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Which Way to Health Care Reform

No one would call driving around at high speed getting anywhere. In order to get anywhere, you have to know where it is and how to get there. Simply driving around accomplishes nothing except by accident. This is not just obvious prattle- too many choices and actions are made without a clear idea of where the individual, or society, wants to go.

In 'Elizabeth', Elizabeth is urged to marry. She replies 'Marry who, my Lord? For some say Spain, and others France, and some can not abide foreigners at all. Perhaps I must marry one of each!'

One of my teachers in OB said that when confronted with a problem, don't just do something, stand there. What he meant was to assess the problem, its source and severity, before just grabbing a knife and doing a cesarean, or forceps and pulling out a baby. Or, as put in 'Braveheart', when the young William reaches for his Uncle's sword, 'first I teach you to use this (pointing to William's head), then I show you how to use this (pointing to his sword)'.

How well these words apply to our current health care bill. The bill is about 2700 pages long. Do you seriously think anyone has even read it? No one's staff has even read it, among other things because there is no written final version available at this time! The congress is going to be given 72 hours to read 2700 pages. I had to read 450 pages of renal pathophysiology in 5 days in medical school, because I was up each night watching the Phillies win their first World Series. I got a 'D' on the test, the lowest grade by far of any clinical test I took (ironic how much renal physiology and pathophysiology I've learned since!). What about reading 2700 pages? Think those people will have any understanding of what they are voting on?

Passing this bill has been made out to be imperative for 'fixing' America's health care problems. How can we fix what we don't understand? There are many ideas floated for improvements in our health care system. Some regulate insurers, some replace insurers with a federal system, some increase coverage for currently uncovered people, some decrease payments to hospitals and doctors, some give tax credits, some tax health insurance, some don't. Congress is in a hurry to jump off a cliff not only without reading the current bill, but without a serious look at what the problems are and the available choices for solutions. The current bill does not address even the perceived needs of the voters, whose main concerns are their own costs and denials of care.

I have sympathy for those who do something impulsively and emotionally. We all do such things- impulse buying, eating a dessert, love at first sight, being unable to resist what Ann Landers once called 'the passing fanny'. But spending 950 billion dollars over 10 years affecting 1/6 of our economy should NOT be an impulse buy. Who commits to buying a house with a mortgage of 18% of their income without looking hard at their needs, their income and their choices?

Unless the current bill gets voted down, that is exactly what we as a nation, through our representatives, are going to do.

Ted

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