That's me. Ahead of the curve.

Over at The New Republic's health care blog, The Treatment, there's a recent post about increasing physician support for universal health care. Leaving aside the mild snarkiness of describing such increase in support as a "miracle," the post itself is worth reading. It represents a heartening change in the way the issue is perceived in the medical community. A few thoughts:
Frequently enough in this drama, physicians’ visible organized presence, the American Medical Association, has willingly played a villain from central casting. My favorite example was when the AMA feared that immunization clinics would lead to socialized medicine. Medicare and other programs were pushed through Congress despite significant opposition from the very same medical providers who would later profit greatly from such legislation.
For the record, I am not a member of the AMA. I've considered it a part of the problem since I became a doctor in the first place. Their practice of selling data about what individual physicians prescribe to pharmaceutic firms for the purposes of marketing was all I needed to know about before I decided I was not interested in membership, opt-out option or no. But there are alternative ways of getting our voices heard:
Most recently, Doctors for America has posted an “Open letter to Congress on the budget for healthcare reform," which reads as follows:
We, the undersigned physicians, strongly urge you to support President Obama’s proposed budget for a healthcare reform reserve fund. President Obama has presented a bold blueprint for health reform. It focuses on our most critical priorities: increased access to care that preserves patient choice reduced healthcare costs that would protect Americans from catastrophic medical bills improved quality care through better healthcare systems, information technology, and research. President Obama’s vision combines the best features of our current system with the reforms we need. These proposals and the values they represent are shared by millions of Americans. They are not Democratic or Republican values--they are American values. As physicians, we are at the frontlines of an increasingly fragmented and dysfunctional health care system. We need the tools and freedom to practice medicine as we were trained to do. Our patients need meaningful reform. So do we. The President has proposed an ambitious budget that makes a crucial down payment for health reform. We strongly urge Congress to keep the health reform reserve fund as proposed in the President’s budget. After many decades of false starts, we must make health reform a reality in 2009.

(Disclosure: I am an informal advisor to this group.)

Disclosure: I am a signatory of the letter.

I also totally agree with this:
Managed care organizations already impose the mindless paperwork and micromanagement physicians once feared would accompany a larger public role. Moreover, our healthcare system fails to honor basic values that physicians hold dear.
Amen to this. Managed care is a disaster. Insurance companies apply so many mind-boggling restrictions to care, government-run health care can hardly be worse. And any system that basically turns health care into a commodity is irrevocably broken, and in need of urgent remedy.


  1. Government can hardly be worse? Every physician I know thinks the current national healthcare system is horribly broken. I refer, of course, to Medicare. I would be interested in your take on Medicare and the way it treats physicians. Would you like to see Medicare expanded to cover everyone? And if you aren't in favor of Medicare-for-all, why do you think we'll get a better system from the political process that currently controls about 20% of total healthcare spending in the US.

  2. Can't really comment on Medicare, Big J, since I'm a pediatrician and just about none of our patient's carry it. Medicaid, at least in our state, has its share of troubles, but nothing that compares to Cigna and Aetna and the rest.

  3. OK, thanks. I thought you might have some MD-insight into what your practice will look like once Medicare (or whatever it is renamed to be) expands to cover everyone in the Great Leap Forward.

    I agree that private insurance is pretty well hosed, and I say that as a paying Kaiser customer who just ponied up for my children's annual exam (my carrier doesn't have the doc on The List, but since he's been the go-to guy from birth...).