This Friday, July 17, I’ll be attending a meeting at the National Press Club in Washington, DC.  The event, titled ‘Health Care Reform:  Putting Patients First,’  is being hosted by Dr. Val Jones of Get Better Health.  There will by many prominent medical bloggers in attendance.  You can read about the meeting, and those attending, at the following link:

I’m honored by the opportunity to attend such a timely meeting.  I’m thrilled, as a practitioner, to be able to sit at the table with such brilliant and influential folks.

But what can I bring to that table?  What do I want to say on the topic of health-care reform?

Well, first off, for whom am I speaking?  My family, of course.  I want to ensure that whatever happens to health-care in America, my family has access to what they need and desire, within reason.  Father of a 12-year-old insulin-dependent diabetic, I’m concerned practically and personally, not theoretically.

Am I speaking for patients?  Well, I should hope so.  A common misconception is that any physician who is opposed to the radical overhaul of the system is 1) heartless, 2) stupid and 3) merely motivated by hope of financial gain.

However, some of us have paid some attention to government driven health-care in other countries (the medical and economic realities, not the sunny fantasies or theories).  And ANYONE who practices medicine in the US has had personal experience with the complications resulting from government’s involvement in American health-care.   Others may disagree, but personally, I can only think of a handful of government interventions that were beneficial…in theory, and only in their inception.  Most of them have ultimately resulted in terrible unintended consequences.

And of course, I represent my specialty.  Emergency medicine has born the brunt of the ‘health-care’ safety net since the inception of EMTALA (the Emergency Medical Treatment and Active Labor Act).  Over and over we have done the right thing, within our power, for millions of patients.  We have many times done if for no compensation, and that trend shows no sign of reversing.  After all, when the feds say you’re going to see patients for free or get sued, you see patients for free!

Pay attention here:  I have worked under government fiat, and it is not efficient, not cost-effective, not  fair or well-thought.   It is complicated, arbitary and irrational.  I offer as evidence the fact that all too many trauma centers and ER’s have closed thanks to the unfunded mandates of the government.  Countless physicians in my specialty are constantly overwhelmed, and many have left the specialty, simply from frustration and exhaustion.

Furthermore, and here’s the elephant in the room, a substantial sub-group of patients all across the country have abused the free care government mandated for them, and continue to abuse it, simply because free care is ultimately worthless to some of those who receive it.

None of my observations are theoretical; all of them come from the hard realities of working in a busy emergency department and observing the way things work in the real world of health-care.

Undoubtedly, the  government has to be at the table in all of these discussions.  The grasping hand of olitics is too deeply embedded in health-care to be extracted at this point.  But it can be smacked with a ruler.  It can be told ‘NO!’  At least it should be told  ‘this far and no further!’

Without doubt, this meeting will result in accusations of self-interest, industry interest, financial interest, etc.  To which I say, ‘so what?’  Everyone is interested in their place in the equation.  Patients are appropriately interested.  Companies, with employees and profits to maintain, are interested.  Physicians are interested in their income and autonomy.  And in continuing to provide good care.

And make no mistake; government is interested.   But where did we get the idea that everyone else’s interest is selfish and sullied, whereas  government behaves out of pure, golden-hearted love of humanity?  Oddly, not so many decades ago, some of the very people leading the charge for government intervention were the ones most distrustful of government!  What an irony!

So, as I go to DC, I hope to be honest about everything, but especially about the fact that I AM motivated by my interests, just as everyone else will be.  And I’ll be certain to express my feelings that I distrust government, just as they clearly distrust me.

To all those attending, I look forward to seeing you.  I wish that I could stay longer than noon Friday, but I have to leave immediately to go home; in order to go to work in the genuine, busy, dirty, hectic, government afflicted emergency room at 11 PM on Friday night.

May God give us all wisdom as we come together on Friday, and bless everyone attending with safety and joy.

Have a great day!


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