Comparing Healthcare Reform to Physician Work-Life Balance
Comparing Healthcare Reform to Physician Work-Life Balance
Surprisingly, as I’ve gotten older, I’ve become more liberal. I grew up in a fairly conservative home, and my parents haven’t gotten any more liberal. So, we sometimes have rather energetic conversations about different political issues. Last week, I went out to dinner with my parents and we discussed healthcare reform. I am a big advocate of a single-payer system. My parents are big advocates of the status quo. In all fairness to them, they have great health coverage and do not see what I see — the harsh realities of no insurance or under-insurance.
As we started the discussion, my dad told me that in Canada, he wouldn’t qualify to receive a kidney transplant since he’s now 65 years old. Now, he’s in good health and would probably enjoy that new kidney for another 15 to 20 years. However, as I pointed out to him, he doesn’t need a kidney because he’s in good health, so it’s not really a fair comparison. I also pointed out that if it was a choice between his new kidney and vaccinations for all the kids in my children’s school, I’d go with the vaccinations. Unfortunately, in our ballooning deficit/financial-cliff culture, we don’t think this way.
Maybe we should. It’s just like work-life balance. It’s great to be a researcher, author, editor, teacher, physician, medical director, and community educator. Just like it’s great to be a room mom, a wife, a mother, a sister/daughter, a scrapbooker, a Sunday school teacher, and a yoga instructor. Just like it’s great to be able to afford to give organ transplants to whoever needs one, regardless of age or health status, and to give everyone vaccinations and new medications and diagnostic testing and so on. But, just like we have personal limits, our country has limits to what it can and should be doing for the health of its citizens.
We’ve all felt the effects of being overextended and overcommitted: Things slip between the cracks, we focus on details instead of the big picture, we try to do everything and end up doing nothing well, we get stressed, angry, tired, and resentful. Think of our healthcare system — trying to simultaneously provide preventive care for everyone (trying, I said, not succeeding!) and leading the world in innovative surgeries, pharmaceuticals, and diagnoses. No wonder the cracks are starting to show in our foundation. It is unsustainable to continue on this path.
I think I know the answer to the healthcare crisis — just like every other American. I’m not sure how it will eventually all settle out. However, it is interesting to me to see what I struggle with on a small scale — my own little world — play out on the global stage. Limits are limits.
Yes indeed. The government can fix everything! Just like Government has turned desert Southern California into a rice growing region by draining the Colorado River estuary.
Having family in Canada (those of which are affluent carry US health insurance cards) who have been let languish unto death because they don't meet criteria for intervening, I see the real world effects of health care rationing. I also see physicians there treated as not very glorified technicians. Having worked as an internal medicine physician in both public and private sectors, I have seen "government health care" up close and personal. There are many practitioners who honestly believe single payer systems work. I hope never to have one of those care for me or my family members because their ability to seek out and critically weigh evidence seems to be absent. Over the past 40 years, physicians have allowed government, insurance lobbies, pharm lobbies, industrial healthcare corporate lobbies and tort lawyers decimate the doctor/patient relationship. Frankly, we deserve what is coming down the pike.

I am all for a single payer system as well - the patient! Let's get insurance companies and the government totally out of the equation. All healthcare resources are limited, not just organ transplants. Healthcare providers, nurses, technicians, certain medications, etc. The list is as long as the new ICD-10 tables. At some point in the future CMS or IPAC or the Whitehouse will implement "death panels" to decide who should get renal dialysis, organ transplants, expensive chemotherapeutic or immunosuppresive therapies. Then of course the ACLU will enter into the equation and bring litigation because of age or socio-economic bias. It is a scary time for physicians who are in the beginning of their career and an even scarier time for those of us who have or are approaching Medicare eligibility.