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You Can Always Count on Americans
- Categorized in: Editor in Chief
“You can always count on Americans to do the right thing—after they’ve tried everything else.”
Attributed to Winston Churchill 1874-1965
It is unclear if Winston Churchill actually ever said this, though there are a number of versions (all attributed to him) on the Internet. Nevertheless, as a student of American history the truth of this comment resonates with me. Particularly in light of the recent American healthcare reform bill debate. After years of failed effort, the House finally passed HR 3590 (Patient Protection and Affordable Care Act) into law by a vote of 219 to 212 (without a single consenting Republican vote) on Sunday, March 21, 2010. This historic legislation represents a course change in a healthcare system that has worked well for the insured but leaves few options for the less affluent in our society. This healthcare ‘disconnect’ has plagued presidents as far back as Theodore Roosevelt, the first president to advocate for universal healthcare in the United States.
As with most important decisions within a democracy, there are many opinions regarding, and opponents of, change in our current healthcare system. The debate in Congress and the media has been serious and at times farcical. Fears of government sponsored “death panels,” denial of lifesaving medical treatment, or concerns of universal healthcare ‘socialism’ are just a few of the contentious issues that have inflamed passions and at times even led to violence. As a federal healthcare provider in one of the larger universal healthcare systems on the planet, I feel I have followed the debate dispassionately. For those of you who must know, I am a registered independent voter.
The bill, from my point of view, does appear to be a positive step in the right direction for healthcare in this country. Arguably, the recently passed legislation is not perfect and there will be repercussions and unintended consequences of the bill as it is phased in by 2014. The absolute worst move would have been to do nothing. We already have a ‘socialized’ system of healthcare in the United States, it just happens to be one of the most costly and inefficient systems. A visit to any hospital emergency room will confirm the plight of our millions of uninsured citizens. These patients often put off less expensive preventive health measures until they are too ill to avoid the hospital. They use the nation’s emergency rooms as a substitute for primary care. The uninsured are billed for this care, but often do not have the means to pay, and the cost of this care is eventually shifted to the insured population in higher premiums (sometimes referred to as the ‘hidden’ healthcare tax). This approach is unsustainable.
Some have suggested that universal healthcare in this country will dilute the quality of care that marks the United States as world leader in medicine. Interestingly, countries such as Canada or Great Britain that maintain nationalized health systems that supply universal health coverage, maintain higher satisfaction rates with the availability of healthcare services among their citizens when compared to the United States. When citizens of each country were asked to rate the quality of their medical care, responses were very similar (Gallup, 25 March 2003).
I have always cherished the freedom of practicing medicine within the federal system, insulated from market forces. Perhaps I am naïve, but I do see healthcare as a fundamental human right. Admittedly, I do not consider myself an expert on healthcare reform legislation. I see HR 3590 as the first positive step in a healthcare reform project that is just beginning in this country. Finally, I have an abiding love and enthusiasm for our system of government. Like Churchill, in the end, I believe Americans will do the right thing.
The opinions expressed here are solely those of the author and not necessarily those of U.S. Medicine, Marathon Medical Communications, Inc. or the United States government and its agencies.