I decided to write this essay late last evening. I was in the emergency room pondering the health journey of the patient in front of me wondering if it could have been a better one. The moment allowed for this reflection.
I believe we have a right to healthcare. It is as inalienable a right as those originally articulated by our founding fathers. Perhaps it is more fundamental, if that is possible, without trivializing the principles underpinning our nation’s birth. Having good health is in fact a prerequisite for our pursuit of life, liberty and happiness. Who among us would not put being physically and mentally healthy high a priority list? And who among us does not believe that when those things are lacking human strife and misery soon follows?
Health science has lead humanity to a better place. Consider the fundamental advances we have made in understanding the human body and the remarkable interventions we have made in illness care and prevention. We have learned simple educational interventions can be very effective. For instance, teaching parents to place their baby on its back during sleep to prevent SIDS. Our nation’s role in developing this knowledge base has been considerable.
A national health care system should weave these advances together with a structure to assure access. But ours doesn’t…yet.
The financing of our system is an obvious problem. I don’t need to detail it here. Recently I was involved in a hospital strategic planning session where a consultant opined that the healthcare system in the future will consider hospitalization a failure. I hope that’s the case. I challenged that statement given the current financial structure of our delivery system. The hospital CEO sitting next to me commented that we will need at least 25,000 such failures this year to stay afloat.
We also need better planning because the number of physicians entering primary care is insufficient. It’s not just physicians its nurses and other health care workers too. As the chief medical officer of a Community Health Center I experience the shortage firsthand when recruiting physicians and nurses to our organization.
The campaign rhetoric for 2008 is already heating up on this issue. That’s good. If the question is framed properly I believe we, the people, will force change and ultimately have as successful an approach to delivering the care as we have had in developing it. I believe we as a nation can be leaders in this area.
The patient who prompted me to focus on these issues last night was unresponsive and on life support. He did not intend to be pursuing healthcare that day but there he was; the very active recipient of our illness response system. That is a good thing for him today. He has reached his 75th year. Will he live longer? At this point I don’t know. But I do wonder this: if we were caring for him in a future healthcare system would he be one of this year’s failures?
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