With the stunning election of the Republican Scott Brown from Massachusetts last evening, the pundits are awash in analysis and retrospection. The forces that aligned to elect a Republican to the “people’s seat” in Massachusetts are too numerous to expand upon here. Not being from Massachusetts, it would be presumptuous of me to claim I understand all of the issues at stake. I am simply not a political pundit.
But from a 50,000 foot perspective, I am amazed that the Commonwealth of Massachusetts, long the shining star upon which our national health care reform efforts were modeled, has effectively stalled (stopped?) the partisan railroading of the current health care legislation hashed out for months in both houses of Congress. Do they know something about their health care program that the rest of the nation doesn’t? The economy? The costs involved? The lack of representation “at the table?” Tough to know. Maybe it was all of these things and more.
But irrespective of the outcome, our country must reconsider the obvious: we have to do something to fix our health care crisis in America. We should not and simply cannot gloat over the victory. Too much is at stake. The reality is that many people simply cannot afford health care any longer. Many have no means to obtain insurance. Many, many people are unemployed and likely to stay that way for some time, yet their health care needs continue.
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So what to do now.
Here are some thoughts (and I’d welcome others’ thoughtful perspectives).
First, this debate cannot occur behind closed doors. I find it ironic that the very President who campaigned and fund-raised with almost uncanny use of the internet’s reach, later decided to go underground with the late-stage health care negotiations securing deals for a cornucopia of interests behind closed doors. When the deals were exposed, most of America realized they’d been hoodwinked at great cost to themselves. Americans don’t tolerate that for long. Especially in the era of the internet. Televise the negotiations on C-SPAN. Open the debate up. Clarify what’s needed. Make the people the concern, not insurers, pharmaceutical companies, and hospital systems.
Second, limit the scope of the legislation. Define where the priorities lie first. If the real need is “insurance reform” rather than “health care reform,” then limit the legislation to that endeavor. Open up the market across state lines. Give people options. There is no question that the tentacles of health care reach many different constituents, but attempting to change such a significant portion of our economy all at once seems counterproductive.
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Third, doctors and their patients need to continue to take a more active role in the process. Health care is becoming more like the internet: better communication between providers and patients is becoming the norm. Legislators better learn this, for doctors and patients will insist on understanding how any piece of legislation will affect their interactions and access. We are the foot soldiers of health care and in that way, the legislature would be well advised to support the troops first.
Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005. He writes regularly at Dr. Wes. DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.
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