To Serve Man

By Evan Falchuk

Fresh off labeling opponents of reform “political terrorists,” the Washington Post’s Steven Pearlstein says that, well, actually, “it is possible to disagree about health reform without being disagreeable.”

ToServeMan3

That’s nice.

I don’t think he means to, but Pearlstein shows one of the reasons why reform has been so contentious:  It’s because people are suspicious that they aren’t getting a clear, direct, honest story from their leaders.

They fear that buried in the thousands of pages of unread legislation is much more than just harmless changes to the health insurance market, or ways to help doctors do a better job, or to control expenses while improving the quality of care. They are skeptical, and the President’s assurances that if they like their coverage they can keep it – that they can somehow “opt out” of reform – aren’t working.

I think it’s because they keep hearing things that make them think otherwise.  The foolishness around “death panels” had such bite because it seemed like just the sort of thing you might try to sneak in as a way to fix “the most important fiscal issue we face as a country.”

I’ve knocked Pearlstein before, but he’s doing a better job of saying what reformers really want than the President and Congressional leaders.  He says reform should be a “bold national experiment aimed at redefining the doctor-patient relationship and dramatically altering the way health care is delivered.”  That’s fine, but if this is what we’re doing, we should be honest about it, and have the kind of thoughtful discussion that kind of endeavor deserves.

Absent that, people get nervous, and they have every right to be.

hen we talk about health care reform, we are really talking about dozens of different issues. Is health care reform about covering the uninsured, or about cutting costs for employers? It is about having a publicly-funded health plan, or changing reimbursements to doctors? Is it about longer life expectancies or creating insurance cooperatives? Is it about caps on medical malpractice awards, or comparative effectiveness? Is it about healthier lifestyles, or cutting the cost of prescription drugs? Is it about cutting administrative waste, or incentives for more people to go to medical school? Is it about implementing new health care IT, or preventing insurers from making excessive profits?

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  • "Medicine is learned by the bedside and not in the class room. Let not your conception of manifestations of disease come from work heard in the lecture room or read from the book: see and then research, compare and control. But see first."
    - Sir William Osler, MD
    The Father of Modern Medicine
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