This article first appeared in the St. Louis Beacon, July 16, 2012 - Dr. Donald Palmisano, a former president of the American Medical Association, was passing the Peabody Opera House downtown on Friday morning when a quote engraved on the building's facade caught his attention.
The quote warned that the greatest threat to democratic institutions comes from influences that "stifle or demoralize discussion."
The words, from Carl Schurz, a Union Civil War general and later a U.S. senator from Missouri, seemed to sum up part of what Palmisano wanted to say about the future of health care during a forum that morning at the Show-Me Institute.
He saved the quote on his cell phone and mentioned it during an interview, saying, "We want to attack people who want to discuss things. We ought to have civility and learn from each other. If you don't have full discussion, then America gets into trouble."
He definitely thinks the nation is in trouble with the Affordable Care Act, even though the AMA, which he led in 2003-2004, embraced the individual mandate. "That was a mistake," he says of the AMA decision.
He argues that competition is the best remedy for escalating health-care costs and says "the broken medical liability system" is adding billions of dollars to the cost of health care. Lawsuits fail 82 percent of the time, but they "frighten" doctors into ordering needless medical tests as a precaution against litigation.
"The most important thing that we need to do is change the health financing system to one where the patient is in control and the doctor is his trusted adviser," he says. "The only way to do that is to let the patients be able to buy insurance across state lines"and "have real competition in the (health insurance) marketplace."
Palmisano teaches at Tulane University's Medical School.
