In the aftermath of the most acrimonious presidential election of my lifetime, we are left with recriminations, celebrations, and more questions than answers. And, of course, no real answers for the medical field at all. Just as in 2008, we face an unknown future.
Will this be good or bad for us? I have no idea. Some of the health care changes that hit small practices hardest were the requirements to upgrade or be penalized. Many of us, including myself, didn’t have the financial means to do that and elected to take the penalties. It would be nice to see those rolled back. Since all insurers peg their rates to Medicare, I’d be thrilled to see those increase, too. The repeal of the hated Sustainable Growth Rate formula showed that the parties can get something done when they’re actually willing to do the work they were elected to do.
On the other hand, I also believe in universal health care. The United States is the only industrialized nation not to have it. The sad truth is that we all pay for the uninsured because they pay nothing. So the rest of us eat their expenses through higher premiums for ourselves and our families. They should be required to chip in, too.
Also, there’s something wrong with a system where (as Bill Bryson wrote in his book, “Neither Here Nor There: Travels in Europe”), “no one seemed to think it particularly disgraceful that a child with a brain tumor could be allowed to die because his father didn’t have the wherewithal to pay a surgeon, or where an insurance company could be permitted by a state insurance commissioner to cancel the policies of its 14,000 sickest patients because it wasn’t having a very good year (as happened in California in 1989).”
Obamacare is far from perfect. It has serious flaws. But the idea behind it is, to me, a step in the right direction. I hope those in power, rather then destroying things and reverting to the broken system we had before, will work to remove the broken parts (such as the failing insurance exchanges here in Arizona) and replace them with something that is more sustainable and fair in the long term.
More than any natural resource, a country’s people are the key drivers of its innovation and economy. So keeping them as healthy as possible is critical to our national well-being. This has to be balanced with a way to make it affordable, since resources are finite.
Where does this leave doctors? I have no idea. Like most of us, I just want to take care of patients. That’s what I came here for. The need to run the practice of medicine as a business is a necessary evil. I hope the changes to come will allow all of us to do what we do best: help those who need us.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.
