Congress returns to Washington this week after the August recess. I think that senators and representatives learned a lot during their month at home. Primarily, they learned that their constituents are scared to death of the prospect of government-run health care, as was expressed daily in town meetings across the country.

After watching the government pour trillions of dollars into the economy to bail out banks and other financial institutions, is it not logical that taxpayers are more than a little jittery about the prospect of spending a trillion more for a health care system that won’t promise them better coverage than they already have?

Last Thursday the Wall Street Journal ran an excellent analysis of how President Obama lost the initiative in the health care debate. It points out that two overarching problems have nagged the president’s effort for reform:

• Most Americans are satisfied with their health care coverage and are worried that changes to the system would diminish what they already have.
• People don’t believe that the $1 trillion projected cost will be budget-neutral.

The fast-ballooning budget deficit convinces me that adding government-run health care is a recipe for national bankruptcy.

I believe most Americans would like to see a fair health care system, where people are not left in the cold when they get sick. But we also want to be leveled with. Don’t try to sell us a program that “breaks the bank,” as Rep. Eric Cantor told the Wall Street Journal.

Incremental and market-basked reform is possible and is most desirable to most Americans. Nobody wants a Canadian or a British system. We want an American system that is competitive, but fair. With the right leadership such a system can be devised without imposing more draconian federal mandates. But so far, such leadership has been strangely lacking.

My message this week is very simple – educate yourself about health care reform.

I’m appealing to everyone who has an interest in the health care reform “debate” to quit trusting what you hear and read in the media and to take what you hear from your elected representatives with a huge load of salt.

It seems that everybody who is chiming in on the issue of reform has a point of view that they are trying to sell.  I don’t care if you are a liberal or a conservative, if you get your news from Fox or from MSNBC – be a skeptic. Quit accepting on face value what is reported about the major issues in our lives, whether it is health care reform, third-world poverty or your local garbage collection schedule.

Information is readily available on the Internet through any number of balanced sources. (There’s a lot of misinformation too, so be cautious.) If you want simple facts about what’s being proposed in the various health care reform bills currently under consideration in Congress, I recommend the Web site of the Henry J. Kaiser Family Foundation. Here’s a link that spells out the various bills: http://www.kff.org/healthreform/upload/healthreform_tri_full.pdf

Also, the Center for Practical Bioethics based in Kansas City offers a sort of clearing house for civil discourse on the subject: http://www.practicalbioethics.org/

Obviously, as an executive of a health care company I have my point of view, and you know that I don’t mind expressing it. I believe we can achieve real reform within the bounds of the free-enterprise system. Genuine free-market reforms in health care will slash the number of the uninsured and lead to the same kinds of innovations and efficiencies that are experienced in most of the rest of the economy. That’s my opinion.

I hope that you develop your own opinion, based on reading the facts. Just don’t let others do your thinking for you.

Shouldn’t the goal of health care reform be about improving people’s health?

I ask the question because from my perspective it seems as if the politicians in Washington are arguing about everything but health. I question whether the politicians ever had that purpose in mind. If they did, they have certainly been distracted. There is a much more nuanced picture of American health that the politicians have simply missed.

The basic cornerstones that President Obama has been pushing for his health care reform plan are access, cost and quality. I think that I’ve been pretty clear in expressing my doubts that the government can have any real impact on cost and quality. Those can only be determined by market forces. So that brings us to access. Will suddenly providing access to 46 million uninsured Americans raise our country’s health level?

“When you need it you really need it,” says Professor Richard Kravitz, professor of medicine at the University of California at Davis. “If you want to see dramatic changers in health, you’re not going to get there even by doubling the efficiency and effectiveness of the health care system.”

Most studies suggest that unfettered access to medical care would contribute only modestly to improving and maintaining the overall health of Americans – only a 10-20 percent improvement.

Insuring everyone might help some, but far less than we are being led to believe by our legislators, who are not experts on the issues by any means. People who have actually studied health and medicine maintain there are many other things that policymakers should focus on that could make the United States a healthier country.

These include education, income, family structure, stress, obesity, environmental toxins, crime, violence, nutrition and exercise to name a few.

People with less education usually are in lower-paying jobs, with higher stress, eat more fast food and possibly live in unsafe housing. Education is the key to improving their situation in the long run.

Taxing everyone for improved access to the system would have limited results. I agree with Dr. Kravitz when he suggests that imposing a surtax on high fructose corn syrup, for example, would probably be more effective than anything we can do for the health care system, just because of obesity alone.

Furthermore, the government could promote more exercise through walking by supporting infrastructure for mass transit systems. We need all kinds of proactive programs to promote better diets and proper exercise. Instead, we’re offering people $4,500 to buy a new car so they can drive off the lot and go to a fast-food joint.

Congress has skewed the incentives for health care reform. Insuring everyone and putting more resources into primary care would make a dent, but it won’t lead to longer lives overall.

If you don’t think that the various proposals for health care reform being considered in the Democrat-controlled Congress will have a detrimental affect on your current health care plan, think again.

The issue has captured the attention of the American public and judging from the reactions that Congressmen are getting from constituents in their local town meetings, the dissatisfaction with what is being proposed is sincere.

I can illustrate the public’s dissatisfaction over health care by telling you of my own family’s experiences. Both my father and an older brother died of prostate cancer. A second older brother was diagnosed with prostate cancer earlier this year. He is on Medicare with supplementary coverage provided through a large national insurer. Because of his private coverage he was able to explore numerous options for treatment including surgery, seed implants or radiation. He chose what he believes to be his best alternative after doing considerable research and talking to several physicians. Obviously, we hope that he has a better outcome than our father and brother. My research shows that the U.S. survival rate for prostate cancer is well above 90 percent if detected early.

My brother has no confidence that he would have had that flexibility under a “one size fits all” national health care plan. I agree with him based on my recent trip to England. I found out that the survival rate for prostate cancer in the United Kingdom is slightly above 50 percent! As you probably know England has had a national health care plan for more than 60 years. The odds are good that I will get prostate cancer. We are both extremely grateful to live in a country where our health care options are not dictated by the government.

Canada is another country with a government-run health care program. I know of a doctor from British Columbia who called a physician friend here in the United States to inquire about a procedure to implant radioactive “seeds” to combat prostate cancer. When asked who needed the procedure, he replied, “I do.” In Canada it would take a year before he could be assessed for the treatment. At that time if they discovered that the cancer had grown, he would be denied. He immediately flew to the U.S. for treatment.

I encourage all Americans, not just those attending town hall meetings, to contact their representatives and senators and tell them to “stop the madness” that is being considered in Congress.

If you believe that our current deep recession is the worst economic mess of your life, then you haven’t seen anything yet. Last year the first of the Baby Boomers started signing up for early retirement Social Security benefits. That means that in only three years they will be eligible for Medicare.

In the next few years nearly 80 million people will stop working, drastically reducing their federal tax payments and becoming eligible for Medicare, where the wheels are already falling off!

If we are ever going to have a chance to emerge from the financing nightmare, which Baby Boomers on Medicare represents, the free market offers our best hope. A growing welfare state will never solve our country’s health care needs. We need to take a hard look at our values and realize that the U.S. must rely on the private sector that embraces individual choice.

Instead of enrolling all the elderly in Medicare we should allow them the freedom to opt out and become true consumers. By liberating patients and giving them more control over their money, including Medicare dollars, we can assure them quality care and cost-effectiveness.

As Congress proceeds in writing health care “reform” legislation we are slipping ever more quickly into a government mandated system when, actually, we need to go in exactly the opposite direction.

Here is an example of how market forces regulate the medical marketplace more effectively than government mandate:

Cosmetic surgery is a medical practice that behaves like a true market. By that I mean most procedures are not covered by private insurance or Medicare. Consumers compare services and prices. Physicians act as entrepreneurs and operate their own medical facilities. Consequently, over the last 15 years every cosmetic surgical procedure has gone down in price, while the price of almost every other kind of surgery has gone up faster than the overall rate of inflation. Meanwhile, the number of people receiving cosmetic surgery has increased six-fold since the early 1990s. It’s simple supply and demand at work.

Freeing patients and doctors from the confines of government control is the only way to achieve true health care reform without sacrificing quality and access.

Health care reform is the hot topic these days for most Americans, because at some point we all need to see a doctor or receive treatment at a hospital. And while I believe that our health care system needs to be reformed, I more firmly believe that reform should emerge through the cooperative efforts of all the players in the health care field using free market principles to achieve our goals of expanding access, controlling costs and improving quality of care.

Unfortunately, President Obama’s health care initiative would restrict the roles of physician-owned hospitals in his “reformed” system. Predictably, many in the news media and Congress, especially Sen. Charles Grassley and Sen. Max Baucus, are spreading misinformation that entrepreneur-based hospitals and clinics are detrimental to reform, all without providing any evidence to support their positions – just innuendo and fear.

The misunderstanding runs the gamut of the media, from the Kansas City Star in my own community, to the national newsweekly Time magazine.

The Star recently ran an article in which a family practitioner said physician-owned hospitals drive up health care costs. Time tried to impugn the quality of care provided at these types of facilities and suggested that existing acute-care hospitals are being hurt by the competition.

These articles are almost laughable in their reliance on rhetoric without hard data to back such claims. Critics of physician-owned hospitals always make these claims. Actually, the truth is 180 degrees in the other direction.

There are a large number of surgery centers in the Kansas City area that are owned by physicians – and some in partnership with hospitals — and they are one of the primary reasons why costs in this market are lower than most. These facilities deliver health care less expensively with better outcomes and patient satisfaction than was available before they existed.

The growth in physician-owned facilities has actually been driven by technology and demographics. For example, conventional Lasik eye surgery costs a third of what it did 10years ago. And there has been virtually no inflation in the prices of cosmetic surgery, even though there have been enormous technological advances, and the demand for these procedures has increased six fold since the early 1990s.

Studies by the Government Accounting Office (GAO), Medicare Payment Advisory Commission (MedPAC), and Centers for Medicare and Medicaid Services (CMS) confirm that general hospitals are largely unaffected by competition from physician owned hospitals. According to an April 22, 2009, study by the Center for Studying Health System Change (HSC), general hospitals are able to respond to the presence of physician owned hospitals with few, if any, changes to the terms of care for their patients.

Physician ownership of hospitals is not new and they are not “upstart competitors” as the Time article suggests. Physician ownership of hospitals has a long and distinguished history in the United States. Physicians’ current interest in hospital ownership comes from the realization that medical care is no longer controlled by the providers, but is dominated by administrators and medical conglomerates that have lost sight of the real task – taking care of people who are sick or injured.

Currently, there are more than 220 physician-owned hospitals in 33 states and only 32 are “single specialty hospitals,” such as those referred to in the Time article. As noted by a Consumer Reports study summarized at HPCwire, many are among the best hospitals in the state in their field. The remainder includes 18 general acute care facilities, 153 multi-specialty facilities (children’s, women’s and multi-specialty surgical hospitals), and 19 rehabilitation/long term care hospitals. More than half are joint ventures with community hospitals and other third parties and are located in rural areas, inner cities and fast-growing suburbs that have shortages of hospital beds and specialty physicians. Together they employ nearly 60,000 Americans.

Under the bills currently being considered, 104 hospitals under development would not be allowed to open and more than 20,000 jobs would be lost.

The government, however, is spreading misinformation about the role of physician-owned hospitals. Senators Grassley and Baucus are either misinformed or overpaid by the status quo. So as we talk about health care reform, expanding access, improving quality and reducing costs, we should embrace physician-owned hospitals instead of smearing them with unfounded accusations.

Next month, I will join with our Nueterra Healthcare leaders and physician partners to celebrate the opening of our first community hospital. Great Bend Regional Hospital is the result of an ongoing vision for the central Kansas region. It was designed primarily by a vast majority of the physicians in that market to deliver not only quality, cost effective care but also to deliver services that are needed in the community so that residents of the region don’t have to go to other cities to receive healthcare.

The facility started as a surgical hospital with a few operating rooms and a few patient beds. It has expanded several times since its opening in 2001 and now is expanding into a full-blown community hospital that will be able to serve all of the healthcare needs of the community for a long time. The hospital is a state-of-the-art facility on a brand new campus that will continue to attract other healthcare services to the region; it has already attracted diagnostic imaging and cancer treatment services and I expect that growth will continue.

I spend a huge amount of time working to bring healthcare partners together for innovative projects like this that I believe are healthcare reform. If we work together and keep the patient in mind, we can do great things for the delivery of healthcare services in this country.

Another healthcare milestone occurred recently when Nueterra Healthcare and our physician and hospital partners celebrated the topping out of a new community hospital in the fast-growing Dallas suburb of McKinney, Texas. Methodist McKinney Hospital will open in early 2010.

What makes the hospital unique is that it was designed based on healthcare needs of the community. It is a collaborative effort with the community itself and the unique design follows the unique needs of the community. Hence, it is really a community hospital. I know the term is overused, but in this case it fits the description.

The hospital will have a significant impact on both the healthcare services and economy of the McKinney area This is a community that needs and deserves improved healthcare services. The project has taken countless hours by numerous people to get to this point … from physicians, Methodist Health System and Nueterra. It is a great example of what the combination of nonprofit and for-profit entities can accomplish when they work together.

I believe this type of approach to healthcare, not just quality but designing what is needed in the community and doing so efficiently, is part of the solution for the healthcare of the future and, in fact, is the reform itself. If the federal government would allow more of this type of development to occur by making it easier and removing certificate of need restrictions that exist in many states the need for some aspects of healthcare reform wouldn’t be necessary.