Friday, August 14, 2009

The Health Care Debate

So I am flying home from Phoenix on Southwest airlines reading Christopher Buckley´s memoir of his father and mother and talking with the passengers seated beside me. I´ve been away from home three long weeks and am anxious to see my farm and kids. To my left is Beth Purdy M.D., an orthopedic surgeon, and her traveling companion named Kit. He is a hospital administrator and CEO of the Arizona Medical Association. She is the president of the Arizona Medical Association.

The doctor and administrator are off to Capitol Hill today to lobby for or against or just be a part of the health care bill discussion taking shape on Capitol Hill. We have had a spirited discussion. I told them I am paying COBRA coverage having been laid off from one employer and taken a contracting job without benefits. President Obama´s recovery plan is paying 65% of my premium. I will stick with that and await wait comes from the congress to see what insurance I might adopt next.

The doctor and the administrator listen to what I tell them and I ask them about the most pressing issues before the doctors lobby. What about the need for more primary health care physicians? They tell me about tort reform. What will you do when the president says he will not support a cap on malpractice lawsuit payments? The administrator tells me of a boy in Phoenix who climbed a cortina wire fence to vandalize an electric plant, lost his balance, sued, and the boy and his attorney pocketed thousands. This clearly flies in the face of common sense, but to an attorney does not matter. I ask, “Did you read DeTocqueville”? He says America´s attorneys are our aristocracy making the laws and passing judgment on the rest of us, complicating life with a patchwork of legislation that even the simple complex. Please face them down I implore as Edward R. Murrow did with Senator McArthy and let the air from their sails.

What about the AMA I ask who have, some say, erected barriers to entry by limiting enrollments in medical schools and not allowed immigrant doctors to practice medicine here? Beth says that state medical boards do allow doctors to come from Guadalajara and Grendada—recall Reagan´s Caribbean war where medical students who could not gain entrée to school in the USA were rescued from the clutches of the Cubans by US Marines. Thinking of the many Asian doctors I tell them that my own profession, IT, is overrun with Indian immigrants who are working here often on the cheap in violation of the spirit of the law by using loopholes that undercuts the American who cannot find work.

Reading policy papers from the Journal of American Medicine and The Heritage Foundation it is clear which point of view has the ear of these medical professionals. The administrator autographs my copy of The Wall Street Journal with the admonition “Don´t Get Sick”. I would say their position on this debate is preordained.

I myself have come full circle breaking with my conservative friends on this issue. When my COBRA runs out I plan to sign up for the government sponsored health insurance option assuming one makes it through the legislature. As I near 50 years of age I am preparing for old age and retirement, a bit prematurely say my kids, having married a girl 14 years my junior and thinking about medical costs. It would be better to spread the the liability and cost among all 330 million of us Americans than have only the gainfully employed burden the bill. Would it not? And ask for the specialization of medicine where one specialist hands off one patient to another in an endless string of referrals I am looking simply for a beating medical heart to attend to my pains, refill my lexapro, and hand me an aspirin.

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