Where's the Doctor's Input on the Healthcare Bill?

When I started this blog, I mentioned that from time to time I would from comment on political issues that were related to healthcare. This is one of them. Healthcare politics is certainly one of the key topics of the moment.

As a third generation doctor, I have been, like it or not, a student of healthcare my entire life. As the senior officer of a large specialty surgical practice, I have been intimately involved in the growth and management of what is fundamentally a service delivery business. From this perspective I have had great difficulty wrapping my arms around what our friends in Washington have recently done with our healthcare system.

A couple of points come immediately to mind regarding fundamental issues about this piece of legislation.

First, to my knowledge the bill that was passed, all 400,000 plus words of it, had zero participation in its construction from any practicing physician. That means that this bill was put together not by those who know the business inside and out from a lifetime dedicated to the care of others but by folks whose only exposure to healthcare has been as a consumer (i.e.- a patient). This idea approaches the same level of credibility as getting a few hundred doctors together and having them reform our legal system. After all, they have all paid for malpractice insurance or had speeding tickets or worked with a lawyer to create a will or became incorporated or had an attorney represent them in court when their neighbor’s tree took out their family room during a thunderstorm. This would make them all as expert in the legal system as the vast majority of our Members of Congress are with our healthcare system.

I’m not being trite here. This really is the case.

Secondly, this bill does more to give the government the opportunity to know every detail about your personal healthcare use than you can imagine. As much as an electronic medical record is a useful tool to help healthcare professionals improve the quality of the care you receive, our government wants our healthcare information on computers so they can readily access this and see what you’ve been up to regarding your health problems and the treatment you received. I can see a positive role for this in terms of population based studies of what’s going on with our healthcare utilization and patterns of disease occurrence and the like. The problem is that this new bill gives our elected officials the ability to gather this information about us without our expressed permission. Did you know this?

I agree that our healthcare system has its problems. And all problems usually have their equitable solutions. Sacrificing a portion of everyone’s individual freedom, yours and mine included, using the excuse of the perceived need of healthcare reform would likely have put Thomas Jefferson, Benjamin Franklin, John Adams and George Washington himself in the hospital.

I’m going to stop here, but I’m rolling now. Wait until next week…