It is hard to put into words what the health care reform bill about to be signed today by the President means to doctors as a group. After all, doctors were as divided about the health care reform bill as the rest of the country was.
The birth of the bill was anything but pretty with infighting, favors, legislative slights-of-hand, enticements, and even threats occurring, But like a difficult breech birth, it still brought forth our new legislative baby. We have learned much from the bill’s gestation:
First, our legislators in Washington rarely read complicated bills before them. Sound bites carry the day when important policy is at stake.
Second, the people have felt too disenfranchised and disempowered for too long. They are tired of feeling powerless to the ever-increasing costs in health care, yet still insist on the new, the shiny, the whizbang. This cultural disconnect will continue to plague our policy makers moving forward.
Third, we have watched the centralization of power and money in health care cede decisions to our Big Box retail-purveyors of health care delivery in favor of the local physician and the patient. Now with government regulators and oversight committees and health czars, a new world order is now upon us. Will it be better? Hard to know. But costs concerns will take precedence over health concerns from time to time, and America is going to have a hard time adjusting to this new paradigm. For doctors, there will be a push for greater efficiencies to care for the greater volume of patients yet paradoxically, taking one’s time and being inefficient is usually synonymous with patient satisfaction.
Fourth, despite the outcome of the vote in the House of Representatives, the government isn’t perfect either. Like the Big Box retailers they aim to regulate, the government is also centralized, oversized, disorganized, and slovenly yet affects every corner of our country. Whether you’re a Southern Baptist or Jewish Rabbi, better get ready for what the government’s health board says, because their decision we be the same for all of us. God forbid they get it wrong: as we’ve seen, changing things takes a while. Still, it’s here, we’re all going to have to chew on it this legislation, digest it, and expel the parts that stink.
Perhaps more than anything is that the war has begun that pits the power of our current health care “stakeholders” and our government. It is sad that it’s come to this – that we could not collectively determine a simpler way to provide health care to our populace with local self-determination that preserves innovation and economies of scale over central oversight of issues affecting our most personal health decisions.
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Yet here we are.
Like King Pyrrhus of Epirus, whose army suffered irreplaceable casualties in defeating the Romans during the Pyrrhic War, the President, the Speaker, and our Congress has set us on a new course.
Hail to the victors.
Let’s just hope their victory was worth it.
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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.
