If you go to the CRNA website you will find that the majority of specialized nurses believe that switching to universal healthcare will cause salary cuts in the medical field. The question then is not if the existing medical professionals are okay with a salary cut. Rather, we should be concerned with the way that this effects medical students. The health industry, more than any other, needs to attract the best and brightest talent so that optimum care and research may be provided. Counting on the goodwill of people who must endure twelve years of education to become specialized in medicine will not provide the talent necessary to fill current shortages (some of which are outlined on the CRNA website as well). Therefore, I believe that any healthcare reform should at least maintain, if not increase, the salary of medical professionals because they will be required to treat more patients, be more knowledgeable, and there will be a desperate need for more people in medicine after the influx of millions of patients with no medical history. If this is not supplied by the proposed bill I don't see how it will keep from tanking along with the health and care of millions of U.S. citizens.

What About the Babies?

Despite being at the top of healthcare expenses (over $6,000 per capita) the U.S. is ranked in the lower portion of the world's nations when it comes to infant mortality rate. How can this be? Many people say that our IMR is so low because we have decentralized healthcare and don't take long term care of infants born into a low socioeconomic status. While this may be so there are at least two perspectives on any problem; an article in the NY Times approaches this particular issue well. Some researchers agree that IMR is high in the U.S. because of our private healthcare while another significant portion claim that the United States is so far behind in terms of IMR because of unnecessary preterm births. Many American women choose to have labor induced early because the last month of pregnancy is so difficult; high number of preterm births means a high IMR no matter how advanced your healthcare is. Yet another aspect of health that is split into two diametrically opposed groups in which no absolute solution can be found proving that a massive healthcare reform may or may not drastically improve the overall health of Americans. Reform is a risky business because if you change something that is working for millions of people based on some disputable statistics and you're wrong then many people will suffer unnecessarily.

Dollars and Sense?

The newest proposed heathcare reform would cost $871 billion dollars, but before we get blown away by this number understand that our current system is not cheap comparatively. According to the Washington Post website the main controversy is that the government would be determining the amount of government aid universally rather than taking into account individual circumstances. So while $871 billion is an enormous amount of money if it is used improperly it will do the people of America no good. The plan that attempts to compensate for this general distribution of funds states that the amount of money should be negotiate with the providers rather than the government so that everyone could benefit from the governmental aid instead of just those with high premiums.

Obama's Latest

Early last month President Obama gave a speech outlining some specifics of his administration's plan to reform America's health care plan, you can find the transcript and video of this speech covered by CNN here. As all presidential address this speech is quite wordy and dances around a lot of the controversial debates. Obama does this, I believe, with partially good intentions, rather than addressing all the issues people are fighting over he tries to get to the point of his plan. However without addressing things like how illegal immigrants will be kept from taking advantage of this plan is extremely important to the southwestern states. All that aside this speech claims that there are three focus points of this reformation. These three points, according to Obama, are to, "provide more security and stability to those who have health insurance. It will provide insurance for those who don't. And it will slow the growth of health care costs for our families, our businesses and our government." We can all agree that keeping insurance companies from dropping people because they develop an expensive disease/disorder should be prevented and that the price of health care should be kept affordable without giving up our cutting edge research and care. The only question remains is how to we provide health care to 45 million more Americans without sacrificing the foremost quality and timeliness of care as discussed in my last post. The answer to this question is not shortcoming and may or may not have a definite solution.

International Physician's Perspective

Before I did any research on international health care systems I decided to limit my search to medical professionals since the would have the most direct contact with the implementation of a socialized system. I came across an article written by David Gratzer whose credentials and past work can be found here; the article claimed to describe socialized health care around the world as patients see it. Gratzer was trained in Ontario, Canada which has a government run health care system. One thing you should know is that private insurance is outlawed in Canada and that has never been a proposed portion of the American bill and will never be considered. However, you can deduce that many people who now barely afford health insurance will be forced to drop it because of the increased payments for government run care thereby leaving only the upper-class with private insurance on top of the national coverage. Gatzer relates numerous stories about insanely long waiting lists for any form of care, people packed into waiting ER waiting rooms for days at a time, and people requiring specialized care, such as radiation therapy, having to wait four months to receive their first treatment. All in all this article, click here to access, reveals some pretty interesting things about socialized medicine that must be considered when proposing a government run system. One final thing to consider; Gatzer brings to attention the argument that America's system is flawed because our life expectancy is lower than other nations. This statistic is justified by excluding the number of people that are killed as a result of accident or homicide. Once this change is made America has a higher life expectancy than most other nations.

While I was back in Fort worth last weekend I picked up the local paper (The Star Telegram) and saw an article titled, "Some Playing the Odds On Healthcare" by Beth Fouhy. In this article Mrs. Fouhy argues that a lot of the people who are uninsured are because they do not want to pay for something that they may not need and take the risk that if something does happen they will pay cash and risk their fiscal stability. Fouhy claims that the high insurance premiums and doubt about what insurers will cove contributes to people choosing not to have insurance. Obviously income is the number one reason for people to not have health insurance, but these other factors seem to be pushed aside. If sanctions were placed on insurance companies that force them to truly insure their clients rather than see them as a money-making venture then the reform in heathcare may not need to be as drastic. Another thing that may make health insurance more enticing to those who choose not to pay for it is to make it clear what the companies will cover and to broaden this list based solely on what the doctor recommends. As it stands now insurance companies make more decisions about the treatment that patients get than the doctors. Something should be done to reverse this relationship, doctors know what is best for the patient and insurance companies should do everything in their power to make sure their clients get the prescribed treatment without tremendous cost on top of their monthly premiums. Changes like these would surely make our healthcare system better for a lot of people.

I was reading the Battalion the other day and I saw that President Obama is coming to the George Bush Library on October the 16th. The article hinted to a possibility of him briefly discussing the health care reform so I would encourage anyone to go and listen to gain information. A good decision is a well informed decision so we will not be able to vote smart if we do not make the effort to gain the information to make a wise decision. Recently health care has become a hostile topic and I would like to encourage people to remember that we are all Americans and we must stay united if we want to remain a powerful nation. Debate is constructive but only if it is sound, logical, and free from emotional swing. As Abraham Lincoln said, "a house divided will not stand" so lets keep a united front and remember that we are all brothers and sisters of the same nation.