Sunday, December 20, 2015

State of Health Reform as Reflected in New York Times Update

When I reflect on the state of health reform, I turn to newspapers – The Wall Street Journal for the conservative view, the New York Times for the liberal view, and the Washington Post for mixed reviews.

Today , being Sunday, I will cite the New York Times, the Bible of modern liberalism. When I think of the Times, I think of a quote from Matthew Arnold (1822-1888), who said in his 1869 book Culture and Anarchy, “ I am a Liberal, yet I am a Liberal tempered by experience, reflection, and renouncement, and I am, above all, a believer in culture.”\

Well, the Times, is in the process of tempering its enthusiasm for ObamaCare, with realism, as reflected in its news reports.
In today’s front page piece, “Cuba U.S. Ties Being Stressed as Doctors Flee,” reporters come to grips with the fact that Cuban doctors flocking to U.S. to escape the horrors of a $70 a month salary and the poverty associated with being a doctor.

The reporters give a nod to the liberal view.

“Cuba’s health system is a source of great international prestige for the government, which provides free training to thousands of Cubans and poor medical students. The state offers universal, if far from perfect, universal care to its citizens and has won praise – even from the Obama administration – for sending medical brigades to help overseas.”

Health care in Cuba may be free, but even the Times admits, health care isn’t much good without doctors, and its doctors are fleeing in the thousands to escape poverty and lack of medical resources to seek asylum in the U.S. As Milton Friedman, the conservative economist, remarked , “There is no such thing as a free lunch.”

In its Sunday Review section, Times columnist Ross Douthat, reflects that ObamaCare is not be headed for repeal, but it is not coming anywhere close to achieving its goals either - reducing the federal deficit, bending the cost curve downward, decreasing premiums, offering people choice of doctors health plans, improving the quality of care, and bringing the uninsured down to a reasonable number. Some 30 to 35 million remain uninsured, and health care has become unaffordable to many in the Middle Class.

The GOP , meanwhile, have been unable to mount an effective counteroffensive or to articulate a conservative plan as to what it would do to provide care for the 20 million Americans who now have subsidized health insurance.

Douthat says we have a “new normal”, in which “ObamaCare is neither fully fixed, nor fully paid for, nor furiously opposed, but simply limps along with the rest of our health care for as long as both can limp,” We are, in other words, in a liberal limbo and conservative chasm, with the neithers, nors, and buts in command.

Finally the Sunday Times Sunday Review Section features an article by a registered nurse, Theresa Brown, “Patients vs. Paperwork,” in which she laments the evils of paperwork, of documentation gone berserk with these warnings. “Electronic documentation has morphed into more than an account of our work; it has replaced the work itself.” And. The paperwork may have good intent – to prevent fraud – but in practice it gives documentary exactitude an outsize importance.” “ Electronic health records present an enticingly clean and clear vision of clinical work, whereas real patients – their histories and their bodies – are messy confusing, and unpredictable. Sadly, all the attention given to our paperwork is taking us further and further way from the difficult truth that meeting every very ill patients’ needs occurs in real time with real people, not in the paperwork about them.

Amen, well said.

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