Some hard questions for docs

Fellow medical student Graham Walker raises some fascinating questions on his reflections of a county medical association meeting. Please check out his very interesting entry, but here are some questions he raised (and I quote):

1. The health care system is one that makes absolutely no sense. No one wants to be a part of it. And why should we have to?

2. How can doctors continue to work on some sort of patchwork system—like suing the insurance companies, like the CMA did with the RICO lawsuit—but not fight for a long-term change?

3. Honestly, how much of this “doctors are barely getting by” mantra am I supposed to believe?

4. The malpractice issue aside, who’s struggling out there? And I mean struggling. When you’re “struggling” to make car payments on the BMW or the 5-bedroom house, you don’t count.

5. Isn’t it more the expectation of a certain level of income that’s the problem? Not the absolute income, but the level relative to one’s societal expectations as an all-important doctor?

6. “Political feasibility” and “tax increases” were cited as the reasons that single-payer wouldn’t fly. “The public would never support it.” “No one would be willing to pay for the tax increases.” I don’t buy either of them. The economics aren’t as bad as they seem—otherwise, how could any other nation be insuring everyone, have higher general health outcomes, and spend less?

On point, Graham, I couldn't have posed these questions better myself. On the topic of malpractice insurance problems, I KNOW that it's a big problem for docs. But I dont' support caps on non-economic damages, instead I support a reform of the insurance system (why do premiums keep increasing? nobody's asking this of insurance companies, we've just got docs and lawyers going at it, and ALL the other important health problems of our time, that docs should be caring about, going down the toilet). Also, Donald Palmisano, the current president of the American Medical Association, said this last week:

"The real crisis is when an expectant mother cannot find an obstetrician to deliver her baby, or a trauma patient can’t reach a neurosurgeon in time. We need a solution that’s a proven performer – real reform – to end this crisis."

Which crisis is he talking about? HE, who is supposed to represent, as the AMA website states as its motto, "Physicians dedicated to the health of America". No -- SURPRISE! -- he's not talking about health access barriers facing the 44 million uninsured, or the fact that the uninsured in emergencies often don't go to the emergency room because of the tens of thousands of dollars in bills they'll have to deal with later. Nor is he talking about the news of the MONTH -- the recent findings of the 6th and final Institute of Medicine report on the consequences of being uninsured, which in no simple words states that EVERYONE in America must have access to universal coverage that is affordable to individuals, families, and socieities, that is continuous, and that is high-quality and equitable (see related post here). He's talking (and the AMA's focusing on) the medical malpractice crisis. Yes, yes. Thankfully the priorities are straight at the American Medical Student Association (AMSA) , not to be confused with the AMA.