Great Equalization: Is MBBS From India Equal To M.D. In U.S.A?

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AAPI Journal • March 2009 From The Editor’s Desk by Sivaprasad Madduri, M.D. It Is Time To Start Work Mr. President! (An open letter to President Obama) Sivaprasad Madduri, M.D. Editor-in-Chief Dear Mr. President, Congratulations. With your win as the President of the United States, you accomplished a victory that was beyond the scope of imagination. The events that followed also are euphoric: the spectacular inauguration ceremony; the adoration you created amongst the younger generation of this country; and the eloquence with which you conduct press conferences has kept the nation in awe. Health care is an issue that deserves your prompt attention. I have been a practicing physician in the same rural town in Southeast Missouri for 30 years. I have seen and experienced ups and downs of health care. Now, unfortunately, like the economy, it is on a downward slump and is at its cross roads; one wrong turn can ruin it further. There are three fundamental problems plaguing our health care system today: lack of access, skyrocketing costs, and disparity of quality of care. America is facing a health care crisis. As of 2006, 47 million Americans have no health insurance, 16 million are under insured, and the number keeps growing. It is not the poor and the indigent that are affected, as they qualify for government funded health insurance, Medicaid. Tragically, it is the young and the working populations who do not have insurance through their employment and cannot afford to buy their own insurance. They fall through the cracks and are left in the cold. Nearly 8.7 million Americans without health insurance are children and eight of 10 8 www.aapiusa.org uninsured live in working homes. Health care is a major issue in every job contract negotiation, and an estimated five million families, since 2000, have filed for bankruptcy in the aftermath of serious medical problems. Health care dictates the every core of our social fabric: when to get married, when to have children, when to get a divorce, when to quit or not to quit a job, when to retire, when not to own a house – to name a few. Ironically, we spend more in health care dollars than any other industrialized nation in the world. Health care spending per year in U.S. is a whopping two trillion dollars, or 16 percent of GDP, while Switzerland, the next most expensive health system, spends only 10 percent. Yet, according to a recent World Health Organization report, the U.S. ranks 37th in overall health system performance out of 191 member nations. We are 10th in life expectancy, 15th in infant mortality rate, 7th in vaccination of general population. It is true beyond doubt, the health care dollar is not being spent efficiently and, to say the least, wisely. Why health care is so expensive, yet inefficient in our country? The reasons are many and to name a few: sophisticated technology that is widely, yet indiscriminately used; profit-seeking middle men including insurance companies; and corporations trying to dictate how to run the system. The ever worsening medical-legal atmosphere that is choking health care providers and is forcing them to practice ‘defensive medicine’ is responsible for 15-20 percent of health care costs. Skyrocketing costs of prescription medicines are forcing our citizens to travel to Canada and Mexico to purchase their daily medications. Paper work and the money spent to comply with the government regulations is also a major culprit for the escalating health care costs in the Unites States. I am sure there are quite a few solutions to mend the ailing health care system. The one possible answer is Universal Health Care, where every one gets health care under one single payer (federal government) system. However, historically, universal health care did not withstand the test of time. The European and Asian countries with universal health care were found to be ineffective in satisfying the needs of their citizens. So is the reason for the two-tier system in those countries where in the wealthy and the affluent go to private hospitals, and the poor end up in underfunded, poorly managed health centers. Continued on page 9
AAPI Journal • March 2009 From The Editor’s Desk Continued from page 8 During the presidential campaign, the much-publicized Obama-Biden plan promised to provide affordable, accessible health care for all Americans. It is built on the existing health care system and uses existing providers, doctors and plans. Under the Obama-Biden plan, the patients will be able to make health care decisions with their doctors, not with their insurance company bureaucrats. We have been promised to reduce the insurance costs to go down by $2,500 dollars per year, and people who do not have insurance will have a choice of new, affordable health insurance. The plan also requires insurance companies to cover pre-existing conditions, create a new Small Business Health Tax Credit to help small businesses provide insurance to their employees; lower costs for businesses to cover catastrophic health costs. We also need more help from the legislators: • Federal tort reform that mandates caps on malpractice settlements and arbitration committees to monitor the medical-legal cases. • Make employers more responsible: those that do not provide health insurance should make a meaningful contribution to the cost of coverage for the employees. • Reduce the federal and state mandated regulations in health care and the associated paper work, so doctors and nurses can spend their time with the patients, not doing paper work. • Corporations that run health care facilities should reinvest the profits into improving the local facility, rather than shipping the money to their corporate offices. • All hospitals should have their share of ‘service beds’ to take care of patients without insurance, an usual norm in 70’s and 80’s. So, Mr. President: The tasks ahead to mend the health care system are many, difficult and arduous, yet achievable if every one works hard at it. You have already proved that nothing is impossible to achieve with dedication, hard work, integrity, and humility. Wishing you luck and praying for your success. Editorial Committe Chair: Members: Sivaprasad Madduri, M.D. Urologist, Poplar Bluff, MO madduri@semo.net M. P. Ravindra Nathan, M.D. Cardiologist, Brooksville, FL ravinath@tampabay.rr.com Subruto Kundu, M.D. Neurologist, San Leandro, CA virtualme2@comcast.net Venkit S. Iyer, M.D. Palm Harbor, FL Jayesh Shah, M.D. Regional Director, SW ( 2006-2008), AAPI Vice Chair, AMA- IMG Section Medical Director Rita Frenchman, M.D. Hendersonville, TN Purvi Parikh, M.D. MSRF Representative for Publications Committee purviparikh7@hotmail.com Monita Soni, M.D. President, PrimePath, P.C. Decatur, AL Janine Saldahna, M.D. Anesthesiologist, Mass. Eye and Ear Infirmary and Mass. General Hospital jansaldanha@gmail.com Niruma Madduri, M.D. Dept. of Developmental Pediatrics nsmadduri@texaschildrenshospital.org Julie Y. Patel, M.D. Assistant Professor Texas A & M Health Science Center Pooja Voria, M.D. Radiology Resident, University of Washington AAPI MSRF Executive Committee img.aapimsrf@gmail.com VenuGopal K. Menon, M.D. Allergy and Immunology, Pearland, Texas doctorvmenon@hotmail.com www.aapiusa.org 9
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Great Equalization: Is MBBS From India Equal To M.D. In U.S.A?

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