So What Are You Going To Do To Make A Difference?

by DavalosMcCormack on March 23, 2010

The health care reform bill that passed in the House of Representatives on Sunday was the end product of a year-long, well debate is too polite a word for what took place, a year-long yelling match with Democrats trying to explain what they were trying to do and Tea Baggers and fear mongers and others trying to shout them down.

It wasn’t pretty. It certainly wasn’t polite. But in the end it meant that we had reform. Not the reform some were hoping for. Too little for some, too much for others. But what’s important to remember is that this is just the beginning. If this bill does nothing more than start a national conversation about health care, and I do mean conversation as opposed to shouting match, then it will have served its purpose admirably.

The bill helps expand health care coverage to millions of Americans who currently don’t have it, and outlaws some of the worst shenanigans of the insurance companies. Clearly there are many flaws with it, including a limited number of ideas on how to contain spiraling medical costs, but it’s a start.

Now we all have to decide what role we are going to  play in shaping the next steps in the debate.

Doctors need to do some serious self-examination when it comes to prescribing tests and procedures. Does the patient really need that third x-ray; if they’ve just come from a fine hospital and have all their lab and blood work done and a copy of their MRI in hand, then do we need to do more at our place just because we can – and just because it’s covered by insurance. Just because we have a cool new robotic surgical device do we need to use it on every patient, particularly when there is no real compelling evidence that it is better than more traditional forms of surgery. (For more on this here’s a great recent article in the New York Times)

Patients need to be more responsible and not take any test recommended just because it’s covered by insurance. If you have a headache, and there’s no indication it’s anything more serious than that, take an Advil or Tylenol not a CT Scan. If you have a sore back get a massage and some arnica gel, not an MRI. If you have a cold don’t pester the doctor for antibiotics, they won’t help you recover any faster and might actually cause you some problems by destroying all the healthy bacteria in your stomach.

Society as a whole needs to start thinking about some uncomfortable, even unpleasant facts. We need to have some way of reaching agreement on when it’s appropriate, even preferable, to stop treating someone. If a person has terminal cancer and they have run out of treatment options we need to ask if it makes sense to keep putting them through chemotherapy and radiation and offering them experimental drugs when the best they can hope for is to postpone death, often only by a matter of weeks and at a huge financial cost, particularly if it also diminishes the quality of what little time they have left. These are not easy things to think about let alone talk about. But hiding from them doesn’t make it any easier.

What happened in the House was, in many ways, historic. But what happens in your house and my house and every other house in the nation to advance the debate, could be even more important.

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