, but who knows? I think that a lot of people became aware of this – who was the broadcaster again? The famous broadcaster? Oh, Tim Russert. Well, poor Tim Russert in his 50s died all of a sudden. People wondered, what were his numbers? I believe I have saved a lot of your lives through Michael Richman, the doctor that I have been going to, and he is now the unofficial doctor, or the physician, of the Dennis Prager show.

Well, it turns out, and I knew this, that he voted for Barack Obama. It didn't mean a thing to me. My doctor can be brilliant in medicine, and wrong in politics. Hey! What do I care?

Well anyway, just the other day we were talking, and one thing I'll tell you about Michael Richman, when he studies an issue, and I mean this, to your credit, he's an extremely serious guy. And he is about the heart, which we've talked about, protecting you heart, and methods that he uses that I think do – I know do a great deal in saving lives, that not all physicians do, unfortunately. And then, looking into the health care issue, likewise, he has brought his razor-like mind and OCD, God bless him, you know, obsessive compulsive, it's not a disorder though in your case, it's a wonderful blessing to the rest of us – OCB. Obsessive Compulsive Blessing. And told me that he regretted voting for Barack Obama. And I didn't even ask you. I didn't care, your politics are your politics. But I love you for your medicine and your integrity. And so I said, "would you be willing for me, cause not a lot of doctors or other would – people are afraid to come out publically – look at the AMA's position" (maybe you'll have a thought on the AMA in a moment). But he said no, absolutely, you could mention my name. And I mentioned that Dr. Michael Richman deeply regretted having voted for Barack Obama. And so I said, "why don't you come on the show and talk about it? and here he is, so Dr. Michael Richman.

DP: Now why does this thing here say thoracic surgeon? Aren't you a heart surgeon?

MR: Right, but it's cardio-thoracic. It's heart, thoracic means chest. So lungs, esophagus..

DP: Oh, really, all of..

MR: Correct.

DP: OK, Very good.

MR: But you know of my cholesterol center, obviously, which we're talking

DP: Yeah, which we always put up at ... you go straight or you can go through our website. OK, dr. Michael, thanks for coming in, he's wearing his – what is that, the superman outfit that doctors wear? What is this blue outfit?

MR: Well I needed it, I got here in 20 minutes since Alan called me at ten to ten and I was seeing a patient.

DP: Oh, I see, so that's it so in case you were stopped by an officer of the law?

MR: No, you know this is my outfit

DP: Yeah, that's right. All right, well very good. It adds to the credibility of what you have to say, especially here on radio.

MR: thank you

DP Just as my tie is effective. All right, we'll be back in a moment and I will ask, in all seriousness, Dr. Michael Richman what troubles him about the health care bill. Coming up.

DP: You know, I have come to the conclusion there is no subject that is too serious for the nonsense that we're prepared to surround it with on this program. There really – that's it. this country may turn in a direction from which it may not be able to go back, and we're playing Doctor, Doctor, I love you, whatever it is. All right. that's fine with me. Anyway, I do love this doctor, Michael Richman, who is not only mine, but many of yours as well. And we have only talked medicine in the past. He voted for Barack Obama, and told me two days ago, out of nowhere – I don't even know how it came up – but he said he does regret having voted for the man, and we're not gonna discuss Barack Obama, that's not the issue, it's the Barack Obama medical care plan.

So first of all Dr. Michael Richman, cardiothoracic surgeon, in West L.A., and founder of the lipid center, welcome back to the show.

MR: thank you, I'm so happy to be here.

DP: Well wonderful, I'm happy to have you. Um... It's such an enormous subject. Let me begin with a psychological question, all right?

When one has faith in a person or system or whatever, and then feels betrayed, was it a painful thing to come to feel that you voted wrong?

MR: Well although I do agree with some of the positions, you know we all believe in certain positions which affect us, and I did not believe that the health care bill would get pushed so fast. Like it's been going on for years and years, and now in it's present form it is gonna destroy health care and destroy doctors, so since it affects me and my patients, and health care in general, I'm frightened.

DP: OK, that's a very big statement, destroy health care as we know it and destroy doctors and patients. That's a pretty big, tall order. Which do you want to begin with, the health care part or the doctors part?

MR: Well, we can begin with the current state of health care.


MR: 'Cause I don't want people to think that I'm a disgruntled doctor cause you know I'm not. I love practicing medicine.

DP: Yes

MR: But I want to talk about the state of health care in this country. First of all, *this is the best health care in the world*, as evidenced by the Arab royal families. The Jordanians go to Texas Heart Institute for their cardiac care, the Saudis go to the Cleveland Clinic, and the Kuwaitis go to the Mayo Clinic. In fact, they have an 11,000 square foot runway at the Mayo Clinic in Rochester, MN. And I went to college with a Jordanian prince who had a very bad injury and they airlifted him immediately from Jordan to Texas Heart. Believe me, England and Germany are a lot closer.

DP: Yup.

MR: OK, so our health care here is phenomenal, and *everybody does have access to health care*. I trained at L.A. county USC, did my six years of general surgery there. You may not like your roommate. He may be cuffed to the bed because he was arrested for a felony, but I gotta tell you, the care is phenomenal. Phenomenal. They have one of the best surgery departments in the world. And there're very few places that if you have an esophageal cancer, that you can have your esophagus taken out by the foremost esophageal surgeon and have a colon put in its place rather than how most guys do it with a – put up a stomach. Yes, the facilities are dreadful and the food is dreadful, but everybody has access. Everybody can go there. So the problem right now is access. It's not quality, and they're misinterpreting that. Because what's gonna happen is quality's going to be destroyed and we can touch on that but it's an access problem.

DP: I wanna just tell my listeners – And I know you can vouch for this because – We discussed nothing of this in advance. Nothing. All I knew was a doctor that I personally entrust with my life and have brought onto this show to talk about medicine happened to vote for Barack Obama, changed his mind, I said "would you like to come on the air?" That was it.

I have said, over and over, we have the best health care. And so to hear you say this, and for ... it is so destructive for people to think that not having health insurance is the same as not having health care. That's not true. As you point out, better than I have, about what is available to anybody. As you say, in a county hospital, you may not like the guy you're next to, it's not going to be a great room, but it's going to be great care.

We'll be back in a moment, and you are free to challenge him all you like, 1-8-PRAGER-776 with Dr. Michael Richman, I'm Dennis Prager.

(break: 24:09)

DP: Hi, everybody, welcome back. Dennis Prager here with my doctor, Dr. Michael Richman, yes, *my* doctor, and the show's doctor for that matter. We've talked only medicine. He voted for Barack Obama, and told me that he regretted doing so. He is deeply worried about this overhaul of the health care system. And you were talking about the effects on American health. He began by saying something that really is disturbing because I believe it was the President himself who said that we pay the most but don't get the best medicine. We *do* get the best medicine in America. We do. And it's angering that the President of the United States denies that fact. Yes, we pay more as a percentage of GDP, or per capita, but we get more. That's just a fact. And we *do* live longer if you remove murder and auto accidents. We do live longer, and a cancer patient is far more likely to live more years, here than anywhere else on Earth. I mean these things should matter to you my dear friends.

All right. Now back to Dr. Richman. You are worried – should we talk about the loss of three things? You want to go to that?

MR: Right, sure. Absolutely.

DP: OK. You were worried about this bill, or these bills leading to a loss of choice, a loss of privacy, and a loss of excellent doctors. Why don't we begin with the excellent doctors?

MR: OK. In 1997, I began my heart surgery retraining. You were lucky to get a spot in any program. I would have gone anywhere. Last year, they only filled two thirds of the program. because you can't sustain, believe it or not, heart surgeons make less than $2000 for a bypass where – I used to sleep in the ICU, I'd spend all day in the hospital, our malpractice is over $50000, some guy paid $80000 a year, and with the advent of stents, we're losing lots of patients that are never even seeing heart surgery and being stented and we can get into the reasons for that whether I agree or disagree. So the volume is down. The volume's up for the cardiologist, our malpractice is up, and payments are down. Just so people have an idea, doctors are not rich. To see you in my office, your Blue Cross policy pays me – and you know how much time I spend with my patients – $106.19. And on January first, Medicare will cut reimbursements 21.5% to physicians unless Congress acts.

DP: Wow. So people are deciding not to go into the field, is what you're saying?

MR: Absolutely.

DP: And by the way, folks, just know that there is no chance for anything to be done about the malpractice because trial lawyers are among the two biggest donors to the Democratic Party. It's really one of the biggest reasons that I don't vote Democrat, because of the power of trail lawyers. There are wonderful people in trial law, of course, I know that, I'm not an idiot, however, the institution itself has hurt my country almost more than any other, except for teachers' unions, and television in my lifetime. But that's – I don't want to take away from your time. So that's the doctors. So there are now openings, as it were.

MR: Absolutely. I mean one comment about malpractice is, if somebody files a lawsuit, frivolous or not, and certain insurance companies, if they just want to settle and get rid of the headache, if you settle, and they can make the decision for you, for more than $29,999, it's with you for life on the National Practitioner's Database, even if you – your insurance company just said, "hey, it's not worth fighting this, it's a nothing, it's a no-brainer for us, you didn't do anything, and the doctor is scarred.

DP: All right, loss of privacy.

MR: OK. Electronical medical records. First of all, you can't make a doctor, without giving him a tax deduction or something, put in a ten thousand or twenty thousand dollar system in their office, cause we just can't afford it. Number two, they're check boxes. It's just a general thing. I can't write the little specific things you tell me which are important, it's a generic form that you're doing. If somebody wants Dennis Prager's medical records, they have to physically break into my office. What's the likelihood of that? But, don't tell me that hackers are not lining up to get Dennis Prager's records. You cannot protect medical records 100%. And yes, maybe it will make it easier. I suggest all my carry their medicines in their pocket, you know, a card of their medicines. Sure, it'll streamline it, but in its present form, we're going to lose our privacy.

DP: Which is interesting, again, my comment here is how much the left was so worried about the Patriot Act which affected nobody. But this will affect everybody, and all of a sudden, privacy doesn't matter.


MR: This is the big thing. Kaiser. You don't have choice. OK, Kaiser has a family practice physician and nothing against them, there're great family practice doctors who do a three year residency vs. my eight year residency. But you have to go to this doctor, and if he doesn't want to refer you to another doctor, to a cardiologist within the Kaiser system, it takes an act of Congress to get beyond that. OK? Now Kaiser's fine, but I can tell you their heart surgery results, just like Canada, and just like England, are inflated to be better than they really are. In Canada, there's a wait list for heart surgery, so it's natural selection. The sick people die before they ever get to heart surgery. The low risk patients get heart surgery, so the results look good. Kaiser does the same thing. When I was training we'd go to Good Samaritan Hospital at USC, and I spent three months there and they were operating every day on Kaiser patients and Kaiser was right across the street, and they were the high risk patients, and yet Good Sam had worse results than Kaiser.

So my point is that you are going to lose your choice, you're gonna have somebody who doesn't know – it's not that they're ignorant, it's that their training is limited – make a decision what is the best care for Dennis Prager, and I can tell you 100%, cholesterol management is gonna go back into the dark ages because there's zero chance that you're gonna get two drugs, or three drugs, or what's necessary.

DP: Hmmm, that's right.

MR: And heart disease is gonna go up and people are gonna start dying again.

DP: That's right, I didn't think of that. Of course, it makes perfect sense. Perfect sense. We have some challenges for the doctor? I'll be happy to take them, begin i think with Barbara in New York City? My doctor, yes, Dr. Michael Richman, who did vote for Barack Obama and now feels he erred in with me. You're listening to the Dennis Prager show.

[Break 31:31]

DP: Dennis Prager here, with Dr. Michael Richman, my doctor, and the doctor that I've had on to speak about heart issues... has changed his mind in that he voted for Barack Obama and now feels it was a mistake given the devastating impact of the health care "reform". We have a number of challenges. New York City on the Apple, Barbara. Hi, Barbara, Dennis Prager Dr. Richman.

Barbara: Hi, Dr. Richman, thank you for taking my call. Hi, Dennis. Dr. Richman, I did just the opposite of what you did. I did not vote for Barack Obama, but now I regret it. Barack Obama, I hope what he's doing is the right thing. They're double-dipping. The health care system in this country is excellent. The medical profession is a disgrace. And I'm in that business. I work at New York Hospital. So I know just what they're doing. When I go to the doctor's, or when anyone in my family goes to the doctor, they never get billed. But their HMO gets billed, Medicare gets billed, their hospital plan at business gets billed, and it gets billed and billed and billed for the one procedure, and if you go and question it, they just calmly say they made a mistake. I had an echogram done fifteen years ago. My HMO at the time, I was not working, my HMO at the time – I don't even want to mention the HMO – was Oxford, up in Connecticut. And believe or not, last summer Oxford called me up and sent me a notice in the mail with the bill. They're not my HMO anymore.

DP: All right, let's get a response from the doctor. I'm glad you called, Barbara, thank you.

MR: Thank you, Barbara. Well first of all I think you're confusing apples with oranges, because I can tell you I spend a half hour each day writing appeals, fighting for every single dollar, and half of them you don't get. The problem – what I think you're referring to, John McCain talked about and I think it needs to be done immediately, is the Medicare / HMO plans need to be destroyed immediately. Because what happens is, somebody like you gets a letter in the mail to sign up for a Medicare prescription drug plan, but in the fine print is you're signing all your rights to the HMO plan. Well, did you know that Medicare pays these plans much more than the doctor would get if the doctor directly billed Medicare. And yes, there's bad apples everywhere, I don't disagree with you. Um, but that's just really not the way it is.

DP: All right. You're listening to the Dennis Prager show, Dr. Michael Richman, cardiothoracic surgeon, and he has – you've been very, very helpful. Don't go away, you are listening to the Dennis Prager show.

No comments: