In health care debate, where are the doctors?

In the ongoing effort to improve healthcare, it makes sense to listen to those with the most expertise.

Cassandra Sundaram

My roommate has mononucleosis. That’s right everyone, whip out the hand sanitizer and duck to the ground when you hear a cough or sneeze because this malady is contagious, and it’s coming for you.

It starts out timid, like an innocent wave on a tropical coast, gathering momentum for a violent tsunami of fatigue. Some nausea here, a sprinkle of a sore throat there and BAM! What you thought was a common cold is actually mono. My roommate was tired, but we’re in college — we’re always tired. She had a sore throat but, like being tired, considered it a symptom associated with the debilitating “staying-up-too-late-studying-and-watching-Titanic-on-HBO” syndrome. It wasn’t until an urgent care doctor ran blood tests that the verdict was in: Menacing mono had made its mark.

All the disease swarming around my apartment made me think about my health and health care in America. I was holding my breath while disinfecting our room when suddenly, I had it: the perfect metaphor. Mono is the health care reform debate. It makes so much sense; like mono, the debate makes us tired, and while our spleens may not be inflamed, the emotions and tempers involved in this debate are certainly splenetic enough. And even though the health care debate’s got us feeling ill, who are we reluctant to go see? You guessed it: the doctor.

We have heard the politicians’ viewpoints on the Patient Protection and Affordable Care Act; it’s either too expensive and contributes to the deterioration of capitalism as we know it, or it doesn’t go far enough in helping the 46 million Americans living without health insurance.

We have heard smatterings of public backlash to PPACA, or as it is colloquially known, “Obamacare.” The “death panel” myth — which was somehow extrapolated from a section of the bill that would pay physicians to provide voluntary counseling to Medicare patients about end-of-life care options — was probably the most famous and embarrassingly ridiculous example of public misinformation.

I want to hear from the people responsible for providing health care: the doctors themselves. As they come across plenty of uninsured patients or patients whose insurance won’t cover the care they desperately need, their opinion and advice is more than warranted in public discussion of health care reform. Sure, CNN has Sanjay Gupta, and surveys have been done to gauge physicians’ opinions of the bill. One survey conducted by the American Academy of Family Physicians in 2010 said that 65 percent of its 2,900 physician respondents “believe the quality of health care in the U.S. will deteriorate during the next five years, with blame going to insurance companies and the health care reform act.”

I was surprised by this seemingly pessimistic view of an act attempting to heal a broken system, and was eager to get some input from an actual doctor, so I spoke with Dr. Mark Paller, executive vice dean of the University of Minnesota Medical School. He suggested that opinions represented in the survey may be more of a testament to individuals’ beliefs about the role of government, rather than derived from a professional medical standpoint. Doctors have political opinions too; we can’t expect them to leave their viewpoints out of a survey specifically asking for them. But in their careers as medical professionals, whatever personal beliefs they may hold take a backseat to providing the best care they can for their patients.

Paller said physicians should definitely weigh in strongly with actual medical opinions about specific questions regarding patient care; he told me there would be few doctors, if any, who wouldn’t agree that access to medical care should be more widely available, but cost and implementation methods are issues better left to politicians and legislators. However, doctors can provide very real and helpful examples of problems they see within the system. Paller is a nephrologist, and he gave me a specific example of an issue he comes across in his specialty —  kidney disease. When a patient gets a kidney transplant, they need special medication to help with its continued function over time. Medicare will not pay for the medication after two years but will pay for kidney dialysis, so the patient often ends up back on a machine where he or she began.

Doctors see many other cases like these, and the voicing of these problems can only improve our health care system, which is something that the University has been able to do at a state level. By providing legislators with specific information on medical issues and by advocating for things like electronic medical records and certain types of stem cell and umbilical cord blood research, the University has been able to help the state see where priorities are in the medical field. I don’t know why these types of discussions and consultations wouldn’t work on a national level, so politicians are on the same page as health care providers. As Paller commented, “We know our system isn’t working optimally, and we need to move it along. Just because you don’t get it 100 percent right away doesn’t mean you don’t keep trying for 70, 80, 90 percent.”

This debate, like mono, doesn’t go away in a few days; it lingers. It sucks time and energy, and it’s frustrating that it’s not getting better. So like mono, we need to ask someone who’s an expert on the matter how we can take care of it. Relying on politicians alone isn’t going to help us with the aches and pains of health care reform. We need something a little stronger and for that; we need to go to the doctor.