Skip to main content

Health Care Reform and Obamacare: Lessons from the Last Century


Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity…The poor have more sickness, but they get less medical care. People who live in rural areas do not get the same amount or quality of medical attention as those who live in our cities.

The above quote wasn’t taken from an Obama administration policy proposal. These words are from a 1945 speech by President Harry Truman. It is astonishing that over 60 years later, the health care crisis is not only still with us, but is slowly smothering us. How many years of oxygen do we have left until health care in America is entirely asphyxiated? Each year, the challenges deepen and multiply, which pushes necessary solutions and reform further out of reach. The financial costs of simply maintaining the current system are sailing beyond the stratosphere. The ‘reform’ strategies in my adult lifetime have been to promise, procrastinate and pray, methods which provide politicians with short term gains at our long term expense.

As I write this, Democrats and Republicans are arguing on reforms to preserve and protect Medicare, even though the contours of the solution are well known to all. Politics is a poison pill.

Last year, about 17% of the GDP was devoted to health care, compared with about 15% in 2003. It is projected that 20% of GDP will be spent on health care in 2017. Medical economists agree that the current rising medical costs are unsustainable. The present government will be under enormous pressure to reduce costs of healthcare. Do we believe that costs can be cut while maintaining, or even improving medical quality? Will budget slashers swing their axes so wildly to drive down costs that medical quality will be crippled as collateral damage? Will the country be satisfied with medical mediocrity as a side-effect of cost control?

Operating on the health care system requires major surgery. The fear is that the government will declare that the operation was a success, even though the patient died. President Obama has stated repeatedly that health care reform is one of his highest priorities. While he didn’t create the mess, once his Patient Protection and Affordable Care Act was passed, he now owns it. Although I oppose Obamacare, and have explained my views throughout this blog, I congratulate the president for taking on this radioactive issue. This was a promise kept. Nevertheless, I hope that many of its damaging provisions will be repealed.

Will Obamacare ultimately sink from its own ponderous weight? If it does, or is watered down, the president may be tempted to start spreading blame around. President Truman, who worried about health care in America before President Obama was born, can offer our new president some advice on leadership. Remember his famous homespun maxim the buck stops here? Let’s hope President Obama remembers it also.

Comments

  1. is there an email address for you, Dr. MDWhistleblower? no contact page on your site......thank you!

    ReplyDelete
  2. oops-should have said you could reply via glasshospital@gmail.com.
    thanks.

    ReplyDelete
  3. There is no problem in American so complex or intractable that it cannot be blamed on the Bush administration and solved by raising tax rates on the wealthy 1%.

    ReplyDelete
  4. The problem with medicare is that it lessens the competency of our first order physicians or the ones who we go to check up for because of the lower cost of their services rather than those doctors who perform operations are credited highly in the medicare problem.

    ReplyDelete

Post a Comment

Popular posts from this blog

Why Most Doctors Choose Employment

Increasingly, physicians today are employed and most of them willingly so.  The advantages of this employment model, which I will highlight below, appeal to the current and emerging generations of physicians and medical professionals.  In addition, the alternatives to direct employment are scarce, although they do exist.  Private practice gastroenterology practices in Cleveland, for example, are increasingly rare sightings.  Another practice model is gaining ground rapidly on the medical landscape.   Private equity (PE) firms have   been purchasing medical practices who are in need of capital and management oversight.   PE can provide services efficiently as they may be serving multiple practices and have economies of scale.   While these physicians technically have authority over all medical decisions, the PE partners can exert behavioral influences on physicians which can be ethically problematic. For example, if the PE folks reduce non-medical overhead, this may very directly affe

Should Doctors Wear White Coats?

Many professions can be easily identified by their uniforms or state of dress. Consider how easy it is for us to identify a policeman, a judge, a baseball player, a housekeeper, a chef, or a soldier.  There must be a reason why so many professions require a uniform.  Presumably, it is to create team spirit among colleagues and to communicate a message to the clientele.  It certainly doesn’t enhance professional performance.  For instance, do we think if a judge ditches the robe and is wearing jeans and a T-shirt, that he or she cannot issue sage rulings?  If members of a baseball team showed up dressed in comfortable street clothes, would they commit more errors or achieve fewer hits?  The medical profession for most of its existence has had its own uniform.   Male doctors donned a shirt and tie and all doctors wore the iconic white coat.   The stated reason was that this created an aura of professionalism that inspired confidence in patients and their families.   Indeed, even today

Electronic Medical Records vs Physicians: Not a Fair Fight!

Each work day, I enter the chamber of horrors also known as the electronic medical record (EMR).  I’ve endured several versions of this torture over the years, monstrosities that were designed more to appeal to the needs of billers and coders than physicians. Make sense? I will admit that my current EMR, called Epic, is more physician-friendly than prior competitors, but it remains a formidable adversary.  And it’s not a fair fight.  You might be a great chess player, but odds are that you will not vanquish a computer adversary armed with artificial intelligence. I have a competitive advantage over many other physician contestants in the battle of Man vs Machine.   I can type well and can do so while maintaining eye contact with the patient.   You must think I am a magician or a savant.   While this may be true, the birth of my advanced digital skills started decades ago.   (As an aside, digital competence is essential for gastroenterologists.) During college, I worked as a secretary