Dr. C. L. Gray is a practicing Board certified internal medicine physician in North Carolina. Previously, Gray served as Chief Medical Resident at Bassett Healthcare, an affiliate of Columbia University. Upon completion of his training in 2000, he received the E. Donnall Thomas Research Award, presented annually for exceptional research. Gray has two scientific publications to his credit. He graduated from the University of Minnesota Medical School in 1995 where he served as president of the Christian Medical and Dental Society (CMDS) and as an honorary member of the CMDS graduate board of ethics.
Gray earned his combined Bachelor of Science degree from University of Minnesota in the areas of electrical engineering, life sciences, and officer training. He was recognized with numerous Air Force ROTC awards for academic excellence. His undergraduate research led to six patent disclosures in the area of fiber optics, robotics, and data acquisition.
Gray's interests include medical ethics, politics, philosophy, medical missions, and writing. Since 1998, he has completed ten international medical trips to Peru, Ecuador, Venezuela, Romania, India, South Africa, and Zambia. The Battle for America’s Soul, Gray’s upcoming book, is the result of years of research and analysis of the history and philosophy of medical ethics leading to Post-Hippocratic medicine in Western culture, as well as our present cultural divide. His second book, Courage to Live, explores the basis for hope while living in a fallen world.
Dr. C.L. Gray
Rationing Medicare: Update
by Dr. C.L. GrayMy last article, Medicare is Already Rationing Care, focused on one small aspect of a much larger story, a story every American needs to know. The battle over the meaning of medicine began 2,500 years ago, not last spring.
In the late 1990’s I gave a lecture entitled “Post-Hippocratic Medicine in the Shadow of Nietzsche” in response to Peter Singer, the chair of bioethics at Princeton University. Singer had proposed we not consider humans “fully human” until they reached five weeks of age (after birth). During the first four weeks, he argued, we should allow the overt killing of infants with disabilities. This was “cost-effective.” It served the “greater good” by controlling the skyrocketing cost of healthcare.
For a decade I studied the question ”How did America reach a place in her history where we could seriously consider resurrecting the ancient practice of infanticide?” What I discovered changed my life.
For the past 2,500 years physicians served only one of two roles in Western culture. They either followed Hippocrates and served the wellbeing of their patients, or they followed Plato and served the greater welfare of the State. The philosophy of Peter Singer is not new—it has been with us for millennia. We once again stand at these same fated crossroads of Plato and Hippocrates as we debate the future of American healthcare.
Based on my study of history, philosophy, and current events, I feared we were rapidly returning to the world of Plato; a world where physicians worked at the behest of government, not solely for the patient. To help Americans understand what was about to transpire, I launched Physicians for Reform in 2006.
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Medicare Is Already Rationing Care
by Dr. C.L. GrayRationing Medicare will not require clandestine meetings in smoke filled rooms. Simply reduce physician reimbursement to below the cost of delivering quality care, and free market forces will take care of the rest.
Medicare has already begun the process of backdoor rationing. Facing overwhelming budget shortfalls, Medicare needs to trim its books. Washington found a clever solution: eliminate the billing code for “physician consults.”
As a hospital physician, I often admit Medicare patients with chest pain or shortness of breath. If my patient needs urgent help from a cardiologist, I call a colleague for assistance.
Until December 31, 2009 the cardiologist could charge a “physician consult” fee for getting out of bed, coming to the hospital, and evaluating a patient with a potentially life threatening problem. Medicare paid $195.76 for this middle-of-the-night work (the same rate as when done during the day).
By eliminating the “physician consult” billing code, Medicare now advises the specialist to charge for a “hospital admission.” For two more months, Medicare will pay $175.67 for this service. However, without a change in current law, the physician’s reimbursement for a “hospital admission” will drop to $141.63 on March 1. This is why the “Doc Fix” is so important for working physicians and their Medicare patients.
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