My Doctor's View of Health Legislation

Recently, I had a doctor’s appointment. I told him that one of the panels at my
55th reunion was entitled: “Is America in Decline?” The lecturer, journalist Robert McCartney of the Washington Post, argued that the health bill offered half a loaf, since it totally left out how it was all to be financed. My doctor shut the door and then spent almost ten minutes arguing the following.

He began by talking about oil. He argued that American needs to end its dependency on foreign oil (although the rest of his remarks indicated that he had a wider view, in that we must end our dependency on oil, in general). It’s not whether we should adjust this safety procedure, or that. Or drill here but not there. It’s that we need to completely revamp the way we think and live. He would love it if Obama would say: “Folks, we’re all upset by the oil spill. But what we need is not better drilling, but discontinuation of being an oil-using society. My goal is to finance new technologies so that in 5 years 50 % of our automobiles will be run electrically.”

If you are wondering why he was talking about oil and not medicine, so was I. But then he turned to medicine and essentially argued that here too, we have to stop tinkering. We have to fact up to the fact that minor changes at the margin are not going to do much. He mentioned that every year some Congressional committee, involved with health, has hearings and these are attended by pharmaceuticals, private hospital people, insurers and many others who have a financial stake in what already exists. They don’t want changes. He even mentioned that someone from the pork industry argued what a good buy pork is, especially for high school students.

His point is that it is all well and good to give bypasses–which incidentally I had in 1993 and is undoubtedly why I am still alive–and stents and use all the great medical techniques at our disposal, but what is ultimately needed is a different and healthier way of living. He of course has in mind, among other things, the enormous obesity problem we now have and specifically mentioned that it’s well and good that McDonald’s now offers a salad, but we have to go far beyond where we are now to attain a healthier intake of food. (Recently, at one of the stops on the NY Throughway, I looked at the enormous vending machine offerings, all “delightful,” but not one of which was healthy.)

Implicitly, finding a way to pay for what we get medically is not the right approach. What is, is changing our living patterns so that we need less medical help, thus reducing medical costs. I realize this is ultimately obvious, but often people overlook the obvious–I think Robert McCartney did–and I thought my doctor told me this with great eloquence (which alas I cannot capture).