Archive for the ‘Healthcare Reform’ Category

Who is going to save the world if not us?

November 28, 2010

The United Nations is creating in a month an Agency on Women’s Rights and the prevention of violence against women. The former president of Chile, Michelle Bachelet will be running this. She is a pediatrician who was first Minister of Health, then Minister of Defense then President of her country.

Part of the point of my book ‘Routine Miracles’ was to remind physicians and medical students that we, as a profession, are in a far better position to help the world and the civilization than most. Why do Americans immediately accept a 700 billion dollar military but begrudge 100 billion to implement healthcare reform?

If doctors were as aggressive as the national rifle association, every American would have two healthcare policies. The recent elections, with many, including DOCTOR Rand Paul in Kentucky running on a platform of repealing healthcare reform is a disappointment at best, and disgusting at worst. At the single highest paid, best educated profession in the country, we should be running on a platform of ‘Do the right thing, we will find a way to pay for it.”

It could have been worse, On the other hand, the right time to do the right thing for suffering people is….NOW! On a single shopping day post Thanksgiving, we spent nearly 20 billion dollars. It seems that we always have enough time and money for what is important to us.

If I can find myself a way into the U.N. to work in that Agency, I am going. What do I have to lose? I sent Michelle Bachelet a letter friday. Let’s see.

This is important for those of you out there wondering whether you should try to go for some dream you have. Maybe you think it is only advice I give to others and not myself.

This agency is to make sure that Violence and rape against women as a routine tool of statecraft is stopped. That U. N peacekeepers who did NOT intervene in Congo while women were raped on the doorway get their asses kicked so that they protect those women.

Time for the six foot four inch USMLE teacher to get on the ground in those places and control male bad behavior. I am not experienced, I don’t know that I am qualified, but I know that my cause is just. So, anybody got Michelle Bachelet’s Phone number or email? I need to tell her how I am going to switch from USMLE teacher to U.N. employee.

The worst thing that could happen is that I fail. So what?


The Greatness of a Society is based on how the BOTTOM 10% are treated, not the top 1%

November 20, 2010

Every society throughout time has had an aristocracy, a top 1%. Even the poorest countries have a luxuriant top few. That is not what distinguishes the greatness of a civilization. It is how we treat the bottom and the middle that makes a Civilization great. Universal public school education does not de-value the educational accomplishments of a Nobel prize winner, yet even this concept in the most affluent countries of universal literacy is only barely 100 years old.

There have been a top few treated well with luxurious food, servants, mansions and massages, but it is the discipline NEVER to mistreat the weak that makes the civilization great. The top people have ALWAYS gotten the best standard of the day in healthcare, but there is something very wrong about people so proud of withholding healthcare from vulnerable people they actually advertise that their number one public policy goal is to repeal healthcare reform.
First off, they will not succeed,but worse than that, they show the smallness of their souls and the narrow minded, dare I say discusting selfishness of their followers.

Those saying healthcare reform will be dismantled won’t succeed

November 20, 2010

A lot of people got elected in a change two weeks ago simply because people are scared. The economy is not what it was, and that is frightening. However, with only one house of congress an the democratic president who originated the healthcare bill in place, there is no way to turn it back. Over the last year all the federal agencies have been preparing the rules and the procedures to implement a good way towards universal care, and this is a good thing.

I am generally NOT a fan of ‘Communistic’ systems that do not put competition in place. But, without the public option, there is still PLENTY of competition. Just remember, everytime you see an ad for an insurer, that was payed for by money NOT spent on healthcare. Someones premium payed for that ad.

That is why any time someone says ‘free market forces will solve healthcare’ they are crazy. the best way to make money in the free market is to give you nothing and have me keep everything. There is NO free market solution by itself that takes care of working middle class people.

What does that is called ‘Decency’. It is called ‘Healthcare is a Right’ not a privilege.

Effect of HealthCare Reform on the Doctor’s Soul

March 25, 2010

You get the impulse to go to medical school You start out pure. You get tarnished along the way by the cares and worries of the effort.

Nothing could be more soul-killing than to kick someone out of your office knowing that a person in need will be neglected. Now we start the cycle of reaction formation and defense mechnisms that lead into the S*&T spiral that leads the physician further off course from ‘vocation’ into ‘business’.
In ‘Routine Miracles’ I wrote about how stunning it was that the Public Turst of physicians was at an all-time high, yet 85% of physicians and students did not believe it.

First I wondered where this false impression came from? Now we have to ask, what damage does it do to the profession that we have this negative self impression?
Here is my conjectural leap.
Until we become happy ‘Buddhas’ immunue to the impression and opinion of ‘the crowd’ we move to the external measurement device. At least psychologically. If the whole profession has this negative self-impression, they will not rise up and devote themslves to the eradication of disease. They will, instead, find a comfortable well feathered nest to hide in.

Our nobility will have been degraded, because we, as a profession cannot stand, cannot bear cannot tolerate thinking the public does not trust and admire us. Hence, we withdraw from the fray.
Healthcare reform will, I believe, help us to stand tall as a profession. No one kicked out for inability to pay, and we will, once again, perfume our minds iwth our sacred calling.

We can all today feel a little prouder to be a physician. We are on the way to a more universal goodness. Perhaps in a year or two, when no on is turned away for inabilty to pay, we will psychologically be able to accept what is a fact. The public trusts us. Perhaps, we will be less embarrassed and realize that with the profit motive becoming desatruated in the field, we really can stand tall and say “Yes, I am indeed worthy of the trust of my society. I stand up for the best in us and I practic compassion. I am trusted, and I am trust worthy’

Forgive my absence, Finishing new Step 2 USMLE book

March 21, 2010

Hello Everyone,
I apologize to the many people have been writing and commenting without my response. I have gone straight from my ‘Routine Miracles’ tour (sept to Nov) I have spent the last five months day and night writing “Master the Boards:Step TWO” which will be out at the end of July. This endeavor takes all my effort, because as you may or may not know, I continue to work as a functional clinical doctor and teacher during the day.

My writing would, I believe, have MUCH less value if I were just some guy who wrote books in a vacuum. Every day I go into New York City and see patients, write prescriptions and deal with the ill, the surviving and the dying.

When a book comes to an end like this, I take time or I am almost forced to contemplate the highest good. Another book? or to contemplate ‘Eschatology’ LOOK IT UP.
What are the ultimate thing? Perhaps this is to be the last one?

In 2009 I produced
Feb 2009: Master the Boards: Step THREE
May 2009: iPhone App ‘USMLE Disease Deck”
Sept 2009: Routine Miracles
Oct 2009: ‘Comprehensive Cases’ an on-line step 2 course.

is my soul larger because of it?
Maybe time to stop. Yet, watching the selfish, hatred and mean spiritedness that I see in the OPPOSITION to healthcare reform, we see…. nothing stays neutral… removal from the fight means it goes backwards…. Never once in all the nastiness that I in those OPPOSING reform do I hear anyone say “Am I my brother’s keeper?” what of those who are sick and injured and need us?

Healthcare Reform a Little Closer

March 21, 2010

rarely do I have the level of sentimentality to gather my two children with me to watch something on TV. today at 4:07 pm a Michigan congressman, albeit grandstanding, threw his support to a bill, that however flawed (No public option) moves this country a hair closer to universal coverage. Fox ‘Opinion’ News network is going full blast to try to scare off the wavering congressmen about their jobs in November. As if the voters will remember another deficit more or less. no one got thrown out of office over the deficit spending on a trillion or two on the war in Iraq. It is hard to see anyone getting emtional and weepy over NOT kicking your brother off his plan for ‘pre-existing condition’ or kicking YOU off YOUR PARENTS plan because you are now 23 and the rules cover you till age 26 now, with the new plan, not age 21.

It is hard to imagine your grandmother living in Florida becoming infuriated because the new health plan STOPS her from having to fork over $1,000 to $2,000 a year OUT of POCKET for her medications. The ‘doughnut hole’ is gone.

If you don’t know what that is, and you are in healthcare you should be ashamed of yourself that you DON’T know that seniors have to pay CASH until they hit a maximum each year.

The Republicans have FAILED to scare off the usually spineless democrats about making a vote that makes it BETTER for sick people.

Tomorrow I will be in the hospital. Tomorrow, I will have to, again, like every day, discharge a person without insurance, a person unable to fill their prescriptions. yet, Tomorrow, I know that at least we will be on the way to ending this horrible and shameful injustice.

Brothers and Countrymen once again

December 26, 2009

It is not often that I must think about the ‘idea of America’, but with the passage of Healthcare reform, we now enter the Golden Age of Medicine.

There is to be a THIRTY percent increase in the output of all US med Schools over three years. There is to be a 15,000 person increase in the number of residents.

So, America sheds a light, or covers a light over MUCH greater area than just our own land.

Robert Kennedy 1968
“SURELY, we can begin to work a little harder,
To bind up the wounds among us,
and to become in our hearts,
Brothers and Countrymen,
Once again.”

Passage of Healthcare Reform in the Senate

December 26, 2009

“More perfect Union” . It’s an interesting and good phrase from the ‘Declaration of Independence”. Not too arrogant, not too much intoxicated demagoguery that obliterates accuracy by saying ‘perfect’ or ‘complete’, but today, In America, we DO have a ‘More Perfect Union’.

Two or three generations ago, a woman could not vote, black people could not get a seat on a bus and it was okay to invade countries if you were strong enough.
In the ‘Post imperial” world, we do not need more territory, more land and geography. And, I am completely sure, that we as a society, have enough money for what is important to us.

Today, 30 million Americans will start on the process towards health coverage, the REAL risk to their lives. Today, enough Americans decided that FIRST you do what is right, then AFTER you figure out how to pay for it.
In America today, goodness has won. Justice is polished, Hope is stronger, the dream of a better america has occurred, ‘more perfect”

This Historic Day

November 8, 2009

Our nation is, today a more perfect Union. It does not matter if the vote be close, it  only matters that we pause to collect the enormous energy to come from  BOTH houses of congress having passed Healthcare reform legislation. Today is the day, we reach out in compassion to the suffering, and the weak.

All we must sacrifice is our own unnecessary worry.  Today America is a prouder place to be. Today, in your lifetime.

Today I was in the room with the President of the American Association of Medical Colleges and listened to him speak for an hour on the grandeur of this day. That a great moral wrong has been corrected.

Our Hour to reach Greatness again in America: Nearing Universal Coverage

November 1, 2009

With Nine Months in office, the President and the Current congress have gone farther towards universal healthcare coverage than at any other time in the History of America. Not since Medicare was voted into being in 1965, against the same objections of the Republican party that it would bankrupt America, that we would get ‘Socialized Medicine” have we seen such a leap forward. i was on a panel discussion today at the University of Missouri and I saw GoodWill in action. With little care for how it would affect us personally in Medicine, I witnessed a total committment to reach out an fulfill the “Idea” that is America.

Remember, ‘America” is an idea, not geography.  My America does not torture. My America protects the weak and the vulnerable. My America is packed with a tulmultuous energy that welcomes everyone, from every land and distills the best drops of the Species on these shores and creates a fragrance of Hope and Heroism.

The Senate and House bills both put us at either 94 or 96% coverage of Americans. Both prevent denial of coverage to those who are the most ill, with pre-existing conditions and those are catastrophically ill. Both increase re-imbursement for primary care to balance the scales.

Let us pause for a moment and rest, and revel in the marvel of change. Let us absorb the energy of this tremendous HOPE and use it to finish the job. A strong public option. Control of the runaway greed of private health insurance. Expansion of the Med schools and the residencies, and let us pause, look at the closing of Guantanamo bay, the re-engagement of the rest of the world as a partner, not a tyrant, and let us feel the bliss, if only for a moment, that the idea of America, our Heroic and best America, our generous and noble America is. today, a more perfect union.