Dr. Dan Fass, an oncologist in Riverside, Conn., has been a vocal advocate of health care reform. On Monday he attended an event with pro-reform doctors at the White House. Last week, he told Hearst newspapers why he's working for reform. Q: Why are you so involved in the fight for health car reform? A: As a practicing physician for the last 15 years, I've really seen how the changes in insurance have had a negative impact on patients. Q: What are the biggest problems with the existing health care system? A: There are significant insurance issues, particularly 'preexisting conditions.' Someone in my family has a preexisting condition. Here I am a physician, fairly successful, and if I had a problem with my insurance carrier. If I moved and had to change insurance companies, I could be uninsurable. I've lost sleep over this. That is not an exaggeration. Because I know health care bills could bankrupt just about anybody. Q: What else needs to be addressed? A: We need to address comprehensive tort reform. Far too much medicine is defensive medicine, which doesn't benefit the patient and costs the country millions of dollars. You're afraid of getting sued, so you order diagnostic tests that you don't need. Someone comes in just with a headache, and you don't really think they need an MRI, but you order an MRI on the remote chance that they might have some neurological problem. And a lot of times that leads to some other tests that they don't really need. In a worst case scenario, you eventually are doing a biopsy, which can cause the patient significant harm. I see it every day in my practice, and I talk to physicians and we all recognize that it's a problem. Q: Do you feel any fear that health care reform will place the government between you and your patients? A: Zero. It's a fear that is totally ungrounded. The government is already involved in health care. It's called Medicare, and people are really happy with Medicare. That's a government plan. It works. The fear that the government is all of a sudden going to dictate health care policy to individual physicians is totally unfounded. Q: What did you think of the town hall meetings this summer? A: You know, I did a meeting with 20 doctors in my home, and then one later in the summer in Greenwich (Connecticut). We had a very good discussion in my home, but not in Greenwich. People were just so misinformed that they became agitated. Intelligent debate was replaced by a lot of fear and yelling. People couldn't really understand the bills that were in front of them because they were too busy expressing their outrage. Real debate was shouted down in this case. Q: How did you feel about the quality of the debate overall? A: I've been kind of disappointed that the debate isn't more pointed to the real issues. Some of the talk show hosts have purposely fed into peoples fears. People rely on news that's distorted. When I explain to people what these bills are actually about, there really isn't a lot of disagreement. Q: Do you think there should be an individual or employer mandate that forces people to buy insurance? A: Yes. People need to carry health insurance. Because a lot of times, if someone needs treatment but they don't have insurance, the system still many times takes care of them -- at a cost to everybody else. Q: Insurance companies have been portrayed as the villain in this debate. What are your thoughts on them? A: I used to have a very neutral take, but over time I have come to realize that the insurance companies profit by denying care to their claimants, by either eliminating people from their rolls who have preexisting conditions or denying payment for services that are medically necessary. Q: How often do you see an insurance company deny care to a patient who needs it? A: Almost weekly. Ten years ago, it wasn't an issue. If you had cancer and you needed radiation, fine. But now the insurance company will deny treatment for the patients. And we can't not treat people with cancer, so oftentimes we end up not getting payment. The insurance companies directly profit from denying patients care, but we don't deny them care, so we end up paying for the care and they profit. Q: How do you deal with it when one of your patient's insurance companies refuses payment? A: I, personally, try not to worry about it. The worst thing you could have to deal with when you're ill is your insurance company denying you the treatment you need to live. So I don't even ask who's paying. But on Wednesday my billing person came in and said, 'We're pulling our hair out because we have six patients whose insurance companies aren't paying.' 