Friday, January 29, 2010

Keep it simple

Passage of health care reform is a must. I have long believed health care to be a right for all American citizens. Equality thus is the basis for my commitment to reform.

However, reforming our system is perhaps the most condenses of any social policy our country has faced in the past half century -perhaps even longer. The reasons are many. Foremost is that we have permitted, and encouraged, health care to be a commodity unlike other countries in the western world where it is a public service.

The passage of Medicare and Medicaid was a triumph of an idea that had been proposed decades before going back to Teddy Roosevelt, Franklin Roosevelt, Harry Truman and then Lyndon Johnson.

When I first considered medicine as a profession was during the debates over Medicare. I had previously spent time in England and learned about their National Health Program. Socially minded, I was shocked at the resistance solicited from the distortions promulgated by the AMA, pharmaceuticals, and social conservatives. Having the government involved in health care would be an irreversible step toward Communism, the quality of care would be compromised, and the care would be rationed. The same falsehoods were shouted at town meetings this summer and continued into the recent senatorial election in Massachusetts.

Now asking anyone to give up his or her Medicare card is like asking a strange dog to give up his bone

Why were the Democrats successful in 1965 but failed in 1993 and now are balancing on the brink of failure in 2010? Again there are many. Social changes then were to include; now they seem to be to exclude.

Then the AMA was a more powerful organization, but insurance companies were not. HMO, PPO, or doughnut did not exit. Following the defeat of President Clinton’s health bill, further solidified those interests entrenched in selling the commodity of health.

Today these same interests are feeling even more emboldened and confident of an unencumbered future if the current reform is watered down or defeated.

So what to do? Take a lesion from the one president who succeeded.

Tell the stories of people excluded from the health system. Tell people what the program will do for them as they enter their doctor’s office, the hospital, or the pharmacy. Tell the people that the principle underscoring health reform is the same as that upon which our nation was established - equality. Tell the people how easily it is to go from having health insurance to joining the one sixth of Americans without insurance. After telling these stories, tell them again!

To do this we must meet with our representatives in congress and insist they do what they were elected for. We must speak to the press to tell the truth about health reform. Tell the story of the influence that the insurance companies, pharmaceutical companies and medical equipment companies have in DC.

When talking about cost, do it in numbers that the public can comprehend. Better than that would be to tell it in the out of pocket costs to the individual. Tell it by comparing how much he or she, is currently paying for the care provided the uninsured and underinsured and over insured and compare it to what one may have to pay with this bill

Explain that social change impacting every citizen is bound to be messy. But don’t talk of the deal to pay for a state’s Medicaid bill without talking of the deals made by the insurance companies and pharmaceuticals and professional organizations. At least those monies for Medicaid will go to people who are desperate rather than into the over-stuffed pockets of management

Keep It simple - no insurance, no doctor; no doctor, no access; no access no treament. But do it.


  1. Dr. Friedin,
    Thanks for writing this blog. I only wish the members of our pitiful Congress would read it. They should have their "cadillac" health policies taken away for a year of two to appreciate what they have, and what so many hardworking, employed Americans do not have because they work multiple part time jobs, none of which qualify them for coverage. Without this coverage their life, and their families' lives are in serious jeopardy. With the recent supreme court decision, now our "representatives" represent the new ever growing financial support of unencumbered businesses. So much for our democracy representing the citizenry!
    Your Not So Patient Patient,
    Christopher Huggins

  2. if there were a way of getting congress to read some of the pieces, i would hand carry it to them. No well informed person could vote against the health reform in either bill unless they had a vested interest in the status quo.