Don't just stand there, pass a bill!

A big stack of doing something!

‘You have to do something.  Anything is better than nothing!  We can’t just sit by and wait!  It’s not a great bill, in fact, we don’t really even know what’s in it, but you have to do something!’

That’s what I’m hearing about the health-care reform bill.  It’s the equivalent of ‘don’t just stand there, do something.’

But in medicine we also say, at times, ‘don’t just do something, stand there.’  It’s an idea that I’ve come to appreciate and put into practice over, and over, as the years go by.  If I don’t know what’s wrong, and I’ve made a thorough attempt to figure it all out,  I next try not to do any damage.  Or to spend too much money on things that won’t be helpful.

Imagine if I said, ‘I don’t know what your abdominal pain is coming from; your CT scan is negative and your labs look great.  But let’s just go in and take some stuff out.  We have to do something, don’t we?’

What if I said, ‘I know you hurt, so take this pill.  It’s brand new and I know absolutely nothing about it.  But take it and we’ll figure out if it works or has dangerous side-effects!  Congratulations; it’s fresh from the factory!’

It would be unimaginable for me to say, ‘nasty open fracture there; rather than wait for the orthopedic surgeon, I’ll just hack it off.  You have to do something!’

I know there are problems in American health-care.  But I know it is also a system that has wonderful qualities.  It provides incredible diagnostics, medicines and procedures.  It fields dedicated researchers, physicians, nurses and administrators.

I”d like to see better access, for all, to the superb care available in this great country.  I certainly think there are ways to do that with relative ease and at a lower cost than the current bill.

I fear the plan currently being considered, massaged and coated with sugar may provide access; but in the end it will be nothing more than access to a ghost-town of medical care, from which excellence has fled.

Brace yourselves, everyone.  And for you who are advocating this unknown monstrosity, brace yourselves to own it.  I realize this is, politically, ‘the hill you’re willing to die on,’ so good luck!  I hope your motivations were pure; because then I can respect your love for the poor and downtrodden.  If it was only for control and political expediency, if it was only to advance an ideology regardless of consequences, then you may look back with remorse.  False martyrs often do.

But that’s OK, right?  Because doing anything is better than doing nothing.

Edwin