Being a doctor has never been an easy career path. It requires years of education (the average physician completes 12,000 hours of training) at great sacrifice of time with family. It requires considerable financial resources to establish a practice or join one (nearly every physician is a small business owner), especially when saddled with medical school debt. It requires accepting that being a doctor is a 24/7 job (with frequent medical inquiries from friends and family). It requires working in a highly regulated environment (and paying for the necessary liability insurance) designed to protect the health and safety of patients. It requires ongoing study and training to keep up on the latest research and deliver the best evidence-supported patient care. It requires constantly dealing with insurers and state and federal governments to simply get paid.
For the past several years, being a doctor also has required responding to and preparing for the complex changes underway in the U.S. health care system. I think we all agree – physicians and patients alike – that our current system is in need of change. Despite spending $2.8 trillion per year on health care, we still have between 48 million and 50 million Americans with no health insurance, which translates into poor access to medical care.
As a physician who has practiced for more than 30 years in Wichita, I clearly see the need to improve access to health insurance every day. My patient population includes individuals who are living with an HIV/AIDS diagnosis, most of whom only have any health insurance coverage thanks to the federal Ryan White HIV/AIDS program. However, that program offers extremely limited coverage, paying only for HIV care. Thanks to our highly respected local Project Access program that coordinates medical care for a portion of the uninsured in Sedgwick County, many of my patients have accessed specialty care that has improved their lives and their ability to work and contribute to our community.
In the past few months, the issue of insurance coverage has driven much of the health reform debate due to the launch of HealthCare.gov, the state health exchanges and the deadline that every American obtains health insurance. But the process of our society coming together to decide how to make the necessary changes to our health care system – and how much change should occur – is larger than the politics surrounding this issue.
While I have no magic answers that will satisfy all of us, it seems to me we as a country should think about change in a broader sense. Let me offer four priorities taken from a recent poll of health care leaders (AMN Healthcare, March 6, 2013) to help guide our conversations:
Looking ahead, our society will continue to discuss health care reform. At times the discussion will be complicated and even messy, but perhaps keeping these four priorities in mind as we work through the issues will help us get some of them right.