Monday, July 04, 2011

ON THIS JULY 4TH; A NEW FREEDOM

I’ve been in discussions with various people about the Affordable care Act; many of whom would prefer to retain our present system. They ask, almost universally,whether I’ve spoken with people in other countries who are disenchanted with their systems, and use that as a basis for not pursuing Universal Health Care in the United States. They discuss its cost, wait times, physician frustration and many other issues, and like those who would have prevented our Declaration of Independence or our entry into WWII because it would be too hard, too costly, or carried the potential for loss, they urge inaction.

To all those who would ask, my answer is yes, I've talked to people (including physicians) in England, Canada and other countries with some form of national health insurance. As a physician, as well as an attorney and a patient, I've been privileged to engage in professional communications with many. I agree (as do they) that there are many inequities in their systems, with different ones burdening each individual system. Almost universally, though, none would choose to return to ours. 

We have a rare opportunity. Universal health care has been an ongoing project in most of the industrialized world since shortly after WWII. These nations have served as laboratories through whose experiments we can see what works and what doesn't, and choose the best while leaving the worst. It is an opportunity we should not miss, simply because to do so would line the pockets of insurance companies while the uninsured, under-insured and, yes even the most insured die. As a physician, I can think of no more frustrating experience than having my patients' care denied because it is not on some insurance company’s “checklist;” a problem I almost never had when dealing directly with Medicare. 

As for those who would use those other allegations to deny such care, I issue this challenge; would you like to explore the "wait time" for the uninsured to see a physician? Would you like to explore the costs of the "uncovered" (including the under-insured) in using Emergency Departments and hospitals as their primary care physicians because they feel they have no other choice? Would you care to discuss with me the bureaucratic rationing of care that has swept the country since the advent of the HMO (I have many stories to tell from my medical and legal practices); or the needed, lower cost community hospitals that have been forced to close because of their inability to provide such free care and stay afloat? Finally, would you like to discuss the declining view of Medicine as a good primary career among the best and brightest in the United States, and physicians so frustrated with the system that they retire early and admonish their children not to enter the profession? 

I have had the opportunity to observe this system degrade for many years and note the reasons. I have "lived" all sides of this "non-system" we call health care in the U.S., and I say to you that our citizens, indeed our nation deserves better.

The first inalienable right mentioned in the Declaration of Independence is “Life.” Isn’t it time we honor our promise and provide the opportunity for even the poorest in our society to receive the care to which they should be entitled, and live?