Show: Larry King Live
Host: Wolf Blitzer
Date: August 11, 2009
Wolf Blitzer: Joining us now, Dr. David Scheiner of Chicago. He’s a member of Physicians for a National Health Program, which supports a single payer national health insurance program. He was Barack Obama’s personal physician in Chicago for more than two decades.
Also joining us, Dr. Dean Ornish, he’s the founder and president of Preventive Medicine Research Institute. He’s the medical editor of HuffingtonPost.com, and Congressman Ron Paul, Republican of Texas, former Republican presidential candidate. He himself is an MD. He was a flight surgeon in the US Air Force and later an OB/GYN in civilian practice.
Gentlemen, thanks to all of you for coming in. Let me play for you what President Obama said today about a so-called single payer system.
Barack Obama: I’m not promoting a single-payer plan. I am promoting a plan that will assure that every single person is able to get health insurance at an affordable price, and that if they have health insurance, they are getting a good deal from the insurance companies. That’s what I’m fighting for.
Wolf Blitzer: Dr. Scheiner, you’re disappointed in your old friend, your patient, President Obama, because you want a single payer system along the lines of what’s the system in Britain or in Canada, is that right?
David Scheiner: Yes. You know, my legitimacy is not just that took care of President Obama. I have a huge practice. I see between 4,000 to 5,000 patient visits a year. Eighty percent of my patients are in single payer. The federal government has never, in the 40 years I’ve dealt with Medicare, never interfered with the care of my patients. This constant myth that the government will get between the patient and the doctor, it is an absolute myth.
The insurance companies are constantly in our way, constantly interfering. I lost a patient yesterday who had to leave me because she didn’t have the right kind of insurance. The cost of private health insurance administration is $400 billion a year. If we had a single payer, that would be eliminated, 50 million or 48 million could be covered just by that saving alone.
Continuing private health insurance is crazy, and the private health insurance companies have not shown us they can be trusted. Why do we keep coming back and asking them that we can trust them? And the pharmaceutical companies, why aren’t we buying in bulk and negotiating the prices of the drugs? The rest of the world looks upon us with disdain. We’re 37th in the world in health statistics. Even Slovenia is ahead of us and as Carville said we pay twice as much as our nearest competitor.
Wolf Blitzer: All right.
David Scheiner: This is insane.
Wolf Blitzer: Let’s ask Congressman Paul to respond. I suspect you disagree.
Ron Paul: Yes, I do. We have a one payer system with Medicare and we had… it’s broke and so that’s part of the problem we have today. Well, everybody agrees we have reform, but where I find we’re missing the boat is the definition of what we’re doing.
For some reason, I think it’s the fact that 35 years ago, we introduced the notion of managed care based on the fact that people thought they have a right to medical care. I don’t accept that because if you do, that means the majority can vote to demand anything they want from the minority and in a free society, we’re supposed to protect the minority and not the majority.
But then also this idea of insurance, they keep using this issue of insurance, it doesn’t even conform to the definition of insurance. Insurance is something that measures risks. The medical insurance does not measure risks. They want paid services. I mean, what if we try to pass out food in this manner. It absolutely wouldn’t work. But the real key to this is not a whole lot of people are totally upset with the medical care system, what they’re upset with is the costs, but nobody is really talking about why the costs are high.
Wolf Blitzer: Well, let me… let me… let me, Doctor…
Ron Paul: You have inflation. You need tort reform. Tort is one thing. We don’t have competition. We’re not allowed to sell these insurance policies across state lines, so there’s a tremendous amount, but let me tell you, you’re never going to solve the problem of high costs of medical care if you don’t solve the problem of inflation and that’s coming down the road.
Wolf Blitzer: All right. Let me let Dr. Ornish…
Ron Paul: And you have to have competition.
Wolf Blitzer: … Dr. Ornish weigh in as well. The President is having a tough enough time, even getting what’s called a public option, a government-run health insurance agency to compete with the private health insurance companies, let alone a single payer system. Realistically, what do you hope for, Dr. Ornish, because I know you’ve done a lot of work in preventive medicine.
Dean Ornish: Well, thank you for the chance to be here. I agree. I have great respect for President Obama and I agree that we need universal coverage. But I’m deeply suspicious of single payer. It sounds great in theory, but I think the Founding Fathers had it right. When you have too much power concentrated in one place, whether it’s the… what happened with the Bush administration, with the executive branch taking on too much power, where a large or some of the large corporations had misused it, or what happened with Medicare. It took us 14 years of Medicare just to get them to cover intensive lifestyle intervention.
I think we’re asking the wrong question… it’s a false choice here. The real issue is that the problem with health reform is that it’s focusing way too much on who is covered – the 48 million, which we need to do – but not enough on what’s covered. We pay for… if we just do more bypass surgeries and angioplasty and drugs and so on 48 million more people, then costs go up exponentially. That’s when we have these painful choices like rationing, raising taxes, letting the deficit go up. That’s threatening the viability of health reform.
But what we’ve found in our studies is that lifestyle cannot only be prevention, it could be treatment. Three quarters of the $2.1 trillion in healthcare costs are really sick care costs. It goes for four diseases; heart disease, diabetes, prostate or breast cancer, and obesity, all of which we found not only can it be prevented, but even reversed by changing lifestyle at a fraction of the costs.
Wolf Blitzer: I believe Dr. Scheiner you probably agree as well. You got to do exactly what Dr. Ornish is saying, “Deal with preventive,” that is to make sure you don’t have to do these very expensive, complicated procedures. You prevent people to try to do the best you can from getting sick in the first place.
But given the current political environment in Washington, Dr. Scheiner, do you see any possibility that even if President Obama wanted a single payer system, what Canada has or Britain has or France has, that he could politically get it through?
David Scheiner: Well, you know, the question is that right now, there are 89 representatives in the House that support single payer. Sixty percent of physicians support single payer. My organization of 16,000 physicians, we’re fighting for single payer. The question is I don’t think the public has adequately been informed as to what single payer is. It has been so demonized. Medicare works. Now why is Medicare expensive? Because it takes care of old, sick people. If it was universal, the cost would be spread out. If the administrative costs were lowered, we would be able to afford it. I don’t know why people are so frightened.
A national health insurance doesn’t mean that we have socialized medicine. We have private doctors and free choice. Patients do not have free choice today. They have to go to the doctor their insurance company says. They have to go to the hospital, the laboratory, the medication constantly changes because they tell us it’s not in their formulae. I want the public to have freedom of choice single payer gives.
Wolf Blitzer: All right. Let’s talk a little bit about some of these advocacy ads that have been running, especially those suggesting that seniors are going to be especially hurt by the Obama plan, the Democrats’ plan, and let David Scheiner, Dr. David Scheiner, who was President Obama’s personal physician for 20 years, let him weigh in. What do you say to those seniors who are really worried that the government will undermine their health in their remaining years?
David Scheiner: Well, you know, eighty percent of my patients are Medicare and a vast majority of those are 75 and older. I think this is a myth that again has been promulgated by the forces that are against health reform because they know that would scare senior citizens.
Now, the idea of addressing advanced directives is an extremely good idea. I mean, I have advanced directives. I think everybody should have them. I think it makes great sense.
Wolf Blitzer: You’re talking like a living will?
David Scheiner: Exactly, but the public has been scared by the scaremongers who obviously don’t want change. But we know the medical-industrial complex does not want change. There’s no way around it. A lot of people will not make that same amount of money.
Wolf Blitzer: All right. Let me let Congressman Paul weigh in [...] on that specific issue. What’s wrong with letting folks decide what kind of major medical treatment they might want down the road, especially at an advanced stage?
Ron Paul: Well, they say they’re not going to have any control, but they’re going to pick the insurance companies and thinking about picking insurance companies, if they pick the insurance companies that like what they have in Oregon, when you have ended life discussions, you know, there they have assisted suicide.
So this idea that that’s a benign argument I don’t think holds water, but it isn’t as radical as some people claim, but I think it opens up the door for these discussions because the government will be paying for the medicine.
But I would just want to make one statement about the payment of this. The cost is a big deal. Every medical program we’ve ever introduced in this country that we claim it will cost us certain amount, it always costs two to three times as much. So if they say this will cost a trillion, it will cost $2 or $3 trillion.
Wolf Blitzer: All right. Let me… Go ahead…
Ron Paul: We already have $50 billion just to keep the records in this. I have a suggestion.
Dean Ornish: Before we run out of time, I’d like to say something…
Ron Paul: Cut the spending overseas. Bring some of that money home and take care of these people until we could get back to a sensible medical system.
Wolf Blitzer: Dr. Ornish, go ahead.
Dean Ornish: You know, we keep talking about health insurance reform, but we’re not really talking about healthcare reform. We found that the more people change, the more, the better they got and no matter how old or how sick they were in terms of their heart disease, their prostate cancer, their diabetes, and so on. Senator Ron Wyden, the Democrat from Oregon and Senator John Cornyn, a Republican from Texas, Senator Tom Harkin, a Democrat from Iowa have introduced the Take Back Your Health Act of 2009 that will pay for intensive lifestyle interventions. That can really make healthcare available to those who need it and have our costs go down rather than up and then we don’t have this painful choice.