Health Care Reform
Commentary on the current health care debate in Congress
In a recent op-ed column in the New York Times (Oct. 9, 2009 "The Baucus Conundrum"), David Brooks wrote "We need to move to a more transparent system, in which people see the consequences of their choice." He continued, "we are going to get health insurance reform, not health care reform. We'll be adjusting and expanding the current system, not essentially changing it."
I could not agree more. Throughout the entire debate on health care these last months, I have been frustrated that a core issue, patient passivity, has never surfaced nor been addressed. And I know why, having spent the last seven years (with kidney loss, dialysis and transplant - all at a major, university hospital) deeply enmeshed as a patient in our dysfunctional health care system.
Most Americans have never had to deal with the medical profession on a daily basis and are ill prepared when they must. Modern medical technology and its doctor-driven delivery system overwhelms even the most intelligent patient. We have been conditioned not to question diagnoses, surgeries and countless tests made and ordered by our doctors on our behalf. We are asked only to endure and trust them.
We are not educated, aware consumers, but are scared, trusting children before these "gods" of medicine, who are only humans practicing an imperfect science. They mean well and sincerely desire our recovery, but they are lost in a maze of their own making. And we as a nation have blithely funded this system assuming all along that they know best. We have abdicated our role as our own health care advocates. And the same is true for our lack of understanding how health care insurance does and doesn’t work.
It took me three years of self education and pain to finally begin questioning my doctors and take control of my own health care regime. I'm better for it and my doctors agree. They consider me a colleague and the head of my health care team. I've recently written a book about my experience, have lectured to 2nd year medical students, and am now devoting my life to patient education in the kidney field.
But I am the rare exception to the normally passive patient who never questions but submits to one unnecessary test after another, who gets contradictory instructions from doctors who never confer with each other about the patient's condition, but prescribe drugs whose side effects are more dangerous than the illness itself.
If we really want to reform our health care system, stop the waste of financial resources, and ultimately improve our health, we must first take the Rx pad out of the physicians' hands and make the patient the chief of his/her own health. It's a radical idea, I know, but there are others, including many doctors who agree with me. (See Pauline W. Chen, MD, "Letting the Patient Call the Shots", New York Times, June 4, 2009)
I like the incremental approach to problems. It is often the small things we do that alter our lives for the better. Grand plans for reform rarely work as we hope. Often the simplest changes make the biggest difference. And so it is with health care. Patient education is the key. Until we do something about it, nothing will really change.
David L. Rosenbloom