Many folks are confused, not only by the wide differences of opinion regarding the prudence of Obamacare, but by the alleged “facts” and “projections” used to support such opinions.  This brief FAQs sheet will help clear things up. MORE.....

I was guardedly optimistic of President Obama’s latest overture to Republicans to join him in crafting a workable health care reform initiative.  Then, the bombshell fell. The discussion must center on the two existing versions of Obamacare, i.e., the “Spruce Goose” prototypes for health care reform.

I picture Obama as Howard Hughes before a Senate hearing in 1947 defending the Spruce Goose, saying, “Now, I put the sweat of my life into this thing. I have my reputation all rolled up in it... “  He appropriately stresses the serious health system and economic problems we face and how Obamacare incorporates many principles most Americans embrace, e.g., insurance reform, expanded coverage, to address them. MORE....

Although a complex 2,000 page bill, the stark difference of opinion over the prudence of enacting proposed health reform legislation is quite simple. Everyone favors increased health care access and quality. This requires resources. If the bulk of these can be derived from cost savings promised by proponents of the legislation – without any diminution in current access and quality – the bill would enjoy universal support. Many believe they cannot.

Paying physicians and institutions less for the provision of necessary services is not an option. Each day the newspapers are full of patients already being denied services (e.g., Grady Memorial Hospital (a safety net facility) in Atlanta, Mayo Clinic in Glendale, AZ) because government insurance plans pay less than cost for certain services. Annually, the Nation’s seniors and military dependents experience a crisis until Congress appropriates “band aid” funds for another year to defer planned reimbursement cuts (that would result in denial of care). More...

Surreal chaos describes the health care policy landscape over the last few months. It extends far beyond the rhetoric and political manipulations on the Potomac, where federal lawmakers attempt to massage over 2,000 pages of disjointed proposals to address the effectiveness and efficiency of the health system. Diverse and widespread health advocacy groups and political bodies are weighing in to demand government assure the health care services they champion are provided to everyone, often for “free”. More....

I awoke at 4 a.m., shaking from a nightmare. I was in the hospital scheduled for elbow surgery after a fall on an icy sidewalk. Over my loud protestations, my lower abdomen had been prepped and I was being wheeled into the O.R. for a hysterectomy. I insisted this made no sense since I was a male, both by biology and gender.

However, the hospital staff declared the government computer reported I was due for a hysterectomy and this was what I would get. I kept hearing the chorus of my peers in the background chanting, we told you this, i.e., the effectiveness and efficiency of the U. S.  Postal Service, is what you would get if you let the government run health care .More

Confused by the current debate, some have posed the above question. Nobody knows. Few of us pretend even to know the question. Physicians reason in a manner missing from the ongoing discussion.

Like the public at large, we reactively opine (often with diverse opinions) regarding the consequences of this or that proposal for payment, insurance, or delivery changes but we are also aware of the Cat’s admonition to Alice ...”it doesn’t matter” if, like Alice, you ...”don’t much care where” you are going.  

Physicians know where they are going. They serve to maintain or improve the health status of each unique patient and community as effectively and efficiently as possible. They have little idea whether this is the goal of health reform. More... 

There is little place for constructive criticism and suggestions upon the ideological health reform debate battlefield. There really is no need to read proposed legislation or insist upon facts, evidence, and analysis. The rift – hardly confined to the issue of health care but also including energy, economy, education, and so forth – involves a huge divide over the roles of the individual and government in contemporary society. Until one extreme pummels the other and establishes totalitarian control – or somehow we regain our sense of propriety and civility – substantive engagement is of little value.

Although pundits and pollsters tend to describe the basis of the divide in partisan political and demographic terms, such descriptions miss the essence of the chasm. Such depictions are but probability statistics revealing the percentage of various groups likely to embrace either side of the divide.

The divide, well described by human development experts like Erik Erickson, involves the crucial balance of “autonomy” and “mutuality” as each of us – as an individual - matures to become a productive member of society - or not.  In literature, Defoe well describes the struggle in Robinson Crusoe, where, alone and shipwrecked, Crusoe weighs his possible “societal” relationship with another upon Friday’s appearance. More...