Tuesday, April 22, 2014

Health Reform: Gloom for Improvement**

He flung himself from the room, flung himself on his horse, and rode madly off in all directions.

Stephen Leacock (1869-1944),  Canadian teacher,  political scientist, and humorist

In the next 3 weeks I am giving talks before a group of hospital chaplains and an association of conservative physicians.  These are 2  divergent audiences,  with different views of the world.

In these talks, I hope to show there is always gloom for improvement – room for puns, poems, apps, prose and cons – on health reform.  In a pluralistic, multicultural, vast, far-flung, continental nation like the U.S.,  there is always room for differences.   One size does not fit all. It never will, despite pressures for homogenization. standardization, and  collectivization.

People with a need for care, especially politicians and those with resources, will always find ways to get that care,  there will always be a need for a social safety net, and there will always be differences on how to provide that net.

We are a resilient, resolute, compassionate  nation, and we will work things out for most of the people most of the time.  We will realize you cannot fool all of the people all of the time, and you cannot please all of the people all of the time. Somewhere there is always a middle ground, for the upper, middle, and lower classes.  We just have not found it yet.

Perhaps with health reform,  we never will. Across the blog,  all health delivery systems  have multiple tiers.  As the U.S. drifts left with ObamaCare,  other developed nations with aging populations are moving right - frenetically introducing private insurance and cash-only schemes to cope with unsustainable expense of  centralized national systems.  These systems are a drag on their economies  and produce long waiting lines, rationing,   and unhappy citizens looking for timely access to personalized  care and more  time spent with physicians.

In the U.S., we are just coming to grips with the realization that increased coverage does not necessarily constitute better and more accessible care.  What good is more coverage without doctors to deal with rapidly expanding demand?   

A primary care physician shortage in the neighborhood of 50,000 doctors  exists, and it grows by the day.   It is exaggerated by the fact that some 100,000 of American’s 900,000 doctors are exiting private practice to work shorter hours in hospitals, to retire early,  to see fewer patients in overloaded offices, and to enter direct pay independent/concierge/cash-only practices where they practice what they have been trained to do and spend more time with patients rather than wrestling with government and 3rd party paperwork and complying with government mandates.

Tweet:   The U.S. and its citizens and physicians are exploring ways to cope with greater demands for care in an aging,  doctor-short environment.


**(If you wish to comment or need more information,  email me at doctor.reece@gmail.com, or call me at 1-860-395-1501.  I am available for writing columns or articles  and for speaking engagements.   I would be happy to publish your comments on my blog, which is currently getting 4000 to 6000 page views each day. If you are interested in being a sponsor for this blog, feel free to contact me.)

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