Can We Get the Government Out of Our Exam Room?


Posted on 02 March 2012

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By Ami Bera, MD

Last week, Congressman Darrell Issa of California chose to review whether it was appropriate for President Barack Obama's administration to mandate that insurance companies cover oral contraception. This week, Sen. Roy Blunt of Missouri introduced legislation that allows any insurance company or any employer to decide what it wants to offer in terms of health insurance coverage. And Rep. Dan Lungren argued that companies had the first amendment right to deny their employees access to these medical services.

My frustration is that none of the above-mentioned individuals has ever gone to medical school. They have never sat with a patient and her family and helped navigate healthcare decisions that may have life and death implications. In short, why are individuals with no healthcare expertise about to decide how a doctor takes care of their patients?

I have been a doctor for more than 20 years. I love the opportunity to help my patients, to work with them to find the best course of action to get them healthy and to give them the information they need to stay healthy.

When I took the Hippocratic oath, and was effectively 'sworn in' as a doctor, I took the same vow that doctors have taken for generations. Patient autonomy is core to this oath. As a doctor, I have committed myself to provide my patients with the best options available and to explain the risks and benefits of those choices. At that point, it is up to my patients to make the best decision that respects their own faith, family and personal circumstances. I take that oath very seriously -- as do the thousands of doctors and medical care providers in this nation.

Members of Congress take their own oath when they are sworn in as elected leaders. They swear to uphold the Constitution, and to defend it against all enemies. But nowhere in their oath of office are they required to protect the medical health and well-being of their constituents.

That fact was driven home to me over the last few weeks as I watched members of Congress play politics with the health and well being of the women in this country.

I have heard the charge from Congressional Republicans that requiring health insurance companies to provide access to oral contraception is an encroachment on religious freedoms. I fear this misses the point. As a physician, I would never encroach upon the religious freedoms of my patients. As mentioned, the oath I swore explicitly requires that I respect patient autonomy. My job as a physician is to make sure I have provided my patients with the best options to make the decisions that affect their lives.

Patient autonomy is paramount to the oath that we take when we enter the profession of medicine. That is why I am appalled when the federal government gets between my patients and their right to the full range of medical information and complete access to health care. Only when fully informed, with all options in front of them, can a patient truly have what she needs to make a fully informed decision -- and to exercise their personal right to religious freedom. In fact, the arguments advanced by congressmen Issa and Lungren are an encroachment on the individual liberties of my patients.

For the record, I believe that women and their doctors should have access to oral contraception when desired by the patient and medically appropriate. I also think unfettered access to these medications improves health, reduces illness, and is cost-effective. This is good medicine and meets the community standard of care that dictates how we practice medicine.

It is not my duty to force oral contraception on my patients, any more than it is a politician's duty to limit access to medically accurate information and a full range of health care options.

It is time that we got the government out of our exam rooms. Yes, the government will have a role, as will the private sector, in determining the amount of resources that we have available to make sure every American has reasonable healthcare coverage. But once we understand the resources that are available, let's leave the business of delivering healthcare to those that have experience doing it.

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Dr. Ami Bera is the democratic candidate running for Congress in California's 7th district, and formerly a Dean of Admissions at U.C. Davis Medical School. This article originally appeared on the Huffington Post.

well, sure, no one should be in that room other than the doctor and the patient. But, the federal government is draggin me in that room to pay for it. Its draggin in companies for the very same reason. So, if you expect third party's to pay for it, you can expect third party's to want to know what their money is doing.

You want me out, than stop making me pay for it.

All the more reason we should have single-payer health and get rid of health insurance companies. In the meantime, insurance companies, as private businesses, have very right to offer what they want. There are many procedures that they do not offer now and where are the big left-wing advocates?

Single payer just turns the government into the insurance company and the taxpayer into the person who pays for it. So, I am still paying for it and, therefore, getting dragged into the room.

First...having insurance companies cover contraception SAVES MONEY in a whole host of ways (and no...I'm not going to educate you on all of those here...you have to go READ to find ALL this data all by yourself). Second, in a civilized society, health coverage includes basic health needs, even if you personally disagree with them due to ignorance or religious beliefs...contraception is about a WHOLE lot more than sex...it saves money, saves lives...damn...do you really need to learn all this now...how old are you? did you graduate high school?

And please...if you cared about what your dollars are going for, rather than be upset about the TINY bit that is going to things (contraception in this case) that SAVE money and lives, you should be upset about the private health insurance industry (and big pharma) that RIPS US OFF for hundreds of billions of dollars a year in order to profit off denying coverage and overcharging consumers (hence why America pays twice as much per capita on health care than any other country in the world that leaves 50 million uninsured, doesn't cover basic needs, and kills 45,000 a year due to being unaffordable!).

In other words your ignorant outrage should be directed at all the industry money spent on CEO salaries, administrative costs (esp. them trying to find ways to DENY coverage to the sick in order to make more money), advertising, and other waste that does nothing to improve human beings health.

Yet here you are crying about "paying" for birth control? Seriously?

Single payer is the answer because it takes the profit motive out of a basic human need and right: health coverage when you're sick or dying...like the rest of the democratic, civilized world has figured out...and that's why they spend less than half what we do and get far better results.

So yes, in a democratic, civilized world that cares about public policy that makes society better and takes care of its people, we all pitch in for health care to SAVE MONEY and lives. Its the dues we all pitch in for a better country...and our membership in it.

Please...stop embarrassing yourself here with your ignorance and lack of basic humanity. Go read...not corporate funded think tank propaganda but ACTUAL academic research on health care policy and its effects/costs.

I hope you beat Lungren like the rented mule that he is.