I started my medical practice in 1966, the year after Medicare was signed into law. There was as much agitation about a government takeover of medicine then as now. The established doctors said they were glad they weren't starting out in practice and that I'd likely not make a living.
Of course, the exact opposite happened. American physicians have benefited financially from the Medicare program, and the health of Americans over the age of 65 has benefited from this U.S.-government-funded program.
How ironic, then, that many physician meetings end with groaning about reimbursement levels, particularly from Medicare. Today's doctors fight any suggestion that Medicare fees be reduced, despite widespread opposition to the program four decades ago.
We seem to have lost our perspective. Instead of complaining, physicians should rejoice in our good fortune.
There is no question that our current health care "system" is seriously flawed and that the status quo can't be sustained. Certainly some of the care and tests currently available are unnecessary. Some members of the medical community have begun to recognize that "the primary cause of unnecessary care is the costly brew of expensive technology and fee-for-service payment of physicians" (New England Journal of Medicine, Oct. 1, 2009).
There are legitimate concerns about how effective the proposed system changes will be (if any changes do occur), and costs are a major concern. Unfortunately, by the time the politicians — influenced by billions of dollars in lobbying payments — get done, we may not have advanced very far toward developing a fair, equitable and affordable means of delivering health care to our citizens, especially for the millions who are too young for Medicare and who do not have health coverage through their jobs.
In response to concerns that a public option would destroy the insurance industry, I say: Putting the government between physicians and patients couldn't be any worse than the roadblocks to care that private insurers currently throw up.
I personally would endorse a more centralized national initiative. But in the absence of reform at the national level, the most practical method for significant change is likely to come from grassroots efforts. After all, medical care — like politics — is local, and incremental changes in our community ultimately will benefit us all.
The Medical Society of Sedgwick County is active in several local collective efforts that we believe offer our community the best chance to increase access to health care, improve the quality of care and begin stabilizing the cost of health care. Some of these activities build on the success of Project Access, a community partnership developed under the leadership of physicians 10 years ago.
To quote former society president Tom Bloxham, "The health care system is only as good as its consistency and the care it provides for its most vulnerable members. Ours is far from adequate. The time of piecemeal improvements and stonewalling change has passed. It is time for physicians individually and collectively to be actively and constructively engaged in the reform process."