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Healthcare in the Obama Age
- Dr Tim
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While Obama’s health plan is touted to be ambitious, when compared with the other first world nations, and seen within that context, it’s beyond ambitious, it is essential. For the first time in the history of the United States the promises of equity and, one of the major components of happiness, good health, has the potential for universal application. While not specifically enumerated as one of the constitutional rights, certainly, health and health care is a basic human right. While the United States has historically been a champion of human rights around the world, it has often been slow to demonstrate their exercise in its own backyard. Our commitment to human rights however keeps us at the effort and periodically brings the more meaningful representations of human rights to the political table. This is certainly the case for healthcare reform.
No doubt, the challenges are complex and overwhelming. Our medical model healthcare mosaic in the United States is so convoluted and administratively burdensome and cost intensive that just trying to understand it boggles the most gifted imagination. While it doesn’t need to be this complicated, the complications provide the best evidence of the chaos represented in a system that is selective, discriminatory, unilaterally profit-driven and dramatically fragmented. It takes a lot of money and work to sustain a system this fragmented. Those who clearly think it to be the best health system in the world have either not needed to use much of it or have always had adequate resources to pay for it. If either of those factors change, without doubt, so will perceptions of its excellence and efficacy. Furthermore, the fact that we are frequently rated lowest across almost all measurement factors when compared with other first world nations regarding the net aggregate health of our citizens is a clear enough indicator that the preponderance of the effort of our medical system is to fix the inadequacies of not really having a health system. Emphasis on the public’s health and the prevention of illness serves as the foundation of almost every successful healthcare system in first world nations. Emphasis on building that infrastructure clearly must serve as a priority in any effort to transform American healthcare and to make it truly accessible to every citizen. And don’t forget, nurses need to be at the forefront of providing the leadership they demonstrate every day in their own efforts to advocate for patients in a system that makes their work increasingly impossible.
President Obama and health secretary Daschle will need to marshal all of the intellectual effort of the nation in getting control of our hugely expensive and inadequate health care system. Shepherding meaningful legislation through Congress during a time of significant economic challenge will be a difficult process. There is a long journey for American healthcare from the Commonwealth Fund’s ranking of 19th to creating a healthcare system consonant with the amount of resources expended on it. It is hoped that the failures of the Clinton administration to affect health care transformation will not be repeated in this process and that current leadership engage stakeholders in a meaningful dialogue and more generalized commitment to ensuring a successful redesign and demonstrating the energy and breadth necessary to shepherd it successfully through the legislative process. Creating transitional devices between private and public insurance and payment plans is a good strategy but one rife with challenges. The insurance industry has proven through its own past practices what a formidable contender it can be when anyone messes in their backyard. Fully invested public support and engagement by the new government healthcare leadership is the only counterweight to insurance power.
It is important that we all be invested in this effort this time. We must monitor carefully the strategies and actions taken in this effort and fully engage in the process at each step of the way. No better time has ever existed to have a meaningful and strong impact resulting in a truly effective and universal healthcare system. Time is of the essence — let’s hope it’s time well spent.—Dr. Tim
