When I speak out against Obamacare, I am often called a hater–at best. The very people I fight for, attack me. Ironically, it is the grueling rite of passage from little girl to physician that has equipped me to take the heat and stay the course in the fight for the patient-doctor relationship and against the government’s effort to supplant it. I learned how to “wear my big-girl pants” and “cowgirl up”. Here is what the American patient must know from the trenches.
Most physicians believe in universal healthcare and providing a safety net to achieve this, as do I. By universal healthcare, I mean providing care to each and every precious human in need. By safety net, I mean a mechanism to care for those precious individuals who cannot afford the care they desperately need. This does not mean I believe in socialized medicine; I do not.
A few years ago, I was getting ready to go to a long-anticipated Saturday family function with my four daughters when my phone rang–it was the ER. A mom had brought in her little boy, injured, and they needed help. I broke the news to my girls that I couldn’t go with them and raced to the ER. Little five year old Luke (fake name, so I won’t be fined for a HIPAA violation) sat quietly in his young mom’s lap. She was weeping. Luke’s older brother had thrown a broken beer bottle at him the night before. Luke had cried himself uncontrollably to sleep. Mom, single, working, and going to school to become an LVN, while caring for four small children, had not noticed the severity of Luke’s beer bottle encounter until the following day when he would not open his eyes.
Beautiful little Luke was at one of those crossroads where your life changes in a blink. The broken glass had cut his eye wide open. His cornea was lacerated with his iris prolapsing out into the outside world blocking total collapse of the globe. He could see only light. The contents of his eye had been exposed to all the germs of the world for hours. The injury was disfiguring and potentially blinding-life-changing. Luke’s mom stated they had no insurance. I contemplated transferring him to the county hospital, but he and I had bonded; he was brave and trusting.
I knew operating on him opened me up to potential lawsuit if he had a bad outcome–even if the injury was horrific initially and even if I had done my best. Again, I contemplated transferring him, but he and I had bonded; he was brave and trusting. My girls were disappointed, patiently waiting for me. This would be a long, intricate operation. Once again, I contemplated transferring him, but the girls were patient and brave and trusted me. My girls trust me to do the right thing in life, even if it is the hard, risky thing; that is our bond.
Luke’s mom passed him from her arms to mine. Our eyes locked, tears welling in all four, as I carried Luke to the OR. Such profoundly humbling moments I cannot put into words, and only through my faith and experience do I muster the courage to do such things. By the grace of God, Luke’s surgery went flawlessly. Today, he sees 20/20, and his eye looks absolutely perfect. I see a bright future for this brave, trusting child.
I never received a penny. In fact, I incurred great expense and great risk to care for Luke over the next several months. My reward is not monetary. My reward– again, no words…
I am privileged and humbled by cases such as Luke’s. This is why I fight. My colleagues and I know better than government how to do what we, America’s physicians, do. My physicians and surgeons and I know better than government how to treat me and my cancer; yes, doctors are patients too.
In reality, Luke could have been on a form of Medicaid, but his mom had not signed him up. Our current safety net for the poor is Medicaid. It does not work well. The United States spends exorbitant amounts of money on it and achieves outcomes worse than those of patients who have no insurance. The status quo is Medicaid, a government safety net for the poor, costing us trillions in unfunded liability for poor access to suboptimal care with a big price tag all tied up with strings of waste, inefficiency, and bureaucracy.
This status quo, Medicaid, is what needs healthcare reform. What does Obamacare do? It expands Medicaid instead of fixing it. Instead of fixing Medicaid, Obamacare expands the definition of poverty to put more people on Medicaid. Instead of getting people out of poverty, Obamacare expands the definition of poverty to get more Americans in it, so they can get on Medicaid (the part of Obamacare that really needs reform). This insanity is so frustrating.
When the Obamacare supporters call me “hater” and say I am cruel for “not wanting 40 million to have health insurance”, I literally chuckle in disbelief. They are the actual haters, befuddled in their mob-mentality-induced blindness, for not wanting all 314 million Americans to have actual medical care. Health insurance does not translate into actual medical care under Obamacare. We can and must do better.
The irony of Luke’s case is that had he actually had Medicaid, he wouldn’t have had me. I don’t accept Medicaid, and the government wouldn’t have let me see him. I prefer to provide my services for free, or even at a loss, than participate in Medicaid, a failed system that is red-lining our economy and flat-lining our people.
Finally, when the Obamacare lovers say “there are no alternatives” and that Obamacare opponents just want to return to the status quo, stop and call out the irrationality. The status quo is Medicaid. Medicaid is the very problem that needs to be fixed. Their fix is to double-down on Medicaid, expanding it and the definition of poverty, so everyone can be on it. Returning to the status quo is returning to dysfunctional Medicaid, which they are expanding. There is no logic or reason here. There is no faith or trust. There is no truth.
Truth is, excellent plans for true patient-centered, physician-guided, market-driven healthcare reform do exist. See examples of such plans at AmericanDoctors4truth.org and Docs4PatientCare.org among others. The same people that want to expand Medicaid do not want you to know about REAL REFORM, because once the public learns about available alternatives to Obamacare, the fewer people will want it. Insanity Reigns. We must dethrone it, because in truth we Doctors are lovers, not haters, with minds ruled by reason not politics. We must stay the course–brave, undeterred, and patient–for the patients.
Kris Held MD is an ophthalmologist in private practice. You can follow Dr. Held on Twitter@kksheld
Cross posted from KrisHeldMD.wordpress.com
Photo by sciain